Week 3: Community Level Public Health Nursing Interventions

1. Identify your county public health department in the community in which you reside or nearby. 

(I live in Scott County MN, zip code is 55378 – for the online research, or you can let me know if you need any help.)

2. List 5 programs offered by your county public health agency and indicate which specific HP 2030 objectives they address (not topic area).
3. Select one program to explore more in-depth. Describe the program. Why and how was the program started? Identify program objectives or goals/mission and vision.
4. Describe how the program is evaluated. If you cannot locate this information, state how you would recommend the program be evaluated?
5. Analyze how the program is consistent with the public health model (Schoon et al., 2019, p. 155).
6. Identify a HP 2030 objective that you feel is not being addressed by your public health agency.
7. Using the resource list provided in the module or another resource, identify an evidence-based program that you feel could be implemented in your community to address the objective.
8. Identify a possible barrier in local implementation.
9. Who would be your community partners? Identify an entity or agency that may be willing to collaborate on this program.
10. Respond to at least two of your group members. Some thoughts to guide your two responses to your peers: similarities, differences, challenges, rural/urban/ partners, etc.

Hematopoietic:
J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately, there have been 6 days of heavy flow and cramping. She denies abdominal distension, backache, and constipation. She has not had her usual energy levels since before her last pregnancy.

Past Medical History (PMH):
Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5 with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries.

Case Study 1 Questions:

1. Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia.
2. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.
3. Why Vitamin B12 and folic acid are important for erythropoiesis? What abnormalities their deficiency might cause in the red blood cells?
4. The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia.
   In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia.
5. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe.
6. Lab results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe appropriate recommendations and treatments for J.D.

Cardiovascular
Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. En route to the hospital, the patient was placed on a nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg PO) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets. He denies chills.

Case Study 2 Questions:

1. For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarction, describe the modifiable and non-modifiable risk factors.
2. What would you expect to see on Mr. W.G. EKG and which findings described in the case are compatible with the acute coronary event?
3. Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarction, which would be the most specific laboratory test you would choose and why?
4. How do you explain that Mr. W.G’s temperature has increased after his Myocardial Infarction, when can that be observed, and for how long? Base your answer on the pathophysiology of the event.
5. Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarction. Elaborate and support your answer.

Submission Instructions:

• This assignment has 2 case studies. You must work and include both case studies in your initial post.
• Your initial post should be at least 500 words for each case study, formatted and cited in the current APA style with support from at least 2 academic sources other than your textbook. Your initial post is worth 8 points.
• You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Use at least 1 academic source for each response to your peers other than your textbook. Your reply posts are worth 2 points (1 point per response). 
• All replies must be constructive and literature must be used accordingly. Your replies must be at least 150 words each.
• Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
• You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date. 

DNP Role Assignment Part I

Title: The Role of a DNP Prepared Nurse Committed to Evidence-Based Practice Acting as a DON in a Clinic

The purpose of this assignment is evaluate a current or new role relative to a DNP prepared nurse.  The emphasis will be on the skills that a DNP prepared nurse brings to the role. What are the differences coming from a DNP perspective? What skills will a DNP prepared nurse have that a MSN prepared  RN would not.  

Please attached detailed instructions. 

Please use the attached RUBRIC to make sure all aspects are covered

Reply to a classmate post

“How Racist Are You?”

Jane Elliot’s racism awareness method reveals a lot about the dynamics of racism within society. First, the training reveals that most people do not acknowledge the racism that happens every day in society. The discriminated group in this experiment initially does not believe that racism exists (Bryanweb, 2019). They believe that discrimination occurs for every person and that racism is not special in any way. They, however, complain about their discrimination but refuse to accept that this happens every day in society. As the experiment continues, some people choose to walk out while others learn the dynamics of discrimination. I believe this truly reflects how society perceives racism. Those who are privileged do not realize the extent of discrimination. On the other hand, the study by Carter and Murphy (2015) explores these differing perception and add the claim that Whites of low socioeconomic status (SES) are more likely to perceive discrimination claims by minorities as legitimate compared to their high SES counterparts. This finding reveals the variability that exists regarding racism within racial groups.

Additionally, many people do not see the imbalance of power that occurs in discrimination. When blue-eyed people complain that they get discriminated against, they fail to realize the fact that discriminated groups have different power dynamics. For example, some complain that they are discriminated against because of their weight. However, they can do something about their weight unlike their natural skin pigmentation and associated race. I believe the fact that people refuse to acknowledge the presence and effect of racism reveals that society still has a long way to go. There are several racist situations I have observed myself and done nothing about. This is because we often fail to acknowledge the depth of this racism and hence do nothing about it. I believe that the experiment forces people to experience discrimination and hence brings up discussion concerning the need to do something to eliminate racism.

Reference

Bryanweb (2019, August 30). How racist are you? with Jane Elliott (shorter version). YouTube.https://www.youtube.com/watch?v=MJ1BQQpdX2c&ab_channel=bryanweb