1. Using Nightengale’s concepts of ventilation, light, noise, and cleanliness, analyze the setting in which you are practicing nursing (working as an employee or student).
2. Using Nightengale’s theory, evaluate the nursing interventions you have identified for an individual patient in your facility or practice.

   OR

3. Your hospital patient is an 82 year-old woman. She does not have immediate family and has been living alone in her own home. Her hospitalization was unanticipated; it followed a visit to the emergency room for a burn on her lower leg. The patient has been hospitalized for 14 days. She pleads with you to allow her friend to bring her dog, a 16-year-old Scotty Terrier, to the hospital. She tells you that none of the other nurses have listened to her when she asked them about such a visit. Based on Nightingale’s model, and 13 cannon, what actions would you take for this patient?

1. Martina is a middle-aged Hispanic woman who brings her family to a local free clinic to obtain medical care. She works part time in a restaurant for minimum wage. She lives in a small apartment with her daughter and four preschool children; her daughter speaks only very broken English. Martina’s medical diagnoses are hypertension, arthritis, and depression.

   Use the Neuman System Model as a conceptual framework to respond to the following:

1. 1. Describe the family as a system.
   2. How does the dominant Anglo culture impact on  the family’s stability as a system?
   3. What stressors (actual and potential) threaten the family?
   4. What additional assessment data are needed related to Martina’s medical diagnoses?
   5. What additional assessment data are needed related to the family’s health status?
   6. How will cultural differences influence planning for prevention as intervention at primary, secondary, and tertiary levels?

      OR

2. Using the Neuman System Model, organize a patient care conference in your workplace to deal with a patient situation that has been difficult to manage.  Involve caregivers from nursing and at least one other disicpline to discuss each of the following:
   1. What factors comprise the patient’s normal and flexible lines of defense and lines of resistance?
   2. What stressors are  causing the problems with this patitent? What is the patient’s reaction to the stressor? What is each discipline’s perspective on the problem or isssues that are involved?
   3. How is the situation influenced by the patient’s family system? By the patient’s environment?
   4. What would be the ideal coutocme in this situation from each discipline’s perspective?  From the patient’s perspective?
   5. What goals would be appropariate to neogotiate with the patient?
   6. What primary, secondary, and tertiary prevention-as-interventions would support attainment of these goals?

1. Think about and write your personal definitions of environment, health, nursing, and person. (Do these sound familiar to you?). Compare your definitions with King’s definitions. How are they similar? How are they different? Are they more alike than different? If they are more alike, develop a plan to use King’s framework and theory more extensively in your paper (and practice).

   OR

2. Does the philosophy of one of the agencies in which you have practiced encourage the involvement of the patients in their care? If so, does mutual goal setting occur? If not, what changes would you suggest to promote more active involvement of the patients in their own care?

   Analyze an interaction  you have had with a patient. Were you able to achieve a transaction as King describes it? If so, think about what you did differently with this person? If not, think about the interaction and try to identify why the transaction was not achieved?

1. During the therapeutic relationship, patients may distort their perceptions of others. Therefore they may relate to the nurse not on  the basis of the nurse’s realistic attributes, but wholly or chiefly on the basis of interpersonal relationships existing in their environment. With  the patient and nurse roles you have described above, discuss how these distorted perceptions may affect the patient’s care and the nurse-patient relationship.

   OR

2. Considering the nurse-patient relationship created in question #1 above, discuss the phases and the changing roles that would be considered when working with this patient. Consider experiences in which you would 0r/and would not be able to accomplish the appropriate goals for each phase of the nurse-patient relationship.

Discuss the usefulness of the Culture Care: Diversity and Universality Theory in the  21st Century to discover nursing knowledge and to provide culturally congruent care. Take into consideration the current trends of consumers of healthcare, cultural diversity factors, and changes in medical and nursing school curricula. Listed below are some examples of trends and changes you may want to consider in your discussion: 

1. The importance of transcultural nursing knowledge in an increasingly diverse world
2. An increase of lay support groups to provide information and sharing of experiences and support for patients and/or families experiencing chronic, terminal, or life-threatening illnesses or treatment modalities from diverse and similar (common) cultures.
3. Use of cultural values, beliefs, health practices, and research knowledge in undergraduate, alternative medicine, herbs, vitamins, minerals, and other over-the-counter medications, which demand a transcultural knowledge base.