Community HESI

Term
1 / 92
WBC
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Terms in this set (92)
WBC
5-10,000
RBC
4.5-5.5
Platelets
150-400,000
aPTT
30-40 seconds
indicates how well pt is clotting
PT
10-12 seconds
PTT
25-35 seconds
INR
less than 1
INR when taking warfarin
2-3
Hgb
12-18
Hct
37-52
Glucose70-100Hypoglycemia<70 <40 severeBUN5-20Cr0.6-1.2LDL<100HDL>60Total cholesterol<200Digoxin0.5-2 s/s of toxicity -blurry vision,confusion,irregular pulse,loss of appetite, NVD,tachycardia,weakness TX dig immune fabLithium0.5-1.2 s/s of toxicity- uncontrollable movements,muscle weakness,tremors,fatigue,stomach pains,NVD tx-stomach pumping,hemodialysis,bowel irrigiant and IV fluidsSchool nurses:help encourage positive response to normal development help promote health and safety help solve actual and potential problems help promote academic success provide case management work with others to develop student and family capacityWho was the founder of school nursing?Lillian WardWho was the first school nurse ?Lina RogersEarly Periodic Screening Diagnosis and Treatmentpromote school nurse role in screening and referralsIEP (Individualized Education Plan)list all the services that are child is to be receiving`Types of school health screeningsimmunizations vision hearing postural BMISchool Health Indexfocuses on how schools can promote physical activitySubstance abusetypically drugs and ETOH marijuana most commonSmokingon the rise with vaping and e cigarettesSafe sexual behavior and teenage pregnancysafe sex education condoms/birth control rates for teen births have decreasedSTIgonorrhea and chlamydia most commonvoluntary health organizationswhose mission is to combat a particular disease, disability, or group of diseases and disabilities, or to improve and protect the health of a particular group of people. ex:American Heart Association,American Cancer AssociationNGOSa non profit organization that operates independently of any government whose purpose is to address a social or political issue ex Doctors without Borders,Mercy CorpsHealthy People 2030Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death. Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of allCarriera person or animal that harbors an infectious organism and transmits the organism to others while having no symptoms of the diseaseIn order for a disease to be communicable1.have portal of exit from the infected person (or animal) 2.a means of transmission 3.a portal of entry to a susceptible hostagentthe microbe that causes the diseaseenviormentexternal factors that cause or allow disease transmissionHatavirus is caused byrat droppingsairborne transmissiontransmitted via droplet nuclei Ex TB PPE: N95 and negative air pressure roomdirect transmissiontransmitted via direct body surface to body surface to body surface contact and physical transfer of microorganisms ex STDSindirect transmissioncontact of a susceptible host with a contaminated intermediate intimate object ex malariadroplet transmissiondroplets are transmitted while coughing sneezing or talking ex flu measles and pertussis PPE mask and gogglescolonizationpresence of infectious organisms without invading or causing damage to tissueendemicthe constant or usual prevalence of a specific disease or infectious agent within a population or geographic areaepidemica local or regional outbreak of a diseasepandemicworldwide epidemicCampylobacter enteritis-leading cause of food borne illness -"travelers diarrhea'" -caused by consumption on contaminated poultry(most common source) -s/s nvd,adbodminal pain fever and headache typically lasting a week or less -dx by stool culture and treated with antidiarrhealListeriatypically only effects the immune compromised food borne illnessSalmonella-bacteria transmitted via contaminated food and water,or reptile contact -s/s fever diarrhea and cramps typically lasting 4-7 days -typically resolves without treatmentE coli-transmitted via contaminated foods -s/s severe cramps,diharrhea,and vomiting -severe complications- temporary anemia,profuse bleeding and kidney failureChlamydia-most common notifiable disease -among the most prevalent -"silent infection" most people asymptomatic and lack abnormal physical examination findings -tx antibiotic Azithromycin (Zithromax) or doxycycline (Vibramycin)Norovirus-most common cause of acute gastritis -spread fecal-oral or close personal contact -s/s •Acute-onset of vomiting •Watery, non-bloody diarrhea •Abdominal cramps •Nausea Headaches Low- grade fever Malaise (body aches). -most common complication dehydration -treat symptomsGonorrhea-s/s urogential,pharygneal,rectal infections,and conjunctivitis -tx cephalosporin and azithromycin or docycolzineSyphillis-the great imitator -primary and secondary most infectious stages -s/s sores that last 3-6 weeks, various body rashes -tx penicillin gHPV-most go away within 2 years on their own and cause no issues, -low risk- cause genital warts and benign cellular changes that aren't associated with increased risk of cancer -High risk-causes cervical dysplasia,moderate to severe pap abnormalites,and possibly cervical cancer -no treatment treat the wartsHIV-AIDS when CD4 count is less than 200 -can take 10-15 years to develop into AIDS -tx ART drugsHerpes Simplex Virus-HSV1 cold sores - HSV2 genital sores and can also infect the mouth -Increases in genital HSV1 warts -no tx manage symptomsHep Bbecomes an STD when transmitted through mucosal contact tx antivirals tecavir (Baraclude), tenofovir (Viread), lamivudine (Epivir), adefovir (Hepsera) and telbivudine (Tyzeka)Hep Atransmitted fecal oral touching food and food surfaces with unclean hands tx non;treat symptoms get vaccineHep Cno vaccine transmitted through contaminated blood s/s most don't have symtomns;jaundice tx a variety of antiviralsprimary preventionpreventing disease and injury before it occurs ex:education and immunizationssecondary preventionreducing the impact of a disease or injury that has already occured ex:regular test and screening,daily ASA to prevent MITertiary preventionlong term management ex:rehab and support groupsmass casualtywhen EMS is overwhelmed by the number of casualtiesPreparednessbeing prepared to respond to a disasterMitigationprevent the disaster or lessen the impactchemical exposureremove clothing wash yourself dispose of clothingsteroidssuppress inflammatory response long term increases blood glucoseMAOIScant be mixed with most medicationsGluccocorticoidsincreases blood glucose in response to stress causes osteporosis with long term useGinkgo,garlic,ginseng,fish oil,donq qaiincrease risk for bleedinghealth care proxyA person legally designated to make health care decisions on behalf of a terminally ill individual who is incapable of making his or her health care preferences knownliving willAn advance directive document that outlines end-of-life care wishes by the resident and for the residentadvance directiveslegal documents that allow people to choose what medical care they wish to have if they are unable to make those decisions themselvesmandatory reporterAny person, including, but not limited to, any: a) physician, osteopathic physician, medical examiner, chiropractic physician, nurse, or hospital personnel engaged in the admission, examination, care, or treatment of persons; b) Health or mental health professional other than one listed in paragraph a); c) Practitioner who relies solely on spiritual means for healing; d) school teacher or other school official or personnel; e) social worker, child care worker, or other professional child care provider, foster care, residential, or institutional worker; f) law enforcement officer; or g) judgemandatory reporters are to report ifHas reasonable cause to suspect that a child has: Been subject to child maltreatment; Died as a result of child maltreatment; or Died suddenly and unexpectedly.Polypharmacyproblem in elderly issues with duplicates and drug interactionsAvian fluspread through contact with birds contact precautions tx antiviral drugs oseltamivir (Tamiflu)/zanamivir (Relenza).West Nile-transmitted via mosquito bite -incubation period 3-14 days -80% of people are asymptomatic; 20% flu like symptoms (NVD,body aches,fever,etc) -use DEET to prevent being bitten -no tx ;manage symptomsLyme diseasetransmitted via tick bite;caused by s/s bull's eye rash (hallmark sign),rashes,pain that moves from joint to joint,and signs of heart and nerves -best clinical marker initial skin lesion Tx doxycycyline,amoxicillin,and cefuroxime axetilEbola-sudden fever,muscle pain and weakness,headache,sore throat,vomitting,diharrhea,rash,compromised liver and kidney function and sometimes internal or external bleeding -spread via contact with body fluids,.direct contact,or indirect contact -incubation 2-21 days;8-10 averageEbola dx-other disease should be ruled out first -Lab test are definite dx (ELSA,antigen detection test,PCR assay,and cultures) -no vaccine;primary preventionZika virus-transmitted via mosquito bite -typically asymptomatic but may have fever,rash,headache,joint pain,red eyes and muscle pain -no treatment prevent and manage symptomsTB-caused by mycobacterium tuberculosis -airborne transmission -typically affects lungs TB s/s chronic productive cough,low grade fever,night sweats, weight loss, and positive test,rust colored sputumWhat is the standard for determining if a person has TB?Mantoux tuberculin skin test culture (most defintive)What are the two types of TB?latent activeLatent TB*asymptomatic *non infectious *+ positve QuantiFERON-TB Gold blood test result or skin test *normal chest x-ray studies and sputum cultureTreatment for latent TBIsoniazid (INH) Rifapentine (RPT) Rifampin (RIF) over 3-4 months or 6-9 monthsActive TBInfected, symptomatic contagious positive test may have abnormal chest x ray or positive smear or cultureTreatment for active TB6-9 months isoniazid (INH) rifampin (RIF) ethambutol (EMB) pyrazinamide (PZA)TB dx testPPD skin test CXR sputum culture quatiferon TB gold examThose at high risk for developing TB-Close contacts of person known or suspected to have active TB -Foreign-born persons from areas where TB is common -Persons who visit TB-prevalent countries -Residents and emploqHealth care workers (HCWs) who serve high-risk clients -Populations defined locally as having increased incidence of latent M. tuberculosis infection or TB disease, such as medically underserved, low-income persons who abuse drugs or alcohol -Children and adolescents exposed to adults at increased risk for infection or diseases of high-risk congregate settings