At-risk groups include groups of individuals that have high chances of contracting diseases or illnesses. An example of this would be adolescents and young adults. These groups are less likely to use protection with sexual activity. They are also at increased risk for using drugs and alcohol due to peer pressure. More at-risk groups include drug addicts, persons with multiple sex partners, and prostitutes (Smith 198). These groups become vulnerable in their community and then become at-risk because of the

situation they are in.

 

“Vulnerable” groups

 

Vulnerable groups include the elderly, infants, disabled, ill, and poor people (Smith 6). These groups of people are vulnerable to disease and illness and can’t help

themselves from debilitations in health.

 

Both groups have trouble advocating for themselves. Adolescents and young adults tend to shy away from healthcare whether it’s because of embarrassment, poor access, or oblivion. Infants cannot speak for themselves and may have caretakers that are able/willing to speak for them. The elderly often get “lost” in the system and have poor access to healthcare (much like infants). Disabled, ill, and the poor often don’t have access to healthcare as well or they have no one to help them.

 

I would advocate for healthcare for all communities. I would make access to health facilities more available for those in poorer communities. I would encourage free/low-cost preventative healthcare to poorer communities. I would also encourage access to sexual health for adolescents and young adults through schools and community clinics. I work with the elderly and always make sure they are well taken care of and if they are having trouble accessing the appropriate information, I am sure to get in touch with someone

that can help.

 

Everyone deserves access to their health.

 

Smith, Maurer a. Community/Public Health Nursing Practice: Health for Families and Populations, 4th    Edition. W.B. Saunders Company, 102008. VitalBook file.

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120  WORDS

Compare and contrast two change theories, and determine which theory makes the most sense for implementing your specific EBP project. Why? Has your mentor used either theory, and to what result?

 

The first change theory is Lewin’s Change Theory. This theory is very widely used in nursing. This theory has three stages the unfreezing stage, moving stage, and refreezing stage. The theory has driving and resistant forces and for the theory to be successful the driving forces have to overcome the resistant forces. The other change theory is Rogers’ Change Theory. This theory has 5 stages and they are awareness, interest, evaluation, implementation and adoption.(Oguejiofo,2017) It is successful when nurses who ignored the proposed change earlier adopt it because of what they hear from nurses who adopted it initially. Both of these theory’s are widely used in nursing and both require nurses that want the change or who are willing to make the change. My mentor has used the Lewin’s change theory recently. The hospital already has hourly rounding but she just introduced new paperwork that has to be signed every hour. The unfreezing period she just explained how the new way will be better and she showed the nurses how it will be easier because the techs can also sign the sheet. The moving stage she let the nurses tell her how they feel about the whole situation and letting them express what they think will work. The final stage is refreezing and during this stage she went around for the first week making sure the nurses get this in their daily habit. I believe this theory makes more sense to my EBP because there are a lot of nurses that will be the driving force to make this happen and less people being the resistant force. So, it will be more likely to succeed.

References:

 

Oguejiofo,N. September 26, 2017. Change Theories in Nursing. https://bizfluent.com/about-5544426-change-theories-nursing.html

  

Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.

Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.

Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”

Please address the following questions related to the scenario.

What do you suspect is the cause of the patient’s symptoms?

Describe the course of action that you will take to confirm this suspicion and prevent further decline.

What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.

While you are caring for this patient, how will you ensure that the needs of your other patients are being met?

I need a comment for this article 250 words minimun

 

It is obvious that breastfeeding provides the initial nutrients and necessary protection regarding antibodies that infants need as they develop. When a nurse realizes that a mother is reluctant to breastfeeding, it is their respective role first to understand the reasons for the action of the mothers (Christian et al., 2015). The next step would be imparting the newborn mother on the importance of breastfeeding and how it is done for those who have no experience. Other alternatives may include creating groups of mothers who come together to breastfeed with the aim of motivating others in maintaining the practice (Khoury et al., 2016).

            The reasons that may cause a mother not to breastfeed may either be occupational or health, nonetheless, as a nurse, it is important to ensure the infant receives the needed nutrition regardless of means method. Babies during their first months after birth require specific diets that are rich in calcium, iron, zinc, and vitamins A, B, C, D, E, and K (Grummer‐Strawn & Rollins, 2015). All with their specific duties insufficiency of any can have negative developmental effects on the baby. However, it should be noted that all these nutrients are available in breast milk. Nevertheless, mothers are required to maintain an alcohol, tobacco, and any other narcotic free lifestyle as the effects of these substances can affect the infant through the breast milk (Grummer‐Strawn & Rollins, 2015).

            The best response for mothers who are reluctant is to provide them with the information they need to give the best care for the infant. If the mother is reluctant on breastfeeding, then as a nurse the best alternative would be advising the best formulas that can be used to ensure the proper and full development of the baby.

Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

Maria Isabel Manlutac 

 

1 posts

 

Re:Topic 5 Mandatory Discussion Question

 

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

 

     Obesity is defined as excess adipose tissue measured by body mass index (BMI) which is =/>30 (CDC, 2016). It can lead to cardiovascular, respiratory, musculoskeletal, gastrointestinal, psychosocial and problems. At a current weight of 134.5 kg and Ht of 68 inches, Mr.C’s BMI is 46.4, which put him in the category III:  “severe” or morbid obesity (CDC, 2016). Having elevated blood sugar, cholesterol and Triglycerides in addition to low HDL predisposes him to cardiovascular disease including Diabetes Type 2, Hypertension, and Coronary Heart Disease. Bariatric surgery is currently the only treatment that has been found to have a successful and lasting impact for sustained weight loss for severely obese individual. I believe that bariatric surgery is an appropriate intervention.  Mr. C meets the criteria for surgery which include BMI ≥40, Type 2 Diabetes, heart disease and sleep apnea. There is no evidence/s of untreated depression, psychosis, binge eating disorders, bulimia, drug and alcohol abuse, severe cardiac disease with anesthetic risk, coagulation problem, or inability to comply with nutritional requirements on Mr. C’s history that will disqualify him for the surgery (NIDDK, 2016).

 

 

 

Medication Administration

 

1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.  —– Take at 10am, 3pm and 9pm
2. Ranitidine (Zantac) 300 mg PO at bedtime. —– take at 10 pm
3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime. —- take at 6 am, 11 am, 5 pm, and 10:30 pm.

 

Sucralfate can make it harder for the body to absorb other medications you take by mouth. If your doctor does recommend using an antacid, avoid taking it within 30 minutes before or after taking sucralfate. Therefore, Sucralfate should be taken 30 mins after Zantac (Healthwise, 2013).

 

 

 

Functional Health Assessment
Pattern of health perception and health management	Seeks solution for his current medical problem especially being morbidly obese. Follows low salt diet
Nutritional Metabolic Pattern	Eats 4X /day including late night snacking before bedtime Follows low salt diet High cholesterol, triglyceride levels High Fasting blood sugar
Pattern of Elimination	Taking Mylanta and antacids can cause, diarrhea, constipation or bloating
Pattern of Activity and Exercise	Works at catalog telephone center Most probably sitting at work all day
Cognitive Perceptual Pattern	A/O X 4 Works at catalog telephone center
Pattern of Sleep and Rest	Patient with history of sleep apnea
Pattern of self-perception and self-concept	Morbid obesity Looking for solution to lower body weight
Role relationship pattern	32 year-old, single
Sexuality-reproductive pattern	32 year-old, single
Pattern of coping and stress tolerance	Presently diagnosed of peptic ulcer disease which can be a sign of stress
Pattern of value and belief	Overweight since childhood

 

 

 

 

 

What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

 

1. Mr.C’s fasting plasma glucose (FPG) is elevated at 146. A FPG of ≥126 is one criteria of being diagnose of diabetes mellitus (DM) type II. In addition, obesity is the most powerful risk factor of developing DM type II.
2. Cardiovascular problems- Mr.C’s blood pressure and cholesterol levels are high which predisposes him to cardiovascular problems such as coronary vascular disease (CVD) that may lead to myocardial infarction.
3. Respiratory problems such as obesity hypoventilation syndrome due to increased work of breathing. In addition, Mr.C is already suffering from sleep apnea.
4. Potential musculoskeletal problems such as osteoarthritis due to the stress on the weight-bearing joints such as hips and knees.
5. Obesity causes 100,000 cases of cancer in the US each year. It is the most important known preventable cause of cancer. The types of cancer most strongly linked to excess body far are cancer of the breast, endometrium, kidney, colon/rectum, pancreas, esophagus, and gallbladder (Lewis et al., 2011).