Leveling up Prevention
Upstream Thinking
Chapter 19
The P's of Public Health
Cultural Competence
100

This is a form of Primary prevention

Vaccinations / Education

100

Your client, Bob Basket, lives alone in an apartment. He recently lost his vision r/t his uncontrolled DMII. You notice he's missed has last 3 endocrinologist appointments. What upstream issue could be impacting his ability to follow up?

Transportation

100

George has a recurrent glioblastoma. His providers have given him and his family the expectation of approximately 6 months to live. What service could you offer the client? 

Hospice

100

How can a correctional facility nurse work to improve inmate nutrition?

Advocate/promote healthy nutrition options. 

100

Your FQHC is working to build trust and connection with the LGBTQIA+ community. What intervention would help a client to feel more welcome in your clinic? 

Inclusive care and paperwork

200

There are ethical issues with performing this type of secondary prevention 

Screening

200

Serena is 42 year old client discharging from the FQHC Hospital. Your primary concern with her discharge is her ability to:

Continue treatment and get follow up care. 

200

Gina has ER PR positive, HER2 negative breast cancer. She is starting chemotherapy and radiation treatment. She is concerned about her overall quality of life throughout treatment. What service would you recommend?

Palliative care

200
A PHN is working to reduce the incidence of HIV in the local LGBTQIA+ community, so the PHN has started a free HIV screening and PrEP program. Which of the 3 P's is this addressing?
Prevention
200

Your client, Vanessa, is visiting you with elevated cholesterol. She doesn't want to start the recommended statin. What tertiary health prevention method could the nurse do?

Educate on lipid-lowering diet and exercise. 

300

Vaccinations are not only primary prevention but health _________

Protection

300

Agnes is a 20 year old client with severe endometriosis  at the Women's Health Clinic. She is currently uninsured because she cannot afford self pay insurance. What upstream intervention would help her continue to see providers and remain on treatment?

Sliding scale/ income based payment plans

300

Life expectancies are improving in the USA thanks to public health interventions such as this tertiary prevention of DMII

Nutrition and medications to manage the disease

300

A PHN is hoping to reduce re-incarceration rates by advocating for better inmate rehab treatments. Which of the 3 P's is this addressing? (there may be more than 1)

Promotion, prevention and protection 

300

Malala Yousafzai is an advocate for women and young girls to have access to an education. This is an example of:

Social justice

400

Why are preventative mammograms performed?

Early detection of breast cancer. 

400
People in the justice system often have poor outcomes due to lack of access to what?

Healthcare 

400

What's the primary goal of hospice care?

Emotional wellbeing and quality of life over quantity

400

A PHN is working to improve the physical fitness of school aged children in the community. What upstream intervention can this PHN advocate for?

Safe outdoor play areas

400

Malala Yousafzai fought for women and young girls to have access to education. The lack of ability to have an education is an example of what inequality?

Gender

500

Treating a patient's pre-diabetes with improved nutrition and medications is what level of prevention?

Tertiary

500

The 1000lb sisters received gastric bypass education at an 8th grade level and were not successful in treatment plan compliance. What nursing assessment could have improved this education?

Assessing overall literacy level.

500
What is the primary goal of palliative care?

Quality of life during treatment. 

500

An anti-smoking campaign is an example of which of the 3 P's

Prevention

500

What is one way a PHN can work to address a culturally diverse community?

Complete diversity education