You are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived alone in a small apartment. The patient reported on admission that she has no surviving family. Her support system appears to be other elders who live in her neighborhood. Because of transportation difficulties, most of them are unable to visit frequently. One of her neighbors has reported that she is caring for the patient’s dog, a Yorkshire terrier. As you care for this woman, she begs you to let her friend bring her dog to the hospital. She says that none of the other nurses have listened to her about such a visit. As she asks you about this, she begins to cry and tells you that they have never been separated. You recall that the staff discussed their concern about this woman’s well-being during report that morning. They said that she has been eating very little and seems to be depressed.

1. Based on Nightingale’s work, identify specific interventions that you would provide in caring for this patient.

2. Describe what action, if any, you would take regarding the patient’s request to see her dog. Discuss the theoretical basis of your decision and action based on your understanding of Nightingale’s work.

3. Describe and discuss what nursing diagnoses you would make and what interventions you would initiate to address the patient’s nutritional status and emotional well-being.

4. As the patient’s primary nurse, identify and discuss the planning you would undertake regarding her discharge from the hospital. Identify members of the discharge team and their roles in this process. Describe how you would advocate for the patient based on Nightingale’s observations and descriptions of the role of the nurse.

Reply 1

Social determinants of health play a huge role in the health of people because they work in combination to either help us prevent disease or contribute to unhealthy conditions that may cause disease. According to HealthyPeople (2020), “Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks,” (para. 4). Examples of social determinants of health include neighborhoods, homes, schools, etc. The conditions of the places where we spend our lives can contribute to the development of disease if they are unsafe or unclean (e.g., a home not having clean water).

The communicable disease chain model is designed to show people the process of disease transmission. The chain of infection is described with six steps or “links” including a pathogen or causitive agent, a resorvior, a portal of exit from the resorvior, a mode of transmission, a portal of entry to a susceptible host, and a susceptible host. Breaking any of these links in the chain of infection can prevent the occurance of a new infection (Chain of infection, n.d.). An example of a way that a nurse can break the link of infection would handwashing. This is the first thing we learn in school and continues to be the simnplest and most important way that we can stop the transmission of pathogens.

Healthy People. (2020). Social determinants of health. Retreived from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health?topicid=39

Chain of infection. (n.d.) Retreived from https://lc.gcumedia.com/nsg403c/chain-of-infection/chain-of-infection-v1.1.html

Reply 2

Re: Topic 2 DQ 1

According to the article, Social Determinants of Health, “social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks” (Healthypeople, 2020). For example, socioeconomic conditions such as concentrated poverty and exposure to crime such as violence and social disorder can be detrimental to a person’s health leading to morbidity and mortality. A family living in poverty is tight on money and is limited to access to healthcare, limited to access to fresh produce, and may not enroll their kids in afterschool programs such as club sports, etc, due to being tight on money. The community they live in is a poverty city where there are crimes and violence. With high rates of poverty, there is a correlation to higher rates of morbidity such as diabetes and obesity. According to the reading, Community & Public Health: The Future of Health Care, illness such as heart diseases, chronic lower respiratory diseases, pneumonia, and diabetes “are among those that are modifiable or preventable, increasing the burden of the disease. The burden of the disease reflects the morbidity, mortality, financial costs, and health disparities resulting from disease, affecting human longevity and the well-being of countries’ social and economic bottom lines” (Grand Canyon University, 2018). These diseases are correlated to low income communities where the risk factors such as “unhealthy diet, physical inactivity, excess weight and obesity, diabetes, high blood pressure, high cholesterol, and cigarette smoking” (Grand Canyon University) are much higher. Nurses are involved in all levels of prevention, “the public benefits from guidance and education from nurses at each level (primary, secondary, and tertiary) preventions” (Grand Canyon University, 2018). For example a community with high rates of diabetes. At the primary level, a nurse can screen for early detection of diabetes and educate to promote health and prevent further complications. At the secondary level, a nurse can educate the community how to manage their diabetes by checking their blood sugars, educating how diet and exercise affects their blood sugar. At the tertiary level, the nurse can continue to educates and help avoid chronic disabilities and complications related to diabetes.

Grand Canyon University (Ed). (2018). Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

Social Determinants of Health. 2020 Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health?topicid=39

A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

A 65-year-old obese African American male patient presents to his HCP with crampy left lower quadrant pain, constipation, and fevers to 101˚ F. He has had multiple episodes like this one over the past 15 years and they always responded to bowel rest and oral antibiotics. He has refused to have the recommended colonoscopy even with his history of chronic inflammatory bowel disease (diverticulitis), sedentary lifestyle, and diet lacking in fiber. His paternal grandfather died of colon cancer back in the 1950s as well. He finally underwent colonoscopy after his acute diverticulitis resolved. Colonoscopy revealed multiple polyps that were retrieved, and the pathology was positive for adenocarcinoma of the colon.

Develop a 1- to 2-page case study analysis in which you:

• Explain why you think the patient presented the symptoms described.
• Identify the genes that may be associated with the development of the disease.
• Explain the process of immunosuppression and the effect it has on body systems.

An important component of this course is the research paper.   Write an 8-12 page paper that will include at least 4-6 evidence/research-based references (no Wikipedia!), an abstract, a graph or chart (data) if applicable to your topic (should not take up more than ¼ of a page).

Your research paper may include (if applicable to your topic) the following information:

• Historical Perspective/Background information on your topic
• Population affected
• Environmental issues
• Epidemiological Research
  • Data Use
  • Morbidity & Mortality Patterns
• Public Health issues & interventions
• Medical Response
  • Prehospital (if applicable)
  • Hospital
  • Other
• Government response
  • Local vs. State vs. Federal
• Economic Factors/Issues
• Media Coverage/Communication Issues
• Logistical Issues
  • What worked – what didn’t – why
• Aftermath
• Lessons Learned

The research paper should include an introduction of the topic, a body in which the topic is developed and references cited, and a well-defined conclusion.

PLEASE SEE AND USE ATTACHMENT