NURS 340 PUBLIC HEALTH PH notes quiz 2 Questions and Answers
Chapter 11
- Introduction
o Cut health care cost by keeping population healthy
o Nurses
... [Show More] health promotion with education
▪ Prevention levels
▪ Work with individuals, families and communities
▪ Knowledge healthcare decisions
- Healthy People 2020
o Education objectives
▪ Based on age and ethnicity
• Unintentional injury
• Violence
• Suicide
• Alcohol/substance abuse
• Unintended pregnancy
• AIDS/HIV
• STD
• Inadequate activity
- Typical Steps in Developing a Health Education Program
o Identify a population specific learning need
o Select one or more learn theories
o Consider which educational principles are most likely to increase learning
▪ Choose by most feasible and most appropriate
o Examine educational issues
▪ Population specific
▪ Cultural concerns
▪ Literacy/ teaching strategies based on
• Age
• Gender
• Culture
• Learning needs
o Design and implement the educational program using carefully chosen strategies
o Evaluate the effects
- Education and learning
o Education
▪ Activity “undertaken or initiated by one or more agents that is designated to effect changes in knowledge, skill and attitudes of individuals, groups or communities”
• Designed to help change attitude, skills and knowledge of a specific topic
▪ Establishment and arrangement of events to facilitate learning, including providing knowledge and skills
• Knowledge can lead to the change of behavior
o Learning
▪ Process of gaining knowledge and skills that lead to behavioral changes
- How people learn
o Shift in ideas how people learn
▪ From sponge or vessel approach to active process between instructor and learner
• Active learning
o What we hear is filtered through our assumption, values, levels of attention and knowledge
o Learners accept information based on a range of factors
▪ What they already know
▪ What they believe
▪ The culture they were raised
▪ Generational experiences
▪ How well they can understand and relate to the information
- Three education principles
o The nature of learning
▪ Examine the cognitive (thinking), affective (feeling), and psychomotor (acting)
• Each domain has specific behavioral components that form a hierarchy of steps or levels
• Each level builds on the previous one
o The educational process
▪ Identify education needs
• Systemic and thorough assessment
▪ Establish educational goals and objectives
▪ Select appropriate educational methods
▪ Implement the educational plan
▪ Evaluate the educational process
o The skills of effective educators
▪ Gain attention
• Important and beneficial
▪ Inform the learner of the objectives of instruction
▪ Stimulate recall of prior learning
• Link new knowledge with old
▪ Present the material
• Clear, organized and simple to match the needs of the learner
▪ Provide learning guidance
▪ Elicit performance
• Demonstration to improve skills
▪ Provide feedback
▪ Assess performance
▪ Enhance retention and transfer of knowledge
- Motivational interviewing
o A tool designed to help clients verbalize their own motivations to change
▪ Collaborative partnership
o Four essential steps:
▪ Engaging
• Person-centered
▪ Empathic listening
▪ Guiding
▪ Evoking
• Particular identified target for change
• Evoking pt own motivations for change
o Change talk
▪ “DARN-CAT”
▪ Desire—I want to change
• Change to commitment—I will make changes
▪ Ability—I can change
• Change to activation—I am ready, prepared and willing
▪ Reason—it is important to change/ Need—I should change
• Change to taking steps—I am taking actions
- Developing effective programs
o Message
▪ Clear message to learner
o Format
▪ Select most appropriate learning format
o Environment
▪ Best learning environment
o Participation
▪ Engaging to learn
o Evaluation
- Educational issues
o Population considerations
▪ Age, culture, ethnicity
o Pedagogy
▪ Learning strategies for children or individuals with little knowledge on health related topic
▪ What will be learn and how will be learned
▪ Teacher directed
o Andragogy
▪ Adults, older adults or individuals with some knowledge
- Barriers to learning
o Educator related barriers
▪ Fear of public speaking
▪ Lack of credibility with respect to topic
▪ Limited professional experiences related
▪ Unable to deal with difficult people
▪ Lack of knowledge about gaining participation
▪ Lack of experience in timing presentation
▪ Uncertain how to adjust instruction
▪ Uncomfortable when learners ask questions
▪ Doesn’t get feedback from learners
▪ Not prepared for use of media equipment
▪ Has difficulty with opening and closings
▪ Overly dependent on notes
o Learned related barriers
▪ Low literacy
• Health literacy
o Degree to which individuals have capacity to obtain and process health
care information to make the most appropriate decisions
▪ Lack of motivation to learn
• Health belief model
o Value
o Expectancy
o affective
• Transtheoretical model
• Precaution adoption process model
- Use of technology in health education
o Examples: computer games, videos, CDs, Internet
▪ May want to use a variety of technology tools
o These technologies may:
▪ Enable the learner to control the pace of instruction
▪ Offer flexibility in the time and location of learning
▪ Be engaging
▪ Provide immediate feedback
▪ Be more consistent with how the learner prefers to receive other kinds of information
- Criteria for assessing quality of internet health information
o Authorship
▪ Credentials/ affiliation listed?
o Caveats
▪ Site clarify function is for information or to market products?
o Content
▪ Disclaimer provider?
o Credibility
▪ Sources posted?
o Currency
▪ Dates listed
o Design
▪ Easy to navigate?
o Disclosure
▪ User disclosed for purpose of site
o Interactivity
▪ Feedback mechanism
o Links
- Evaluate the educational process
o Evaluate the educator
o Process evaluation
o Evaluate the educational product
o Evaluate health and behavioral changes
▪ Long-term evaluation
- Working to effectively educate groups
o Groups can be used to initiate and implement changes for individuals, families, organizations, and the community.
o Community groups represent the collective interests, needs, and values of individuals; they provide a link between the individual and the larger social system.
o Groups can bring about changes to improve the health and well-being of individuals and communities.
▪ Some individual changes for health are difficult or impossible to achieve without group support and encouragement.
o Through community groups, nurses help people identify priority health needs and capabilities and make valuable community changes.
- Group concepts
o Group definition
▪ Interacting individuals who have a common purpose
▪ Effective and powerful medium to initiate and implement changes for individuals, families, organizations and community
o Key elements: Member interaction, group purpose
o Group development
o Cohesion
▪ Attraction between each member to the group
o Task and maintenance functions
o Norms: Task, maintenance, reality
o Group culture
o Leadership
o Group structure
- Promoting health through group education
o Health behavior is influenced by the groups to which people belong.
o Groups who will support an individual’s health changes are unavailable to some people because of their social or emotional isolation.
o Choosing groups for health change
o Established groups
o Selected membership groups
o Beginning interactions
o Conflict
o Strategies for change
o Evaluation of group progress
Chapter 21
- Vulnerability
o Those at greater risk for poor health status and health care access
▪ Related to current economic status of community
• Lay offs, part-time, no health coverage
▪ Natural history of disease model
• Physiology and environment impact a population
o More likely for health problems
▪ Web of causation model
• Predisposition of illnesses
▪ Vulnerable population group
• Subgroup of a population
• Homeless, elderly, babies
• Pregnant teens
• Immigrants
• Mental health pt
• Substance abusers
• HIV/STD
• Incarcerated
• LGTBQ
▪ Multiple cumulative risks
• Environmental hazards
• Social hazards
• Genetics
• behaviors
▪ Resilience
• Members of vulnerable pop that do not succumb to diseases
• Individuals living in poverty that manage to attend school and get out of the vulnerable population
o Susceptibility to actual or potential stressors that may lead to an adverse effect
▪ Results from the interaction of internal and external factors that cause a person to be susceptible to poor health
o Health disparities: wide variations in health services and health status among certain populations
▪ Goal is for equity
- Factors Contributing to vulnerability
o Lack of resources
▪ Physical
• poverty
▪ Environmental
• Hazardous working environment
▪ Personal
▪ Biopsychosocial
o Disenfranchisement
▪ Feeling of separation from mainstream society
• Dangerous to community
• Danger to themselves
o Social determinants of health
▪ Economic status
• Poverty
• Lack of health insurance
▪ Education
▪ Access to health care
▪ Nutrition
▪ Stress
▪ Prejudice
o Health status
▪ Age
▪ Changes in normal physiology
- Vulnerable populations
o More likely to develop health problems as a result of exposure to risk
o More sensitive to risk factors because they are often exposed
o More likely to suffer from health disparities
o Vulnerability results from combined effects of limited resources
- SDOH
o Neighborhood and built environment
o Health and health care
o Social and community context
o Education
o Economic stability
- Health Equity
o Ensuring all individuals are able to access resources, not that all individuals are given the same exact resources
- Seven WHO Factors
o Income and social status
o Education
o Physical environment
o Social support networks
o Genetics/personal behavior and coping skills
o Health services access
o gender
- Health Status
o Age Is related to vulnerability
o Physiologic changes can predispose
o Life experiences
▪ Especially childhood trauma
▪ Levels of stress (positive to toxic)
o Protective social factors
o Locus of control
- Outcomes of Vulnerability
o Negative or positive
o Often have worse health outcomes
o Cycle to vulnerability
▪ One problem solved, another emerges
▪ Feelings of hopelessness
- Nursing Approach
o Trend toward providing more comprehensive, family centered services when treating vulnerable pop
▪ One stop services
• Wrap around services
• Comprehensive services
o Advocacy
▪ Social justice
- Healthy People 2020
o Emphasize improving healthy by modifying the individual, social and environmental determinants of health
▪ Coordinates health services and provides preventive services
- Levels of prevention
o Primary
▪ Influenza vacc
o Secondary
▪ Tb screening
o Tertiary
▪ Therapy group for severely mentally ill adults
- Assessment issues
o Socioeconomic resources
o Preventive health needs
o Congenital and genetic predispositions
o Amount of stress
o Living environment
o Neighborhood surroundings
- Planning and Implementation
o Create trusting environment
o Show respect, compassion and concern
o No assumptions
o Coordinate services and providers
o Advocate
o Focus on prevention
Chapter 22
- Rural vs Urban
o Farm residency vs nonfarm
o Metropolitan area
▪ Core urban 50k+
o Micropolitan
▪ More than 10k, less than 50k
- Moving to rural areas
o Fastest growing areas
o More affordable housing
- Population Characteristics
o Under insured
o Last of physicians/practices
▪ Traveling long distance
o Higher proportion of whites
o More likely widowed or married
o Tend to be poorer
- Health status of rural residents
o Poorer perception of overall health and function
o Less likely to engage in preventive behavior
o More likely to have chronic conditions
o Health care providers
▪ Small staff to service large area
▪ Provide care to people who live in several counties
- Womens health
o Higher infant and maternal morbidity rates
o Higher proportion of racial minorities
o Extreme variations in pregnancy outcomes
o Higher at risk
▪ Live on or near Indian reservation
▪ Migrant workers
▪ African American descent and live in rural deep south
▪ Victims of sexual assault
- Health of children
o Urban children more likely to see pediatrician when ill
o Rural adults and children more likely to have general practitioner
o Children who work on farms
o School nurses
- Mental health
o Delay seeking care
o Depression
▪ High rate of poverty
▪ Insufficient number of mental health services
o Domestic violence
o Alcohol, tobacco, and other drug use and abuse
- Occupational and environmental health problems in rural areas
o High risk industries found in primarily in rural
▪ Forestry
▪ Mining
▪ Fishing
▪ Agriculture
o Lack of OSHA regulation for farming
o Common injuries
▪ Getting ran over from tractors due to accidental falls
o Exposure to chemicals
▪ Pesticide exposure
- Rural health care
o Barriers: available, affordable, accessible, or acceptable services
o Providers attitudes, insights and knowledge
o Designing community health programs
- Health of minotires
o Characteristics
o Migrant lifestyle
o Housing
- Issues in migrant health
o Lack of knowledge about services
o Inability to afford care
o Availability of services
o Transportation
o Hours of service
o Mobility and tracking
o Language barriers
o Discrimination
o Documentation
o Cultural aspects
o Children of migrant workers
o Dental disease
o Incidence of TB
o Incidence of HIV/AIDS
o Depression
o Anxiety related disorders
o Domestic violence
- Cultural considerations in migrant health care
o Nurse client relationship
▪ Lack of trust
o Health values beliefs and practices
▪ Women are caretakes
▪ Men are decision makers
▪ Want to try to be healthy for children
▪ Will bow and say yes to everything
• Need to ensure they are understanding
- Nursing care in rural environments
o Community oriented nursing vary by community
o Need for
▪ School nurses
▪ Family planning services
▪ Prenatal care
▪ Care for individuals with AIDS and their families
▪ Emergency care services
▪ Children with special needs
▪ Mental health services
▪ Services for older adults
Chapter 23
- Introductuon
o Four vulnerable populations:
▪ Poor
▪ Homeless
▪ Pregnant teens (and s/o)
▪ Mentally ill
- Attitudes and Beliefs
o Cultural attitudes
▪ Perspectives about individuals responsibility for health and well being are influenced
- Poverty
o Poverty and homelessness affect peoples health status
o Federal income poverty guidelines
▪ Temporary assistance to needy families (TANF)
▪ Women, infants, and children (WIC)
▪ Head Start
o Persistent poverty
o Neighborhood poverty
o The Near Poor
▪ Earn slightly above the poverty level; income inadequate but ineligible for Medicaid and similar services
o Factors affecting growing number of poor persons
▪ Decreased earnings
▪ Increased unemployment rates
▪ Changes in the labor force
▪ Increase in female headed households
▪ Inadequate education and job skills
▪ Inadequate antipoverty programs and welfare benefits
▪ Weak enforcement of child support statues
▪ Dwindling social security payments to children
▪ Increased numbers of children born to single women
o Higher rates of chronic illness
o Higher infant morbidity and mortality
o Shorter life expectancy
o More complex health problems
o More significant complications and physical limitations resulting from chronic disease
o Hospitalization rates three times more than for persons with higher incomes
- Effects of poverty
o Has a negative effect on:
▪ Women of childbearing age
▪ Adolescent women
▪ Children
▪ Older adults
▪ Both urban and rural communities
- Community and poverty
o Poor neighborhoods are linked with the following:
▪ Poorer general health status
▪ Higher mortality rates
▪ Higher rates of disability, injury, and violence
▪ Less access to healthy food and health care
▪ Few opportunities for good employment
▪ Inadequate transportation
▪ Problem related to police brutality
▪ Poor housing conditions
- Homelessness
o Poverty can lead to homelessness
o Determining number of people who are homeless
▪ Point in time counts
▪ Period prevalence counts
o Crisis poverty
o Persistent poverty
- Homelessness in the united states
o Crisis poverty
▪ Marked by hardship and struggle
▪ Transient or episodic
▪ Brief stays in shelters
▪ Younger and the majority
o Persistent poverty
▪ Chronic state; fewer ~16%
▪ Older with disabilities, addictions, sever metal or chronic physical illness
▪ Significant family difficulties
o Effects on health
▪ Hypothermia and heat related illness
▪ Infestations and poor skin integrity
▪ Peripheral vascular disease and htn
▪ DM and nutritional deficits
▪ Respiratory infection and COPD
▪ TB
▪ HIV/AIDS
▪ Trauma
▪ Mental illness
▪ Use and abuse of tobacco, alcohol and illicit drugs
o At risk populations
▪ Pregnant women
▪ Children
▪ Adolescents
▪ Older adults
- Levels of prevention
o Providing affordable, adequate housing
▪ Low income housing
▪ Supportive housing
▪ Emergency housing
o Primary
o Secondary
o Tertiary
- Trends in adolescent sexual behavior
o Teens making better decision
o Reproductive health care services to teens
o Support needed during and after pregnancy
o Background factors
o Sexual activity, use of birth control, peer/partner pressure
o Other factors
▪ Sexual victimization
o Young men and paternity
o Early identification of the pregnant teen
o Special issues in caring for the pregnant teen
▪ Violence
▪ Nutrition
▪ Infant care
▪ Schooling and educational needs
- Mental Illness
o High prevalence rates
o Deinstitutionalization
o At risk
▪ Children/ adolescents
▪ Adults
▪ Adults with serious illness
▪ Older adults
▪ Cultural diversity
- Levels of prevention
o Primary
▪ Affordable hosing
▪ Housing subsidies
▪ Effective job training
▪ Employer incentives
▪ Preventive health care services
▪ Multisystem case management
▪ Birth control services
▪ Safe sex education
▪ Needle exchange program
▪ Parent education
▪ Counseling
o Secondary
▪ Reducing prevalence of pathologic nature of condition
▪ Supportive and emergency housing
▪ Soup kitchens
▪ Screening for depression
o Tertiary
▪ Prevention attempts to restore and enhance functioning
▪ Support affordable housing
▪ Promotion of psychosocial rehabilitation programs
Chapter 24
- Introduction
o Number-one national health problem is abuse of tobacco, alcohol and illicit drugs
▪ Causing more deaths, illnesses and disabilities
o Substance abuser is not only at risk for personal health problems but also may be a threat to the
health and safety of family members, coworkers, and other members of the community.
- Scope of problem
o ATOD [alcohol/tobacco/other drugs] abuse and addiction can cause multiple health problems for individuals.
o Contributing factors.
▪ Lack of knowledge about use of drugs
▪ Labeling of certain drugs (alcohol, nicotine, caffeine) as nondrugs
▪ Lack of quality control of illegal drugs
▪ Law enforcement rather than prevention and treatment
▪ Drug laws that label certain drug users as criminals
• Encourages negative attitudes and stigma
o Every culture has beliefs and attitudes toward ATOD. These attitudes are influenced by the way
society categorizes drugs as either “good” or “bad.”
o In US good drugs
▪ Over the counter
▪ Prescription drugs
o Bad drugs
▪ Illegal drugs, users are criminals regardless of addiction
▪ (NOT OKAY)
- Definitions
o Alcohol, tobacco, and other drugs (ATOD)
▪ leading drug problems
o Substance abuse
▪ Use of any substance that threatens health, or impairs social/economic functioning
o Drug dependence
▪ Physiological change in CNS as a result of chronic use
▪ Withdrawal—needs to keep taking to prevent
• Taper off
o Drug addiction
▪ Pattern of abuse categorized by compulsive use of a drug securing its supply
o Alcoholism
▪ Addiction to alcohol
- Psychoactive drugs
o Psychoactive drugs: drugs that affect mood, perception, and thought.
o Are used for enjoyment in social and recreational settings and for personal use to self-medicate physical or emotional discomfort.
o Psychoactive drugs are divided into categories according to their effect on the CNS and the general feelings or experiences the drugs may induce.
- Depressants
o Depressants: drugs that reduce the activity of the central nervous system.
▪ Lower the body’s overall energy level, reduce sensitivity to outside stimulation, and, in high doses, induce sleep
• Low doses produce stimulation caused by initial sedation
o In general, depressants decrease heart rate, respiration rate, muscular coordination, and energy
while dulling the senses.
o Higher doses lead to coma and, if the vital functions shut down, death.
o Major categories include alcohol, barbiturates, benzodiazepines, and the opioids.
- Stimulants
o Stimulants: drugs that increase the activity of the CNS, causing wakefulness
▪ The stimulant causes the nerve fibers to release noradrenaline and other stimulating neurotransmitters.
▪ These drugs do not give the person more energy; they only make the body expend its own energy sooner and in greater quantities than it normally would.
▪ Can be useful with little affect if used carefully and appropriately
• Allow body time to replenish
• Cost for high is the feeling of down
o Sleepiness, mental fatigue, depression
o Nicotine
o Cocaine
o Caffeine
o Amphetamines
- Alcohol
o Oldest and most widely used psychoactive drug in the world.
o About two-thirds of American 12 years or older drink alcohol.
o Binge drinking.
o Chronic alcohol abuse.
▪ National Institute on Alcohol Abuse and Alcoholism
▪ Nutritional deficiency
• Folate
• Iron
• Niacin
▪ GI disturbances
• Inflammation
• Cancer
▪ Cardio
• Dysrhythmias
• Myopathy
• HTN
• Atherosclerosis
- Tobacco
▪ CNS
• Memory loss
• Sleep disturbances
• Alcohol withdrawal syndrome
o Smoking is the foremost preventable cause of death in the United States.
▪ Cardiovascular disease
▪ Respiratory diseases
o Nicotine acts as both depressant and stimulant.
o Mainstream smoke.
▪ Inhaled by the smoker
o Secondhand smoke (sidestream smoke).
▪ Inhaled by others in vicinity of a cigarette
▪ Contains higher concentration of toxic and carcinogenic compounds than mainstream
o Chewing tobacco or snuff.
▪ Higher concentrations of nicotine, because not burned by smoke
▪ Enters blood stream less directly
- Caffeine
o One of the most widely used psychoactive drugs in the world
o Found in coffee, tea, soft drinks, and various medications
o Moderate dose
▪ 100-300 mg per day
▪ Increase mental alertness
o High dose
▪ Health effects
• Insomnia
• Irritability
• Anxiety
• Dysrhythmias
• GI disturbances
• headaches
▪ Withdrawal symptoms
• Headaches
• Slowness
• Occasional depression
- Illicit drugs
o Epidemic in US of poisoning deaths of overdose
▪ 200% increase since 2000’s due to opioids
o Heroin
▪ Most often recreationally used opioid.
• Oxycodone/hydrocodone most commonly prescribed natural/semi-synthetic opioid
o Most overdose
▪ Tolerance and physical dependence develop quickly.
▪ Serious complications result from unsanitary administration of the drug and complications due to overdose or the intoxication it can cause.
o Cocaine
▪ Expensive
▪ Has effects on brain, heart and emotions
▪ Extremely addictive
▪ Injected or smoked cocaine produces hyperstimulation, alertness, euphoria, and feelings of competence and power.
• Power- snorted or injected
• Crack- made by chemical process in order to be smoked
▪ Young men 18-25 biggest users
▪ Interaction with dopamine seems to be the basis for the addictive patterns.
• Feeling of high
o Increased energy, alertness
o Elevated mood
o Feeling of supremacy
▪ Signs
• Dilated pupils
• High levels of energy, activity
• Excited, exuberant speech
• Affects wear off in 30-120 minutes
▪ Crack addiction develops rapidly and is expensive.
o Amphetamines
▪ Similar to cocaine but effects last longer and the drugs are cheaper.
▪ Have a chemical structure similar to adrenaline and noradrenaline and are generally used to decrease fatigue, increase mental alertness, suppress appetite, and create a
sense of well-being.
• Can be taken by pills, injected, snorted, smoked
o IV- intense rush
▪ User can go on “speed run”—crash and sleep for 18+ hours
• Cause elevation in mood
• Increase wakefulness, alertness, concentration
• Intensified physical performance
• Feeling of well being
• Enhance sexual desire, but erectile function in men
▪ Users prone to accidents.
• Associated with unsafe sex
• Produces static of excitement and grandiosity
o Usual danger warning signals do not worth effectively
o Marijuana
▪ The most widely used illicit drug in the United States.
• Little toxicity
• Safest therapeutic agents
▪ Psychological dependence can occur with chronic use, but little is known about any potential physical dependence.
▪ Because of its illegal status, there is no quality control, and a user may consume contaminated marijuana.
▪ Mild euphoria, relaxed feeling +intensity of sensory perceptions
• Dreamy state of consciousness
o Ideas seem disconnected, unanticipated, free flowing
o Time, color, special perceptions are altered
▪ Side effects
• Dry, red eyes
• Increased appetite
• Dry mouth
• Drowsiness
• Mild tachycardia
▪ Adverse effects
• Anxiety
• Paranoia
• Disorientation
▪ Greatest concern
• Respiratory concerns from smoking
- Psychoactive drugs: Hallucinogens
o Hallucinogens: drugs that stimulate the nervous system and produce varied changes in perception and mood
▪ Bath Salts
• Crystalling powder that can be swallowed, inhaled or injected
• Extremely addictive
• Contain man-made stimulants similar to amphetamines
• Increase dopamine levels and increase feeling of euphoria
▪ Ectasy (MDMA)
• Man-made stimulant
• Snorted or injected
• Increases levels of chemicals in the brain
o Serotonin, dopamine and norepinephrine
o Can cause intoxication and lead to altered perception and impaired judgment
▪ Response to these drugs is related to user’s mood, basic emotional makeup and expectations, including the ability to cope with perceptual distortions, expectations and the immediate surroundings
o Chronic use can lead to psychological effects and impaired judgement which can then lead to dangerous decisions or accidents
o Indole hallucinogens; hallucinogens that resemble adrenalin and amphetamines
- Predisposing/contributing factors
o Drug
o Set: refers to the individual using the drug
▪ expectations
o Setting: refers to the influence of the physical, social and cultural environment within which the
use occurs
o Two major variables influence experience are set and setting
- Primary Prevention
o Promotion of healthy lifestyles and resiliency factors
▪ Assisting clients to achieve optimal health
▪ Teaching assertiveness and decision-making skills
▪ Teaching stress reduction and relaxation techniques
o Drug education
▪ Teaching that no drug is completely safe and that any drug can be abused
▪ Helping persons learn how to make informed decisions about their drug use to minimize potential harm
- Secondary Prevention
o Assessing for ATOD problems
o Drug testing
o High-risk groups
▪ Adolescents
▪ Older adults
▪ Injection drug users
▪ Drug use during pregnancy
▪ Use of illicit drugs
o Codependency and family involvement
- Tertiary Prevention
o Detoxification
o Addiction treatment
o Smoking cessation programs
o Support groups
▪ Alcoholics Anonymous (AA)
▪ Narcotics Anonymous (NA)
▪ Pills Anonymous for persons with polydrug addictions
▪ Overeaters Anonymous
▪ Gamblers Anonymous
Chapter 25
- Introduction
o Violence
o Significant mortality and morbidity result from violence
o Nurses often care for the victims, the perpetrators and those who witness physical and psychological violence
o Nurse can also take an active role in developing community responses to violence through working on public policy and needed resources
- Social and community factors
o Work
o Education
o Media
o Organized religion
o Population
o Community facilities
- Work
o Fulfilling and contribute to a sense of well being; it can also be frustrating and unfulfilling, contributing to stress that may lead to aggression and violence
o Frustration and resentment may contribute to violent behavior
o May have difficulty separating feelings generated at work from those at home
o People hesitate to give up jobs even if they are frustrating, boring, or stressful
▪ Particularly true in times of economic downturns
- Education
o Schools have assumed many responsibilities traditionally assigned to the family
▪ Sex ed
▪ Disciple
o Spanking
o Bullying
o Powerful contributor to nonviolence
- Media
o TV programs and print articles can inform and increase public awareness about family violence
o Abused women and rape victims benefit from media attention
o Can indirectly lead people to choose violence
- Organized religion
o Generally teaches nonviolent conflict resolution
- Population
o Community’s structure can influence the potential for violence
▪ Crowded conditions= greater potential for tension and violence
o Lack of jobs and low paying jobs can lead to feelings of inadequacy, despair, and social
alienation
o Gangs
- Community facilities
o Differ in the resources and facilities they provide to residents
▪ Some are more desirable places to live, work and raise families and have facilities that can reduce the potential for crime and violence
▪ Recreational facilities such as playgrounds, parks, swimming pools, movie theaters, and tennis courts provide socially acceptable outlets for a variety of feelings, including aggression
- Violence against individuals or oneself
o Homicide
o Assault
o Sexual violence
o Suicide
- Family violence and abuse
o Development of abusive patterns
o Types of family violence
▪ Physical abuse
▪ Sexual abuse
▪ Neglect
▪ Child abuse
• Indicators
▪ Intimate partner abuse
• Signs of abuse
• Abuse as a process
▪ Abuse of older adults [Show Less]