Write a paper of 800-900 words examining your personal values and beliefs. Include the following:

1. Describe your personal values and spiritual beliefs.
2. Using the elements of cost, quality, and social issues to frame your description, differentiate your beliefs and opinions about health care policy. Give examples of relevant ethical principles, supported by your values.
3. Analyze how factors such as your upbringing, spiritual or religious beliefs/doctrine, personal and professional experiences, and political ideology affect your current perspective on health care policy.
4. Examine any inconsistencies you discovered relative to the alignment of your personal values and beliefs with those concerning health policy. Discuss what insights this has given you.

As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

1. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
2. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.
3. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
4. A minimum of three scholarly references are required for this assignment.

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 required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

The calculation of Body Mass Index (BMI) is an important measurement tool for determining relative disease risk for preventable conditions like type 2 diabetes, hypertension, and heart disease. These conditions may be controlled and/or prevented by maintaining a healthy weight relative to height. For instance, the higher the BMI number above the normal range (18-25), the greater the degree of overweight.  National indicators for obesity, as determined by the BMI report that women are more likely to have higher BMI’s in comparison to men. In addition, minority women including African Americans, Hispanics, and Asian Americans are more likely to have a higher BMI in comparison to white women. However, recent research suggests that current standards for measuring BMI may not be accurate for African American women. Read the article “Ethnic-Specific BMI and Waist Circumference Thresholds” and create a 4 page report in Microsoft Word document that covers the following: 

•Explain why the current BMI scale may not be an accurate measure of obesity for African American women. 

•How can these findings impact the manner in which physicians communicate with their female patients about weight loss and disease prevention? In your explanation, be sure to describe at least one positive and one negative implication that these findings might have on how physicians counsel their female patients regarding weight-loss. 

•What influence might these findings have on societal perceptions of body image and weight loss? 

•Explain how an accurate perception of body image is associated with appropriate weight-control behavior. 

•What social and cultural factors influence African American women’s risk of becoming obese? 

•What role do the media play in promoting healthy eating behaviors in women and girls? 

•What can be the implications for healthcare policy as a result of the findings of the study?  

Submission Details: 

•Support your responses with examples. 

•Cite any sources in APA format.

The  4 pages(doesn’t include cover or reference page)

Chief Complaint“My left foot feels weak and numb. I have a hard time pointing my toes up.”History of Present IllnessD.T. is 42-year-old Caucasian woman who has had an elevated blood sugar and cholesterol 2 years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed her fasting blood sugar was 160 and her cholesterol was 250. However, she felt “perfectly fine at the time” and did not want to take any more medications. Except for a number of “female infections,” she has felt fine recently.Today, she presents to the clinic complaining that her left foot has been weak and numb for nearly 3 weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. She does report that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 50 pounds since her last pregnancy 10 years ago, 20 pounds in the last 6 months alone.Past Medical HistorySeasonal allergic rhinitis (since her early 20s)Breast biopsy positive for fibroadenoma at age 30Gestational diabetes with second child 10 years agoMultiple yeast infections during the past 3 years that she has self-treated with OTC antifungal creams and salt bathHypertension for 10 yearsPast Surgical HistoryC-section 14 years agoOB-GYN HistoryMenarche at age 11Last pap smear 3 years agoFamily HistoryType 2 DM present in older brother and maternal grandfather. Both were diagnosed in their late 40s. Brother takes both pills and shots.Mother alive and wellFather has COPDTwo other siblings alive and wellAll three children are alive and wellSocial HistoryMarried 29 years with 3 children; husband is a school teacherFamily lives in a four bedroom single family homePatient works as a seamstressSmokes 1 pack per day (since age 16) and drinks two alcoholic drinks 4 days per weekDenies illegal drug usesNever exercises and has tried multiple fad diets for weight loss with little success. She now eats a diet rich in fats and refined sugars.AllergiesNKDAMedicationsLisinopril 10 mg dailyLoratadine 10 mg dailyReview of SystemsGeneralAdmits to recent onset of fatigueHEENTHas awakened on several occasions with blurred vision and dizziness or lightheadedness upon standing: Denies vertigo, head trauma, ear pain, difficulty swallowing or speakingCardiacDenies chest pain, palpitations, and difficulty breathing while lying downLungsDenies cough, shortness of breath, and wheezingGIDenies nausea, vomiting, abdominal bloating or pain, diarrhea, or food intolerance, but admits occasional episodes of constipationGUHas experienced increased frequency and volumes of urination, but denies pain during urination, blood in the urine, or urinary incontinenceEXTDenies leg cramps or swelling in the ankles and feet; has never experienced weakness, tingling or numbness in arms or legs prior to this episodeNeuroHas never had a seizure and denies recent headachesDermHas a rash under her bilateral breast and in groin areaEndocrineDenies a history of goiter and has not experienced heat or cold intoleranceVital SignsBP 165/100, T 98 F, P 88 regular, HT 5 feet 4 inches, RR 20 non labored, WT 210 lbsWhat you need to do:Develop an evidence-based management plan.Include any pertinent diagnostics.Describe the patient education plan.Include cultural and lifespan considerations.Provide information on health promotion or health care maintenance needs.Describe the follow-up and referral for this patient.Prepare a 3–5-page paper (not including the title page or reference page).FormatThe paper should be no more than 3–5 pages (not including the title page and reference pages.Assignment Requirements:Before finalizing your work, you should:be sure to read the Assignment description carefully (as displayed above);consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; andutilize spelling and grammar check to minimize errors.Your writing Assignment should:follow the conventions of Standard American English (correct grammar, punctuation, etc.);be well ordered, logical, and unified, as well as original and insightful;display superior content, organization, style, and mechanics; anduse APA 6th Edition format as outlined in the APA Progression Ladder.

Carmen Medina, aged 39, lives with her husband, Raúl, aged 43, who works as a mechanic in a small auto shop. Mr. Medina has worked in the same place since he and his wife came to the United States from Puerto Rico 15 years ago. The Medinas have a 4- year-old son, José; a 16-year-old daughter, Rosa; and an 18-year-old son, Miguel. The Medinas both attended vocational school after completing high school. Mrs. Medina is employed 4 hours a day at a garden shop. She stopped working her full-time job to care for her ill mother and aged father, who do not speak English and depend on government assistance. The family income last year was $28,500. The family has health insurance through Mr. Medina’s job. They live in a threebedroom apartment in a low-income Illinois community. Miguel works in a fast-food store a few hours a week. Because Rosa has responsibilities at home, the Medina’s do not allow her to work outside the home. She is very close to her grandmother but avoids talking with her parents. Both Rosa and Miguel are having difficulties in school. Rosa is pregnant and the family does not know. She is planning to drop out of school, get a job in a beauty shop, and leave home without telling the family. Miguel frequently comes home late and, on occasion, sleeps out of the home. He is beginning college next semester and has plans to move out of the house during the summer. The family is having difficulty dealing with Rosa’s and Miguel’s developmental and behavioral challenges. Although Mrs. Medina is outspoken about these concerns, Mr. Medina is quiet and not actively involved in the discussion. He is more preoccupied with the family’s financial situation. Mrs. Medina’s parents are encouraging them to return to Puerto Rico. Mr. Medina was diagnosed with hypertension 2 months ago, when he went to the emergency room for a respiratory infection. He smokes cigarettes and drinks two to three beers every evening after work. He has not followed up on his blood pressure treatment. Miguel is beginning to smoke, but not at home. José has had frequent colds and sinus allergies. He has been to the emergency room three times during the past year for respiratory infections. Mrs. Medina’s last physical examination was after she had José. She is experiencing insomnia, tiredness, headaches, and gastrointestinal problems. She is very concerned about Rosa and Miguel, her parents, and the family’s finances. Mrs. Medina is Catholic and recently has been visiting her church more often. Study Questions 

1. Explain Mrs. Medina’s attitude in her relationship with her adolescent daughter. 

2. Identify strategies to ensure that Rosa seeks prenatal care. 

3. Identify barriers to accessing health care for the Medina family. 

4. What are the high-risk behaviors exhibited by this family? 

5. What communication barriers exist in this family that affect care delivery? 

6. Discuss gender and family roles in the context of traditional Puerto Rican culture. 

7. Identify sociodemographic factors affecting the physical- and mentalhealth well-being for this family.

8. Identify Puerto Rican folk practices appropriate for this family.

9. If the Medina family chose to visit a folk healer, which one(s) do you think they might visit? Why? 

10. If Mrs. Medina’s parents visit a health-care provider, what might they expect? 

11. Identify culturally congruent interventions to ensure compliance with Western health prescriptions for Mr. Medina.

12. Discuss the importance of respeto and familism in the Medina family. 

13. Identify culturally congruent interventions for Rosa’s pregnancy. 

14. Identify health-promotion and disease-prevention interventions needed for José. 

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