Assignment Overview

You have just been hired by your State’s health department to help develop a health promotion program. Your first assignment is to use the CDC database, WISQARS Leading Causes of Death Reports, to find out what the leading causes of death in your State are, and how different groups within your State compare to those of the State as a whole. You will use that information to decide which determinants of health your program should focus on. *** I am living in Korea, but from Florida if you want to use that state****

Case Assignment

1. Go to http://www.cdc.gov/injury/wisqars/leading_causes_death.html, and select “Leading Causes of Death 1999 to 2017 (ICD-10), National, Regional and State (Restricted).”
2. For Report Options, select your State.
3. Scroll down to “Advanced Options” and select “Top 5” as the number of causes.
4. Look at the column on the right, labeled All Deaths, to find the top 5 causes of death.
5. Repeat those steps, but select Race, Sex, and specific Age groups on the Report Options to see how/if the leading causes of death vary among differing demographic groups.
6. In an essay, please answer the following:
   1. What state did you select?
   2. What are the 5 leading causes of death for your State. How do they compare with the 5 leading causes of death for the US?
   3. Describe how/if the leading causes of death vary based on different demographic variables such as race, sex, and age. Be specific about which variables you looked at.
   4. Based on the findings for your state, what 3 determinants of health would you choose as priorities for health promotion programs? Would you focus your efforts on any specific one?
   5. Please explain how those 3 determinants of health affect people’s behaviors in ways that promote well-being. How do they affect people’s behaviors in ways that hinder well-being? Give examples and support your statements with references.

Assignment Expectations

Length: 2 pages

Assessment and Grading: Your paper will be assessed based on the performance assessment rubric. You can view it under Assessments at the top of the page. Review it before you begin working on the assignment. Your work should also follow these Assignment Expectations.

Required Reading

U.S. Department of Health and Human Services. (2018). Healthy People 2020: Leading Health Indicators. Retrieved June 30, 2018, from http://www.healthypeople.gov/2020/LHI/default.aspx

U.S. Department of Health and Human Services (2016). Healthy People 2020: Leading Health Indicators.Retrieved from http://www.healthypeople.gov/2020/LHI/default.aspx

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion (2014). Public Health Learning Modules-Module 1: Using Healthy People 2020 to Improve Population Health. Part Three: Healthy People and the National Center for Health Statistics. Retrieved from https://vimeopro.com/aptrmodules/phlm/video/75910069

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required

Please choose ONE of the following topics and respond to the thread corresponding to the question you select. Please include at least three scholarly sources within your initial post. 

1. Screening, gender- and age-specific. Discuss the screening process and upcoming possibilities for screening options. Be sure to provide examples of three different health screens (one related to age, one related to gender, and one related to ethnicity or culture).

2. Keeping patients healthy and preventative care. Include statistics regarding population-specific preventative care as well as those diseases that are caught early with better outcomes, not only to the patient but to the healthcare system (for example, independence, financial cost). Discuss three preventative care opportunities that can have a significant impact on the life and health of the patient. Focus primarily on immunizations. 

3. Health counseling and education barriers to preventative care (for example, inadequate reimbursement, insufficient time, healthcare literacy). Discuss three barriers and offer suggestions as to how an APRN can address these barriers. 

4. Levels of prevention (primary prevention is most important in adult learning). Review the five levels of prevention and then focus on primary prevention. Offer three innovative ways in which to engage the adult population.

5. Secondary prevention screening in the general adult population age 18–64 (diabetes, HIV, Hep C, etc.). Discuss current literature and statistics regarding secondary screening: success, failure, and cost. Review what is considered secondary screening and provide three examples. 

6. Screening tools as part of health promotion and disease prevention, etc. Discuss screening tools that should be used in most healthcare settings. Some of these tools may be age-, gender-, or situation-specific. Discuss three screening tools you use daily as you engage with patients. Do you think there are benefits to using these screening tools? Why or why not? 

7. Mental health care is lacking in almost every community in our country. Discuss three issues that the United States faces in terms of mental health care as related to health promotion and disease prevention. What challenges do you see in your own community?

– Please include at least 3 scholarly sources within your initial post.

– APA style.

– Minimun 400 – 450 words.

– Turnitin Assignment (No plagiarism)

Note: My background for you to have as a reference: I am currently enrolled in the Psych Mental Health Nurse Practitioner Program, I am a Registered Nurse, I work at a Psychiatric Hospital.

  Select a potential natural or man-made disaster that could happen in your community. Hurricane Then, write a 4-5 -page paper about the disaster from the community nurse’s perspective.

Section 1: The Disaster, Man-Made or Natural- 

· What disasters may strike your community and why? For example, do you live in “Tornado Alley,” (Charlotte County,  Florida) or has climate change resulted in unusual cold weather snaps or blizzards in your community? Are you located in a flood plain? Include possible diseases that may result from a natural disaster, such as tetanus or cholera.

Section 2: The Nursing Response

· Formulate responses to the disaster, considering systems and community levels of intervention.

· Review websites where a disaster plan may be available for the public, or if one is not currently available, call public health department to see if a disaster plan exists for your community and what the plan contains.

o In addition to reviewing websites for information about your local disaster plan, you will need to locate best practice/evidence-based practice guidelines in professional literature to determine whether your community’s disaster plan is as sound as it might be or if there is room for improvement.

Section 3: Is My Community Prepared for a Disaster?

· What conclusions can you draw about your community’s preparedness plan from having completed this evaluation?

For this Assignment, review the following:

Descibed a potential local natural or man-made disaster.

Considered system level responses to the disaster including nursing role with information from a local expert or evaluation of the local website.
Evalauated community preparedness for the disaster.
Offered conclusions about the community’s preparedness plan.

Cover page, title of paper on second page, level headings, Times New Roman 12 font, 1″” margins, and page numbers. APA References: 

Uses in-text citations appropriately and format correctly. Paraphrases to avoid plagiarizing the source.
Reference list is in alphabetical order, hanging indent, double spaced in format. Each specific entry contains all information required by APA format including author, year of publication, title of publication, pages, DOI, website, as appropriate.

Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier. 

· Chapter 15, “Evidence-Based Practice” (pp. 342–354)

· Chapter 23, “Public Health Nursing Practice and the Disaster Management Cycle” (pp. 503–528)

· Chapter 24, “Public Health Surveillance and Outbreak Investigation” (pp. 529–544)

· Chapter 25, “Program Management” (pp. 545–567)

· https://www.ted.com/talks/caitria_morgan_o_neill_how_to_step_up_in_the_face_of_disaster

·  

Select an ethnic minority group that is represented in the United States (American Indian/Alaskan Native, Asian American, Black/African American, Hispanic/Latino, Native Hawaiian, or Pacific Islander). Using health information available from Healthy People, the CDC, and other relevant government websites, analyze the health status for this group.

In a paper of 1,000-1,250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:

1. Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group?
2. What are the health disparities that exist for this group? What are the nutritional challenges for this group?
3. Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors.
4. What health promotion activities are often practiced by this group?  
5. Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.
6. What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why?

Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.