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• Palliative care


  The primary purpose is to improve quality of life for anyone suffering from a serious illness, such as cancer or end-stage renal failure
• Hospice care


  Begins after treatment of the disease is stopped and when the person is not going to survive the illness. The primary purpose is to provide comfort and support to dying patients
• Hospice care


  Focuses on caring for dying patients while palliative care can also be for patients who are not necessarily dying
• Ways to prevent opioid overdoses

  • Improve opioid prescribing
  • Reduce exposure to opioids
  • Prevent misuse
  • Treat opioid use disorder
• Average age of death due to overdose is 25-44 years of age
• What makes someone increased risk to overdose

  • Changes in tolerance
  • Changes in drug supply
  • Mixing opioids with respiratory depressants (alcohol, benzos)
  • Mixing opioids with stimulants (cocaine, meth)
  • Having chronic health conditions (HIV, Hep C, etc)
  • History of overdoses
• Naloxone


  Brand name "Narcan" (nasal spray naloxone), can be administered IV, IM, or intranasally, shelf life ranging from 24 months to 36 months, safe, easy to administer, no side effects, highly effective at reversing opioid overdoses, antidote effect lasts 30-90 minutes, overdose will continue afterward (need hospitalization)
• Steps to responding to opioid overdose

  1. Dial 911 immediately

  2. Administer naloxone (if available)

  3. Try to keep the person awake and breathing

  4. Turn the person on their side to prevent choking
• PTSD


  Post-Traumatic Stress Disorder, a mental health condition that is triggered by a terrifying event, either by experiencing something or witnessing it, and it can occur at any age
• Populations at risk for PTSD

  • Veterans
  • People actively in military
  • Children
  • People who have been through sexual and physical abuse, trauma, been assaulted, violence, been in an accident, or natural disasters can cause traumatic experience
• PTSD


  Can show up as a part of complicated grief, that's when the symptoms of grief have not lessened after 6 months, it can develop if someone witnesses a murder or finds someone who has committed suicide, it may have cause nightmare and some people may find it hard to function
• Living Will


  A written legal document that spells out medical treatments you would and would not want to be used to keep you alive, as well as your preference for other medical decisions, such as pain management, CPR, mechanical ventilation, organ donation
• Durable Power of Attorney


  A document that empowers someone of your choosing to make medical decisions on your behalf in the event of your incapacitation, it applies to both end of life treatment as well as other areas of medical care, the proxy only has power to act on your behalf when you are unable to do so yourself, whether from loss of consciousness or mental ability, medical professionals will determine if you are capable
• Tuberculosis (TB) is a highly communicable disease caused by infection with Mycobacterium tuberculosis, the organism is transmitted when a person with active TB coughs, laughs, whistles, or sings, infected respiratory droplets become airborne and may be inhaled by others
• People at risk for developing TB

  • Those with weak immune systems, or HIV
  • Those with constant and close contact with someone who is infected with TB
  • Homeless people
  • Those who live in crowded environments
  • Users of injection drugs or alcohol
  • Lower socioeconomic groups
  • Foreign immigrants where TB cases are high
• Latent TB infection


  When a person with TB infection doesn't feel sick or doesn't have any symptoms, they are not infectious and cannot spread TB to others
• TB disease


  When the TB bacteria overcomes the defenses of the immune system and begin to multiply, some people develop TB after being infected, and others later when their immune systems become weak
• Barriers to healthcare access

  • Lack of insurance
  • Type of insurance
  • Transportation
  • Cannot afford co-pays or deductibles
  • Literacy or health literacy
  • Cultural barriers
  • Language barriers
  • Immigration concerns
  • Income or affordability
  • Complex health needs
  • Disability (cognitive/physical)
  • Mental health issues
• Social determinants of health

  Economic stability, education access/quality, healthcare access/quality, social community/support, neighborhood environment
• Grief


  A combination of psycholic, biological & behavioral responses to loss, can vary person to person emotionally and physically, normal responses include sadness, anxiety, guilt, anger, confusion, sleep disturbances, loss of appetite
• Perinatal loss


  Death of fetus or infant any time from conception to 28 days after birth (within first month of life), can include miscarriage (before 20 weeks), stillbirth/intrauterine fetal death/fetal demise (after 20 weeks), traumatic for parents & family members, perinatal grief can be more intense than any other losses, mother can experience postpartum depression (PPD) from infant loss or complications during pregnancy
• Causes of Perinatal Loss

  • Infection
  • Uncontrolled diabetes
  • Uncontrolled thyroid disease
  • Abnormality in the fetus
  • Problems with the placenta
  • Accidents involving the umbilical cord
  • Domestic abuse
  • Accidents
  • Sometimes cause is unknown
• Learning Styles


  Visual: Likes to see the information, Auditory: Likes to listen to the information, Kinesthetic: Likes to do hands on activities, Reading & Writing: Likes to read and write
• Community Health Nursing


  Goals are to promote health and prevent illness, ensure everyone has the same standard medical care to maintain their health, enhance the health of individuals, families and communities with their health needs and is concerned for their well being
• Nursing Roles


  • Leader: Guides other team members to meet goals effectively and make sure care is given properly
  • Educator: Ensures the patient is aware of and fully understands their care
  • Advocate: Stands up for the patients rights, interests, choices and beliefs
• Types of families


  • Nuclear family: Family with Father, Mother, Offsprings
  • Binuclear: Family with separated parents but partnering to raise children together
  • Blended family(Step family): Family unit where one or both parents have remarried, bring together children from previous relationships into new household
  • Intergenerational family: Family with multiple generations living together
  • Gay and lesbian family: Family consisting of same sex parents
  • Single parent family: A parent who is raising a child or multiple children alone (ex. single, divorced, or widowed)
• Cultural Humility


  A process of being aware of how people's culture can impact their health behaviors and in turn using this awareness to cultivate sensitive approaches in treating patients, example: when the patient is hesitant to follow the prescribed treatment plan due to cultural beliefs about health and healing, the nurse shows respect for the patient's autonomy and cultural identity instead of imposing nurse's own views
• Anxiety Disorders


  Mental health conditions characterized by excessive worry or apprehension, decreased concentration or memory, difficulty sleeping, fatigue or muscle tension, significant distress and/or impairment, and subjective experience, the most common mental health disorder in the US, affecting about 18% of adults (approximately 40 million people)
• Anxiety Disorder Prevention


  • Sleep quality (sleep well through night)
  • Cutting out Caffeine
  • Building a support network
  • Relaxation techniques (deep breathing)
  • Regular exercise
  • Stress-reduction techniques (time management, setting boundaries)
• Kubler Ross Grief Cycle

  • Denial: avoidance, Confusion, Elation, Shock, Fear
  • Anger: Frustration, irritation, Anxiety
  • Depression: Overwhelmed
  • Bargaining: Struggling to find meaning, Reaching out to others (Telling one's story)
  • Acceptance: Exploring options, New plan in place, Moving on
• Disenfranchised Grief


  When individual cannot acknowledge loss to others, loss is not socially recognized (Ambiguous loss), may include feelings of isolation as well as grief
• Complicated Grief


  When individual cannot process grief to resolution, diagnosed when the grief has not diminished after 6 months, grief has become debilitating
• About 18% of adults, approximately 40 million people
• Prevention


  • Sleep quality (sleep well through night)
  • Cutting out Caffeine
  • Building a support network
  • Relaxation techniques (deep breathing)
  • Regular exercise
  • Stress-reduction techniques (time management, setting boundaries)
• Kubler Ross Grief Cycle

  • Denial: avoidance, Confusion, Elation, Shock, Fear
  • Anger: Frustration, irritation, Anxiety
  • Depression: Overwhelmed
  • Bargaining: Struggling to find meaning, Reaching out to others, Telling one's story
  • Acceptance: Exploring options, New plan in place, Moving on
• Disenfranchised Grief


  When individual cannot acknowledge loss to others, Loss is not socially recognized (Ambiguous loss, loss of child due to abortion, loss of pet), May include feelings of isolation as well as grief
• Genogram


  How to read genograms: The male is noted by a square and the female by a circle, Children are placed below the family line from the oldest to the youngest; left to right, A family is shown by an horizontal line connecting the two
• What are basic symbols to be aware of

  • Male is square
  • Female is circle
  • Half shaded is a carrier of trait
  • A cross inside of the box is deceased
  • The number in the box is age
  • The index patient is noted by a double square
• Characteristics of a healthy family

  • Members interact with one another
  • Members understand that family needs are a priority
  • Healthy families affirm, support, and respect each other
  • The members engage in flexible roles and relationship, share power, respond to change,and support the growth and autonomy of others
  • Teaches family and societal values and beliefs and shares a religious core
  • Healthy families have a sense of play and humor
  • Cope with stress and crises and grow as a result of positive coping
• Otitis Media


  • Patient Education: Take the medications for the full length of time, Must keep ear dry to prevent infection, Molded ear plug to protect the ears, Follow up for frequent ear cleaning