Health care considerations for the homeless
无家可归者的健康医疗考虑
1. Identification of those who are homeless should be done through avenues such as outreach programs.
无家可归者的识别应通过各种方式进行，如通过服务延伸活动。
2. The initial health care visit and every visit thereafter need to be done with a nonjudgmental, nonthreatening approach.
最初的健康医疗访问及此后的每次访问均须通过不带主观意见的非胁迫性方式进行。
3. The nurse should focus on reported symptoms first - this will encourage adherence and follow-up.
护士应首先关注患者报告的症状，这会鼓励患者坚持并随访。
4. Subsequent care should include health maintenance, attention to social problems and/or mental health problems, and establishing an emergency contact person if available.
后续医疗应包括健康维护、关注社会问题或心理健康问题，可以的话，要确立紧急联系人。
5. Homeless individuals often experience poor nutrition, sleep deprivation, violence, physical trauma, emotional trauma, and long-term exposure to toxic agents.
无家可归者经常出现营养不良、睡眠缺乏、暴力、身体创伤、情绪创伤和长期的有毒物质暴露。
6. Homeless individuals may not adhere to medical treatment recommendations and therefore require close follow-up.
无家可归者可能不会坚守医疗建议，因此需要密切随访。
7. This population tends to lack health insurance, have longer hospital stays, and have poorer health outcomes.
这一群体往往缺少健康保险，医院停留时间较长，健康结果较差。
8. Certain medications should be avoided in the homeless population due to the potential for serious interactions with alcohol and recreational drugs; the potential for abuse; risk for dehydration; and contraindications in chronic conditions (Refer to the Box for some of these medications).
鉴于可能与含有酒精饮料和娱乐药物发生严重的相互作用，及可能存在滥用、脱水风险及慢性疾病禁忌，无家可归者应避免使用某些药物（见下表）。
Some Medications That Should be Avoided in the Homeless Population 无家可归者应避免的药物
Albuterol 沙丁胺醇
Benzodiazepines 苯二氮卓类
Beta blockers β-阻滞剂
Bupropion 安非他酮
Calcium channel blockers 钙通道阻滞药
Clonidine 可乐定
Nonsteroidal antiinflammatory drugs 非甾体类抗炎药
Quetiapine 喹硫平
Some diabetic medications, particularly sulfonylureas
某些糖尿病药，特别是磺脲类药
Statins 他汀类药
★Vocabulary for Today ★
homeless – a. 无家可归的
identification – n. 识别，确定，认出
outreach program – n. 延伸服务，外展服务
nonjudgmental – a. 不按个人道德标准进行评定的，客观的
adherence – n. 坚持，固执，信奉
subsequent – a. 继…之后的，后来的
deprivation – n. 剥夺，缺乏
adhere to – 依附于，坚持
recreational drugs – 娱乐药物
Albuterol 沙丁胺醇
Benzodiazepines 苯二氮卓类
Beta blockers β-阻滞剂
Bupropion 安非他酮
Calcium channel blockers 钙通道阻滞药
Clonidine 可乐定
Nonsteroidal antiinflammatory drugs 非甾体类抗炎药
Quetiapine 喹硫平
sulfonylureas 磺脲类药
Statins 他汀类药
★Video ★
Social Determinants of Health
★NCLEX-RN Experience★
考试从来不易，前行者的经验可以使后来者少走不少弯路！
参加考试的人大都有过这们的经历，买一大堆复习材料，然后……
其实没有然后，因为…考试还是没通过……
Lost in NCLEX resources
By hapham3693, BSN
Hello,
I have been out of school for 3 months. I took the NCLEX in August and failed it the first time. Now, I'm in preparation to take it the second time. I used Uworld and watched some Youtube videos for the first time, but I think I was lack of strategies and method. I still don’t know why I failed, just need to study more. Anyways, I am using NCSBN, repurchasing ATI, and I heard good things about Saunders, so I purchased it too. Now, I feel overwhelmed from the resources! Am I on the right track? I have heard people advised to use only one resources and stick with it, but I really cannot help but looking around and feeling not prepared enough.
By rnhopeful82, ASN, RN
How much of Uworld did you use prior to the test? I was slammed for time and only completed about 600 questions (plus the 2 assessments) but I loved the rationales they gave. I passed in 75 questions but I feel that my strategies were pretty sound. We had ATI in school and I absolutely hated everything about it. The rationales were weak and those in my class that need to get the green light still are having issues with correct answers not being what we were taught or what's in the book.
Did you score passing or almost passing in categories or was it all below? Depending on how many, you may want to hone in on those categories more. If it's all areas and testing or general content is weak, I'd possibly pick 1 content review resource.
Good luck!
By neena_, BSN, RN
I feel that using too many sources at once can overwhelm you.
I personally used UWorld and Youtube videos to study for my NCLEX. I would say I used my Saunders comprehensive review book, but because it had so much information, I skimmed through it for the important NCLEX stuff.
Think back to how you were preparing yourself for your previous exam: Do you think you truly utilized your resources to the best of your ability? Did you get enough sleep? When you studied, did it feel productive? You must question yourself and find the solution from there as well.
If you study effectively, you don't need to utilize so many sources at once and you'll be prepared! Good luck to you!
★Test ★
1. The nurse is caring for a female client in the emergency department who presents with a complaint of fatigue and shortness of breath. Which physical assessment findings, if noted by the nurse, warrant a need for follow-up?
A. Reddened sclera of the eyes
B. Dry flaking noted on the scalp
C. A reddish-purple mark on the neck
D. A scaly rash noted on the elbows and knees
2. The nurse working in a community outreach program for foster children plans care knowing that which health conditions are common in this population? Select all that apply.
A. Asthma
B. Claustrophobia
C. Sleep problems
D. Bipolar disorder
E. Aggressive behavior
F. Attention-deficit hyperactivity disorder (ADHD)
答案 Answers
1. C
Rationale: The client in this question should be screened for abuse. Battered women experience bruises, particularly around the eyes, red or purple marks on the neck, sprained or broken wrists, chronic fatigue, shortness of breath, muscle tension, involuntary shaking, changes in eating and sleeping, sexual dysfunction, and fertility issues. Mental health issues can also arise, including post-traumatic stress disorder, nightmares, uncontrollable thoughts, depression, anxiety; low self-esteem, and alcohol and drug abuse. Reddened sclera, a dry rash on the elbows, and flaking of the scalp do not pose an indication of abuse. 2. C, D, E, F
Rationale: Foster children are at risk for a variety of health conditions later in life, including ADHD, aggressive behavior, anxiety disorder, bipolar disorder, depression, mood disorder, post-traumatic stress disorder, reactive detachment disorder, sleep problems, prenatal drug and alcohol exposure, and personality disorder. Claustrophobia and asthma are not specifically associated with foster children.
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