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Community Study Guide for the HESI

Keep in mind: This guide does not necessarily mean you will see these topics. There maybe
other topics that are not included here. I just did an internet search to see which topics are most
frequently covered and have tried to give you some pointers here.
Review
Healthy People 2020
objectives in the chapters of your textbook- ust familiarize yourself with thema these are the
basis for community health programsa &agesg) *g+
,eading Health Indicators + a c c e s s t o H e a l t h S e r v i c e s * a C l i n i c a l & r e v e n t a t i v e
Services .aEnvironmental zuality 0 a I n j u r y a n d v i o l e n c e *a2aternal)
I n f a n t ) a n d C h i l d h e a l t h 3 a 2 e n t a l h e a l t h 4anutrition) physical
activity) and obesity s a o r a l h e a l t h 7 a R e p r o d u c t i v e a n d s e x u a l
h e a l t h +gaSocial determinants ++aSubstance abuse +*atobacco

Population Groups across the Lifespan and their Health Risks


Infants
Number 1 cause of injury or death is suffocation followed by motor vehicle accident then
HomicideaSudden Infant 9eath SyndromeInfection is the most significant cause of illness in
infants and childrena
Vertical transmission of infection-
Passage of a disease-causing agent (pathogen) from mother to baby during the period
immediately before and after birth. Transmission might occur across the placenta, in
the breast milk, or through direct contact during or after birth. For example, HIV can be a
zertically transmitted pathogen. also known as perinatal transmission.
Children Obesity
Healthy people objectives have addressed youth fitness and obesity defined by using BMI which
is a ratio of weight to height
Risks for childhood obesity were related to obesity in the parents
obesity rates are higher in populations such as native American, Hispanic, and African
Americans groups. Lower socioeconomic groups in urban settings
have been associated with higher rates.

Injuries and accidents


- number one cause of death in ages 1 – 24 yrs.
- vehicles accidents are the leading cause of death among children and teenagers
Toddlers
experience a large number of falls, poisonings, and motor vehicle accidents, lead poison from
lead based paint in older homes is a health concerns ,lead has detrimental effects particularly on
the neuro system.
Can decrease IQ.
If on WIC and have lead poisoning the program will provide additional foods high in calcium
and iron.
Review treatment of lead poison. - Chelation therapy and a diet high in calcium. vitaminC and
iron. Don’t want BLL>5mcg/dL

Infant mortality Rate: th measure most commonly used around the world as an indicator of overall healtg and
availability of health services. May want to review ho to calculate it. ( # of infant <1 who die/ # of live births in the
same year.

School age children have the lowest injury rate; however, this group has difficulty judging speed and distances,
placing them at risk for pedestrian and bicycle accidents.
Vision screening in young children would match shapes or colors.

Adolescents; injury account for 75% of all death and risk-taking becomes more conscious at this time especially
among males
Suicide is the seond leading cause of death among youth between the ages of 10 and 24 years. Community
health programs for adolescents should focus on suicide prevention

Developing a smoking program for adolescents- first want to determine the incidence of smoking amonf the
teenagers in the community.
Menomune vaccine given to adults older than 30. It prevents infection by certain groups of meningococcal
bacterial. Discharge teaching- give tylernol, watch for signs and symptoms of reaction such as fever, behavior
change, seizures or difficulty breathing.
Acute illness- also a significant cause of illness in children
Chronic Health Problem- improved medical technology has increased the number of children surving with
chornic health prolems. Examples: Down syndrome, spina bifida, cerebral palsy, asthma, diabetes, congenital
heart disease, cancer, hemophilia, broncopulmonary dysplasia and AIDS.
Routing immunizations have been very successful in preventing selevted diseases.
Immunization rates are the amount of people that get schedules vaccines. These rates are used as quality
indicatos of health of the population. Review the immunization schedule in children **
Good nutrition is essential for health growth and development and influences disease prevention in later life. E.g
Children and adolescents calcium intake affects if they develop osteoporosis in adulthood

Women
tHE WOMEN’S HEALTH MOVEMENT IS PIVOLTA IN BRINGING NATIONAL RECOGNITION TO
WOMEN’S HEALTH ISSUES
women have a logner life expectancy than men
Women are more likely to have acute and chronic conditions that require them to use more services than men
Africna American or black women are statiscallu more likely to have poor health outcomes because of poor
undersanding of health, lack of acces to health care, and lifestyle practices
Heart disease leading cause of death in women
Lung Cancer leading cause of cancer in women and 2nd leading cause of death

Men
Men are physiologically the more vulnerable gender, shorter life span and higher infant mortality rate
Life expectancy of men in the US is one of the lowest in the developed countries
Men enage in more risk-taking beavhiors than women
Men tand to avoid diagnosis and treatment of illness that may result in serious health problems
Elderly
Steadily growing population
Increase in chronic conditions, demnd for services, and strained health care budgets
More older adults live in the community- age in place
Nurse address the chronic health concerns of elders with a focus on maintain or improving self-care and
preventing complications to maintain the highest possible quality of life
Assessing the elderly incorporated physical, psychological, social, and spiritual domains.
Individual and community focused interventions involve all three levels of prevention through collaborative
practice

What vaccines should the elderly receive and how often?


-tetanus diphtheria every 10 years
- influenza vaccine annually
- pneumonia vaccine once after 65 (ask physician about booster every 5 years)
herpes zoster (shingles) one time dose at age 60
hep A and B for those at risk

U.S Healthcare problem


More than 43 million people in the U.S are uninsured, and may more simply lack access to adequate health care
Healthcae reform measures seek to make changes in the cost, quality, and access of the present system. Review
TQM and Quality Assurance
TQM- consists of organization continuously improves its ability to deliver high-quality products and services to
customers. (long term success through customer satisfaction)
Quality assurance: the maintenance of a desired level of quality in service of produce, especially by means of
attention to every stage of the process of delivery of productions

The integration of primary care and public health is necessary for the future health of the nation. We must have
more emphasis on primary prevention.
To achieve the specific health goals of programs such as Healthy People 2010, primary care and public health
must work within the community for community-based care.

Target approach focuses on a certain group of individuals and their health needs (e.g. Hispanic pregnant women
with STDs). The approach looks at spiritual, cultural and leadership aspects.

The most sustainable individual and system changes come when people who live in the community have actively
participated. Important to involve community in program planning. Coomunity stakeholders.
Nurses are more than able to fill the gap between personal care and public health because they have skills in
assessment, health promotion, and disease and injury prevention knowledge of community resources; and ability
to develop relationships with community members and leaders.
Home visits- give a more accurate assessment of the following than do clinical visits;
- the family structure
- the natural or home environment

Home visits provide oppurtunities to identify both barriers and supports for reaching family health promotion goals
Home visits afford the opportunity to gain a more accurate assessment of the family structure and behavior in the
natural environment
Home visits also provide oppuruntiies to observe the home envinment and to identify both barriers and supprts to
reduce health risks and reaching family health goas
Home Health Nurse Delegation- What must RNs do and what can they delegate? Home health RNs must
do the initial assessment of the patient. ADLs can be delegated to a nursing care aide.
Parish nurses: nurses who respond to health and wellness needs within the faith context of population of faith
communities and are partners with the chuch in fulfilling the mission of health ministry.
Parish nursing: a community-based and population-focuses professional using pactice with faith communities to
promote the whole person health to its parishioners usually focused on primiary prevention
Parish nurse coordinator- a parish urse who has completed a certificate program designed to develop the nurse
as a coordinator of a parish nursing service.
Parish nurse services respond to health, healing and wholeness within the context of the church. Although the
emphasis is on health promotion and disease prevention throughout the life span, the spiritual dimension of nursing
is central to the practice.
The parish nurse partners with the wellness committee and volunteers to plan programs and consider health-related
concerns within faith communities
To promote a caring faith community, usual functions of the parish nurse include personal health counseling,
health teaching, facilitating linkages and referral to congregation an community resources, advocating and
encouraging support resources, and providing pastoral care
Parish nurses collaborate plan, implement and evaluate health promotion activities considering
the faith community’s beliefs, rituals and policy. Healthy People guidelines are the basic to the
partnering for the programs

Nurses working in the parish nursing specialty must seek to attain adequate educational and skill
preparation for the accountability to those served and to those who are entrusted the nurse to
serve
Nurses are encourafe to consider innovative approachese to creating caring communities. These
may be in congrations as parish nurses, among several faith community agencies or models such
as block nursing.
To sustain oneself as patish nurse healer, the nurse takes heed to heal and nurture self while
supporting individuals, families, an congregation communities in their healing process.

Hospice: palliative system of health care for terminally ill people; takes place in the home with
family involvement under the direction and supervision of health professionals, especially the
visiting nurse. Hospice care takes place in the hospital when severe complications of terminal
illness occur or when family become exhausted or does not fulfill commitments. A patient
admitted into hospice usually is expected to die within 6 months. The care in hospice is palliative
care for the dying patient.