Carmen Medina, aged 39, lives with her husband, Raúl, aged 43, who works as a mechanic in a small auto shop. Mr. Medina has worked in the same place since he and his wife came to the United States from Puerto Rico 15 years ago. The Medinas have a 4- year-old son, José; a 16-year-old daughter, Rosa; and an 18-year-old son, Miguel. The Medinas both attended vocational school after completing high school. Mrs. Medina is employed 4 hours a day at a garden shop. She stopped working her full-time job to care for her ill mother and aged father, who do not speak English and depend on government assistance. The family income last year was $28,500. The family has health insurance through Mr. Medina’s job. They live in a threebedroom apartment in a low-income Illinois community. Miguel works in a fast-food store a few hours a week. Because Rosa has responsibilities at home, the Medina’s do not allow her to work outside the home. She is very close to her grandmother but avoids talking with her parents. Both Rosa and Miguel are having difficulties in school. Rosa is pregnant and the family does not know. She is planning to drop out of school, get a job in a beauty shop, and leave home without telling the family. Miguel frequently comes home late and, on occasion, sleeps out of the home. He is beginning college next semester and has plans to move out of the house during the summer. The family is having difficulty dealing with Rosa’s and Miguel’s developmental and behavioral challenges. Although Mrs. Medina is outspoken about these concerns, Mr. Medina is quiet and not actively involved in the discussion. He is more preoccupied with the family’s financial situation. Mrs. Medina’s parents are encouraging them to return to Puerto Rico. Mr. Medina was diagnosed with hypertension 2 months ago, when he went to the emergency room for a respiratory infection. He smokes cigarettes and drinks two to three beers every evening after work. He has not followed up on his blood pressure treatment. Miguel is beginning to smoke, but not at home. José has had frequent colds and sinus allergies. He has been to the emergency room three times during the past year for respiratory infections. Mrs. Medina’s last physical examination was after she had José. She is experiencing insomnia, tiredness, headaches, and gastrointestinal problems. She is very concerned about Rosa and Miguel, her parents, and the family’s finances. Mrs. Medina is Catholic and recently has been visiting her church more often. Study Questions 

1. Explain Mrs. Medina’s attitude in her relationship with her adolescent daughter. 

2. Identify strategies to ensure that Rosa seeks prenatal care. 

3. Identify barriers to accessing health care for the Medina family. 

4. What are the high-risk behaviors exhibited by this family? 

5. What communication barriers exist in this family that affect care delivery? 

6. Discuss gender and family roles in the context of traditional Puerto Rican culture. 

7. Identify sociodemographic factors affecting the physical- and mentalhealth well-being for this family.

8. Identify Puerto Rican folk practices appropriate for this family.

9. If the Medina family chose to visit a folk healer, which one(s) do you think they might visit? Why? 

10. If Mrs. Medina’s parents visit a health-care provider, what might they expect? 

11. Identify culturally congruent interventions to ensure compliance with Western health prescriptions for Mr. Medina.

12. Discuss the importance of respeto and familism in the Medina family. 

13. Identify culturally congruent interventions for Rosa’s pregnancy. 

14. Identify health-promotion and disease-prevention interventions needed for José. 

Edit question’s body

  This I need 3 slides power point. 

1) As a group, develop a 12-15 slide PowerPoint presentation that addresses a childhood disease or illness (infectious, noncontiguous, or congenital) seen in the adult population.

Sickle cell anemia.

Evaluate how this disease or illness impacts the adult client in the following areas:

a) Mentally and emotionally.

b) Physically.

c) Sexually.

2) Include the following in the presentation:

f) A validation of the health problem with demographic and health statistics, including citations of sources.

While APA style format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable, since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.  

Photo Credit: Getty Images

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

To Prepare

• Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
• Reflect on situations in which children should be prescribed drugs for off-label use.
• Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

By Day 5 of Week 11

Write a 1-page narrative in APA format that addresses the following:

• Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
• Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center offers an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

 Select the state where you plan to practice as a nurse practitioner and/or nurse leader and investigate the state’s policies on access to contraception and abortion for women with insurance and those without. What are the state’s infant and maternal mortality rates? Discuss the possible relationship between these factors.  

 As a reminder, all discussion posts must be minimum 250 words, references must be cited in APA format, and must include minimum of 2 scholarly resources published within the past 5-7 years. 

You are now in Phase 6 of your Capstone project. You have developed a comprehensive care plan for the aggregate. Over the next two weeks, you will develop an implementation plan for your aggregate.

The first step to effective implementation is planning. As you go about this task, answer the following questions:

• What small group would you select (for example, three families with young children, a group of five AIDS patients, and so on)? What made you select this particular group?
• What portion of the plan would you like to implement in the small group?
• What health risk do you expect to tackle by implementing this intervention?
• What results do you expect?
• How do you plan to implement this intervention? Do you have any specific strategy in mind? What resources will you need?
• How long do you think it will take for the results to be seen?
• What resources do you need?

By the due date assigned, prepare a 1-2 page Microsoft Word document with your responses to the questions above and submit it to the Submissions Area.