Levels of Prevention: Primary vs Secondary vs Tertiary — The Public Health Framework
The NCLEX hands you a nursing action — teaching a diabetic about foot care, giving an MMR vaccine, scheduling a mammogram — and asks which level of prevention it represents. Mixing up screening with prevention or rehab with screening costs you the question every time. The distinction hinges on one variable: where is the patient relative to disease onset?
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Quick reference
Comparison
- Prevent disease BEFORE it occurs
- Detect disease EARLY while asymptomatic
- Limit disability from EXISTING disease
- Healthy people, no disease present
- At-risk or asymptomatic disease
- Diagnosed, active or chronic disease
- Pre-pathogenesis — disease not yet present
- Early — present but no symptoms
- Late — diagnosed, symptoms present
- Immunizations
- seatbelt & smoking teaching
- Mammography, colonoscopy, PPD, glucose screen
- Cardiac rehab, diabetes self-mgmt, stroke rehab
- Cues: prevent, immunize, educate healthy
- Cues: screen, detect, early identification
- Cues: rehab, manage complications, support group
- Teaching a healthy client = primary (not secondary)
- Screening finds disease — it does not prevent it
- ★Diabetic foot-care teaching is tertiary, not primary
Primary
- Prevent disease BEFORE it occurs
Secondary
- Detect disease EARLY while asymptomatic
Primary
- Healthy people, no disease present
Secondary
- At-risk or asymptomatic disease
Primary
- Pre-pathogenesis — disease not yet present
Secondary
- Early — present but no symptoms
Primary
- Immunizations
- seatbelt & smoking teaching
Secondary
- Mammography, colonoscopy, PPD, glucose screen
Primary
- Cues: prevent, immunize, educate healthy
Secondary
- Cues: screen, detect, early identification
Primary
- Teaching a healthy client = primary (not secondary)
Secondary
- Screening finds disease — it does not prevent it
★ marks the fact that sets a column apart.
Clinical Pearl
No disease yet = primary. Disease hiding = secondary (screen). Disease diagnosed = tertiary (rehab).
Component Topics
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