Infectious diseases
Which vaccine is recommended for adults every 10 years?
Tetanus (lockjaw )---pick up in soil or injury
How is sleep regulated? What is a typical sleep cycle?
sleep is controlled by the central nervous system.
The two-process model: circadian rhythm and sleep homeostasis regulation
Circadian rhythm: 1) controlled by suprachiasmatic nucleus (SCN) nerve cells in the hypothalamus, which reflects clock genes expression in SCN ; 2) circadian pacemakers: i.e. melatonin (a. Sensitive to light: daytime--melatonin secretion is suppressed and the circadian alerting signal is high; nighttime---melatonin secretion starts; b) melatonin secretion can be altered by light exposure: e.g. screen light (blue wave) delays dim light melatonin onset time)
Sleep homeostasis regulation: 1) representing sleep debt, increases during wakefulness and declines during sleep, 2) inhibitory neurotransmitters such as adenosine
Sleep cycle: NREM Stage 1, 2, 3, 4>> 3, 2, >>REM
What's the difference between disasters and emergencies?
•Disasters: Events that require extraordinary efforts beyond those needed to respond to everyday emergencies
•Emergencies: Serious events that fall within the coping abilities of the individual or community
What is the primary role of the occupational health nurse?
Providing health promotion and work-related emergency care
What is evidence-based public health?
•Making decisions using the best available evidence
•Using data and information systems
•Applying program planning frameworks
•Engaging the community in assessment and decision making
•Conducting evaluations, and disseminating what has been learned
How are Lyme disease, West Nile virus, and Legionellosis transmitted? What are common symptoms?
Lyme disease, tick-borne (most common vector-borne disease in the US)--- low-grade fever, bulls-eye rash, joint stiffness
West Nile virus: mosquito-borne---80% of those infected with WNV have no symptoms; severe: e.g. High fever, HA, neck stiffness, disorientation, tremors, muscle weakness, vision loss, numbness and paralysis
Legionellosis: water, heat-exchange in building---symptoms resemble pneumonia
What are physiological characteristics and sleep disorders associated with REM sleep and slow-wave sleep?
NREM stage 3&4: (1) Vital signs decline, muscles are relaxed, the sleeper is difficult to arouse and rarely moves. (2) common NREM disorders: enuresis, sleep terrors, sleepwalking
REM sleep: (1)typified by rapidly moving eyes, loss of skeletal muscle tone, active brain activities, vivid, full-color dreaming occurs, very difficult to arouse sleeper, increased and fluctuating blood pressure, heart rate, respiration ; (2) common disorders: narcolepsy
True or False:
1. Making ethical decisions regarding exposing self to potentially lethal substances is the primary responsibility of the nurse in preparation for disaster management.
2. Anthrax, Botulism, and plague are Category A biologic agents
1. F. Being aware of the agency's emergency response plan is the primary responsibility of the nurse in preparation for disaster management.
2. T
1. Which agency is responsible for investigating workplace illnesses, accidents, and hazards through research activities?
2. Which agency sets and enforces workplace safety and health standards?
1. National Institute for Occupational Safety and Health (NIOSH)
2. Occupational Safety and Health Administration (OSHA)
What is healthcare informatics?
What are examples of clinical informatics, consumer health informatics and population health informatics?
The design, development, adoption, and application of IT-based innovations in healthcare services delivery, management, and planning.
Website resources, EHR, telehealth,
surveillance data
How are Hepatitis A, B, and C transmitted?
HAV: Fecal/oral transmission, Rapid onset, fever, fatigue, jaundice
HBV: Parenteral, percutaneous, transmucosal transmission, gradual onset,rash, arthralgia, jaundice
HCV: parenteral transmission; gradual onset,fatigue, jaundice
What are the health effects of air pollution?
Short-term: e.g. upper respiratory infection, acute respiratory infection, and carbon monoxide poisoning
Long-term: e.g. cardiovascular disease, chronic obstructive pulmonary disease, and cancer
What are standard precautions?
Standard precautions are work practices that help prevent the spread of infectious diseases in healthcare facilities. Apply to: blood, all body fluids, non-intact skin, and mucous membranes.
E.g. Hand hygiene, Use of personal protective equipment (e.g., gloves, masks, eyewear), Clean and disinfected environmental surfaces; Safe injection practices; Sterile instruments and devices.
What are essential steps to develop cultural competency based on Campinha-Bacote’s model?
ASKED: Cultural awareness, skill, knowledge, encounters, desire
Self-awareness (FIRST STEP): Recognize the values, beliefs, and practices that make up your own culture.
What are the basic theories of Traditional Chinese medicine (TCM)?
e.g. Yin and Yang balance; flow of Qi;
MMR: what are the differences between measles (Rubeola) and German Measles (Rubella), ie. symptoms?
Measles (Rubeola): high fever red rash (starts on the face and moves cephalocaudal, by day four my be one large rash), Koplick spots on buccal mucosa, non-productive cough---transmitted by respiratory secretions, blood and urine
German Measles (Rubella): mild fever, rash is the first and only symptom (1-3 days) highly infective---transmitted by blood, stool, urine
What is insomnia? What is the common treatment?
Insomnia: sleep need > sleep ability; difficulty initiating and maintaining sleep, early wake-up with inability to return to sleep
non-pharmacological: sleep hygiene, sleep restriction (during non-usual sleep time), CBT;
pharmacological approaches: prescription (i.e. complications of benzodiazepine: respiratory distress), OTC
What are actions in the disaster management cycle: especially preparedness, response, recovery, and evaluation?
Preparedness: Assembling emergency supplies is an example of individual preparedness. Community preparedness involves developing an evacuation plan to remove individuals from danger. Training.
Response: Priority: reestablishing sanitary barriers and focusing on water, food, waste disposal, vector control, shelter, and safety are the first goals. After this has been established, the nurse can address the cleanup of the environment, the stress reactions of the victims, and the need to bring in additional workers.
The recovery phase begins almost immediately after a disaster occurs. Recovery is about returning to the new normal
what are examples of workplace exposures/agents and their health effects?
•Hospital workers: Infectious agents, cleansers, radiationà Infections, latex allergies, unintentional injuries
•Agricultural workers: Pesticides, infectious agents, gases, sunlightà Pesticide poisoning, “farmer’s lung,” skin cancer
•Automobile workers: Asbestos, plastics, lead, solventsàAsbestosis, dermatitis
•Office computer workers: Repetitive wrist motion on computers--> Tendonitis, carpal tunnel syndrome, tenosynovitis, eye strain
•Dry cleaners : Solventsà Liver disease, dermatitis
What is Community-based participatory research (CBPR)?
What is implementation science?
CBPR is a collaborative approach to research that equitably involves all partners in the research process and recognizes the unique strengths that each brings. CBPR begins with a research topic of importance to the community and has the aim of combining knowledge with action and achieving social change to improve health outcomes and eliminate health disparities
Implementation science focuses on the strategies used to implement evidence-based practices
What are the symptoms of syphilis?
Stages:
Primary infection-ulcer or chancre
Secondary infection-rash, fever, swollen lymph glands, sore throat, patchy hair loss, HA, weight loss, muscle ache, fatigue
Tertiary infection-damage to brain, nerves, heart, eyes, liver, bones, and joints. Difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, dementia, and possibly death
True or false
1. Lead-based paint may increase the risk for learning disabilities in children.
2. Older people are at the highest risk for air-pollution related death
3. Environmental health risk assessment sets the standard of an acceptable level of emissions or a maximum contaminant level allowed for factories
4. Hazard Communication Standard provides information of pollutants in the drinking water of a community
5. Ground-level ozone has a protective effect on health.
1. T
2. T
3. F. Environmental standards may describe a permitted level of emissions, a maximum containment level, an action level for environmental cleanup, or a risk-based calculation.
4. F. This is an example of Consumer Confidence Report: the results of the annual testing of the public water supply
5. F. One of the six common air pollutants identified in the Clean Air Act. Most likely to reach unhealthy levels on hot sunny days in urban environments
In Mass casualty Incidents, how will you triage patients based on the Simple Triage and Rapid Treatment (START) System?
respirations, perfusion, and mental status (RPM):
Immediate (RED): RR= >30; P= Capillary Refill >2sec; M= Doesn’t obey commands
Urgent (Yellow): RR= <30: P= <2sec; M= Obeys commands; After Red cases
Delayed (Green): Walking Wounded; After Red and Yellow.
Expectant (Black): R=not breathing; Lowest priority
What are cultural preservation, cultural accommodation, cultural repatterning, and culture brokering in providing culturally competent care?
Cultural preservation: retain and preserve traditional values
Cultural accommodation: work with the patient to integrate patients’ health practices with the nurse’s;
Cultural repatterning: change or modify a cultural practice for new or different health care patterns that are meaningful, satisfying, and beneficial
Cultural brokering: e.g. Advocating, mediating,
What are common clinical and public health applications of the following therapies?
Acupuncture
Cupping
Exercise (Qi Gong, Tai Ji)
Acupuncture: e.g. types of pain that are often chronic, such as low-back pain, neck pain, osteoarthritis/knee pain, and carpal tunnel syndrome, headache, Nausea and vomiting et al.
Cupping: relieve muscle tension, which can improve overall blood flow and promote cell repair and reduce pain. It may also help form new connective tissues and create new blood vessels in the tissue
Exercise (Qi Gong, Tai Ji): e.g. improve balance and stability in older people and those with Parkinson’s disease, reduce pain (from knee osteoarthritis, back pain), and promote quality of life and improve mood in people