Exam 2 Objectives (chap 13, 15, 19, 21, 23, 24, 25, 28, 29, 30, 31, 32, 33, 34) Chapter 13: Cultural Diversity and Community HealthNursing -Describe ethical definitions of Autonomy, Non-maleficence, Beneficence, Distributive Justice and how lack of can affect health care and access to all. • Autonomy- patientindependence, making own decisions, a self-governing state • Non-maleficence- to do no harm • Beneficence- doing good • Distributive justice- perceived fairness of how rewards and costs are shared by (distributed across) group members. Distributive justice concernsthe equitable distribution ofscarce resources among allsocioeconomic groups and population sectors. Chapter 19: Senior Health -Identify age-related risk factors and education for Senior Health • Nutrition status and exercise • Falls • Dental, hearing, & vision problems • Abuse/maltreatment • Medication safety o When applicable, anti-inflammatory medications may be administered before physical activity to address accompanying pain • Cold and heatstress: o Hypothermia (very serious)- keep the patient warm; watch for the signs: confusion or sleepiness, slowed slurred speech, weak pulse, shivering, poor control of body movements o Heatstroke (life-threatening) - wrap a wet sheet, move to a cooler area; watch for hot dry skin that’s usually red, mottled, or cyanotic, loss of consciousness, or convulsions -What are functional assessments and why are they used when assessing the elderly? • Examinations and Tests; a continuous collaborative process that combines observing, asking meaningful questions, listening to family stories, and analyzing individual child skills and behaviors within naturally occurring everyday routines and activities across multiple situations and settings. • For All Older Adults o Complete physical: Annually o Blood pressure: Annually; more frequently if hypertensive or at risk o Blood glucose: Annually; more frequently if diabetic or at risk o Serum cholesterol: Every 5 years; more frequently if at high risk o Fecal occult blood test: Annually o Sigmoidoscopy: Every 5 years o Colonoscopy: Every 10 years; more frequently if at high risk o Visual acuity and glaucoma screening: Annually Exam 2 Objectives (chap 13, 15, 19, 21, 23, 24, 25, 28, 29, 30, 31, 32, 33, 34) 100% GUARANTEED o Dental examination: Annually for those with teeth with cleaning every 6 months; cleaning every 2 years for denture wearers o Hearing test: Every 2 to 5 years • For Women o Breastself-examination: Monthly o Clinical breast examination: Annually o Mammogram: Every 1 to 2 years if aged 40 years or older; check with health care provider if 74 years or older o Pelvic examination and Papanicolaou smear: Annually; may check with health care provider about discontinuation at 66+ years or after three consecutive negative Pap test results or >2 consecutive negative HPV and Pap tests, no abnormal results in previous 10 years and not otherwise at risk, or have had a total hysterectomy o Digital rectal examination: Annually with pelvic examination o Bone density: Once after menopause and more frequently if at risk • For Men o Digital rectal examination and prostate examination: Annually o Prostate-specific antigen (PSA) blood test: Annually • Immunizations for All Older Adults o Tetanus, diphtheria, pertussis(Tdap): Every 10 years o Influenza/flu vaccine: Annually o Pneumonia vaccine: Once after age 65 years; ask physician about booster every 5 years o Hepatitis A (liver infection found in stool and blood very contagious )and B(is spread when blood, semen, or other body fluids from a person infected)those at risk o Herpes zoster (shingles): One-time dose o Varicella (chickenpox): If evidence of lack of immunity and significant risk for exposure Chapter 21: Populations Affected by Disabilities -Medicare and Medicaid access and funding • medicare o Medicare is the federal health insurance program for: ▪ people 65 or older ▪ certain younger people with disabilities ▪ people with ESRD (end stage renal disease) ▪ funded by the social security administration (tax payers) • medicaid o Forlow-income families w/ disability and pregnant women o Funded by federal and state government Exam 2 Objectives (chap 13, 15, 19, 21, 23, 24, 25, 28, 29, 30, 31, 32, 33, 34) 100% GUARANTEED eligibility is based off of household size and income and priority given to children, pregnant women, and those with a disability (federally funded) -What protection is provided to those who identify having a disability • Contemporary disability policy minimizes the disadvantaged view and maximizes opportunities for people with disabilities to live productively in their communities. Public policy on disability (these are your programs) includes civil rights protections, skill enhancement programs, and income and in-kind assistance programs (e.g., Social Security Disability Insurance [SSDI] and Medicare) -What does ADA accommodations mean and do they refer to • The Americans with Disabilities Act (ADA) (PL 101-336) became a law in July 1990. This landmark civil rights–styled legislation prohibits discrimination against people with disabilities by guaranteeing equal opportunities for people with disabilities in relation to employment, transportation, public accommodations, public services, and telecommunications • A qualified individual with a disability must meet legitimate skill, experience, education, or other requirements of an employment position. The person must be able to perform the essential job functions, such as those contained within a job description, with or without reasonable accommodation(s). Reasonable accommodations should make it easier to be successful in job duties and may either involve altering the duties or the tasks of the job performed. Qualifying organizations must provide reasonable accommodations unlessthey can demonstrate that the accommodation will cause significant difficulty or expense, producing an undue hardship. -Discuss the Ticket to Work Act and how it affects Medicaid or Medicare • Addresses employment and benefit issuesfor persons with disabilities. • Increase access to vocational services and provided methodsfor retaining health insurance. • Provided higher cap to accommodate earnings when beneficiaries make progress in their employment plans but before they reach the level of earnings that would terminate their benefits Chapter 23: Homeless Populations(ati pg 64) -Identify health care workers engagement and care with homeless populations • Refer those who have underlying mental health disorders to therapy and counseling • Enhance parenting skills that can prevent teens from running away • Assistin temporary shelter, long-term shelter • Advocate and provide efforts towards political change • Make referralsfor employee assistance and emotional programs