Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

1. Chickenpox
2. Tuberculosis
3. Influenza
4. Mononucleosis
5. Hepatitis B
6. HIV
7. Ebola
8. Measles
9. Polio
10. Influenza

Epidemiology Paper Requirements

1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2. Describe the social determinants of health and explain how those factors contribute to the development of this disease.
3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

Discussion 1

Melissa, a 12-year-old girl with cystic fibrosis comes to the primary care office with complaints of increased cough and productive green sputum over the last week. She also complains of increasing shortness of breath. She denies sore throat or nasal congestion. On physical examination, her temperature is 101 and she has inspiratory wheezes bilaterally. Negative lymphadenopathy noted. Posterior pharynx is pink without exudate. BP 112/72 HR 96 RR 28. 1.

In cystic fibrosis, the airway microenvironment favors bacterial colonization. In a minimum of 150 words explain the pathophysiological reason for this occurrence.

APA 7 format 

Summary: A theory can be used to guide practice.  This assignment is an exercise in supporting a clinical practice with theory and evidence.

Directions: Identify an outcome of nursing practice in your area of practice that can be improved.  For example, if you work in home health, you may identify that throw rug use by fall risk patients is too prevalent.  You may be able to use the problem that inspired the theory concepts that you developed in week two.

Briefly support why it is a problem with evidence from the literature. This is not the major focus of the assignment so do not elaborate.

Create a clinical nursing (not medical) theory in the form Concept A | Proposition | Concept B. Think of the structure like two nouns and a verb. While the term proposition is much more complex in the dictionary, in our use it is the connecting term between the two concepts. Examples include Concept A improves Concept B, Concept A is related to Concept B, when Concept A increases then Concept B also increases, etc. When you get to research, you will explore this further as you develop independent and dependent variables. How to use these statistically will come in research and statistics courses.

This clinical theory is identified as an empirical theory when you get to the C-T-E model later in this course. It is empirical in that they can be measured.

Identify and define your concepts. Identify how they could be measured in a research study. Be careful that you do not use compound concepts. If you find the words “and” or “or” in your theory, you are probably too complex.

If you research your question and seek funding, you will need a theoretical model to guide the research. In our assignment, we are using Watson. You will identify the concepts in Watson’s theories that are represented by the concepts you are using in your clinical theory. Match the proposition in her theory with your proposition. To help, the 10 Caritas Processes are Concept A. Choose the one that matches your concept. To clarify, let’s look at Caritas 1 Embrace and use it in middle-range theory. Sustaining humanistic-altruistic values by the practice of loving-kindness, compassion, and equanimity with self/others (Concept A – Very complex and abstract) improves (Proposition) subjective inner healing (Concept B). 

Remember that the paper is not about the problem. It is about constructing a clinical theory and matching it to a middle-range theory and conceptual model your clinical theory represents.

Conclude the paper with your discoveries made in your readings and the impact on the nursing profession of your discoveries. Explore, briefly, discovered questions that require further research. Summarize the paper in the conclusion.

Present your outcome in an APA formatted paper that meets the University’s standards for a written assignment.

Expectations

• Due: 5/19/21
• Length: 5 to 7 pages including title and reference pages
• References: 3 to 10.  There should be enough to support the links between the concepts of the problem and the concepts of Watson’s Theory of Caring.

An elderly widow who just lost her spouse. 

Subjective: A patient presents to your primary care office today with chief complaint of insomnia. Patient is 75 YO with PMH of DM, HTN, and MDD. Her husband of 41 years passed away 10 months ago. Since then, she states her depression has gotten worse as well as her sleep habits. The patient has no previous history of depression prior to her husband’s death. She is awake, alert, and oriented x3. Patient normally sees PCP once or twice a year. Patient denies any suicidal ideations. Patient arrived at the office today by private vehicle. Patient currently takes the following medications: 

• Metformin 500mg BID 
• Januvia 100mg daily 
• Losartan 100mg daily 
• HCTZ 25mg daily 
• Sertraline 100mg daily 

Current weight: 88 kg

Current height: 64 inches

Temp: 98.6 degrees F

BP: 132/86 

By Day 3 of Week 7

Post a response to each of the following:

• List three questions you might ask the patient if she were in your office. Provide a rationale for why you might ask these questions. 
• Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why. 
• Explain what, if any, physical exams, and diagnostic tests would be appropriate for the patient and how the results would be used. 
• List a differential diagnosis for the patient. Identify the one that you think is most likely and explain why. 
• List two pharmacologic agents and their dosing that would be appropriate for the patient’s antidepressant therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other. 
• For the drug therapy you select, identify any contraindications to use or alterations in dosing that may need to be considered based on the client’s ethnicity. Discuss why the contraindication/alteration you identify exists. That is, what would be problematic with the use of this drug in individuals of other ethnicities?
•  indicate any therapeutic changes that you might make based on possible outcomes that may happen given your treatment options chosen. 

I had started the discharge project on CVA stroke but it is not completed. Please complete it using the rubric and instruction. There is also a sample project from last year about diverticulitis. Please use the attached text books to assist. the patient is fictional. this is a final project and worth 20%. 

Thank you for your help.