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Unit 1 - Intro to Vulnerable Populations
Test 1
80
Nursing
Undergraduate 3
06/06/2014

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Cards

Term
What is a vulnerable population?
Definition
Pts that are more likely to develop health problems as a result of:
Excess risks
Limited access to health care services
Dependent on others for care
Term
Who are the underserved populations?
Definition
Health professional shortage area (HPSA)
Inmate
Medically underserved area (MUA)
Medically underserved population (MUP)
Trimorbidity
Underserved population
Term
What are MUA/P and HPSA?
Definition
areas, population groups, and facilities designated by the United States Department of Health and Human Services as having met criteria indicating a significant need for additional primary health care resources.
Term
Who are the vulnerable populations?
Definition
Poor
Older adults
Homeless
Immigrants
Abused
Substance abusers
Mentally ill
Disabled
Term
What makes poor people vulnerable?
Definition
Lack financial resources
Term
Why does living in poverty make you vulnerable?
Definition
Live in hazardous environments
Work at high risk jobs
Eat less nutritional diets
Have multiple stressors
Have poor or unavailable transportation
Term
What makes older adults a vulnerable population?
Definition
Increasing prevalence of chronic dzs
which Increases demand for health care services
Term
Why is the population average age steadily increasing?
Definition
Increased life expectancy, improved health care, access to health care: medicare, technology, new treatments, preventive care: screenings, Nutrition,
Term
What will seniors be by 2030?
Definition
nearly 20% of the total U.S. population.
increase Baby Boomers, born between 1946-1964, turned 65 in 2011.
Term
Which states have the largest amount of seniors?
Definition
California, Florida, NY, Texas, Pennsylvania, Ohio, Illinois, Michigan, and NJ.
Term
Why does a change in education status effect health care?
Definition
more high school degrees, 17% older adults had a bachelors degree or higher in 2003 compared to 3% in 1950.

People who are more educated are more likely to seek healthcare.
Term
What are the gender disparities between seniors?
Definition
Older women out number older men.
Older men are more likely than older women to be married.
Older women were twice as likely as older men to live alone.
Term
What is most of seniors income spent on?
Definition
spent on health care.
Term
Where do older adults want to live?
Definition
Older adults want to live in their own home for as long as possible, 93% age 65 and older.
Term
Where does senior's income come from?
Definition
Social Security 39% of income, earnings accounted for 25%, pensions provided 19%, and asset income 14%.
Term
What is medicare?
Definition
health insurance for those 65 and older, disabled, or have end-stage renal disease.
Term
What should you do for people w less than a high school education?
Definition
Slow pace, include family, give written information.
Term
What psychosocial issues do seniors face?
Definition
Role Changes
Boredom
Relocation
Term
What are the role changes?
Definition
Retirement
Social status/lower income
Widowhood, raising grandchildren
Term
What is relocation?
Definition
As a result of impairment, unable to maintain home, safety, ADLs declined
lists common physiological changes associated with aging.
Term
What should nurses consider about their attitude towards seniors?
Definition
Nurses need to recognize and address ageism by questioning prevailing negative attitudes and stereotypes and emphasizing what really happens during the aging process.When caring for older adults, we need to be aware of their wishes, give them the opportunity to participate in their own care, and treat them with dignity.
Term
What is ageism?
Definition
Defined as bias against older people because of their age
Represents dislike by the young of the old
Differs from other forms of discrimination in that it cuts across gender, race, religion, and national origin
Term
What are the facts about aging?
Definition
-Senses decline
-Muscular strength declines
-REgular sexual expressions are important
-At least 50% of restorative sleep is lost
-Older adults are major consumers of prescription drugs
-Older adults have a high incidence of depression
-Many individuals experience difficulty when retired
-Older adults are prone to be victims of crime
-Older widows adjust better than younger ones
Term
What are the myths about aging?
Definition
-Most are demented
-Sexual interest declines
-Older adults are not able to learn new tasks
-More rigid thinking and change
-Financially secure
-Most older adults are informed and require help w/ everything
-All older adults are hard of hearing and should be yelled at
Term
What are the effects of ageism?
Definition
Older adults receive less information about their health care and less care than younger adults
Negative attitudes of health care workers reflect views of society
Important to instill positive attitudes toward older adults during basic nursing education
Term
What is homelessness?
Definition
An individual who lacks a fixed, regular, and adequate nighttime residence and
An individual who has a primary nighttime residency that is the following:
-publicly or privately operated shelter designed to provide temporary living accommodations
-An institution that provides a temporary residence for individuals intended to be institutionalized
-A public or private place not designed for or ordinarily used as a regular sleeping accommodation for human beings.
Term
What are homeless youth and children defined as?
Definition
-sharing the housing
-motels, hotels, trailer parks, or camping grounds
-not designed for or ordinarily used as a regular sleeping
-cars, parks, public spaces, abandoned buildings, substandard housing, bus or train stations, or similar settings
-migratory children
Term
What is Homeless Information Management System (HMIS)?
Definition
The federal government mandated a Homeless Information Management system (HMIS) to obtain national data including counts and basic demographic information. 2006 the first report was finalized. Results indicated that the number of homeless people is not decreasing.
Term
What are the demographics of homelessness?
Definition
-Individuals:
69% Single men
25% Single women
5% Unaccompanied youth
-Families:
62% children
38% adults
Women account for 82% of adult members
-Racial/Ethnic Groups:
African Americans make of 55% of sheltered homeless population
Term
What factors contribute to homelessness?
Definition
-Shortage of Affordable Housing
-Insufficient income and lack of employment
-Scarcity of supportive services for low-income people
-Lack of health insurance leads to serious illness then loss of job and homelessness
Term
What are some supportive services lacking for homeless people?
Definition
Need for Health care: both physical and behavioral, i.e. serious chronic mental health and/or substance abuse problems.
People w/o physical and mental disabilities need assistance with child care, transportation, and vocational training.
Homeless do not have health insurance.
Term
What is the health status of a homeless man?
Definition
Respiratory infections, trauma, and skin disorders
Chronic disorders and poor dentition
HIV/AIDS, TB, Hepatitis C, and STDs
Alcohol and drug abuse (mostly in men)
Mental health issues
Term
What are the chronic conditions of homeless man?
Definition
HTN musculoskeletal disorders, GI problems, PVD, respiratory problems, neuro problems: seizures.
These chronic diseases are often exacerbated by alcoholism.
Term
What is the health status of a homeless woman?
Definition
Mental illness, substance use/abuse
History of violence, physical or sexual assault
“Disconnectedness” begins in childhood
Pregnancy with higher preterm births and low-birth weight infants
STDs and PID related to forced sex and survival sex
Term
What is important to note about where women reach out and their education level?
Definition
They prefer care from shelter and outreach clinics rather than from county/government clinics.
Shelter staff, health professionals, and other homeless women are critical for facilitating access to health care.
Homeless women have limited education, limited earning power, and fragmented support networks.
Term
What is the health status of homeless children?
Definition
Children born to mothers who are homeless are more likely to be preterm or low birth weight.

Immunization delays
Upper respiratory tract and ear infections, asthma, skin disorders, diarrhea, anemia, and hunger
Mental health problems and developmental delays
Problems with educational achievement
Term
What have homeless children experienced?
Definition
They have experienced violence, repeated moves, and family separation. Miss days at school, repeated grades. Problems with resources for clothes, school supplies, personal hygiene. They are at risk for nonacceptance, teasing, all worsen the effects for their physical and mental problems.
They experience depression, anxiety, and withdrawal.
Term
What is health status is homeless youth and adolescents?
Definition
Homeless adolescents experience health problems from high-risk behaviors at higher rates than the general adolescent population.

STD’s, physical and sexual abuse, skin disorders, anemia, drug and alcohol abuse, and unintentional injuries
Depression; suicidal ideation; and disorders of behavior, personality, or thought
Family disruption, school failures, prostitution or “survival sex,” and involvement with the legal system
Term
What is important to note about runaway youth?
Definition
Runaway homeless adolescents make up a large percentage of youth involved in prostitution. They need money to survive.
Runaways are more likely to have mental illness, suicidal, use alcohol and drugs, history of physical and sexual abuse.
Term
What are the unintentional injuries with homeless youth?
Definition
Unintentional injuries: (usually males age 15-24) MVC, falls, firearm accidents, drowning, fire related deaths, accidental poisoning
Term
Who has the highest rate of psychiatric disorders?
Definition
Homeless
Term
Who has the highest rate of alcohol and substance abuse among vul. pops?
Definition
extremely high among the homeless, especially men, resulting in many health problems: liver, nervous system, heart; risk for infection from drug use
Term
What are the measurements of mental illness?
Definition
unhappiness, discouragement, worry, and fatigue.
Term
What are the abnormal behaviors with homeless people?
Definition
Behaviors of survival are often labeled crazy or abnormal: rummaging in garbage cans, urinating in public
Homeless people lack money for food, access to public restrooms, resulting in abnormal behavior.
Term
What are some important notes to remember w/ homeless people?
Definition
-Men’s self-reports may underestimate problems with lack of knowledge and reluctance to seek care.
-Women prefer care from shelter and outreach clinics designed specifically to meet their needs rather than care from county/government clinics.
-U.S. policies on assistance to the poor often view children as the most “blameless” and “deserving” of support= more funding for families w/ minors.
-Adolescents from all sectors of society engage in health risk behaviors that result in serious health problems, but homeless adolescents experience these problems at higher rates than the general adolescent population.
-Homeless families experience substandard living conditions, social isolation, and a myriad of physical and health problems.
Term
Why are immigrants a vul. pop?
Definition
Develop health problems and experience poorer outcomes
Limited access, lack of insurance, poverty
High-risk behaviors: accidents, injuries
Term
What are the health care risks with immigrants?
Definition
Accidents/Injuries
No preventive screening
Respiratory conditions
Exposure to pesticides
Problems with:
Musculoskeletal discomfort, HTN, vision, hearing, & dentition; ETOH, obesity, firearm injuries and suicide
Term
What is one of the goals of healthy people 2020 that deals with immigrants?
Definition
Goal of Healthy People 2020:
Focus is on Elimination of health inequities by:
Studying the effectiveness of interventions for treating the mentally ill
Diagnosis and treatment of heart disease in women of color.
Term
What are the 4 types of abuse?
Definition
-Physical
-Emotional
-Sexual
-Neglect
Term
What is emotional abuse?
Definition
kills the spirit and the ability to succeed later in life, feel deeply, or make emotional contact with others.
Term
What is physical abuse?
Definition
includes emotional abuse in addition to the potential for long-term physical deformity, internal damage, and acute painful tissue damage, bone damage, and sometimes death.
Term
What is sexual abuse?
Definition
may never be resolved if treatment is unavailable, can cause behavioral and emotional difficulties throughout life.
Term
What should nurses be aware of when inspecting for abuse?
Definition
Nurses must be aware of judging and accusing, client will be defensive, instead: ask questions re: ways to solve disagreements or methods of disciplining children, do not use the word abuse or violence for they are judgmental and threatening.
Term
Why are women more vulnerable to abuse?
Definition
Women abused usually in self defense. They stay out of fear, finances, no support system
Older adult abuse is commonly: domestic, institutional, and self-neglect. The abuse may be physical, sexual, psychological, financial, and neglect.
Term
What is the extra abuse that elders are exposed to?
Definition
Financial exploitation
Term
What are signs of abuse in women?
Definition
-Denial and blame
-Control through isolation
-Control through intimidation
-Control Through Economic Abuse
-Control Through power
Term
What are the risk factors for abusive relationships?
Definition
Mental health problems
Substance abuse
Socioeconomic stressors
Dysfunctional relationships
Term
What is the main goal for the abused patient?
Definition
Provide protection
Term
What is another vulnerable pop?
Definition
Not just the use of illegal drugs, but the abuse of them and alcohol and other rx meds
Term
How do you assess for substance abuse?
Definition
Amt
Frequency
Type
Term
What are the effects of substances?
Definition
Alcohol: affects all organ systems: central nervous system, GI-esophagitis, gastritis, pancreatitis, hepatitis, cirrhosis of the liver, Cardiovascular- increased triglycerides, stroke, cardiomyopathy, cardiac dysrhythmia, sudden cardiac death. TB, accidents, suicide, homicide
Term
What do mentally ill people suffer with?
Definition
Issues r/t health & finance
Living arrangements
Employment
Self-care
Tx requirements
Risk of abuse & assault
Term
How are mentally ill people treated?
Definition
Individuals diagnosed with mental illness are shunned, less likely to be hired and less likely to be accepted as neighbors.
Term
Where do the mentally ill live?
Definition
homeless, incarcerated, or living in boarding homes, decreased ability to maintain self care.
Term
Do mentally ill have community services?
Definition
There is a decrease in community services leaving these people with mental illness vulnerable to victimization.
Term
What does a decrease in state funding mean?
Definition
Decreased state and federal funding, managed care, discriminate private insurance coverage, & the influenced of deinstitutionalization has resulted in:

Limited access to mental health services.
Acute care settings have downsized,
private insurance reimburses fewer mental health services.
Lack of insurance coverage for mental illness.
Term
What is mental health?
Definition
determined by how a person feels about himself or herself, how a person feels about others, and how a person meets the demands of everyday life.
Term
What is mental illness?
Definition
refers to maladaptive responses to distress and an inability to mobilize resources.
Term
What is a disability?
Definition
Any restriction or inability (resulting from an impairment) in performing an activity in a normal manner or within the normal range
Term
What is an impairment?
Definition
an anatomical, mental, or psychological loss or abnormality
Term
What is a handicap?
Definition
a disadvantage resulting from an impairment or disability that prevents fulfillment of an expected role
Term
What are some disabilities effecting vul. pops?
Definition
Physical disabilities
Sensory disabilities
Intellectual disabilities
Serious emotional disturbances
Learning disabilities
Significant chemical and environmental sensitivities
Health problems
Term
What is the Amer. With Disabilities Act of 1990?
Definition
defined disability by the limitations in carrying out a major like activity. Major life activities include the ability to breath, walk, see hear, speak, work, care for oneself, perform manual tasks, and learn.
Term
What is an example of a sensory and intellectual disability?
Definition
Sensory-Deaf, Blind
Intellectual -Mental retardation
Term
What trend is disabilities?
Definition
Proportion of the U.S. population with disabilities continues to rise with age for both sexes.
Men under age 65 and boys have higher disability rates as compared with females.
Over 65, women have a higher disability rate compared to men (corresponds to longer lifespan).
Term
Which race has the highest incidence of disabilities?
Definition
African Americans, American Indians, Alaskan natives reported the highest overall disability rates at 24.3% each.
Inability to leave the home due to disability results in unemployment.
Term
Why is disabilities in elderly people declining?
Definition
improved medical treatments for arthritis, heart disease, HTN, cataracts, decrease in cigarette smoking, decreased fat intake, increased availability and use of assistive devices decrease ADL limitations, assisted living facilities and in-home care options= safety.
Term
What are the top 20 health status and causes of disability?
Definition
Arthritis/rheumatism
Back, spine problem
Heart trouble/hardening of arteries
Lung, respiratory problem
Deafness, hearing problem
Limb/extremity stiffness
Mental, emotional problem
Diabetes
Stroke
Broken bone/fracture
Mental retardation
Cancer
High blood pressure
Head or spinal cord injury
Learning disability
Alzheimer’s disease/senility/dementia
Kidney problems
Paralysis
Missing limbs
Stomach/digestive problems
Term
What are the costs associated with disability?
Definition
Live at or near the poverty level
Less likely to be employed if disabled
Poor long-term care and personal assistance support
More likely to participate in public health programs; less likely to have private health insurance
More likely to develop secondary conditions
Term
What are common issues r/t vulnerable populations?
Definition
Employment/Finances
Safety
Housing
Language barriers
Fear
Addiction
Illegal activities
Access to care
Lack of assistance
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