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CH_MH test2

community and mental health nursing test 2

Community “A social network of interacting individuals, usually concentrated in a defined territory” (Wheel’s definition)
Steps in the referral process. Engage________, establish______, explore_____, accept _______, make ______, facilitate ________ Engage in a working relationship with the client, Establish criteria, Explore resources, Accept the client’s decision to use a resource, Make a referral, Facilitate a referral
Differential vulnerability hypothesis population groups who are particularly sensitive to risk factors and who possess multiple, cumulative risk factors
Primary cause of vulnerability Having less than sufficient financial resources to meet basic living expenses
Definition of case mgt: Ability to establish an …… based on ……..and coordinating the…… for the client’s benefit. appropriate plan of care based on assessing the client/family and coordinating the necessary resources and services for the client’s benefit.
Knowledge and skill requisites for case mgt resources, financing mechanisms, communication, negotiation, critical thinking, evidence-based practice
Essential skills for case mgt advocacy, Process of advocacy, Skill development, Systematic problem solving, Illuminating values, Generating alternatives, Impact of advocacy, Allocation, conflict mgt, collaboration
Educational process Identify edu needs, Establish edu goals and objectives, Select appropriate edu methods, Implement the edu plan, Evaluate the edu process
Local Health Departments re: environmental Waste disposal, Food & lodging,Insect and rodent control, Animal control, Noise pollution, , biologic pollutants, Tattoo parlors, Well, water & pool, sanitation
What level of lead is safe? none.
Long-term exposure to even low levels of lead can cause ….? irreversible learning difficulties, mental retardation, and delayed neurological and physical development
Living or going to school close to traffic is linked with ______ asthma
Problems/symptoms of Indoor air pollution asthma, headaches, respiratory tract infections ,allergic reactions, congestion, eye/skin irritations , sneezing, fatigue and nausea
Indoor pollutants There are 3 physical hazards
Control for dust mites Maintain what% relative humidity, Avoid _______furniture that can trap allergens, Remove carpeting, Replace blinds with ____________ 30-50% upholstered washable curtains
Common VOCs: toluene, xylene, formaldehyde, acetone, and isopropanol
What does VOC stand for? Why are they a problem? volatile organic compounds, highly toxic and Elevated concentrations can persist in the air long after completed activity,
Heatlh effects of VOC’s include Eye, nose, and throat irritation, -headaches -loss of coordination-nausea -damage to liver, kidney, and central nervous system.
A major source of man-made VOCs are solvents such as especially paints and protective coatings
Chlorofluorocarbons, which are banned or highly regulated, were widely used in??? cleaning products and refrigerants.
Many building materials such as paints, adhesives, wall boards, and ceiling tiles slowly emit _______ formaldehyde
Coal-burning power plants are the largest human-caused source of _______(element) emissions to the air in the United States mercury
_____&_____are the main sources of methyl mercury exposure to humans Fish and shellfish
In unborn and young children, mercury can slow development of the ________ system nervous system
Why are children more at risk?? respirations are more rapid, Shorter, Less developed brain barrier; kidneys less effective in filtering; drink more fluid per kg (more water & fruit & juice)
What is IPREPARE? investigate potential exposures, present work, residence, environmental concerns, past work, activities, resources/referrals, educate
Process to determine the probability of a health threat associated with an exposure. Access toxicology, how agent released, how much/route, Predict based on estimated exposure.
Addiction brief interventions model FRAMES Feedback of personal risk., Responsibility of the patient (personal control)., Advice to change., Menu of ways to reduce substance use (options), Empathetic counseling., Self-efficacy, or optimism of the patient.
Trexan, Revia (naltrexone) Blocks ______receptors, Interferes with mechanism of ______, Reduces or eliminates _______ craving opiate, reinforcement, alcohol craving
Campral (acamprosate) Helps client abstain from ________ but Mechanism not well understood alcohol
Antabuse (disulfiram) Works on classical conditioning principle. Alcohol-disulfiram reaction causes unpleasant what? physical effects.
Infants prenatally exposed to opioids have high incidence of neonatal abstinence syndrome (NAS). NAS characterized by hyperactivity of central and autonomic nervous systems; reflected in changes in what? gastrointestinal tract and respiratory system.
w/d symptoms in infants w/ NAS appear when? Withdrawal symptoms begin minutes or hours after birth to 2 weeks later; most appear within 72 hours.
Alc. nicotine, heroin or morphine and cocaine activate the ______pathway? reward pathway
action of THC in the __________explains its ability to interfere with memory and actions in the _________are responsible for its ability to cause uncoordination and loss of balance. hippocampus cerebellum
Dopamine pathways reward (motivation), pleasure, euphoria, motor function, compulsion, perserveration
Serotonin pathways mood, memory processing, sleep, cognition
Name 2 antianxiety meds that can be used w/ bipolar to help w/ psychomotor agitation. klonopin, Ativan
Tegretol, Depakote, Lamictal, Neurontin, Topamax are what class. Used for bipolar. Which ones need lab monitoring? Which one can have life threatening Steven’s Johnson syndrome? anti-epileptic, Depakote, tegretol, lamictal.
How many days until Lithium is therapeutic? And what is tx level? 7-14 days, 0.8 to 1.4 (maintenance is 0.4 to 1.3)
Lithium toxicity early s/s same as s/e except for what 2? What is blood level? slurred speech, muscle weakness. 1.5
Late signs of lithium toxicity include persistent GI upset, coarse hand tremors and mental confusion 1.5 to 2.0
Severe lithium toxicity blood level? 2.5+, clonic movements, ataxia, coma, death, cardiac arrhythmias, hypotension, seizures, abdominal pain
Tx for lithium tox Gastric lavage, Tx w/ urea, mannitol and aminophylline: hastens li+ excretion
Major long term risks of Li+ tx Hypothyroidism, Impairment of kidneys ability to concentrate urine
0.05mg% 1-2 drinks changes in mood, behavior; impaired judgement
0.10mg% 5-6 drinks clumsiness in voluntary motor activity; legal level of intox in most states
0.20 mg% 10-12 drinks depressed function of entire motor area of brain, staggering/ataxia, emo lability
0.30 mg% 15-18 drinks confusion, stupor
0.40 mg% 20-24 drinks coma
0.50mg% 25-30 drinks death due to resp depression
Alcohol withdrawal delirium: can result in sepsis, MI, fat embolism, vascular collapse, electrolyte imbalance, aspiration pneumonia, suicide.
Created by: kerinska