Hypothetical Family Health Promotion Assessment
It is important to be familiar with frameworks that are commonly recognized and used to guide nursing practice. In Nursing 436, the Friedman Family Assessment Model

(FFAM) has been selected as one example of a guide for assessing the status of a family’s health. This assignment gives you the opportunity to show how the FFAM can be used as a guide to assess the health of the Morrison family in the novel, Crow Lake.

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Assignment Guidelines
• Friedman, Bowden & Jones (2003) outline six (6) assessment categories, and data to be collected within each, in Appendix A (long version) and Appendix B (short version). After reading about the Morrison family in the novel Crow Lake , select the two (2) assessment categories you perceive as most relevant for promoting their health. Provide the rationale for your selection. Hypothetical Family Health Promotion Assessment 

• Using the short version of the FFAM as an organizational guide, identify the data from the novel that a nurse could use to complete the two selected assessment categories.
• Once the assessment data are presented, identify at least two and at most three priority family health promotion nursing diagnoses for the Morrison family that rise out of the assessment process. Provide the rationale for their selection as priorities .

Marking Criteria
• Assignment Guidelines are followed
• Critical analysis and synthesis of the content is evident
• Writing is succinct and clear
• APA (6th ed.) scholarly format is followed
• Assessment and identification of family health promotion nursing diagnosis is completed in 10 double spaced typed pages (excluding title and reference pages typed pages) Hypothetical Family Health Promotion Assessment 

Assignment 1: Product Development

Due Week 3 and worth 160 points

Health services continue to affect the gross domestic product, and this dramatic transformation has great demands on each dollar spent to deliver patient-centered products. Health care marketing must be repeatedly applied and practiced strategically to include environmental dimensions, such as technology, socioeconomics, competition, and regulatory. Assignment 1: Product Development

That being said, in today s global economy, investors and potential entrepreneurs must tap into the so-called unexplored market. In this aspect, health care establishments must utilize marketing, advertising, as well as sales strategies when pursuing new customers (e.g., suppose a health care investor wanted to build a small hospital in a rural community); this would entail exploration and logistical experimentation to determine who will patronize the facility. In an impoverished neighborhood, the feasibility of having lucrative profits may see diminishing returns, and so the venture may be not worth the effort. Also, suppose that the potential investor wants to sell mosquito deterrents (e.g., bedside netting in malaria-infested regions of Asia or Africa); then it would be wise to investigate the number of beds that are actually in the village, and who would be willing to purchase them. These activities take into account the investor portfolio, as well as the feasibility of marketing and selling the product. Such exploration also examines competitors, cultural differences, and most important identification of the customer.

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Identify a local health care establishment (e.g., hospital, rehabilitation center, emergency medical center) and determine its product development practices. Utilize concepts from previous weeks to substantiate information, as needed. You may develop the discussion based on the ideas presented here, but feel free to inject any salient marketing strategy that you believe might support your presentation.

Write a three to four (3-4) page paper in which you:

1. Justify the purpose of the selected health care establishments product(s) / service (s) and their associated life cycle(s).
2. Suggest one (1) strategy to improve the marketing mix of the selected health care establishment. Support your strategy by highlighting one (1) benefit of (1) portfolio analysis and providing two (2) examples that display differential advantages.
3. Assess the importance of technology in providing patients with clear and accessible information about health care organizations and the product(s) / service(s) that they provide.
4. Outline a survey to capture patients expectations regarding the delivery and / or accessibility of product(s) / service(s) identified.
5. Use at least three (3) quality academic resources. Note: Wikipedia and other Websites do not qualify as academic resources. Assignment 1: Product Development

Your assignment must follow these formatting requirements:

• Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student s name, the professor s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

• Analyze how products evolve through the four stages of the product life cycle.
• Determine the appropriate product succession planning efforts of health care services.
• Examine the marketing research process and market segmentation strategies in the health care industry.
• Evaluate marketing research tools involved in the marketing process.
• Use technology and information resources to research issues in health services strategic marketing.
• Write clearly and concisely about health services strategic marketing using proper writing mechanics. Assignment 1: Product Development

1. Costovertebral angle tenderness should be assessed whenever you suspect the patient may have: – Polynephritis
2. In older adults, overflow fecal incontinence is commonly due to: -Fecal impaction
3. A 1 month old boy has been vomiting for 2 weeks. How is this symptom of GERD and pyloric stenosis further differentiated in this child’s assessment? – The infant has regurgitation with pyloric stenosis
6. Auscultation of borborygmi is associated with: – Gastroenteritis, early intestinal obstruction, or hunger
7. When auscultating the abdomen, which finding would indicate collateral circulation between the portal and systemic venous systems? – Venous hum. nurs 6512 final exam. NURS 6512 FINAL EXAM
8. Conversion of fat-soluble wastes to water-soluble material for renal excretion is a function of the: – Liver
9. The major function of the large intestine is: -Water absorption
10. Which structure is located in the hypogastric region of the abdomen? –Ileum, bladder, and pregnant uterus
11. A 45 year old man relates a several week history of severe intermittent abdominal burning sensations. He relates that the pain is relieved with small amounts of food. Before starting the physical examination, you review his laboratory work, anticipating a (n): -Positive Helicobacter pylori result
12. You are caring for a patient with trigeminal neuralgia. During the assessment, the patient would describe the pain as: – Burning or shocklike
13. Your 85 year old patient is complaining of right knee pain. She has a history of osteoarthritis for which she is given anti-inflammatory medication. To assess her right knee pain, you should ask her if: – The pain gets better when she sits
14. A 5 year old is complaining of nondescriptive “belly pain.” Your next action should be to ask him to: – Point to the area of pain nurs 6512 final exam
15. The perception of pain: – Is variable and is affected by emotions, and cultural background
16. Patients presenting with ascites, jaundice, cutaneous spider veins, and nonpalpable liver exhibit signs of: – Cirrhosis
17. A patient presents to the emergency department after a motor vehicle accident. The patient sustained blunt trauma to the abdomen and complains of pain in the upper left quadrant that radiates to the left shoulder. What organ is most likely injured? – Spleen
18. Imaging studies reveal that a patient has dilation of the renal pelvis from an obstruction in the ureter, what condition will be documented in this patient’s health record? – Hydronephrosis
19. Visible intestinal peristalsis may indicate: – Intestinal obstruction nurs 6512 final exam
20. Infants born weighing less than 1500g are at higher risk for: – Necrotizing enterocolitis
21. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? – The patient’s age and social status
22. One of the most important aspects to consider in the orthopedic screening examination is: – Symmetry
23. The sequence of the physical examination should be individualized to: – Minimize the number of times the patient has to change positions to conserve the patient’s energy
24. As you greet the patient, which examination technique is first implemented? – Inspection
25. Which of the following is most likely to enhance examiner reliability? – The examiner attempts to qualify data
26. A 7 year old boy is brought to your office with a chief complaint of possible fracture to his left third finger. He jammed it while playing basketball 2 days ago. The mother states that she really does not think it is broken because he can move it. What is your best response? – This is common misconception, and the finger may be broken. An x-ray is indicated nurs 6512 final exam. NURS 6512 FINAL EXAM
27. A patient presenting for the first time with typical low back pain should receive which of the following diagnostic tests? – None of the above. X-ray is not indicated because lumbar pain is usually musculoskeletal etiology.
28. Skeletal changes in older adults are the result of: -Increased bone resorption
29. A positive straight leg raise test usually indicates: – Lumbar nerve root irritation
30. What technique is performed at every infant examination during the first year of life to detect hip dislocation? – Barlow-Ortolani maneuvers

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31. Expected normal findings during inspection of spinal alignment include: – Convex lumbar curve
32. Temporalis and masseter muscles are evaluated by: – Having the patient clench his or her teeth
33. When palpating joints, crepitus may be caused when: – Irregular bony surfaces rub together
34. A 3 year old is brought to the clinic complaining of a painful right elbow. He is holding the right arm slightly flexed and pronated and refuses to move it. the mother states that symptoms started right after his older brother had been swinging him around by his arms. This presentation supports a diagnosis of: – Radial head subluxation. nurs 6512 final exam.
35. Light skin and thin body habitus are risk factors for: – Osteoporosis
36. Risk factors for sports-related injuries include: – Failure to warm up before activity
37. Injuries to long bones and joints are more likely to result in fractures than in sprains until: – Adolescence
38. Ligaments are stronger than bone until: – Adolescence
39. The family history for a patient with joint pain should include information about siblings with: -Genetic disorders nurs 6512 final exam.
40. The Thomas test is used to detect: – Flexion contractures of the hip
41. A goniometer is used to assess: – Range of motion
42. During a football game, a player was struck on the lateral side of the left leg while his feet were firmly planted. He is complaining of left knee pain. To examine the left knee you should initially perform the ­­­­­­­­­­­­­­­­________ test. – Valgus stress
43. You note that a child has a positive Gower Sign. You know that this indicates generalized: – Muscle weakness
44. The dowager hump is: – The hallmark of osteoporosis
45. What temporary disorder may be experienced by pregnant women during the third trimester because of fluid retention? –Carpal tunnel syndrome
46. A common finding in markedly obese and pregnant women is: – Lordosis
47. A 45-year-old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression?A 45 year old laborer presents with low back pain, stating that the pain comes from the right buttock and shoots down and across the right anterior thigh, down the shin to the ankle. Which examination finding is considered more indicative of nerve root compression? – Positive straight leg raise result nurs 6512 final exam. NURS 6512 FINAL EXAM
48. Mrs. Bower is a 57 year old patient who comes in for an office visit. Which of the following disorders is known to be hereditary? – Huntington chorea
49. Testing of cranial nerve ­­­­________ is not routinely performed unless a problem is suspected. – I
50. The patient is able to rapidly touch each finger to his thumb in rapid sequence. What does this finding mean? – The patient has appropriate cerebellar function
51. Which question asked by the examiner may hellp to determine prevention strategies for seizures that a patient is experiencing? – “Are there any factors or activities that seem to start the seizures?”
52. A patient has a complaint of dizziness. The patient makes the following statement: “I sometimes feel as if the whole room is spinning.” What type of neurologic dysfunction should the examiner suspect? – Inner ear dysfunction affecting the acoustic nerve
53. The examiner asks the patient to close her eyes, then places a vibrating tuning fork on the patient’s ankle and asks her to indicate what is felt. What is being assessed? – Peripheral nerve sensory function
54. Which of the following findings should an examiner consider a normal finding if associated with pregnancy? – Acroparesthesia nurs 6512 final exam.

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55. Jack is a 52 year old obese man with a history of poorly controlled diabetes. He also smokes. Based on the above data, the examiner should recognize that Jack has several risk factors for: – Cerebrovascular accident
56. Mrs. Jones is a 24 year old patient who presents to your office 2 days postpartum. She complains that she is experiencing foot drop. Which of the following problems should the examiner consider? – Lumbosacral plexopathy
57. The examiner is assessing deep tendon reflex response in a 12 year old boy. The response is an expected reflex response. Which of the following scores should be documented? – 2+
58. A 68 year old patient presents to your office for follow-up. He tells you, “I have a hard time finding the right words when I am talking;” he also is experiencing numbness. On examination, you note postural instability. This symptom may be: – A late symptom of Parkinson’s disease nurs 6512 final exam.
59. Motor maturation proceeds in an orderly progression from: – Head to toe
60. The thalamus is the major integration center for perception of: – Pain
61. The examiner should be concerned about neurologic competence if a social smile cannot be elicited by the time a child is ________old. – 3 months
62. Normal changes of the aging brain include: – Diminished perception of touch. — this is by process of elimination/educated guess. I could not find direct information addressing this in Seidel
63. When interviewing a 70 year old female clinic patient, she tells you that she takes ginkgo biloba and St. John’s Wort. You make a short note to check for results of the: -Mini-mental state examination
64. The area of body surface innervated by a particular spinal nerve is called a: – Dermatome
65. If a patient cannot shrug the shoulders against resistance, which cranial nerve (CN) requires further evaluation? – CN XI, spinal accessory nurs 6512 final exam. NURS 6512 FINAL EXAM
66. The finger-to-nose test allows assessment of: – Coordination and fine motor function
67. You ask the patient to follow a series of short commands to assess: – Attention span
68. As Mr. B. enters the room, you observe that his gait is wide based and he staggers from side to side while swaying his trunk. You would document Mr. B.’s pattern as: – Cerebellar ataxia
69. When is the mental status portion of the neurologic system examination performed? – Constantly throughout the entire interaction with a client
70. An aversion to touch or being held, along with delayed or absent language development, is a characteristic of: -Autism
71. The autonomic nervous system coordinates which of the following? – Internal environment of the body
72. The major function of the sympathetic nervous system is to: – Orchestrate the stress response
73. The parasympathetic nervous system maintains the day-to-day function of: – Digestion
74. Cerebrospinal fluid serves as a: – Shock absorber
75. You are performing a two-point discrimination test as part of a well physical examination. The area with the ability to discern two points in the shortest distance is the: -Finger tips
76. Which type of hallucination is most commonly associated with alcohol withdrawal? – Visual-bugs, pink elephants. nurs 6512 final exam,
77. On a scale of 0 to 4+, which deep tendon reflex score is appropriate for a finding of clonus in a patient? –3+
78. Which statement is true regarding mental status changes in older adults? – There is an increased risk of delirium with acute illness or metabolic derangement.
79. A characteristic related to syphilis or diabetic neuropathy is testicular: -Insensitivity to painful stimulation
80. When collecting personal and social history data from a woman complaining of breast discomfort, you should question her regarding: – Alcohol, tobacco, and caffeine use
81. What risk factor is associated with cervical cancer? – HPV
82. A 23 year old female presents with severe right lower quadrant tenderness. All of the following should be considered in the differential except: – Classis diverticulitis
83. What is the initial diagnostic radiology test that should be ordered if you suspect a ruptured ovarian cyst? – Abdominal and transvaginal ultrasound
84. A 17 year old male was brought into the emergency room with testicular/scrotal pain. The differential diagnosis should include all except: – Inguinal herniation
85. The nursing mother complains that her breasts are tender. You assess hard, shiny, and erythremic breasts bilaterally. You should advise the patient to: – Massage gently and continue nursing
86. A normal vas deferens should feel: – Smooth
87. In a woman complaining of a breast lump, it is most important to ask about: – Its relationship to menses
88. The finding of a painless indurated lesion on the glans penis is most consistent with: – Chancre
89. Thrombosed hemorrhoids are: – Blue, shiny, painful masses
90. Pregnancy-related cervical changes include: – Softening and bluish coloring
91. You are inspecting the genitalia of an uncircumcised adult male. The foreskin is tight and cannot be easily retracted. You should: – Inquire about previous penile infections. nurs 6512 final exam. NURS 6512 FINAL EXAM
92. An adolescent male is being seen for acute onset of left testicular pain. The pain started 3 hours ago. He complains of nausea and denies dysuria or fever. Your prioritized assessment should be to: – Establish absent cremasteric reflex
93. A 23 year old white woman has come to the clinic because she has missed two menstrual periods. She states that her breasts have enlarged and that her nipples have turned a darker color. nurs 6512 final exam Your further response to this finding is: – Suggest pregnancy testing
94. What accommodations should be used in the position of a hearing-impaired woman for a pelvic examination? – The head of the table should be elevated
95. Sexual differentiation in the fetus has occurred by ­­­_______weeks gestation. – 12
96. You are performing a clinical breast examination for a 55 year old woman. While palpating the supraclavicular area, you suspect that you felt a node. In order to improve your hooked technique, you should: -Ask the patient to turn her head toward that side
97. If a firm, transverse ridge of compressed tissue is felt bilaterally along the lower edge of a 40 year old patient’s breast, you should: -Record the finding in the patient’s record
98. A therapeutic technique for dealing with grieving individuals is to: – Tell them that is good to cry and to share feelings
99. The examination of the newborn should begin with: – Inspection noting skin color, flaccidity, tension, gross deformities, or distortions of facies
100. Which one of the following patient characteristics is most likely to limit patient reliability during history taking? – Patient is sleep and sensory deprived
101. In crying infants, it is often difficult to: – Auscultate heart sounds
102. Which of the following statements accurately reflects the sensitivity and specificity of laboratory tests? – No test has 100% sensitivity and specificity
103. Which medical condition would exclude one from sports participation? – Fever
104. Your 15 year old patient is athletic and thin. Radiography of an ankle injury reveals a stress fracture. You question this patient about her: – Menstrual cycles
105. Which of the following are examined with the patient in a reclining 45 degree position? –Jugular venous pulsation and pressure. nurs 6512 final exam,
106. Functional assessment is most important during the examination of a(n): -Older adult
107. The best way to ease the apprehension of a 3 year old child before a physical examination is to: – Encourage child’s participation
108. An ophthalmoscopic eye examination involves: – Lens inspection
109. When conducting a geriatric assessment, basic activities of daily living (ADLs) include: – Bathing
110. The checkout station for preparticipation physical evaluation (PPE) is critical because at this point: – The coordination of follow-ups is reviewed
111. Which of the following is true regarding the relationship between the examiner and the patient? – The patient is a full partner with the examiner. nurs 6512 final exam,
112. Which of the following factors is not known to affect patient compliance with his or her treatment regimen? – The patient’s age and social status
113. One of the most important aspects to consider in the orthopedic screening examination is: – To look for symmetry of muscle, stature, and joint movement
114. As you greet the patient, which examination technique is first implemented? – Inspection
115. Which portion of the physical examination is best done with the patient standing? –Spinal
116. Which patient position facilitates inspection of the chest and shoulders? – Sitting
117. The least reliable indicator of newborn distress is: – Color
118. Proprioception should be assessed while the patient is: – Standingnurs 6512 final exam.
119. Part of the screening orthopedic component of the examination includes evaluating the person while: – Duck walking nurs 6512 final exam. NURS 6512 FINAL EXAM

Healthcare Information Technology Trends

I currently work in a small community hospital that is part of a bigger network. We are one of six hospitals spanning 3 hours away in either direction. Being part of a bigger network provides great resources for our facility but is difficult to maintain continuity at times. A few of the other hospitals are in larger cities, while our community has fostered this small, positive hospital since 1911. Family physicians have grown the hospital prior to hospitalists becoming the new thing. We now have telemedicine and consults that are performed from a distance. Nurses that are performing assessments and being the eyes and ears using technology. While for years I have found this to be unsafe and ineffective, I do believe that there is some benefit to this type of medicine. Do I want a cardiologist trusting an LPN to assess my condition and provide concrete evidence? Probably not Healthcare Information Technology Trends.

Test results, radiology exams, diagnostic studies, assessments etc are all data/information that is relayed from our mothership. We can provide the services and perform all the required testing, however, the information is sent to the mothership and diagnosed from a distance. Our facility is limited in its specialty practices. Our ED physician can make decisions immediately in the case of an emergency but must consult our mothership where the specialists are located.

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Time is of the essence and by taking the time to reach out to our other facilities, lives are at risk. Physicians are properly educated and should be granted the opportunity to treat their patients. If assistance or a second opinion is needed, then our network should be available. Otherwise, let the physicians and nurses do what they do best and “treat” our patients. This also poses a HIPPA issue as well. We should not be accessing records of patients that we are not treating. Patients enter the ED to obtain treatment locally, not at a hospital that is 3 hours away. We form our best assessments by “laying eyes of the patient” when sending information to the mothership, their assessment is based on black and white. How comfortable does that make you feel like a patient? The information, however, would be relayed quickly and efficiently using the integrated system between hospitals Healthcare Information Technology Trends.

With the lack of providers in rural areas, legislatures continue to push for the needs of APP’s to practice to their full capability to assist in the curtailment of the shortage while providing quality care to our communities. Physicians are retiring at a record level and there must be providers available to provide medical treatment. Telemedicine could be a benefit in this type of setting to assist APP’s with the diagnosis and treatment of difficult cases. Patients will have the ability to remain at home, get evaluated and treated, and follow up with other physicians, if necessary, with the use of telemedicine. Patients will also have the availability of seeking treatment from well-known physicians in other states without leaving their homes. This is a huge benefit to rural communities that do not have access to the best technological advances in medicine. If utilized as a benefit to the patient and not as a convenience for facilities, telemedicine can provide many benefits such as saving money, efficiently and effectively care for patients, accessibility, etc. I do not believe that this is an end-all to medicine because I am a strong believer in putting your eyes, ears, and hands-on your patients, but it is definitely a benefit to have for quick and effective treatment. The quick treatment will assist in early diagnosis and improvements in patient health and outcomes. If a provider is able to diagnose a heart or lung condition with the use of diagnostic studies and telemedicine, prompt treatment will eliminate the long process of waiting on an appointment while the condition worsens or even worse causes the demise of the patient Healthcare Information Technology Trends.

References

Benefits of Telemedicine. Johns Hopkins Medicine. (n.d.). https://www.hopkinsmedicine.org/health/treatment-tests-and-therapies/benefits-of-telemedicine.

Brom, H. M., Salsberry, P. J., & Graham, M. C. (2018, March). Leveraging health care reform to accelerate nurse practitioner full practice authority. Journal of the American Association of Nurse Practitioners. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6800077/. Healthcare Information Technology Trends

Issues at a Glance: Full Practice Authority. American Association of Nurse Practitioners. (2021, January). https://www.aanp.org/advocacy/advocacy-resource/policy-briefs/issues-full-practice-brief Healthcare Information Technology Trends.

Discussion: Healthcare Information Technology Trends

By Day 3 of Week 6

By Day 6 of Week 6

response 2

Well done with your post. I agree with you you that Electronic medical records are more localized and more difficult to transparent with other health organizations or practices. One of the challenges of using the e-MAR (electronic medical records) is that most healthcare professionals have limited knowledge on how to use the system. My organization has fully implemented electronic health records, with electronic medical administration records (e-MAR) being the most recent addition. The e-MAR is a system designed to aid healthcare providers in the real-time transmission of information while guaranteeing that only authorized employees have access to it. One of the difficulties with using the e-MAR is that most healthcare practitioners are unfamiliar with how to utilize it. New nurses who have never used the system before or who have not gotten proper training may find it challenging to use. As a result, they may enter medicine orders incorrectly into the system.

The two most notable advantages of e-MAR are accuracy and flexibility. In terms of precision, e-MAR reduces medication administration errors. Any order that is mistakenly entered, such as ordering the wrong dose, is flagged or hard stopped by the system. When it comes to flexibility, using Emar eliminates the challenge of finding time to administer medications or organize patient records. It makes it easier to keep track of med passes, which is the procedure of giving medications to patients. A flexible record med pass not only minimizes medication errors, but it also allows employees to focus on other patient-care activities Healthcare Information Technology Trends.

 

References

Alanazi, A., Alomar, M., Aldosari, H., Shahrani, A., & Aldosari, B. (2018). The effect of electronic medication administration records on the culture of patient safety: a literature review. Data, Informatics and Technology: An Inspiration for Improved Healthcare, 223-226.

McGonigle, D., & Mastrian, K. (2021). Nursing informatics and the foundation of knowledge. Jones & Bartlett Publishers Healthcare Information Technology Trends.

Developing a Nursing Care Paper

Developing a Care Plan

Introduction

Care planning in nursing is a vital aspect of nursing practice as it provides the outline for patient care. A good care plan should include aspects such as accuracy, completeness, and the content should be relevant (Johnson et al., 2018). Accordingly, this paper will provide a care plan for the aggregate population (South Charlotte), as well as the disaster management plan to address the major health risks in the population.    Developing a Nursing Care Paper

Comprehensive Care Plan

Assessment

The aggregate participants in South Charlotte are older adults aged 65 years and over. The main health risks for this aggregate population include A1C management, surgical risks of diabetes, and increased BMI (obesity).

Nursing Diagnosis

• Ineffective A1C management deficit and increased of infections, wound healing and slow healing surgical outcomes
• Imbalanced nutrition more than body requirements as indicated by a BM1>40

Strategies to Address the Major Health Risks

• A multidisciplinary team should be formed to promote health in the target population. Health promotion should include providing support for self-management education for people with diabetes. The health promotion program in South Charlotte should ensure that all older adults with diabetes take part in diabetes self-management education. This will equip them with the required skills, knowledge, and ability for diabetes self-care, and especially managing and reducing the AIC values, as a measure of effective glycemic control (Al-Rasheedi, 2015). Effective HbA1c control will also prevent long-term complications associated with diabetes. Moreover, the participants should be provided with self-management support that will help them implement and sustain the gained self-management skills and behaviors.
• Implement an exercise program in South Charlotte targeting older adults with diabetes: The older population with type 2 diabetes will be recruited to the exercise program where they will be encouraged to perform at least two weekly sessions of resistance exercise. Evidence shows that resistance training among older adults diagnosed with type 2 diabetes reduces AIC (Alvarez et al., 2017). Moreover, the increased physical activity will help in lowering the BMI for the target population and thus address the issue of obesity in this population. Developing a Nursing Care Paper
• Recommend compulsory influenza and anti-pneumococcal immunization for all older adults in South Charlotte. These immunizations will reduce respiratory infections, hospitalization, and the mortalities associated with respiratory tract infections (Alvarez et al., 2017). Infections, including respiratory tract infections, are very prevalent in people with type 2 diabetes.
• Smoking cessation counseling programs should be integrated into the routine element of diabetes care. In addition, all individuals with type 2 diabetes should be educated to stop smoking or inhaling secondary tobacco smoke. Tobacco smoking is attributed to numerous health risks, including the development of type 2 diabetes, cardiovascular conditions, and premature death. Smoking cessation is associated with the improvement of metabolic parameters, as well as decreased blood pressure in individuals with type 2 diabetes (Hieshima et al., 2018).
• Integrating nutritional therapy in diabetes treatment: All older adults with type 2 diabetes in South Charlotte should be provided with a personalized eating plan. Nutrition therapy is a key aspect of diabetes management and plays a big role in stabilizing AIC values; therefore, the older adults with type 2 diabetes should be vigorously involved in education, treatment planning, and self-management with their healthcare team, and this should include the collaborative development of the personalized eating plan (Franz & MacLeod, 2018). All people with type 2 diabetes in South Charlotte should be referred and linked with a registered dietitian with the required skills and knowledge to provide diabetes-specific nutrition therapy. Emphasis should focus on providing healthy eating patterns. Also, to reduce weight in the target population, the participants should be educated to eat healthily by consuming a variety of fruits and high vegetable intake, while reducing intake of carbohydrates (Franz & MacLeod, 2018). This will assist in weight loss. Developing a Nursing Care Paper
• Lastly, all aggregate participants in South Charlotte should be educated on the importance of adhering to the prescribed medications. Improved adherence to treatment in individuals with type 2 diabetes will enhance glycemic control and thus reduce morbidity and mortality allied to uncontrolled type 2 diabetes (Polonsky & Henry, 2016).
  

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Disaster Management Plan

Charlotte NC region is mainly typified by a moderate climate with a clear discrepancy between warm and cold seasons. Winters are normally characterized by cold weather with a lot of snowing and heavy rainfalls. The likely disasters that may affect the aggerate population in Charlotte NC include hurricanes and flooding. Charlotte NC is a region at a high risk of flooding and storm surge associated with hurricanes. Floods and hurricanes lead to effects such as deaths, injuries, adverse effects on human health and welfare, destruction to the infrastructure, and interruptions to education and business (Tullos D. (2018).

The national climate assessment shows that Charlotte NC has a high probability of experiencing flooding and hurricanes. However, flooding the most likely environmental risk to affect Charlotte NC. This is because Charlotte NC has varying physiography that makes it extremely venerable to flooding and also hurricanes. Charlotte NC has many areas that are low-lying and flat and also coastlines and valleys that make it predisposed to flooding, after an accumulation of heavy rainfall (Lickley, et al., 2014). From the historical evidence, there is a high likelihood that Charlotte NC will continue experiencing flooding and a moderate likelihood of Charlotte NC experiencing hurricanes in the future.

To mitigate the effects of possible hurricanes and flooding, projects, and policies aimed to lower or eliminate the effects of flooding and hurricanes on people and property should be implemented (Tullos D. (2018). This should include evacuation plans and procedures in case of a disaster. Additionally, the shelter and feeding of the affected individuals should be prioritized, and more importantly provision of treatment to the injured. Developing a Nursing Care Paper

Secondly, education, training, and outreach efforts emphasizing the effects of the hazards and methods to increase resiliency should be conducted. This should include educating and training the community members on the appropriate precautionary measures to take in case of flooding or hurricanes Lickley, et al., 2014). For example, community members should be educated to avoid low spots such as basements or underpasses during flooding and avoid low-lying areas. People should also be advised to always remain indoor during hurricanes since strong winds blow away anything around and if their homes are not on higher ground, to access a shelter. It is also important to avoid driving into flooded areas.  In case the emergency managers advise people to evacuate, the community members should be advised to ensure they evacuate immediately (Tullos D. (2018). This type of education will inform community members on actions to take in case of a disaster.

More importantly, healthcare providers in the area, and especially nurses who are the front-line healthcare workers should be educated and trained regarding disaster management. This will equip them with the required skills and knowledge to handle victims of disasters such as hurricanes and flooding within healthcare organizations.

Lastly, a flood/hurricane insurance program should be in place to provide residents of Charlotte NC with incentives to adopt land-use regulations and prohibit constructions lower than the 100-year flood elevation (Lickley, et al., 2014).

Conclusion

The nursing diagnosis for the aggregate population includes ineffective A1C management deficit and increased infections, wound healing and slow healing surgical outcomes; and imbalanced nutrition more than body requirements. Strategies include outreach education to the community members on diabetes self-management, including implementation of weight loss programs, promoting physical activities, and integrating a healthy diet in the diabetes treatment plan. The most likely disasters in Charlotte NC include flooding and hurricanes. Developing a Nursing Care Paper

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