Diversity And Health Assessments

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Diversity And Health Assessments

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.”

Case 2

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

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Case 3

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected. Diversity And Health Assessments

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

 This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2013 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

CLASS LEARNING RESOURCES

**Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

• Chapter 1, “The History and      Interviewing Process” (pp. 1-20)

This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.

• Chapter 2, “Cultural      Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

**Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby. Diversity And Health Assessments

• Chapter 2, “Evidenced- Based Health Screening”      (pp. 6-9)

**Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi: 10.3109/02770903.2014.906605

Retrieved from the Walden Library Databases.

The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.

**Centers for Disease Control and Prevention (2015). Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence

This website discusses cultural competence as defined by the Center for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website. 

**United States Department of Human & Health Services. Office of Minority Health. (2016). A physician’s practical guide to culturally competent care. Retrieved from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, the Website offers CME and CEU credit and equips health care professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

**Espey, D., Jim, M., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(S3), S303-S311. 

The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.

**Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian J Trop Med Public Health., 47(1):109-20.

The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers. Diversity And Health Assessments

Fetal Abnormality

Details:

Based on “Case Study: Fetal Abnormality” and other required topic study materials, write a 750-1,000-word reflection that answers the following questions:

1. What      is the Christian view of the nature of human persons, and which      theory of moral status is it compatible with? How is this related to the      intrinsic human value and dignity?
2. Which      theory or theories are being used by Jessica, Marco, Maria, and Dr. Wilson      to determine the moral status of the fetus? What from the case study      specifically leads you to believe that they hold the theory you selected?

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3. How      does the theory determine or influence each of their recommendations for      action?

4. What      theory do you agree with? Why? How would that theory determine or influence      the recommendation for action?
5. Remember to support your responses with the topic study materials. Fetal Abnormality

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud. Fetal Abnormality

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother. Fetal Abnormality

Benchmark – Future Scope, Role, And Professional Obligations Paper

Advanced registered nursing graduates are entering the profession at dynamic time when roles and scope of practice are shifting based on developments in legislation and policy in response to the evolving needs of the health care system. Professional nursing organizations play an important role in making sure the perspectives of advanced registered nurses are heard, and in supporting nurse specialties in their efforts to expand their scope of practice and their full participation throughout the health care system. Benchmark – Future Scope, Role, And Professional Obligations Paper

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For this assignment, you will conduct research on the current scope of practice for your specialty and efforts that are being made to expand that scope and the role of the advanced nurse in positively influencing the health care system.(Emergency Room R.N.) Write a 1,250-1,500-word paper that includes the following:

1. A discussion of the scope of your future role as an advanced registered nurse, including any regulatory, certification, or accreditation agencies that define that scope.
2. A discussion of three professional nursing organizations that you think are most influential in advancing the scope and influence of advanced nursing. Of these organizations, evaluate the one that you would most like to join. How do its goals and mission fit in with your worldview and philosophy of care? How might membership in this organization improve your practice?
3. A discussion of a controversial or evolving issue that is most likely to affect your scope of practice or role in the next few years. How do you think this issue could influence the profession and other stakeholders, and why does it matters to the advanced registered nurse? Benchmark – Future Scope, Role, And Professional Obligations Paper

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Benchmark – Future Scope, Role, And Professional Obligations Paper

Legislation Comparison Grid And Testimony/Advocacy Statement

Post an explanation for how you think the cost-benefit analysis in the statement from page 27 of Feldstein (2006) affected efforts to repeal/replace the ACA. Then, explain how analyses such as the one portrayed by the Feldstein statement may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Legislation Comparison Grid And Testimony/Advocacy Statement

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Based on the health-related bill you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:

• Determine the legislative intent of the bill you have reviewed.
• Identify the proponents/opponents of the bill.
• Identify the target populations addressed by the bill.
• Where in the process is the bill currently? Is it in hearings or committees?
• Is it receiving press coverage?

Part 2: Legislation Testimony/Advocacy Statement

Based on the health-related bill you selected, develop a 1- to 2-page Legislation Testimony/Advocacy Statement that addresses the following:

• Advocate a position for the bill you selected and write testimony in support of your position.
• Describe how you would address the opponent to your position. Be specific and provide examples.
• Recommend at least one amendment to the bill in support of your position. Legislation Comparison Grid And Testimony/Advocacy Statement

PICOT STATEMENT

Formulate a PICOT statement for your capstone project. (Childhood Obesity)

A PICOT starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention should be an independent, specified nursing change intervention. The intervention cannot require a provider prescription. Include a comparison to a patient population not currently receiving the intervention, and specify the timeframe needed to implement the change process. PICOT STATEMENT

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Formulate a PICOT statement using the PICOT format provided in the assigned readings. The PICOT statement will provide a framework for your capstone project.

In a paper of 750 -1000 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Make sure to address the following on the PICOT statement:

1. Evidence-Based Solution
2. Nursing Intervention
3. Patient Care
4. Health Care Agency
5. Nursing Practice PICOT STATEMENT

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center. PICOT STATEMENT