Prompt: What is the theoretical basis for community nursing? Broadly, what is the relationship of systems to health? How do these systems impact a plan of care? What are your thoughts on the nurse’s role? What is the role of screening and health promotion? What is the impact of economics and ethics on healthcare screening? What is the relationship to collaborative community and national partnerships and policies and the development of screening programs? Do you agree with the goals of health education? What do you think it the greatest barrier? What are your thoughts on MyPlate? How do you think it compares to other versions of daily requirements? Do you MyPlate this would work in your population? Why? Or why not?

Directions: 

Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.

Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.

Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”

Please address the following questions related to the scenario.

What do you suspect is the cause of the patient’s symptoms?

Describe the course of action that you will take to confirm this suspicion and prevent further decline.

What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.

While you are caring for this patient, how will you ensure that the needs of your other patients are being met?

Read chapter 27 of the class textbook and review the attached PowerPoint presentation.  Once done answer the following questions;

1. What types of challenges have you encountered in working with patients with mental health issues? How do you feel these challenges would be different in a community-based setting? Would it be easier or more difficult and why?
2. Discuss scenarios in which community health nurses might encounter ethical issues related to mental health. Examples could include hospice patients wanting to end their lives or asking nurses to give them too much medication; school nurses having students confide things to them that indicate serious mental health issues; nurses working in homeless shelters whose patients are abusing drugs and potentially exposing others to a communicable disease, etc.

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used (excluding the class textbook).  A minimum of 2 replies to any of your peers sustained with the appropriate references must be posted.  Only the assignment must be attached in a word document in the forum, replies do not.  References must be no older than 5 years.  A minimum of 700 words is required.  

1. What types of challenges have you encountered in working with patients with mental health issues? How do you feel these challenges would be different in a community-based setting? Would it be easier or more difficult and why?
2. Discuss scenarios in which community health nurses might encounter ethical issues related to mental health. Examples could include hospice patients wanting to end their lives or asking nurses to give them too much medication; school nurses having students confide things to them that indicate serious mental health issues; nurses working in homeless shelters whose patients are abusing drugs and potentially exposing others to a communicable disease, etc.

As stated in the syllabus the assignment must be presented in an APA format word document, Arial 12 font attached to the forum on the discussion board.  A minimum of 3 evidenced-based references must be used (excluding the class textbook).    References must be no older than 5 years.  A minimum of 700 words is required.