CASE STUDY

You are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived alone in a small apartment. The patient reported on admission that she has no surviving family. Her support system appears to be other elders who live in her neighborhood. Because of transportation difficulties, most of them are unable to visit frequently. One of her neighbors has reported that she is caring for the patient’s dog, a Yorkshire terrier. As you care for this woman, she begs you to let her friend bring her dog to the hospital. She says that none of the other nurses have listened to her about such a visit. As she asks you about this, she begins to cry and tells you that they have never been separated. You recall that the staff discussed their concern about this woman’s well-being during report that morning. They said that she has been eating very little and seems to be depressed.

1. Based on Nightingale’s work, identify specific interventions that you would provide in caring for this patient.

2. Describe what action, if any, you would take regarding the patient’s request to see her dog. Discuss the theoretical basis of your decision and action based on your understanding of Nightingale’s work.

3. Describe and discuss what nursing diagnoses you would make and what interventions you would initiate to address the patient’s nutritional status and emotional well-being.

4. As the patient’s primary nurse, identify and discuss the planning you would undertake regarding her discharge from the hospital. Identify members of the discharge team and their roles in this process. Describe how you would advocate for the patient based on Nightingale’s observations and descriptions of the role of the nurse.

Select two clients you observed or counseled this week during a family therapy session. Note: The two clients you select must have attended the same family session. Do not select the same family you selected for Week 2.

Then, address in your Practicum Journal the following:

• Using the DSM-5 criteria, explain and justify your diagnosis for each client.
• Explain whether solution-focused or cognitive behavioral therapy  would be more effective with this family. Include expected outcomes  based on these therapeutic approaches.
• Explain any legal and/or ethical implications related to counseling each client.
• Support your approach with evidence-based literature.

** No plagiarism

** Four references required

** Please see attachments for assignment completion

Research Paper #1:  APA STYLE        REFER TO THE RUBRIC ATTACHED PLEASE

Please, review the following case study. The following questions with guide your research paper. 

Maria is 15 years old and 74 pounds overweight. Her father is an uber driver who was recently diagnosed with type 2 diabetes and cardiovascular disease. Her mother works for a cleaning company. She is overweight with lipid disorder (high blood levels of low-density lipoprotein (LDL) cholesterol and triglycerides). She is taking two antihypertensive medications at present time. At a recent health science fair at Maria’s school, a student-led screening clinic documented Maria’s blood pressure at 141/92 mm Hg. The family immigrated from Nicaragua 3 years ago and they do not have health insurance. 

During health science fair, the following data was recorded: 56% of the students with BMI 25.0 to <30 and 18% of the students with BMI 30.0 or higher.

Consider yourself a community health nurse. 

1. Is obesity a major health issue in the United States? 

2. According to the National Health and Nutrition Examination Survey (NCHS, CDC; BRFSS, 2012), how is obesity defined?

3. What is your role as a community nurse? 

4. What risk factors should be explored for Maria’s family for cardiovascular disease? Mention social determinants of health in this case. Incorporate the concepts of health promotion and risk reduction. 

5. Would you apply any of the behavioral change models to address health promotion and risk reduction in this case (theoretical frameworks of behavioral change / models discussed on Chapter 5 of textbook). Describe your selection. 

6. Public health nurses use statistics to demonstrate the need for obesity program development and community interventions. According to the most recent CDC data: What data were identified about obesity in children and adults? 

7. Is there a necessity of planning a community nursing intervention? How will you do that? Will you work alone or in collaboration / teamwork? Will you look for funding? How? 

8. If you decide to do a community intervention. How would you evaluate the community-level intervention(s)? 

9. Will you use social marketing to change health behaviors or beliefs, social or cultural norms, or community standards to improve health or benefit society. Which resources will you use?

10. Mention research studies that support any of the above (1 through 9) (mention at least 3 research studies in the paper).

the discussions are below. I just want a response between 150 and 170 words excluding references for each one.

two references needed for each one

    All papers submitted must be in APA format according to the Publication Manual American Psychological Association (APA) (7th ed.). 2020 ISBN: 9781433832154, 1433832151 

discussion 1

Opioids are used widely in the United States (US) to treat millions of patients who have high levels of pain. A majority of these patients are older adults. With complications that come with aging, it is important that care givers be keen on how they medicate geriatric patients using opioids. I’m instreated on knowing how the used of opioids effect the againg population. In my opinion i think alternative medications should be used. Because Slight mistakes of excessive used of opioids can result in complications such as physiologic difficulties and addiction to the drug

Old age comes with physiologic complications that may be increased by the wrong use of opioid medication. It is difficult to forecast how the elderly will react to opioid treatment. Health providers ought to make thorough evaluation on their patients like asking them to describe their levels of pain before beginning any form of treatment (Tracy, 2013). For instance, how one’s liver functions should be observed to ensure proper dosage. If not checked, opioid medication can result in difficulties such as a stressed respiratory system. It is also vital to monitor the period of time that the medication will be administered.

New research suggests that geriatric patients are just as likely to get addicted to opioid medications similar to young adults. This fact was unknown for a long time because such cases were rarely ever reported or noticed. The emerging research gives evidence that as much as the numbers of elderly patients addicted to opioid drugs are lower than that of young adults, the cases of addiction are on the rise (Gazelka, Leal, & Lapid, 2020). Stereotyping and stigmatization contributes to low discovery of addicted geriatric patients by health care providers. 

discussion 2

The topic that I will conduct the research on is about ischemic stroke. Reports show that, stroke is among the leading causes of deaths globally; around 795, 000 individuals, die of stroke in the United States alone, every year (Boehme et al., 2018). The individuals who are more predisposed to the condition are the elderly. The past few years have seen a record decrease in the number of mortalities from the disease. However, recent studies have shown that the numbers are rising again, due to unknown reasons. It has therefore been the motivation behind selecting this topic, to find out the reason behind the rising cases, including how to prevent, diagnose, and manage the condition, to reduce the mortality rates.

The most common type of stroke is ischemic stroke, which occurs due to the formation of a blood clot in the artery that supplies blood to the brain, causing a blockage. This blockage prevents the flow of blood and oxygen into brain, damaging the brain cells (Musuka et al., 2015). The common cause of the condition is the narrowing of the arteries, which is commonly caused by the gradual deposition of cholesterol on the artery walls (atherosclerosis). The effects that ischemic stroke has on a patient are life changing. It affects the vision, speech, the coordination and movement, and the general mental health of a patient.

Another critical issue to worry about stroke is the cost and the burden that the disease leaves on the healthcare services, on the economy; missed workdays, and on the medications. In my family, we had an individual who suffered from acute ischemic stroke, and the condition was worse. therefore, doing this research will help me found out the common and recent predisposing factors to the condition, and find out the advanced forms of treatment, that can help stroke patients live a smooth live a smooth life. 

 discuss potential obstacles that each aging issue may face if it were put to a popular vote. Is there an issue that may be harder than others to gather support if left to popular opinion? Your reply posts should be 100 to 150 words, with a minimum of one supporting reference included .

Response 1 

Social isolation is a major health problem that’s receiving more attention especially during the Covid-19 pandemic. The AARP Foundation (2016) has reported that social isolation is growing into a pandemic as over 8 million older adults are affected by this issue. Social isolation is associated with multiple health problems such as neglect of health practices, cognitive impairment and more (Lubben, 2018).
As individuals grow older changes in abilities, physical and social environments occur. Social isolation becomes part of the person’s life and affects them negatively. Some of the risk factors to social isolation include depression, hearing impairment, poor health, death of a spouse, friends or relatives. Individuals who are isolated are more likely to develop physical and mental health problems, dementia and suicidal risk; it also leads to increased risk for hospitalization (Hand, 2017).
All of these elements stated above are valuable findings that justify the reason why social isolation should be placed at the top of the list of social issues in aging. Social isolation is the catalyst for the development of many health problems and mental health issues in older adults. Second on the list should be addressing gaps in mental health services.
Researchers predict that the Coiv-19 pandemic will lead to a range of long-term mental health problems. They attest that the U.S is not fully ready to handle the wave of health problems caused by the global pandemic concurrently with the increased life expectancy. In order to face those challenges all health professions need to join forces and develop strategies to deliver appropriate care to individuals and empower global health community to care for the aging population (Vahia, 2020).

Response 2

As a senator preparing for this year’s policy agenda, it is imperative to address current social aging concerns.  The following concerns will be the main focus of this year’s agenda, and are listed from highest to lowest priority: social isolation, mental health service gaps, fall prevention programs, and HIV/AIDS interventions. With the current covid-19 pandemic, social isolation amongst the elderly is of biggest concern as it impacting both physical and mental health. In a study completed by Sepúlveda-Loyola et al. (2020), results determined that physical and mental health have been negatively impacted amongst the elderly population due to the social restrictions associated with the pandemic. Reported effects include anxiety, depression, poor sleep quality, and lack of physical activity (Sepúlveda-Loyola et al., 2020). Is it imperative to develop policies that will increase social interactions amongst the elderly population without putting their health at risk. The next most important concern to be addressed is the gap of mental health services available to the elderly population. Anxiety and depression are common amongst older adults; yet mental health services are limited, and underused by older adults (Parkar, 2015). Policies must be put into place to increase access to mental health services while removing the stigma surrounding mental health problems. 

Every year, one out of every four adults aged 65 and older experiences a fall, with one out of every five falls resulting in a serious injury (CDC, 2017). Every year, roughly 300,000 older adults are hospitalized for a hip fracture, with 95% of those fractures resulting from a fall (CDC, 2017). Fall prevention programs must be put into place in order to reduce the risk of an older adult experiencing a fall, as a fall can greatly limit an older adult’s ability to complete activities of daily living. Lastly, HIV/AIDS interventions is a social health concern that must be addressed. In 2018, 51% of individual with HIV were 50 years of age and older, and 1 in 6 newly diagnosed HIV cases were amongst people aged 50 and older (CDC, 2020). Policies must be put into place in order to prevent HIV and AIDS amongst older adults by increasing awareness, providing education on prevention, and providing resources for testing.