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1.How does critical social theory (CST) differ from other nursing theories such as the health belief model or Orem’s self-care deficit theory?
CST focuses on oppression and facilitates group action.
CST is an approach that raises questions about oppressive situations, involves community members in the definition and solution of problems, and facilitates group interventions. The other two theories focus more on individual beliefs and choice of action.
2.In what way is environmental health (EH) more challenging than other variables related to an individual’s health?
EH requires social, economic, and political changes to improve.
Intervening to improve environmental conditions requires basic social, economic, and political changes. Aggregates must work together to create such change.
In what way is environmental health (EH) different from the usual practice based on evidence?
The Precautionary Principle suggests action even if causative factors have not been confirmed.
The Precautionary Principle says, “When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause-and-effect relationships are not fully established scientifically.”
4.What is a factor that makes environmental health (EH) challenging?
People going about daily tasks ignore their surroundings or take them for granted.
Ordinarily, society takes systems and structures (buildings, schools, transportation, workplace) for granted, ignoring or overlooking potentially harmful environmental situations.
5.Which crucial question, needed by the nurse to determine health problems, might not be written on the health history form?
Can you tell me what you do at work?
Because 25% of worldwide preventable illnesses are caused by poor environmental quality, nurses need to ask critical questions about their clients’ work and home environments to help discern the contributions of specific hazards to their health. This can be accomplished by an environmental health history.
6.Which nursing actions may be most helpful to the community’s long-term health?
Helping the community create political change through organization, use of media, legislative lobbying, and mass demonstrations
The ultimate goal is liberating people from health-damaging environmental conditions by using collective actions. Mechanisms have included strategic organization, litigation, public hearing testimony, letter-writing campaigns, legislative lobbying, and mass demonstrations.
7.What is one reason it is difficult to get others interested in environmental health?
People respond more to an acute crisis than chronic environmental problems.
People respond to acute crises with dramatic media coverage (such as hurricanes or earthquakes), but ongoing consistent pressure is needed to ensure day-to-day environmental integrity. Chronic environmental problems are rarely addressed effectively.
8.What would be an appropriate term for intoxicated drivers, secondhand smoke, urban crowding, noise, and mechanization?
--Living patterns risks
Living patterns are the relationships among people, communities, and their surrounding environments that depend on habits, interpersonal ties, cultural values, and customs. Most people live within areas that require almost daily contact with potential health risks and threats such as intoxicated or impaired drivers, secondhand smoke, urban crowding, noise exposure, unabated traffic, and the stress of increased mechanization.
What is meant by environmental racism?
a. Backlash against affirmative action programs
b. Daily insults to people of color
c. Locating industrial hazards in low-income communities
d. Political recognition that people of color don’t vote
Locating industrial hazards in low-income communities
Discriminatory land use ensures that many impoverished and marginalized groups, especially people of color, live in close proximity to industrial contamination. This is called environmental racism. Members of these communities are at risk for illness and injury.
When it becomes known that a particular industry has vastly polluted the surrounding neighborhood, what would most persons living there do?
a. Band together to shut the industry down
b. Nothing, because of family ties and cost of relocation
c. Immediately move to a different neighborhood
d. Seek legal reimbursement for the hazard exposure
Residents may be unwilling to disrupt family ties and cultural roots to start over elsewhere, or they may be unable to afford to move. Residents are revictimized by the difficulty in obtaining compensation.
11.Why is it believed that statistics showing the risks of various employment positions are inaccurate?
Individuals assume it is a personal problem, not an employment issue.
Statistics do not reflect unreported health problems. Collective problems related to employment or occupation are often perceived as individualized injuries.
12.What has happened to air quality since the United States outlawed use of chlorofluorocarbons, halons, and carbon tetrachloride?
Little change, because these chemicals remain in the atmosphere.
These chemicals, which were in widespread use, remain in the atmosphere.
13.Why are health care providers concerned over such social issues as mass transit, clean power, and the farming industry?
Because air pollutants are contributors to asthma and other health problems.
14.What seems to be the problem with action to reduce the amount of toxic elements in our housing?
Controversy exists because of the high cost in removing toxic substances.
Much controversy surrounds the economic hardship that industry, government, business, and multidwelling owners would face if they were forced to reduce concentrations of toxic elements.
15.What issue exists from communities using solid waste landfills to dispose of trash from private residences?
Methane gas may move through the soil to cause fire or explosions nearby.
Solid waste landfills accumulate methane gas, a by-product of decomposing organic wastes. Without proper venting, this volatile gas can move through soil and cause fires and explosions in nearby areas. Waste incineration is not the best solution because it causes particulate air pollution.
What is the most common cause of health problems resulting from radiation?
a. Medical tests (x-rays)
b. Nuclear power plants
c. Nuclear weapons testing or waste disposal
d. Radon gas in homes
The three primary sources and distribution of radiation exposure are radon (43%); medical exposure (20%); and other nonnatural sources such as nuclear weapons testing, nuclear waste disposal, and transportation, storage, loss, and misuse of radioactive sources (19%). Radon contamination is the second leading cause of lung cancer mortality in the United States.
17.What conclusion can be drawn concerning efforts to decrease environmental pollution?
Federal policies have been weakened, and enforcement lacks funding.
Legislation in the 1970s was aimed toward a comprehensive national environmental policy. The momentum slowed in the 1980s, with policies being reversed and regulation losing its funding. This trend has continued. The EPA sets rules but lacks resources to accomplish the goals.
A local factory was told to clean up or face a large fine every day until it did. The local factory closed, although it had been extremely profitable. What action may probably follow?
The company will move to a country where it can continue to pollute.
As corporations become global entities, many escape U.S. standards by moving operations to unregulated areas of the world.
19.A nurse explained the causes of asthma in a child, how to observe for “triggers” that lead to an attack, and how to use the inhaler. What does this nurse-patient interaction ignore?
By focusing only on the child, the nurse has absolved local government and industry from taking any action to improve air quality.
20.The local stream was full of trash. The Boy Scouts had a cleanup day so they could again canoe on the stream. What should local nurses do?
Hold dialogue with community members about the problem and its effects
21.How could a small community group hope to accomplish goals against a large powerful corporation?
Form coalitions with other groups that have similar goals
22.How does participatory action research (PAR) differ from other research methods in seeking knowledge?
PAR also seeks to raise consciousness.
23.How might a nurse remember what should be included in a health history?
Memorize the I PREPARE mnemonic
The I PREPARE environmental exposure history mnemonic is a quick reference for primary care providers. This tool will help the nurse remember what to ask to determine environmental factors relevant to health.
What are some problems with U.S. water quality today?
Many aquifers are contaminated with pesticides and fertilizers.
More than 42 million Americans drink untreated water.
Sediment from construction, agriculture, and deforestation is often present.
Underground water, if contaminated, can’t be cleansed.
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