Health Screening And History Of An Adolescent Or Young Adult Client

In this assignment, you will be completing a comprehensive health screening and history on a young adult. To complete this assignment, do the following:

Select an adolescent or young adult client on whom to perform a health screening and history. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one.

Complete the “Health History and Screening of an Adolescent or Young Adult Client” worksheet.

Complete the assignment as outlined on the worksheet, including:

Biographical data

Past health history

Family history: Obstetrics history (if applicable) and well young adult behavioral health history screening

Review of systems

All components of the health history

Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis)

Rationale for the choice of each nursing diagnosis.

A wellness plan for the adolescent/young adult client, using the three nursing diagnoses you have identified.

Format the write-up in a manner that is easily read, computer-generated, neat, and without spelling errors. Use correct acronyms or abbreviations when indicated.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation 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 not required to submit this assignment to Turnitin.

Nursing Essay

The requirements for this essay are:

  1. 500-600 words; 5-paragraph structure (can have more than five).
  2. Your idea about the story itself—the value of the story (at least a paragraph)
  3. How it applies to life in general (at least a paragraph)
  4. How it applies to you. Write about an item that is important to you, one that has been passed down to you or one that you hope will be or an item that you have that you will plan to pass down to someone (at least a paragraph). .
  5. Be sure to supply a. A parenthetical reference b. A Works Cited

I will wait for her in the yard that Maggie and I made so clean and wavy yesterday afternoon. A yard like this is more comfortable than most people know. It is not just a yard. It is like an extended living room. When the hard clay is swept clean as a floor and the fine sand around the edges lined with tiny, irregular grooves, anyone can come and sit and look up into the elm tree and wait for the breezes that never come inside the house.

Maggie will be nervous until after her sister goes: she will stand hopelessly in corners, homely and ashamed of the burn scars down her arms and legs, eying her sister with a mixture of envy and awe. She thinks her sister has held life always in the palm of one hand, that “no” is a word the world never learned to say to her.

You’ve no doubt seen those TV shows where the child who has “made it” is confronted, as a surprise, by her own mother and father, tottering in weakly from backstage. (A pleasant surprise, of course: What would they do if parent and child came on the show only to curse out and insult each other?) On TV mother and child embrace and smile into each other’s faces. Sometimes the mother and father weep, the child wraps them in her arms and leans across the table to tell how she would not have made it without their help. I have seen these programs.

Sometimes I dream a dream in which Dee and I are suddenly brought together on a TV program of this sort. Out of a dark and soft.seated limousine I am ushered into a bright room filled with many people. There I meet a smiling, gray, sporty man like Johnny Carson who shakes my hand and tells me what a fine girl I have. Then we are on the stage and Dee is embracing me with tears in her eyes. She pins on my dress a large orchid, even though she has told me once that she thinks orchids are tacky flowers.

In real life I am a large, big.boned woman with rough, man.working hands. In the winter I wear flannel nightgowns to bed and overalls dur.ing the day. I can kill and clean a hog as mercilessly as a man. My fat keeps me hot in zero weather. I can work outside all day, breaking ice to get water for washing; I can eat pork liver cooked over the open fire minutes after it comes steaming from the hog. One winter I knocked a bull calf straight in the brain between the eyes with a sledge hammer and had the meat hung up to chill before nightfall. But of course all this does not show on television. I am the way my daughter would want me to be: a hundred pounds lighter, my skin like an uncooked barley pancake. My hair glistens in the hot bright lights. Johnny Carson has much to do to keep up with my quick and witty tongue.

But that is a mistake. I know even before I wake up. Who ever knew a Johnson with a quick tongue? Who can even imagine me looking a strange white man in the eye? It seems to me I have talked to them always with one foot raised in flight, with my head fumed in whichever way is farthest from them. Dee, though. She would always look anyone in the eye. Hesitation was no part of her nature.

“How do I look, Mama?” Maggie says, showing just enough of her thin body enveloped in pink skirt and red blouse for me to know she’s there, almost hidden by the door.

“Come out into the yard,” I say.

Have you ever seen a lame animal, perhaps a dog run over by some careless person rich enough to own a car, sidle up to someone who is ignorant enough to be kind to him? That is the way my Maggie walks. She has been like this, chin on chest, eyes on ground, feet in shuffle, ever since the fire that burned the other house to the ground.

Dee is lighter than Maggie, with nicer hair and a fuller figure. She’s a woman now, though sometimes I forget. How long ago was it that the other house burned? Ten, twelve years? Sometimes I can still hear the flames and feel Maggie’s arms sticking to me, her hair smoking and her dress falling off her in little black papery flakes. Her eyes seemed stretched open, blazed open by the flames reflected in them. And Dee. I see her standing off under the sweet gum tree she used to dig gum out of; a look of concentration on her face as she watched the last dingy gray board of the house fall in toward the red.hot brick chimney. Why don’t you do a dance around the ashes? I’d wanted to ask her. She had hated the house that much.

I used to think she hated Maggie, too. But that was before we raised money, the church and me, to send her to Augusta to school. She used to read to us without pity; forcing words, lies, other folks’ habits, whole lives upon us two, sitting trapped and ignorant underneath her voice. She washed us in a river of make.believe, burned us with a lot of knowl edge we didn’t necessarily need to know. Pressed us to her with the serf’ ous way she read, to shove us away at just the moment, like dimwits, we seemed about to understand.

Dee wanted nice things. A yellow organdy dress to wear to her grad.uation from high school; black pumps to match a green suit she’d made from an old suit somebody gave me. She was determined to stare down any disaster in her efforts. Her eyelids would not flicker for minutes at a time. Often I fought off the temptation to shake her. At sixteen she had a style of her own: and knew what style was.

I never had an education myself. After second grade the school was closed down. Don’t ask my why: in 1927 colored asked fewer questions than they do now. Sometimes Maggie reads to me. She stumbles along good.naturedly but can’t see well. She knows she is not bright. Like good looks and money, quickness passes her by. She will marry John Thomas (who has mossy teeth in an earnest face) and then I’ll be free to sit here and I guess just sing church songs to myself. Although I never was a good singer. Never could carry a tune. I was always better at a man’s job. I used to love to milk till I was hooked in the side in ’49. Cows are soothing and slow and don’t bother you, unless you try to milk them the wrong way.

I have deliberately turned my back on the house. It is three rooms, just like the one that burned, except the roof is tin; they don’t make shingle roofs any more. There are no real windows, just some holes cut in the sides, like the portholes in a ship, but not round and not square, with rawhide holding the shutters up on the outside. This house is in a pasture, too, like the other one. No doubt when Dee sees it she will want to tear it down. She wrote me once that no matter where we “choose” to live, she will manage to come see us. But she will never bring her friends. Maggie and I thought about this and Maggie asked me, “Mama, when did Dee ever have any friends?”

She had a few. Furtive boys in pink shirts hanging about on washday after school. Nervous girls who never laughed. Impressed with her they worshiped the well.turned phrase, the cute shape, the scalding humor that erupted like bubbles in Iye. She read to them.

When she was courting Jimmy T she didn’t have much time to pay to us, but turned all her faultfinding power on him. He flew to marry a cheap city girl from a family of ignorant flashy people. She hardly had time to recompose herself.

When she comes I will meet—but there they are!

Maggie attempts to make a dash for the house, in her shuffling way, but I stay her with my hand. “Come back here, ” I say. And she stops and tries to dig a well in the sand with her toe.

It is hard to see them clearly through the strong sun. But even the first glimpse of leg out of the car tells me it is Dee. Her feet were always neat.looking, as if God himself had shaped them with a certain style. From the other side of the car comes a short, stocky man. Hair is all over his head a foot long and hanging from his chin like a kinky mule tail. I hear Maggie suck in her breath. “Uhnnnh, ” is what it sounds like. Like when you see the wriggling end of a snake just in front of your foot on the road. “Uhnnnh.”

Dee next. A dress down to the ground, in this hot weather. A dress so loud it hurts my eyes. There are yellows and oranges enough to throw back the light of the sun. I feel my whole face warming from the heat waves it throws out. Earrings gold, too, and hanging down to her shoul.ders. Bracelets dangling and making noises when she moves her arm up to shake the folds of the dress out of her armpits. The dress is loose and flows, and as she walks closer, I like it. I hear Maggie go “Uhnnnh” again. It is her sister’s hair. It stands straight up like the wool on a sheep. It is black as night and around the edges are two long pigtails that rope about like small lizards disappearing behind her ears.

“Wa.su.zo.Tean.o!” she says, coming on in that gliding way the dress makes her move. The short stocky fellow with the hair to his navel is all grinning and he follows up with “Asalamalakim, my mother and sister!” He moves to hug Maggie but she falls back, right up against the back of my chair. I feel her trembling there and when I look up I see the perspiration falling off her chin.

“Don’t get up,” says Dee. Since I am stout it takes something of a push. You can see me trying to move a second or two before I make it. She turns, showing white heels through her sandals, and goes back to the car. Out she peeks next with a Polaroid. She stoops down quickly and lines up picture after picture of me sitting there in front of the house with Maggie cowering behind me. She never takes a shot without mak’ ing sure the house is included. When a cow comes nibbling around the edge of the yard she snaps it and me and Maggie and the house. Then she puts the Polaroid in the back seat of the car, and comes up and kisses me on the forehead.

Meanwhile Asalamalakim is going through motions with Maggie’s hand. Maggie’s hand is as limp as a fish, and probably as cold, despite the sweat, and she keeps trying to pull it back. It looks like Asalamalakim wants to shake hands but wants to do it fancy. Or maybe he don’t know how people shake hands. Anyhow, he soon gives up on Maggie.

“Well,” I say. “Dee.”

“No, Mama,” she says. “Not ‘Dee,’ Wangero Leewanika Kemanjo!”

“What happened to ‘Dee’?” I wanted to know.

“She’s dead,” Wangero said. “I couldn’t bear it any longer, being named after the people who oppress me.”

“You know as well as me you was named after your aunt Dicie,” I said. Dicie is my sister. She named Dee. We called her “Big Dee” after Dee was born.

“But who was she named after?” asked Wangero.

“I guess after Grandma Dee,” I said.

“And who was she named after?” asked Wangero.

“Her mother,” I said, and saw Wangero was getting tired. “That’s about as far back as I can trace it,” I said. Though, in fact, I probably could have carried it back beyond the Civil War through the branches.

“Well,” said Asalamalakim, “there you are.”

“Uhnnnh,” I heard Maggie say.

“There I was not,” I said, “before ‘Dicie’ cropped up in our family, so why should I try to trace it that far back?”

He just stood there grinning, looking down on me like somebody inspecting a Model A car. Every once in a while he and Wangero sent eye signals over my head.

“How do you pronounce this name?” I asked.

“You don’t have to call me by it if you don’t want to,” said Wangero.

“Why shouldn’t 1?” I asked. “If that’s what you want us to call you, we’ll call you.”

.

“I know it might sound awkward at first,” said Wangero.

“I’ll get used to it,” I said. “Ream it out again.”

Well, soon we got the name out of the way. Asalamalakim had a name twice as long and three times as hard. After I tripped over it two or three times he told me to just call him Hakim.a.barber. I wanted to ask him was he a barber, but I didn’t really think he was, so I didn’t ask.

“You must belong to those beef.cattle peoples down the road,” I said. They said “Asalamalakim” when they met you, too, but they didn’t shake hands. Always too busy: feeding the cattle, fixing the fences, putting up salt.lick shelters, throwing down hay. When the white folks poisoned some of the herd the men stayed up all night with rifles in their hands. I walked a mile and a half just to see the sight.

Hakim.a.barber said, “I accept some of their doctrines, but farming and raising cattle is not my style.” (They didn’t tell me, and I didn’t ask, whether Wangero (Dee) had really gone and married him.)

We sat down to eat and right away he said he didn’t eat collards and pork was unclean. Wangero, though, went on through the chitlins and com bread, the greens and everything else. She talked a blue streak over the sweet potatoes. Everything delighted her. Even the fact that we still used the benches her daddy made for the table when we couldn’t effort to buy chairs.

“Oh, Mama!” she cried. Then turned to Hakim.a.barber. “I never knew how lovely these benches are. You can feel the rump prints,” she said, running her hands underneath her and along the bench. Then she gave a sigh and her hand closed over Grandma Dee’s butter dish. “That’s it!” she said. “I knew there was something I wanted to ask you if I could have.” She jumped up from the table and went over in the corner where the churn stood, the milk in it crabber by now. She looked at the churn and looked at it.

“This churn top is what I need,” she said. “Didn’t Uncle Buddy whittle it out of a tree you all used to have?”

“Yes,” I said.

“Un huh,” she said happily. “And I want the dasher, too.”

“Uncle Buddy whittle that, too?” asked the barber.

Dee (Wangero) looked up at me.

“Aunt Dee’s first husband whittled the dash,” said Maggie so low you almost couldn’t hear her. “His name was Henry, but they called him Stash.”

“Maggie’s brain is like an elephant’s,” Wangero said, laughing. “I can use the chute top as a centerpiece for the alcove table,” she said, sliding a plate over the chute, “and I’ll think of something artistic to do with the dasher.”

When she finished wrapping the dasher the handle stuck out. I took it for a moment in my hands. You didn’t even have to look close to see where hands pushing the dasher up and down to make butter had left a kind of sink in the wood. In fact, there were a lot of small sinks; you could see where thumbs and fingers had sunk into the wood. It was beautiful light yellow wood, from a tree that grew in the yard where Big Dee and Stash had lived.

After dinner Dee (Wangero) went to the trunk at the foot of my bed and started rifling through it. Maggie hung back in the kitchen over the dishpan. Out came Wangero with two quilts. They had been pieced by Grandma Dee and then Big Dee and me had hung them on the quilt ftames on the ftont porch and quilted them. One was in the Lone Stat pattetn. The other was Walk Around the Mountain. In both of them were scraps of dresses Grandma Dee had wotn fifty and more years ago. Bits and pieces of Grandpa Jattell’s Paisley shirts. And one teeny faded blue piece, about the size of a penny matchbox, that was from Great Grandpa Ezra’s unifotm that he wore in the Civil War.

“Mama,” Wangro said sweet as a bird. “Can I have these old quilts?”

I heard something fall in the kitchen, and a minute later the kitchen door slammed.

“Why don’t you take one or two of the others?” I asked. “These old things was just done by me and Big Dee from some tops your grandma pieced before she died.”

“No,” said Wangero. “I don’t want those. They are stitched around the borders by machine.”

“That’ll make them last better,” I said.

“That’s not the point,” said Wangero. “These are all pieces of dresses Grandma used to wear. She did all this stitching by hand. Imag’ ine!” She held the quilts securely in her atms, stroking them.

“Some of the pieces, like those lavender ones, come ftom old clothes her mother handed down to her,” I said, moving up to touch the quilts. Dee (Wangero) moved back just enough so that I couldn’t reach the quilts. They already belonged to her.

“Imagine!” she breathed again, clutching them closely to her bosom.

“The ttuth is,” I said, “I promised to give them quilts to Maggie, for when she matties John Thomas.”

She gasped like a bee had stung her.

“Maggie can’t appreciate these quilts!” she said. “She’d probably be backward enough to put them to everyday use.”

“I reckon she would,” I said. “God knows I been saving ’em for long enough with nobody using ’em. I hope she will!” I didn’t want to bring up how I had offered Dee (Wangero) a quilt when she went away to college. Then she had told they were old~fashioned, out of style.

“But they’re priceless!” she was saying now, furiously; for she has a temper. “Maggie would put them on the bed and in five years they’d be in rags. Less than that!”

“She can always make some more,” I said. “Maggie knows how to quilt.”

Dee (Wangero) looked at me with hatred. “You just will not under.stand. The point is these quilts, these quilts!”

“Well,” I said, stumped. “What would you do with them7”

“Hang them,” she said. As if that was the only thing you could do with quilts.

Maggie by now was standing in the door. I could almost hear the sound her feet made as they scraped over each other.

“She can have them, Mama,” she said, like somebody used to never winning anything, or having anything reserved for her. “I can ‘member Grandma Dee without the quilts.”

I looked at her hard. She had filled her bottom lip with checkerberry snuff and gave her face a kind of dopey, hangdog look. It was Grandma Dee and Big Dee who taught her how to quilt herself. She stood there with her scarred hands hidden in the folds of her skirt. She looked at her sister with something like fear but she wasn’t mad at her. This was Maggie’s portion. This was the way she knew God to work.

When I looked at her like that something hit me in the top of my head and ran down to the soles of my feet. Just like when I’m in church and the spirit of God touches me and I get happy and shout. I did some.thing I never done before: hugged Maggie to me, then dragged her on into the room, snatched the quilts out of Miss Wangero’s hands and dumped them into Maggie’s lap. Maggie just sat there on my bed with her mouth open.

“Take one or two of the others,” I said to Dee.

But she turned without a word and went out to Hakim~a~barber.

“You just don’t understand,” she said, as Maggie and I came out to the car.

“What don’t I understand?” I wanted to know.

“Your heritage,” she said, And then she turned to Maggie, kissed her, and said, “You ought to try to make something of yourself, too, Maggie. It’s really a new day for us. But from the way you and Mama still live you’d never know it.”

She put on some sunglasses that hid everything above the tip of her nose and chin.

Maggie smiled; maybe at the sunglasses. But a real smile, not scared. After we watched the car dust settle I asked Maggie to bring me a dip of snuff. And then the two of us sat there just enjoying, until it was time to go in the house and go to bed.

Nursing Essay

The requirements for this essay are:

  1. 500-600 words; 5-paragraph structure (can have more than five).
  2. Your idea about the story itself—the value of the story (at least a paragraph)
  3. How it applies to life in general (at least a paragraph)
  4. How it applies to you. Write about an item that is important to you, one that has been passed down to you or one that you hope will be or an item that you have that you will plan to pass down to someone (at least a paragraph). .
  5. Be sure to supply a. A parenthetical reference b. A Works Cited

I will wait for her in the yard that Maggie and I made so clean and wavy yesterday afternoon. A yard like this is more comfortable than most people know. It is not just a yard. It is like an extended living room. When the hard clay is swept clean as a floor and the fine sand around the edges lined with tiny, irregular grooves, anyone can come and sit and look up into the elm tree and wait for the breezes that never come inside the house.

Maggie will be nervous until after her sister goes: she will stand hopelessly in corners, homely and ashamed of the burn scars down her arms and legs, eying her sister with a mixture of envy and awe. She thinks her sister has held life always in the palm of one hand, that “no” is a word the world never learned to say to her.

You’ve no doubt seen those TV shows where the child who has “made it” is confronted, as a surprise, by her own mother and father, tottering in weakly from backstage. (A pleasant surprise, of course: What would they do if parent and child came on the show only to curse out and insult each other?) On TV mother and child embrace and smile into each other’s faces. Sometimes the mother and father weep, the child wraps them in her arms and leans across the table to tell how she would not have made it without their help. I have seen these programs.

Sometimes I dream a dream in which Dee and I are suddenly brought together on a TV program of this sort. Out of a dark and soft.seated limousine I am ushered into a bright room filled with many people. There I meet a smiling, gray, sporty man like Johnny Carson who shakes my hand and tells me what a fine girl I have. Then we are on the stage and Dee is embracing me with tears in her eyes. She pins on my dress a large orchid, even though she has told me once that she thinks orchids are tacky flowers.

In real life I am a large, big.boned woman with rough, man.working hands. In the winter I wear flannel nightgowns to bed and overalls dur.ing the day. I can kill and clean a hog as mercilessly as a man. My fat keeps me hot in zero weather. I can work outside all day, breaking ice to get water for washing; I can eat pork liver cooked over the open fire minutes after it comes steaming from the hog. One winter I knocked a bull calf straight in the brain between the eyes with a sledge hammer and had the meat hung up to chill before nightfall. But of course all this does not show on television. I am the way my daughter would want me to be: a hundred pounds lighter, my skin like an uncooked barley pancake. My hair glistens in the hot bright lights. Johnny Carson has much to do to keep up with my quick and witty tongue.

But that is a mistake. I know even before I wake up. Who ever knew a Johnson with a quick tongue? Who can even imagine me looking a strange white man in the eye? It seems to me I have talked to them always with one foot raised in flight, with my head fumed in whichever way is farthest from them. Dee, though. She would always look anyone in the eye. Hesitation was no part of her nature.

“How do I look, Mama?” Maggie says, showing just enough of her thin body enveloped in pink skirt and red blouse for me to know she’s there, almost hidden by the door.

“Come out into the yard,” I say.

Have you ever seen a lame animal, perhaps a dog run over by some careless person rich enough to own a car, sidle up to someone who is ignorant enough to be kind to him? That is the way my Maggie walks. She has been like this, chin on chest, eyes on ground, feet in shuffle, ever since the fire that burned the other house to the ground.

Dee is lighter than Maggie, with nicer hair and a fuller figure. She’s a woman now, though sometimes I forget. How long ago was it that the other house burned? Ten, twelve years? Sometimes I can still hear the flames and feel Maggie’s arms sticking to me, her hair smoking and her dress falling off her in little black papery flakes. Her eyes seemed stretched open, blazed open by the flames reflected in them. And Dee. I see her standing off under the sweet gum tree she used to dig gum out of; a look of concentration on her face as she watched the last dingy gray board of the house fall in toward the red.hot brick chimney. Why don’t you do a dance around the ashes? I’d wanted to ask her. She had hated the house that much.

I used to think she hated Maggie, too. But that was before we raised money, the church and me, to send her to Augusta to school. She used to read to us without pity; forcing words, lies, other folks’ habits, whole lives upon us two, sitting trapped and ignorant underneath her voice. She washed us in a river of make.believe, burned us with a lot of knowl edge we didn’t necessarily need to know. Pressed us to her with the serf’ ous way she read, to shove us away at just the moment, like dimwits, we seemed about to understand.

Dee wanted nice things. A yellow organdy dress to wear to her grad.uation from high school; black pumps to match a green suit she’d made from an old suit somebody gave me. She was determined to stare down any disaster in her efforts. Her eyelids would not flicker for minutes at a time. Often I fought off the temptation to shake her. At sixteen she had a style of her own: and knew what style was.

I never had an education myself. After second grade the school was closed down. Don’t ask my why: in 1927 colored asked fewer questions than they do now. Sometimes Maggie reads to me. She stumbles along good.naturedly but can’t see well. She knows she is not bright. Like good looks and money, quickness passes her by. She will marry John Thomas (who has mossy teeth in an earnest face) and then I’ll be free to sit here and I guess just sing church songs to myself. Although I never was a good singer. Never could carry a tune. I was always better at a man’s job. I used to love to milk till I was hooked in the side in ’49. Cows are soothing and slow and don’t bother you, unless you try to milk them the wrong way.

I have deliberately turned my back on the house. It is three rooms, just like the one that burned, except the roof is tin; they don’t make shingle roofs any more. There are no real windows, just some holes cut in the sides, like the portholes in a ship, but not round and not square, with rawhide holding the shutters up on the outside. This house is in a pasture, too, like the other one. No doubt when Dee sees it she will want to tear it down. She wrote me once that no matter where we “choose” to live, she will manage to come see us. But she will never bring her friends. Maggie and I thought about this and Maggie asked me, “Mama, when did Dee ever have any friends?”

She had a few. Furtive boys in pink shirts hanging about on washday after school. Nervous girls who never laughed. Impressed with her they worshiped the well.turned phrase, the cute shape, the scalding humor that erupted like bubbles in Iye. She read to them.

When she was courting Jimmy T she didn’t have much time to pay to us, but turned all her faultfinding power on him. He flew to marry a cheap city girl from a family of ignorant flashy people. She hardly had time to recompose herself.

When she comes I will meet—but there they are!

Maggie attempts to make a dash for the house, in her shuffling way, but I stay her with my hand. “Come back here, ” I say. And she stops and tries to dig a well in the sand with her toe.

It is hard to see them clearly through the strong sun. But even the first glimpse of leg out of the car tells me it is Dee. Her feet were always neat.looking, as if God himself had shaped them with a certain style. From the other side of the car comes a short, stocky man. Hair is all over his head a foot long and hanging from his chin like a kinky mule tail. I hear Maggie suck in her breath. “Uhnnnh, ” is what it sounds like. Like when you see the wriggling end of a snake just in front of your foot on the road. “Uhnnnh.”

Dee next. A dress down to the ground, in this hot weather. A dress so loud it hurts my eyes. There are yellows and oranges enough to throw back the light of the sun. I feel my whole face warming from the heat waves it throws out. Earrings gold, too, and hanging down to her shoul.ders. Bracelets dangling and making noises when she moves her arm up to shake the folds of the dress out of her armpits. The dress is loose and flows, and as she walks closer, I like it. I hear Maggie go “Uhnnnh” again. It is her sister’s hair. It stands straight up like the wool on a sheep. It is black as night and around the edges are two long pigtails that rope about like small lizards disappearing behind her ears.

“Wa.su.zo.Tean.o!” she says, coming on in that gliding way the dress makes her move. The short stocky fellow with the hair to his navel is all grinning and he follows up with “Asalamalakim, my mother and sister!” He moves to hug Maggie but she falls back, right up against the back of my chair. I feel her trembling there and when I look up I see the perspiration falling off her chin.

“Don’t get up,” says Dee. Since I am stout it takes something of a push. You can see me trying to move a second or two before I make it. She turns, showing white heels through her sandals, and goes back to the car. Out she peeks next with a Polaroid. She stoops down quickly and lines up picture after picture of me sitting there in front of the house with Maggie cowering behind me. She never takes a shot without mak’ ing sure the house is included. When a cow comes nibbling around the edge of the yard she snaps it and me and Maggie and the house. Then she puts the Polaroid in the back seat of the car, and comes up and kisses me on the forehead.

Meanwhile Asalamalakim is going through motions with Maggie’s hand. Maggie’s hand is as limp as a fish, and probably as cold, despite the sweat, and she keeps trying to pull it back. It looks like Asalamalakim wants to shake hands but wants to do it fancy. Or maybe he don’t know how people shake hands. Anyhow, he soon gives up on Maggie.

“Well,” I say. “Dee.”

“No, Mama,” she says. “Not ‘Dee,’ Wangero Leewanika Kemanjo!”

“What happened to ‘Dee’?” I wanted to know.

“She’s dead,” Wangero said. “I couldn’t bear it any longer, being named after the people who oppress me.”

“You know as well as me you was named after your aunt Dicie,” I said. Dicie is my sister. She named Dee. We called her “Big Dee” after Dee was born.

“But who was she named after?” asked Wangero.

“I guess after Grandma Dee,” I said.

“And who was she named after?” asked Wangero.

“Her mother,” I said, and saw Wangero was getting tired. “That’s about as far back as I can trace it,” I said. Though, in fact, I probably could have carried it back beyond the Civil War through the branches.

“Well,” said Asalamalakim, “there you are.”

“Uhnnnh,” I heard Maggie say.

“There I was not,” I said, “before ‘Dicie’ cropped up in our family, so why should I try to trace it that far back?”

He just stood there grinning, looking down on me like somebody inspecting a Model A car. Every once in a while he and Wangero sent eye signals over my head.

“How do you pronounce this name?” I asked.

“You don’t have to call me by it if you don’t want to,” said Wangero.

“Why shouldn’t 1?” I asked. “If that’s what you want us to call you, we’ll call you.”

.

“I know it might sound awkward at first,” said Wangero.

“I’ll get used to it,” I said. “Ream it out again.”

Well, soon we got the name out of the way. Asalamalakim had a name twice as long and three times as hard. After I tripped over it two or three times he told me to just call him Hakim.a.barber. I wanted to ask him was he a barber, but I didn’t really think he was, so I didn’t ask.

“You must belong to those beef.cattle peoples down the road,” I said. They said “Asalamalakim” when they met you, too, but they didn’t shake hands. Always too busy: feeding the cattle, fixing the fences, putting up salt.lick shelters, throwing down hay. When the white folks poisoned some of the herd the men stayed up all night with rifles in their hands. I walked a mile and a half just to see the sight.

Hakim.a.barber said, “I accept some of their doctrines, but farming and raising cattle is not my style.” (They didn’t tell me, and I didn’t ask, whether Wangero (Dee) had really gone and married him.)

We sat down to eat and right away he said he didn’t eat collards and pork was unclean. Wangero, though, went on through the chitlins and com bread, the greens and everything else. She talked a blue streak over the sweet potatoes. Everything delighted her. Even the fact that we still used the benches her daddy made for the table when we couldn’t effort to buy chairs.

“Oh, Mama!” she cried. Then turned to Hakim.a.barber. “I never knew how lovely these benches are. You can feel the rump prints,” she said, running her hands underneath her and along the bench. Then she gave a sigh and her hand closed over Grandma Dee’s butter dish. “That’s it!” she said. “I knew there was something I wanted to ask you if I could have.” She jumped up from the table and went over in the corner where the churn stood, the milk in it crabber by now. She looked at the churn and looked at it.

“This churn top is what I need,” she said. “Didn’t Uncle Buddy whittle it out of a tree you all used to have?”

“Yes,” I said.

“Un huh,” she said happily. “And I want the dasher, too.”

“Uncle Buddy whittle that, too?” asked the barber.

Dee (Wangero) looked up at me.

“Aunt Dee’s first husband whittled the dash,” said Maggie so low you almost couldn’t hear her. “His name was Henry, but they called him Stash.”

“Maggie’s brain is like an elephant’s,” Wangero said, laughing. “I can use the chute top as a centerpiece for the alcove table,” she said, sliding a plate over the chute, “and I’ll think of something artistic to do with the dasher.”

When she finished wrapping the dasher the handle stuck out. I took it for a moment in my hands. You didn’t even have to look close to see where hands pushing the dasher up and down to make butter had left a kind of sink in the wood. In fact, there were a lot of small sinks; you could see where thumbs and fingers had sunk into the wood. It was beautiful light yellow wood, from a tree that grew in the yard where Big Dee and Stash had lived.

After dinner Dee (Wangero) went to the trunk at the foot of my bed and started rifling through it. Maggie hung back in the kitchen over the dishpan. Out came Wangero with two quilts. They had been pieced by Grandma Dee and then Big Dee and me had hung them on the quilt ftames on the ftont porch and quilted them. One was in the Lone Stat pattetn. The other was Walk Around the Mountain. In both of them were scraps of dresses Grandma Dee had wotn fifty and more years ago. Bits and pieces of Grandpa Jattell’s Paisley shirts. And one teeny faded blue piece, about the size of a penny matchbox, that was from Great Grandpa Ezra’s unifotm that he wore in the Civil War.

“Mama,” Wangro said sweet as a bird. “Can I have these old quilts?”

I heard something fall in the kitchen, and a minute later the kitchen door slammed.

“Why don’t you take one or two of the others?” I asked. “These old things was just done by me and Big Dee from some tops your grandma pieced before she died.”

“No,” said Wangero. “I don’t want those. They are stitched around the borders by machine.”

“That’ll make them last better,” I said.

“That’s not the point,” said Wangero. “These are all pieces of dresses Grandma used to wear. She did all this stitching by hand. Imag’ ine!” She held the quilts securely in her atms, stroking them.

“Some of the pieces, like those lavender ones, come ftom old clothes her mother handed down to her,” I said, moving up to touch the quilts. Dee (Wangero) moved back just enough so that I couldn’t reach the quilts. They already belonged to her.

“Imagine!” she breathed again, clutching them closely to her bosom.

“The ttuth is,” I said, “I promised to give them quilts to Maggie, for when she matties John Thomas.”

She gasped like a bee had stung her.

“Maggie can’t appreciate these quilts!” she said. “She’d probably be backward enough to put them to everyday use.”

“I reckon she would,” I said. “God knows I been saving ’em for long enough with nobody using ’em. I hope she will!” I didn’t want to bring up how I had offered Dee (Wangero) a quilt when she went away to college. Then she had told they were old~fashioned, out of style.

“But they’re priceless!” she was saying now, furiously; for she has a temper. “Maggie would put them on the bed and in five years they’d be in rags. Less than that!”

“She can always make some more,” I said. “Maggie knows how to quilt.”

Dee (Wangero) looked at me with hatred. “You just will not under.stand. The point is these quilts, these quilts!”

“Well,” I said, stumped. “What would you do with them7”

“Hang them,” she said. As if that was the only thing you could do with quilts.

Maggie by now was standing in the door. I could almost hear the sound her feet made as they scraped over each other.

“She can have them, Mama,” she said, like somebody used to never winning anything, or having anything reserved for her. “I can ‘member Grandma Dee without the quilts.”

I looked at her hard. She had filled her bottom lip with checkerberry snuff and gave her face a kind of dopey, hangdog look. It was Grandma Dee and Big Dee who taught her how to quilt herself. She stood there with her scarred hands hidden in the folds of her skirt. She looked at her sister with something like fear but she wasn’t mad at her. This was Maggie’s portion. This was the way she knew God to work.

When I looked at her like that something hit me in the top of my head and ran down to the soles of my feet. Just like when I’m in church and the spirit of God touches me and I get happy and shout. I did some.thing I never done before: hugged Maggie to me, then dragged her on into the room, snatched the quilts out of Miss Wangero’s hands and dumped them into Maggie’s lap. Maggie just sat there on my bed with her mouth open.

“Take one or two of the others,” I said to Dee.

But she turned without a word and went out to Hakim~a~barber.

“You just don’t understand,” she said, as Maggie and I came out to the car.

“What don’t I understand?” I wanted to know.

“Your heritage,” she said, And then she turned to Maggie, kissed her, and said, “You ought to try to make something of yourself, too, Maggie. It’s really a new day for us. But from the way you and Mama still live you’d never know it.”

She put on some sunglasses that hid everything above the tip of her nose and chin.

Maggie smiled; maybe at the sunglasses. But a real smile, not scared. After we watched the car dust settle I asked Maggie to bring me a dip of snuff. And then the two of us sat there just enjoying, until it was time to go in the house and go to bed.

Benchmark Assignment – Spiritual Needs Assessment And Reflection

This assignment requires you to interview one person and requires an analysis of your interview experience.

Part I: Interview

Select a patient, a family member, or a friend to interview. Be sure to focus on the interviewee’s experience as a patient, regardless of whom you choose to interview.

Review The Joint Commission resource found in topic materials, which provides some guidelines for creating spiritual assessment tools for evaluating the spiritual needs of patients. Using this resource and any other guidelines/examples that you can find, create your own tool for assessing the spiritual needs of patients.

Your spiritual needs assessment survey must include a minimum of five questions that can be answered during the interview. During the interview, document the interviewee’s responses.

The transcript should include the questions asked and the answers provided. Be sure to record the responses during the interview by taking detailed notes. Omit specific names and other personal information through which the interviewee can be determined.

Part II: Analysis

Write a 500-750 word analysis of your interview experience. Be sure to exclude specific names and other personal information from the interview. Instead, provide demographics such as sex, age, ethnicity, and religion. Include the following in your response:

What went well?

Were there any barriers or challenges that inhibited your ability to complete the assessment tool? How would you address these in the future or change your assessment to better address these challenges?

How can this tool assist you in providing appropriate interventions to meet the needs of your patient?

Did you discover that illness and stress amplified the spiritual concern and needs of your interviewee? Explain your answer with examples.

Submit both the transcript of the interview and the analysis of your results. This should be submitted as one document. The interview transcript does not figure into the word count.

Prepare this assignment according to the guidelines found in the APA Style Guide,

Therapeutic Assessment

Assignment:

Identify an older adult age 65 +, use a 1st and last initial. Execute a therapeutic assessment interview with them for at least two interview sessions assessing their self-identified:

Demographics, life time education and career/employment

Two most significant (positive) times in their lives

What past hardship or loss has the client successfully negotiated in the past?

Two personal strengths

Engage them in identifying what is healthy versus non-healthy coping skills

Inquire of 2 healthy coping skills they have used in the past and/or now

Three (3) pieces of advice they would give to their younger self if they could?

Support the client in taking the Geriatric Depression Scale.pdf

Support the client in taking the Fulmer SPICES Assessment.pdf

Perform a Mini Mental State Exam.pdf and Patient_Stress_Questionnaire.pdf (attach here)

Perform a Hall, Ryan, Hall, Richard, and Chapman Article.pdf

Report the findings from the Geriatric Depression Scale, Fulmer Spices, Patient stress questionnaire and the mini mental status exam

Discuss your older adult’s level of ego integrity vs. despair as described by psychoanalyst Erik Erikson. If you had to rate them on a scale of 1-10, with 1 representing a full state of despair and 10 representing full ego integrity, what rating would you give your older adult?

Describe at least two nursing diagnoses for this client.

Create a plan of care for the client to include at least three nursing goals with two nursing interventions each.

The assignment should be written in an APA-formatted essay. DO NOT COPY OR PLACE THE ASSESSMENTS INTO YOUR PAPER- JUST SUMMARIZE THEM IN PARAGRAPH FORMAT. The essay should be at least 1500 words in length and include at least two scholarly sources other than provided materials. Don’t forget the format of an APA essay paper includes the title page, intro, assignments, conclusion, and references. Note that in this assignment when you interview the older adult, it is ok to just denote their responses- you do not have to quote them or use personal communication citations- I know that you are interviewing them. Please do not give full names of your interviewees, just give their initials or say, Mrs. S. or something like that.

Healthcare Systems And Quality Outcomes: Quality Improvement Issue

In this course, you develop a comprehensive Course Project: Promoting Health Care

Quality. To initiate this project, this week you examine the systems and structures of an

organization with which you are familiar.

Organizational Systems and Structures, Part 1

Section 1: Organizational Systems and Structures Evaluation

When a problem related to health care quality and patient safety arises, there can be an

inclination to focus on a specific event rather than to examine the larger context

surrounding it. Analyzing the systems and structures within an organization provides a

foundation for generating a fuller understanding of how and why the event occurred and

for developing strategies to address the underlying issues. Perhaps more importantly,

such an analysis can be used to proactively identify potential challenges and improve

organizational systems and structures in order to promote positive outcomes.

In the first section of your Course Project, you analyze the systems and structures of a

health care organization with which you are familiar.

To prepare:

Identify a health care organization with which you are familiar; one that you will be

able to sufficiently analyze to complete the full scope of the Course Project. (Refer to

the Course Project Overview as needed.)

Select two or more of the following frameworks:

· Learning organizations

· Complex adaptive systems (CAS)

· Clinical microsystems

· Good to great

· The 5 Ps

With these frameworks in mind, analyze the systems and structures of the

organization. Be sure to research and consider:

· Mission, vision, and values

· Strategic plan, goals, and objectives, if possible

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

Week 4: Organizational Systems and Structures, Part 2

Section 1: Organizational Systems and Structures Evaluation

As you continue your evaluation of a health care organization, it is essential to pay

attention to culture. Organizational culture provides the context in which all interactions

and processes occur and is therefore central to any effort to enact change.

To prepare:

Continue to analyze your selected organization, as indicated in Week 3 (Section 1 of

the Course Project).

Continue to analyze essential elements of organizational culture and evaluate the

influence of culture on the ability to achieve goals within your selected organization.

To complete:

Write a 3- to 5-page paper in which you:

· Provide a description of the organization that you selected

· Present your analysis of the organization with attention to:

· Its mission, vision, values

· Strategic plan, goals, and objectives

· Key operational processes and patterns

· Information technology use

· Organizational priorities and investments, as indicated by financial data

· The essential elements of the organization’s culture

· The influence of culture on meeting organizational goals

Section 2: Quality Improvement Issue

To help you move forward with your Course Project, this week you identify a quality

issue that you would like to address and submit a description of this issue for Instructor

feedback.

Your proposed issue should reflect a genuine need for improvement within your

selected health care organization. Through your Course Project, you will analyze this

issue and propose strategies to improve outcome(s), including the redesign of a related

process.

To prepare:

· Review the six quality improvement aims from the Institute of Medicine (IOM)

· Safe: Avoiding harm to patients from the care that is intended to help them.

· Effective: Providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and misuse, respectively).

· Patient-centered: Providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.

· Timely: Reducing waits and sometimes harmful delays for both those who receive and those who give care.

· Efficient: Avoiding waste, including waste of equipment, supplies, ideas, and energy.

· Equitable: Providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.

· Conduct a search of the literature to help you identify a specific issue that warrants attention and action to promote quality improvement.

· Consider what you have surmised thus far through your analysis of the organization

that you selected. What have you noticed that could help you identify a quality related need for improvement? For instance:

· What has captured your attention in meetings, reports, and/or daily activities?

· Have you noticed discrepancies between activities in the organization and

recommendations in the research literature, quality standards, and/or the

organization’s stated policies and procedures?

· If so, what do you think could be the reason(s) for variations or gaps between

what you have observed and what is recommended?

Identify a quality improvement issue that you would like to investigate for this project.

Note: Review the Course Project Overview/full instructions, located in the Week 3

Learning Resources, as needed to identify a quality improvement issue that is viable for

completing the full scope of this project. Once you receive a response from your

Instructor on the quality improvement issue that you submit, be sure to integrate his or

her feedback before moving forward with Section 3 of your Course Project.

To complete:

Write a brief description of the quality improvement issue that you would like to address

for your Course Project.

Advance Pathophysiology : Anaemia

In clinical settings, advanced practice nurses often encounter patients with blood disorders such as anemia. Consider the case of a 17-year-old girl who is rushed to the emergency room after suddenly fainting. The girl’s mother reports that her daughter has had difficulty concentrating for the past week, frequently becomes dizzy, and has not been eating normally due to digestion problems. The mother also informs the nurse that their family has a history of anemia. With the family history of anemia, it appears that this is the likely diagnosis. However, in order to properly diagnose and treat the patient, not only must her symptoms and family history be considered, but also factors such as gender, ethnicity, age, and behavior. This poses the question: How do patient factors impact the incidence and prevalence of different types of anemia?

To Prepare

· Review Chapter 21 in the Huether and McCance text. Reflect on the pathophysiological mechanisms of iron deficiency anemia.

· Select one of the following types of anemia: pernicious anemia, folate deficiency anemia, sideroblastic anemia, chronic inflammation anemia, or post-hemorrhagic anemia. Identify the pathophysiological mechanisms of the anemia you selected.

· Consider the similarities and differences between iron deficiency anemia and the type of anemia you selected.

· Reflect on how patient factors such as genetics, gender, ethnicity, age, and behavior might impact these anemic disorders.

Write

· An explanation of the pathophysiological mechanisms of iron deficiency anemia and the anemia you selected (pernicious anemia). explanation at the cellular or molecular level (whenever possible).

· Compare these two types of anemia, as well as their potential causes.

· Finally, explain how genetics, gender, ethnicity, age, and behavior might impact the anemic disorders you selected.

Critiquing a Change Effort

As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

To prepare:

Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process.
Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change?
How did the change affect your job and responsibilities?
Consider the results of the change and whether or not the intended outcomes have been achieved.
Was the change managed skillfully? Why or why not? How might the process have been improved?
Post (1) a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. (2) Explain the rationale for the change, and whether or not the intended outcomes have been met. (3) Assess the management of the change, and propose suggestions for how the process could have been improved.

Readings
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application(8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.
Review Chapter 7, “Strategic and Operational Planning”
Chapter 8, “Planned Change”

This chapter explores methods for facilitating change and the theoretical underpinnings of implementing effective change
McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C., Baumgart, A., Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. Quality Management in Health Care, 23(4), 254-267 doi: 10.1097/QMH.0b013e31828bc37d

An international group of investigators explored the issues of organizational culture and Quality Improvement (QI) in different health care contexts and settings. The aim of the research was to examine if a core set of organizational cultural attributes are associated with successful QI systems.
Mitchell, G. (2013). Selecting the best theory to implement planned change. Nursing Management – UK, 20(1), 32-37. doi: 10.7748/nm2013.04.20.1.32.e1013

Abstract: Planned change in nursing practice is necessary for a wide range of reasons, but it can be challenging to implement. Understanding and using a change theory framework can help managers or other change agents to increase the likelihood of success. This article considers three change theories and discusses how one in particular can be used in practice.
Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. The Journal of Nursing Administration, 43(2), 69-72. doi:10.1097/NNA.0b013e31827f20a9

Abstract: This department [manuscript] highlights change management strategies that may be successful in strategically planning and executing organizational change initiatives. With the goal of presenting practical approaches helpful to nurse leaders advancing organizational change, content includes evidence-based projects, tools, and resources that mobilize and sustain organizational change initiatives. In this article, the author explores the use of the Lewin’s Theory of Planned Change as a strategic resource to mobilize the people side of change. An overview of the theory is provided along with a discussion of its strengths, limitations, and targeted application.
Media
Laureate Education, Inc. (Executive Producer). (2012g). Organizational dynamics: Planned change and project planning. Baltimore, MD: Author.

Note: The approximate length of this media piece is 9 minutes.

In this week’s media presentation, experts discuss how today’s health care organizations can capitalize on the strengths of nurse leaders to plan for and navigate change effectively.
Optional Resources
Marquis, B. L., & Huston, C. J. (2015). Leadership roles and management functions in nursing: Theory and application(8th ed.). Philadelphia: Lippincott, Williams & Wilkins.
Chapter 9, “Time Management”
Batras, D., Duff, C., & Smith, B. J. (2014). Organizational change theory: implications for health promotion practice. Health Promotion International, Retrieved from MEDLINE with Full Text, EBSCOhost

This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners.

Nursing Research Designs

Research Designs

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Read “Chemotherapy Use and Patient Treatment Preferences in Advanced Colorectal Cancer.”Preview the documentView in a new window Is this quantitative research design appropriate for the research problem and question? Support your answer with rationale. How might you change the study if you were to use a qualitative design?

Chapters 8 & 9 to be reviewed.

Required Texts

Boswell, C. & Cannon, S. (2013). Introduction to nursing research: Incorporating evidence

based practice (3rd ed.). Sudbury, MA: Jones and Bartlett. ISBN: 1-4496-9507-8

Dear H 365 student: Do use an APA reference for postings and try to connect your point to the chapter(s) we are studying. Do try to tie your “post” to a particular concept in the text/chapter and do consider asking a question that clarifies or probes a classmate (in your reply post).

I have listed the point guide here below. We are off to a good start – thank you, Dr Cullen

10 points: Demonstrates excellence in grasping key concepts; critiques work of others, stimulates discussion; provides citations for support of opinions. Ideas are expressed clearly and concisely. Uses appropriate vocabulary. Student makes a thoughtful an initial post and makes a thoughtful comment on a classmates post.
8 points: Shows evidence of understanding major concepts; offers an occasional divergent viewpoint or challenge; show some skill in supporting ideas. Expression of ideas somewhat disorganized. Student makes an initial post and a thoughtful response to a peer.
5 points: Shows evidence of understanding most major concepts, offers an occasional divergent viewpoint or challenge; lacks skill supporting ideas. Some signs of disorganization with expression; transition wording may be faulty. Student makes an initial post and/or doesn’t give much of a response to group members post
3 point: Has mostly shallow grasp of material; rarely takes a stand on issues; offers inadequate support. Poor language use garbles much of the message and expression seems disjointed. Overuse of simple sentence and comments are redundant without commentary. Paragraphs appear unrelated. Student does not respond to a peer.

Diagnosis and Management of Hematologic and Metabolic Disorders

Case Study 2:

Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.

To prepare:

•Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text.

•Review and select one of the three provided case studies. Analyze the patient information.

•Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.

•Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.

•Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

POST 1 TO 2 PAGES DISCUSSION PAPER ON : 1.An explanation of the differential diagnosis for the patient in the case study you selected.

  1. Explain which is the most likely diagnosis for the patient and why.
  2. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis.
  3. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments.
  4. Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

References

•Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.

◦Chapter 25, “Endocrine and Metabolic Disorders” (pp. 529–556)

◦Chapter 26, “Hematologic Disorders” (pp. 557–584)

•Hyperbilirubinemia: current guidelines and emerging therapies by Schwartz,H.P., Haberman, B.E., & Ruddy, R.M. in Pediatric Emergency Care, 27(9), 884-889.