Arab Board Community Health Nursing Part 1 cheat sheet

Community health nursing focuses on the health of populations, with the community itself as the unit of care, not just individuals.

Primary prevention acts before disease occurs (immunization, sanitation); secondary prevention is early detection (screening); tertiary prevention limits disability (rehabilitation).

Levels of prevention map to the natural history of disease: prepathogenesis (primary) and pathogenesis (secondary and tertiary).

The nursing process in the community is population-based: assessment, diagnosis, planning, implementation, and evaluation applied to aggregates.

Case finding and outreach deliberately seek clients outside health facilities; this distinguishes community nursing from hospital-based practice.

Home visiting has defined phases: initiation, pre-visit planning, actual visit, and post-visit documentation and evaluation.

Cultural competence requires awareness of one's own biases, knowledge of the client's culture, and adaptation of care to the client's values.

Community assessment uses a systematic framework such as the community-as-partner model, examining people, environment, and health/social services.

Incidence rate = new cases in a period / population at risk during that period; it measures risk of developing disease.

Prevalence = all existing cases at a point or over a period / total population; prevalence ≈ incidence × average duration of disease.

Attack rate = new cases / population at risk during an outbreak, usually expressed as a percentage.

Relative risk (cohort studies) = incidence in exposed / incidence in unexposed; RR = 1 indicates no association.

Odds ratio (case-control studies) approximates relative risk; OR = (a×d)/(b×c) in a 2×2 table.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives).

Positive predictive value depends on disease prevalence as well as test sensitivity and specificity.

Crude mortality rate = deaths in a year / midyear population × 1000; infant mortality rate = deaths under age 1 / live births × 1000.

Herd immunity threshold ≈ 1 − 1/R0; higher R0 requires higher vaccination coverage to interrupt transmission.

The Ottawa Charter (1986) identifies five actions: healthy public policy, supportive environments, community action, personal skills, and reorientation of health services.

The health belief model predicts behavior from perceived susceptibility, severity, benefits, barriers, and cues to action.

The transtheoretical (stages of change) model: precontemplation, contemplation, preparation, action, maintenance (and relapse).

Social cognitive theory emphasizes self-efficacy, observational learning, and reciprocal determinism between person, behavior, and environment.

The precede-proceed model begins with social and epidemiological diagnosis before educational and ecological diagnosis.

Health literacy includes the ability to obtain, process, and understand basic health information to make appropriate decisions.

Teach-back is a method to confirm comprehension by asking the learner to explain the information in their own words.

Primary prevention targets risk factors before disease; examples include immunization, seatbelt laws, and tobacco taxation.

WHO recommends at least eight antenatal contacts for a positive pregnancy experience; the first contact should occur before 12 weeks.

Danger signs in pregnancy include vaginal bleeding, severe headache with visual disturbance, severe abdominal pain, and reduced fetal movement.

Preeclampsia is defined as new hypertension after 20 weeks with proteinuria or other end-organ dysfunction; magnesium sulfate prevents and treats eclamptic seizures.

Postpartum hemorrhage is the leading direct cause of maternal death worldwide; uterine atony is the most common cause.

Active management of the third stage includes a uterotonic, controlled cord traction, and uterine massage.

Exclusive breastfeeding is recommended for the first six months, with complementary feeding starting at six months and continued breastfeeding to two years.

Kangaroo mother care (skin-to-skin contact plus breastfeeding support) reduces mortality in low-birth-weight infants.

The Apgar score assesses heart rate, respiratory effort, muscle tone, reflex irritability, and color at 1 and 5 minutes; it does not predict long-term outcome.

The integrated management of childhood illness (IMCI) approach classifies sick children by danger signs, main symptoms, and nutritional status to guide treatment.

General danger signs in a child include inability to drink or breastfeed, persistent vomiting, convulsions, lethargy, and chest indrawing.

Growth monitoring uses weight-for-age, height-for-age, and weight-for-height; weight-for-height reflects acute malnutrition.

Mid-upper-arm circumference below 115 mm indicates severe acute malnutrition in children aged 6–59 months.

Oral rehydration solution (ORS) plus zinc is first-line treatment for acute watery diarrhea in children.

Adolescent health risks cluster around injuries, mental health, substance use, sexual and reproductive health, and nutrition.

The WHO growth standards are the reference for children under five; they describe how children should grow under optimal conditions.

Developmental milestones allow early detection of delay: social smile by 2 months, sitting without support by 8 months, walking by 18 months.

Hypertension is diagnosed at sustained systolic ≥140 mmHg or diastolic ≥90 mmHg on repeated measurement (targets may be lower in some guidelines).

Screening for type 2 diabetes is recommended for adults with risk factors such as obesity, family history, or hypertension.

Polypharmacy, defined as use of multiple medications, increases risk of adverse drug events and falls in older adults.

Falls are the leading cause of injury in older adults; multifactorial risk assessment includes gait, vision, medications, and home hazards.

The geriatric syndromes include falls, incontinence, delirium, pressure ulcers, and functional decline.

Activities of daily living (bathing, dressing, toileting) and instrumental activities (shopping, finances) measure functional status.

Palliative care focuses on relief of suffering and quality of life for serious illness; it is not limited to end-of-life care.

Delirium is acute and fluctuating with altered attention; dementia is chronic and progressive; depression can mimic both.

The chain of infection has six links: infectious agent, reservoir, portal of exit, mode of transmission, portal of entry, and susceptible host.

Control measures interrupt the chain: isolation, disinfection, vector control, immunization, and hand hygiene.

Contact, droplet, and airborne precautions correspond to different modes of transmission and required personal protective equipment.

Tuberculosis is transmitted by airborne droplet nuclei; directly observed therapy (DOT) improves adherence and reduces resistance.

Herd immunity protects unvaccinated individuals when a sufficient proportion of the population is immune.

Non-communicable disease control targets shared modifiable risk factors: tobacco, unhealthy diet, physical inactivity, and harmful alcohol use.

The WHO 4×4 approach addresses four major NCDs (cardiovascular disease, cancer, diabetes, chronic respiratory disease) and four shared risk factors.

Screening programs for NCDs require adequate sensitivity, specificity, and follow-up to be effective.

Psychological first aid principles: look, listen, and link; it provides safety, stabilization, and connection to services.

The IASC intervention pyramid has four layers: basic services and security, community and family supports, focused supports, and specialized services.

Community mental health care emphasizes deinstitutionalization, continuity of care, and integration into primary care.

Stigma reduction requires contact-based education and accurate information; it improves help-seeking behavior.

Suicide risk assessment includes ideation, plan, intent, means, and protective factors; ask directly about suicidal thoughts.

Depression screening tools (e.g., PHQ-9) support but do not replace clinical assessment.

Mental health disorders account for a large share of global disability; most people in low-resource settings receive no treatment.

Psychosocial support in emergencies addresses basic needs and safety before specialized psychological treatment.

The hierarchy of occupational hazard controls, from most to least effective: elimination, substitution, engineering controls, administrative controls, and personal protective equipment.

Waterborne diseases are prevented by safe water supply, sanitation, and hygiene (WASH); boiling or chlorination inactivates pathogens.

Air pollution (particulate matter, indoor smoke) is a major risk factor for respiratory and cardiovascular disease.

Vector control includes source reduction (eliminating standing water), larviciding, and insecticide-treated nets.

Occupational exposure limits set maximum permissible concentrations of workplace hazards; monitoring verifies compliance.

Noise-induced hearing loss is preventable with engineering controls, hearing protection, and audiometric screening.

Food safety relies on safe water, hygienic handling, proper cooking temperatures, and separation of raw and cooked food.

Solid waste management hierarchy: reduce, reuse, recycle, recover energy, and dispose safely.

The Alma-Ata Declaration (1978) defined primary health care as essential care based on practical, scientifically sound, and socially acceptable methods.

Primary health care principles: equity, community participation, intersectoral collaboration, appropriate technology, and accessibility.

The WHO health system building blocks are service delivery, health workforce, information, medical products, financing, and leadership/governance.

Universal health coverage means all people receive needed health services without financial hardship.

Community health workers extend access to underserved populations and require training, supervision, and support.

Leadership styles in nursing include transformational, transactional, and situational; transformational leadership is associated with better team outcomes.

Delegation requires matching the task to the delegate's competence, clear instructions, and accountability retained by the delegator.

Quality improvement uses the plan-do-study-act (PDSA) cycle to test changes and measure results.

The four ethical principles are autonomy, beneficence, nonmaleficence, and justice.

Informed consent requires disclosure, comprehension, voluntariness, and competence.

Confidentiality may be breached only when required by law or to prevent serious harm (e.g., reportable diseases, imminent danger).

Research ethics principles: respect for persons, beneficence, and justice; institutional review board approval is required before human subjects research.

Quantitative designs include experimental, quasi-experimental, and observational; randomized controlled trials provide the strongest evidence for causality.

Validity refers to whether a tool measures what it intends; reliability refers to consistency of measurement.

Levels of evidence rank systematic reviews and randomized trials above cohort, case-control, and expert opinion.

Evidence-based practice integrates best evidence, clinical expertise, and patient values and preferences.

Health education is a planned process to influence knowledge, attitudes, and behavior; it should be based on a needs assessment.

Learning objectives should be specific, measurable, achievable, relevant, and time-bound (SMART).

Adult learning (andragogy) emphasizes relevance, experience, self-direction, and problem-centered learning.

The communication process includes sender, message, channel, receiver, and feedback; barriers include noise, language, and literacy.

Health promotion differs from health education: health promotion includes environmental, policy, and social interventions.

Behavior change is more likely when the environment supports the behavior, not just when the individual is informed.

Mass media and community mobilization extend reach; interpersonal channels improve trust and adoption.

Evaluation of health education includes process, impact, and outcome measures.

Health system financing includes revenue collection, pooling of funds, and purchasing of services.

Out-of-pocket payments are the least equitable financing mechanism and increase risk of catastrophic health expenditure.

Health information systems support surveillance, monitoring, and evaluation; data quality requires completeness, timeliness, and accuracy.

Referral systems link community, primary, and tertiary levels; clear criteria reduce unnecessary use of higher levels.

Essential medicines lists guide procurement and availability of affordable drugs at primary care level.

Human resources for health planning considers distribution, skill mix, and retention, especially in rural areas.

Intersectoral action (education, agriculture, housing) is required for many health determinants beyond the health sector.

Community participation in planning and monitoring improves responsiveness and sustainability of services.

Family planning methods include barrier, hormonal, intrauterine, and permanent methods; effectiveness is measured by typical-use failure rates.

Emergency contraception is most effective the sooner it is used after unprotected intercourse.

Skilled birth attendance at delivery reduces maternal and newborn mortality.

Newborn care essentials: warmth, early initiation of breastfeeding, hygienic cord care, and identification of danger signs.

Postpartum visits should occur within 24 hours, at day 3, and at weeks 1–2 and 6 to detect complications.

Adolescent-friendly reproductive health services are confidential, non-judgmental, and accessible.

Screening for cervical cancer (e.g., HPV testing or cytology) and breast awareness supports early detection.

Preconception care addresses nutrition (folic acid), immunization, and chronic disease control before pregnancy.

The expanded program on immunization schedules vaccines by age; completion requires tracking and catch-up for missed doses.

Vitamin A supplementation and deworming are periodic child health interventions in many programs.

Exclusive breastfeeding and timely complementary feeding prevent stunting and micronutrient deficiency.

Adolescent health services address mental health, substance use, injuries, and sexual and reproductive health.

School health programs include screening, health education, and referral.

Child protection and recognition of maltreatment are responsibilities of community nurses.

Oral rehydration and zinc reduce diarrhea mortality; antibiotics are reserved for specific indications.

Growth monitoring and promotion detect faltering growth early, enabling timely intervention.

Chronic disease self-management education improves outcomes for diabetes, hypertension, and heart failure.

Home safety assessment for older adults addresses lighting, handrails, rugs, and bathroom modifications.

Medication review reduces polypharmacy and adverse drug events in older adults.

Depression and cognitive impairment are common and underdetected in older adults; use validated screening tools.

Palliative and end-of-life care address pain, symptom control, and family support.

Caregiver support and respite reduce burden and improve continuity of care.

Physical activity and fall prevention programs maintain function and independence.

Advance care planning documents patient preferences for future care.

Surveillance is systematic ongoing collection, analysis, and dissemination of health data for action.

Passive surveillance relies on routine reporting; active surveillance seeks cases directly.

Outbreak investigation steps: verify diagnosis, define cases, find cases, analyze, control, and communicate.

Notifiable disease reporting enables early detection and response.

Vaccine cold chain maintains potency from manufacture to administration.

Antimicrobial stewardship reduces resistance through appropriate prescribing and completion of therapy.

Contact tracing interrupts transmission for infectious diseases.

Screening programs require quality assurance, follow-up, and evaluation of outcomes.

Mental health integration into primary care improves access and reduces stigma.

Recovery-oriented practice emphasizes hope, empowerment, and community inclusion.

Trauma-informed care recognizes the impact of trauma and avoids re-traumatization.

Suicide prevention includes means restriction, gatekeeper training, and follow-up after attempts.

Psychoeducation for families improves adherence and outcomes.

Community support groups reduce isolation and provide practical help.

Substance use services include screening, brief intervention, and referral to treatment.

Mental health legislation protects rights and regulates involuntary care.

Safe water, sanitation, and hygiene prevent diarrheal and other waterborne diseases.

Indoor air pollution from solid fuel cooking increases respiratory disease risk.

Vector control reduces malaria, dengue, and other vector-borne diseases.

Food hygiene prevents foodborne illness through safe handling and cooking.

Waste management protects communities from environmental contamination.

Occupational health services include hazard assessment, monitoring, and worker education.

Climate and environmental change affect health through heat, floods, and air quality.

Community environmental assessment identifies local hazards and exposures.

Primary health care provides first-contact, continuous, comprehensive, and coordinated care.

Community participation and intersectoral collaboration are core principles.

Equity means reducing avoidable differences in health status.

Appropriate technology is scientifically sound, affordable, and acceptable to the community.

Referral and counter-referral support continuity of care.

Team-based care includes nurses, physicians, community health workers, and others.

Quality improvement uses measurement and feedback to improve services.

Universal health coverage aims for access without financial hardship.

Transformational leadership inspires shared vision and development of staff.

Delegation requires competence matching and retained accountability.

Conflict resolution uses negotiation and clear communication.

Advocacy protects patient rights and access to care.

Professional regulation includes licensure, standards, and continuing education.

Interprofessional collaboration improves patient outcomes.

Change management uses planned steps and stakeholder engagement.

Mentoring and preceptorship support workforce development.

Research process: question, design, sampling, data collection, analysis, and dissemination.

Sampling methods include probability (random) and non-probability (convenience, purposive).

Validity and reliability determine measurement quality.

Ethical review protects human subjects.

Levels of evidence rank systematic reviews and randomized trials highest.

Evidence-based practice integrates evidence, expertise, and patient values.

Data analysis uses descriptive and inferential statistics.

Dissemination translates findings into practice.

Needs assessment identifies learning needs before teaching.

SMART objectives guide planning and evaluation.

Adult learning emphasizes relevance and experience.

Teach-back confirms comprehension.

Health literacy affects understanding and action.

Behavior change theories guide intervention design.

Evaluation includes process, impact, and outcome measures.

Supportive environments enable healthy choices.

Incidence measures new cases; prevalence measures existing cases.

Relative risk and odds ratio quantify association.

Sensitivity and specificity describe test performance.

Predictive values depend on prevalence.

Outbreak investigation identifies source and controls spread.

Surveillance supports early detection and response.

Herd immunity protects populations through vaccination.

Screening programs require follow-up and quality assurance.