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Nursing-Medical Screening
Cards on the nurse's role in medical screening
58
Medical
Undergraduate 3
03/03/2008

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Cards

Term
What form of prevention is screening?
Definition
Secondary prevention
Term
What is the objective of screening?
Definition
To detect disease in the earliest stage, reduce the cost of the disease by avoiding more rigorous interventions of later stages, and deter its progression.
Term
What are 3 advantages to screening?
Definition
-often simple, inexpensive and do not always require a nurse to perform.
-Can be used for both individuals and large groups.
-One test disease screening or multiple test screening can be used.
Term
What are 3 disadvantages to screening?
Definition
-Margin of error exists for screening and instrument.
-False positives lead to needless referals and anxiety
-False negatives lead to delays in the true identification and treatment
Term
What are 3 disadvantages to screening?
Definition
-Margin of error exists for screening and instrument.
-False positives lead to needless referals and anxiety
-False negatives lead to delays in the true identification and treatment
Term
Having to balance the benefits of some against the losses of others is an example of what?
Definition
An ethical consideration associated with screening.
Term
What is one thing that must be evaluated with each and every screening test, disease and population?
Definition
The ethical considerations involved.
Term
What are the 3 criteria for determining the selection of a screenable disease?
Definition
-Does the significance warrant screening?

-Can the disease be screened?
-Should screening be done for this disease?
Term
What does significance refer to in terms of screening?
Definition
The level of priority as a public health concern
Term
What is "prevelence" in reference to screening?
Definition
It is the proportion of existing cases during a specific time period (chronic)
Term
Define "Incidence" in reference to screening.
Definition
Is the frequency of new cases during a specified time period (acute cases)
Term
Define reliability
Definition
The degree of consistency or reproducibility of the tests results.
Term
How can we be sure that reliability has been achieved?
Definition
Achieved when different individuals of the same skill level perform the test during different periods and under different conditions
Term
Define: Interovserver reliability
Definition
Achieving the same result when two different people perform the test.
Term
Define: intraobserver reliability
Definition
When the same person can reproduce the same result several times. If not, the machine is in error.
Term
Define: Validity
Definition
The ability to distinguish correctly between diseased and non-diseased individuals, or the accuracy of the test.
Term
What do we use to quantify the margin of error for validity?
Definition
Sensitivity and specificity
Term
Define: Sensitivity
Definition
The proportion of people who correctly test positive when screened. A test with poor sensitivity will produce a large number of false negatives.
Term
Define: specificity
Definition
Measures the test's ability to recognize negative reactions on non-diseased individuals. A test with low specificity will produce a large number of false positives.
Term
What is a condition in which a number of false negatives could occur?
Definition
Moderate specificity- it may not identify people with the disease in the early stages who could benefit from treatment.
Term
What are the next steps taken once a lead agency has been chosen to oversee development of the screening process?
Definition
Lead agency will then identify stakeholders who are usually key community individuals. This forms a parntership.
Term
List some constraints involved in operating a screening service.
Definition
Financial, political, cultural, follow-up and referral services and accessible treatment centers.
Term
What assesment must a partnership perform after being formed by the lead agency?
Definition
A community assessment, which provides data regarding type, quantity and quality of resources.
Term
What should be done if the screening agency does not have the ability to make appropriate referrals for positive screens?
Definition
Screening should not be done.
Term
What type of group should be sought out when selecting a screenable population?
Definition
It's important to select a high risk group that will yield a significant number of diseased individuals.
Term
What is PKU?
Definition
A Genetic lack of the enzyme to metabolize phenylalanine
Term
What is the incidence of PKU?
Definition
About 1:10,000 births, but the cost of care is very high.
Term
What screen is used to test for PKU?
Definition
Guthrie test @ 2-3 days old.
Term
What is the consequence of untreated PKU?
Definition
Severe brain damage results
Term
This is the 2nd leading cause of death in women
Definition
Most common cancer, breast cancer.
Term
What are the major risk factors for breast cancer?
Definition
Increased age, No children (or first child in late 30's), family history of breast cancer, obeisity, and high fat diet.
Term
How often should breast cancer screen be performed?
Definition
Women should have a mammogram every 1-2 years with or without CBE at age 40.
Term
Where does cervical cancer rank in terms of cancers most commonly affecting women?
Definition
It is the 10th most common cancer among women.
Term
What course of screening is reccommended for women at risk of cervical cancer?
Definition
Pap smear anually for all women age 18 or older or for women who are sexually active
Term
What risk factors increase a woman's chance of acquiring cervical cancer?
Definition
Multiple sex partners, low socioeconomic status, early intercourse, smokers and HPV
Term
Where does Colorectal cancer rank in terms of cancer deaths affecting women in the US?
Definition
It is the second leading cause of cancer deaths among US women
Term
What are the risk factors for colorectal cancer?
Definition
Inflammatory bowel disease, history of endometrial, ovarian or breast cancer, polyps, 1st degree relative w/CRC
Term
Describe screening reccomendations for women concerning colorectal cancer
Definition
Screening includes annual rectal exam, annual fecal occult blood with sigmoidoscopy every 5 years and colonoscopy every 10 years beginning at 50
Term
Describe the rankings of prostate cancer in terms of commonality and cause of death among men
Definition
It is the most common cancer in males and the 2nd leading cause of death among males
Term
What are the risk factors associated with prostate cancer
Definition
Risk increases with age 50 and among black men
Term
What screening tests are used for detecting prostate cancer?
Definition
PSA and DRE
Term
What is the major modifiable risk factor for heart disease?
Definition
Elevated cholesteral
Term
How are total cholesterol and HDL levels determined?
Definition
By fasting or non-fasting blood level.
Term
When is a cholesterol screen reccommended for men and women?
Definition
Recommended for men at age 35-65 and women age 45-65 every 5 years. Over 65 is on a case by case basis.
Term
What are the risk factors for elevated cholesterol?
Definition
Genetic, diet and sedentary lifestyle
Term
Hypertension is the leading risk factor for 4 life-threatening conditions. What are they?
Definition
Congestive heart failure, stroke, heart attack, and renal disease.
Term
Whom is HTN screening reccommended for?
Definition
Anyone over 18 years of age.
Term
When is treatment reccommended for HTN?
Definition
When systolic pressure 140mmHg, regardless of diastolic
Term
Where does glaucoma rank among causes of irreversible blindness?
Definition
Glaucoma is the second leading cause of this
Term
What are the risk factors for glaucoma?
Definition
Black race, increased age, those with diabetes, myopia, and family hx.
Term
What is the leading cause of death in the black population ages 25-44?
Definition
HIV is the leading cause in this age group of this race
Term
What diagnostic criteria are used to screen for glaucoma?
Definition
Increased intraocular pressure(tonometer), damage to optic nerve (eye exam), and visual field loss (perimetry)
Term
What is the fastest growing group with new HIV infections?
Definition
Monority women are the fastest growing group diagnosed w/this
Term
Who should be offered HIV screening?
Definition
Screening should be offered to all individuals who are at increased risk for this disease
Term
What screening test is used to diagnose HIV?
Definition
The enzyme immunoassay is used to diagnose this
Term
This condition is associated with long term damage to multiple organ systems
Definition
Diabetes mellitus is associated with this
Term
What are the risk factors for diabetes mellitus?
Definition
These include age, obeisity, lack of exercise, family history, hypertension, hyperlipidemia, and macrosomic infants
Term
How do we screen for diabetes mellitus?
Definition
Includes checking fasting plasma levels every 3 years for individuals at risk
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