Research

Discussion #1

The Essentials of Master’s Education in Nursing reelects the profession’s continuing call for imagination, transformative thinking, and evolutionary change.

-Explain the importance of following the essentials of Master’s Education in Nursing in a clinical nurse practitioner program such as the FNU?

-Please select one of the essentials and expand as to why the selected essential is crucial in succeeding in this program. (Essentials I-IX)

Discussion Rubric

The initial post will be regarding the topic of the week and will be a minimum of 250 words. Make sure you provide appropriate references and utilize APA style.

 

1Information is clear and relates to topic

2- Provides relevant resources using APA guidelines

3- Enhances the critical thinking process through premise reflection

Please answer each question by separated.

 
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Nursing (Health Assessment)

The needs of the pediatric patient differ depending on age, as do the stages of development and the expected assessment findings for each stage. In a 500-750-word paper, examine the needs of a school-aged child between the ages of 5 and 12 years old and discuss the following:

  1. Compare the physical assessments among school-aged children. Describe how you would modify assessment techniques to match the age and developmental stage of the child.
  2. Choose a child between the ages of 5 and 12 years old. Identify the age of the child and describe the typical developmental stages of children that age.
  3. Applying developmental theory based on Erickson, Piaget, or Kohlberg, explain how you would developmentally assess the child. Include how you would offer explanations during the assessment, strategies you would use to gain cooperation, and potential findings from the assessment.

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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

 
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DQ Response

Carrie

In this discussion board, I will briefly describe my proposed solution to address the suggestion/educational need and how it has changed since I first envisioned it. (P), would providing teaching about tobacco cessation (I) compared to medications to assist in tobacco cessation (C) lead to a decrease in tobacco dependency and better health outcomes (O), after four weeks of intervention date (T)? Provide tobacco cessation techniques through the help of community services to decrease potential health problems secondary to tobacco dependency. The solution to this PICOT statement is to provide all patients who are admitted into the hospital with tobacco addiction, education prior to discharge. The education we provide patients at our facility is a sheet of paper that includes: What is my main problem, what is smoking cessation, what do I need to do, and Why is it important for me to do this? Making the patient aware of the risk they are posing to their health is important. When the patient has this information, they are able to make an informed decision on the next step to receive help with tobacco cessation. The fact that education is needed in order for the patient to begin tobacco cessation has not changed. The way that education is provided has changed. Education can be provided in various ways. In our facility, patients are handed a piece of paper that is reviewed with them with the nurse at bedside. In other facilities, education is performed on the television. Patients must complete the education by discharge. “With tools and smoking cessation resources from the Tips From Former Smokers® (Tips®) campaign, you can ensure your patients have the right resources to begin their quit journeys” (Centers for Disease Control and Prevention, 2019, para. 1). There are many resources and paths a patient can take to quit tobacco products. It is the nurse’s job to provide the patient with a variety of resources so that the patient can decide which method will help them individually be successful with tobacco cessation. Providing the patient options with tobacco cessation has changed my perspective. Not everyone learns the same way. Some people may be visual, tactile, etc. types of learners. Knowing the patients learning style is essential before providing any education. When the patient learns in a way that they better understand, they will be more successful in their cessation journey.

Resource  Centers for Disease Control and Prevention. (2019). Healthcare Providers: Tools and Resources  | Health Care Providers | Partners | Tips From Former Smokers | CDC. Retrieved from   https://www.cdc.gov/tobacco/campaign/tips/partners/health/index.html

 
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Theory Discussion #1

Discuss the various ways in which Florence Nightingale’s model of care can be applied in current nursing practice. Identify the most important factor of Nightingale’s theory that you utilize in your current practice.

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.  Please be sure to cite your reference(s) in APA format, at the end of your posting. 

 
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Week 1

Please answer the following Discussion Question.  Please be certain to answer the three questions on this week DQ and to provide a well-developed and complete answer to receive credit.  Also, please ensure to have read the assigned chapters for the current week.

Q 1: Case Study, Chapter 1, Entry Into Practice: The DThe entry-into-practice debate in the United States continues to be one of the oldest and hottest professional issues nurses face as we enter the second decade of the 21st century. It appears that little progress has been made since 1965 in creating a consensus to raise the entry level into professional nursing practice, although experts do not agree even on that issue. Your neighbors ask you for information about considerations for selection of an appropriate nursing eduhild.

1. Your neighbor is confused because both ADN and BSN schools preparing graduates for RN licensure meet similar criteria for state board approval and have roughly the same number of nursing coursework units. How would you summarize the arguments for changing or not changing the nursing entry level?

2. There is current evidence-based research that explores the impact of registered nurse educational level on patient outcomes. What does the current evidence-based research conclude about the impact of RN educational level on patient outcomes?

3. Achieving the BSN as the entry degree for professional nursing practice will take the best thinking of our nursing leaders. What will it require in order to successfully achieve the BSN as the entry degree for professional nursing practice?

 
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Case Study On Biomedical Ethics In The Christian Narrative

This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles of principlism.

Based on the “Case Study: Healing and Autonomy” and other required topic study materials, you will complete the “Applying the Four Principles: Case Study” document (LOCATED IN ATTACHMENTS) that includes the following:

Part 1: Chart

This chart will formalize principlism and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.

Part 2: Evaluation

This part includes questions, to be answered in a total of 500 WORDS, that describe how principalism would be applied according to the Christian worldview.

Remember to support your responses with the topic study materials.

APA style is not required, but solid academic writing is expected.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

LOOK IN ATTACHMENTS TO COMPLETE THE WORK

 
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PICOT Question And Literature Search

The first step of the evidence-based practice process is to evaluate a nursing practice environment to identify a nursing problem in the clinical area. When a nursing problem is discovered, the nurse researcher develops a clinical guiding question to address that nursing practice problem.

For this assignment, you will create a clinical guiding question know as a PICOT question. The PICOT question must be relevant to a nursing practice problem. To support your PICOT question, identify six supporting peer-revised research articles, as indicated below. The PICOT question and six peer-reviewed research articles you choose will be utilized for subsequent assignments.

Use the “Literature Evaluation Table” to complete this assignment.

  1. Select a nursing practice problem of interest to use as the focus of your research. Start with the patient population and identify a clinical problem or issue that arises from the patient population. In 200–250 words, provide a summary of the clinical issue.
  2. Following the PICOT format, write a PICOT question in your selected nursing practice problem area of interest. The PICOT question should be applicable to your proposed capstone project (the project students must complete during their final course in the RN-BSN program of study).
  3. The PICOT question will provide a framework for your capstone project.
  4. Conduct a literature search to locate six research articles focused on your selected nursing practice problem of interest. This literature search should include three quantitative and three qualitative peer-reviewed research articles to support your nursing practice problem.

Note: To assist in your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Search for diabetes and pediatric and dialysis. To determine what research design was used in the articles the search produced, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods. Systematic Reviews, Literature Reviews, and Metanalysis articles are good resources and provide a strong level of evidence but are not considered primary research articles.  Therefore, they should not be included in this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines

 
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Need Response To Below Discussion Post

APA format 1 page long 3 references and please include one from discussion post

MSN degree Need ASAP for 9/7/19.

 

Audience

First-year nursing students come in an associate degree nursing program have typical prerequisite coursework, yet often come with a high degree of variable life experiences. Nursing students, in general, are academic achievers who could not be admitted to their program without a high grade point average. Prerequisite coursework, such as anatomy and physiology, resides at the knowledge and comprehension level of Bloom’s taxonomy, which requires students to explain, memorize, and describe concepts (Bristol & Kerwekh, 2011).  Early nursing coursework begins to include application and analysis where students must criticize, compare, and develop ideas. For many, this is a big leap. Bradshaw and Hultquist (2017) describe that students’ progress through learning via set steps. The first step is dualistic thinking where concepts are black and white. This progresses to multiplicity, where more diverse ideas are tolerated. Nursing students also experience a difficult transition to understanding the conceptual grey areas.

Learning Need

Early in the nursing program, students are expected to identify scholarly versus non-scholarly sources of information. Students are expected to include scholarly sources in their self-directed learning and include these in their assignments. Being able to evaluate evidence is critical for patient safety as they advance in their training and career (Horntvedt, Nordsteien, Fermann, & Severinsson, 2018).  The following are two learning objectives for this lesson:

  • Summarize the difference between academic and non-academic sources of nursing knowledge
  • Provide two examples of academic sources of knowledge

Horntvedt et al. (2018) found that interactive teaching and integration into clinical practice were effective strategies for teaching students to evaluate evidence.  The learning activity will provide necessary information about scholarly sources of information in an online format. This lesson will use a video presentation to highlight critical concepts related to assessing academic sources of information. During the lesson, students will be shown five different sources of information and be asked to rank the sources in order of most reliable to least reliable.

Evaluation

Shank (2005) emphasizes the need to match the skill level of the learner with the learning objectives and activities. For first-year nursing students, a basic understanding of scholarly versus non-scholarly work is appropriate. An analysis of formal research study validity is beyond the scope of what is needed at their level. The verb summarize corresponds with the knowledge level of learning in Bloom’s taxonomy. The second objective asks the student to provide two examples, which demonstrates comprehension-level understanding in Bloom’s. Both objectives, if successfully met, will allow the student to complete the required work, accessing scholarly work, successfully.

References

Bradshaw, M. J., & Hultquist, B. L.  (2017). Innovative teaching strategies in nursing and

            related health professions (7th ed.). Burlington, MA: Jones and Bartlett.

Bristol, T. J., & Zerwekh, J. (2011). Essentials of e-learning for nurse educators. Philadelphia,

PA: F. A. Davis Company.

Horntvedt, M.-E. T., Nordsteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for

teaching evidence-based practice in nursing education: a thematic literature review. BMC MEDICAL EDUCATION, 18. https://doi-org.ezp.waldenulibrary.org/10.1186/s12909-018-1278-z

Shank, P. (2005). Writing learning objectives that help you teach and students learn (Part 1).

Online Classroom, 4–7. Retrieved from the Walden Library databases.

 
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QI Report Of Project: Written

Instructions:

This is a group assignment. During Week 1, you will self-select and self-enroll to groups (3 persons/group). If enrollment numbers/changes require a different number, please coordinate with faculty. Faculty will assign your group a case study and data; this is what you will work with the remainder of the course to create your final QI report. Please find your case study and data, along with other project resources in “QI Project Resources: (button found on L-hand side of course site). The case study will prompt you to consider best practices regarding a particular clinical problem (e.g., preventing/reducing falls). Please note how Discussion board topics Weeks 2-4 prompt you to individually complete several portions of this project. Use the individual work done in these discussions and the opportunity to see others’ work and receive feedback to refine your group’s work on the final QI report.

You and your group mates are responsible for 1) initiating contact with each other, 2) exchanging contact information, 3) creating a timeline for assignment completion, 4) determining collaborative tools you’d like to use to complete the assignment (e.g., Google Docs), 5) identifying and assigning group roles and distributing work load evenly, and 6) maintaining effective communication with each other (e.g., conflict prevention and resolution, timely and frequent communication, etc.). Collaborative resources are available to assist you, under “Course Support” (L-hand side of course site).

Using your assigned project (i.e., case study/data), components of the final written report must include:

Background of the problem

  • Depth and breadth of the problem (e.g., national statistics and local data to demonstrate a problem exists)
  • Definition of the problem with references
  • PICO question

Evidence

  • What evidence did you find? Synthesize the evidence
  • Appraisal of the evidence using the JBI appraisal tools (include as appendix)
  • Levels of evidence

Analysis of Current Condition

  • Narrative and table, graph, flow chart of current condition (data from assigned problem)
  • Include missed opportunities (examination of current process versus what the evidence says should be done using a flowchart); these are your indicators.

Cause Analysis

  • Root Cause Analysis and Fishbone Diagram. Identify where the problems exist that you will address.

Action Plan for Each Indicator

  • What the evidence says should be done. The changes that should occur in order to improve practice, to include:
    • Indicator (look at your indicator sheet): Provide the evidence to support in one sentence.
    • Measurement: Numerator and denominator. How will you measure that the change is being done?
    • Goal: What is your goal data? Benchmarks?
  • Implementation:  Include Best Practices for implementing your change and evidence to support your implementation strategy
  • Create a table with the following information for each indicator:
    • Who (is responsible)?–>Describe who is responsible
    • What (are they responsible for?)–>Explain what they are responsible for completing (each indicator described above)
    • Why (did you select this person?)–>Rationale for why this person should be responsible for this action
    • When (will they perform the action?)–>What is the timeline for completing the task?
    • How (will they complete the action?)–>Explain how the person should complete the action (think of implementation described above)
    • Completion Date–>Date for completing the action

References

There is no template for the written report; it is up to your group how to best present content in a professional and scholarly manner. Please include the following as part of your final product:

Names and Summary of Contributions of Group Members completing assignment.docx

RCA(Root Cause Analysis):

 

1- There is only one WSCN for entire facility to provide wound care.

  2– The WSCN only provides care on Monday-Friday from 8am-7pm.

3-The WSCN has no speciality certification or master’s degree in wound care.

  4- Patients are only assessed once per shift, which should be assessed during every shift.

  5-  Nurses on the floor don’t have skills and proper training or education on assessment and treatment of pressure ulcers.

 6- There is no clear path or protocol in wound care within the facility.

    7- Lack of effective communication between nurses for patients who need wound care in case for any technical issue it doesn’t appear in generated computer list.

PICO question:

For hospitalized patients with restricted movement, does the use of I.S.K.I.N bundles reduce the future rate of HAPU compared to the current hospital regulations?

Best Available Evidence Action Plan
-Frequent position changes (at least every two hours)

-Avoid friction and shear when repositioning.

-When repositioning, use proper technique.

-Implement pressure relieving mattresses or surfaces.

-Avoid turning patient on an area that is already reddened related to pressure.

-For pressure ulcer prevention, do not rub or massage area.

-Emollients can be used to hydrate the skin.

-Barrier creams to protect skin from increased moisture.

-Frequent skin assessments per protocol.

-Nutritional risk assessments with interventions.

-Additional protein supplements in additional to their regular diet  Alderden et al (2011) list the following best practices in preventing HAPU’s.

 
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Case Studies

Complete the following:

  • African-American case study #2
  • Appalachian case study #1

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FRICAN AMERICAN CASE STUDY #2
Mr. and Mrs. Evans are an African American couple who retired from the school
system last year. Both are 65 years of age a
nd reside on 20 acres of
land in a large rural
community approximately 5 miles from a Superfund site and 20 miles from two
chemical plants. Their household consists of
their two daughters, Anna, aged 40 years,
and Dorothy, aged 42 years; their grandc
hildren, aged 25, 20, 19, and 18; and their 2-
year-old great-grandson. Anna and Doro
thy and their children all attended the
university.
Mr. Evans’s mother and three of his
nieces and nephews live next door. Mr.
Evans’s mother has brothers, sisters, ot
her sons and daughters, grandchildren, and
great-grandchildren who live ac
ross the road on 10 acres of land. Other immediate and
extended family live on the 80 acres adjacent
to Mr. Evans’s mother. All members of
the Evans family own the land on which they live.
Mrs. Evans has siblings and extended fa
mily living on 70 acres of land adjacent
to Mr. Evans’s family, who live across the road. Mr. and Mrs. Evans also have family
living in Chicago, Detroit, New York, Sa
n Francisco, and Houston. Once a year, the
families come together for a reunion. Every other month, local family members come
together for a social hour. The family believes in
strict discipline with
lots of love. It is
common to see adult members of the family
discipline the younger children, regardless
of who the parents are.

Mr. Evans has hypertension and diabetes
. Mrs. Evans has hypertension. Both
are on medication. Their daughter Dorothy is
bipolar and is on me
dication. Within the
last 5 years, Mr. Evans has had several re
latives diagnosed with lung cancer and colon
cancer. One of his maternal uncles died last
year from lung cancer. Mrs. Evans has
indicated on her driver’s licen
se that she is an organ donor.
Sources of income for Mr. and Mrs. Ev
ans are their pensions from the school
system and Social Security. Dorothy receives SSI because she is unable to work any
longer. Mr. Evans and his br
others must assume responsibility for their mother’s
medical bills and medication. Although she ha
s Medicare parts A and B, many of her
expenses are not covered.
Mr. and Mrs. Evans, all members of th
eir household, and al
l other extended
family in the community attend a large Bap
tist church in the city. Several family
members, including Mr. and Mrs. Evans, sing
in the choir, are members of the usher
board, teach Bible classes,
and do community ministry.
Study Questions
1.
Describe the organizational st
ructure of this family and identify strengths and
limitations of this
family structure
.
2.
Describe and give examples of what you be
lieve to be the family’s values about
education.
3.  Discuss this family’s
views about child rearing.

4. Discuss the role that spirituality plays in this family.
5.
Identify two religious or spiritual practices in which members of the Evans
family may engage for treating hypert
ension, diabetes, and mental illness.
6.
Identify and discuss cultural
views that Dorothy and her parents may have about
mental illness and medication.
7.
To what extent are members of the Evans fa
mily at risk for illnesses associated
with environmental hazards?
8.
Susan has decided to become an organ donor. Describe how you think the Evans
family will respond to her decision.
9. Discuss views that African Ameri
cans have about advanced directives.
10. Name two dietary health risks for African Americans.
11.
Identify five characteristics to consider
when assessing the skin of African
Americans.
12. Describe two taboo views that Afri
can Americans may have about pregnancy.

AMISH CASE STUDY
Elmer and Mary Miller, both 35 years old, liv
e with their five children in the main
house on the family farmstead in one of th
e largest Amish settlements in Indiana.
Aaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents’
cottage. Mary is the youngest of their ei
ght children, and when she married, she and
Elmer moved into the grandparents’ cottage
with the intention that Elmer would take
over the farm when Aaron wanted to retire.
Eight years ago, they traded living space.
Now, Aaron continues to help with
the farm work, despite increasing pain in hi
s hip, which the doctor advises should be
replaced. Most of Mary’s and Elmer’s sibli
ngs live in the area, though not in the same
church district or settlement. Two of Elmer’s brothers and their families recently
moved to Tennessee, where farms are less expensive and where they are helping to
start a new church district.
Mary and Elmer’s fifth child, Melvin,
was born 6 weeks prematurely and is 1
month old. Sarah, aged 13, Martin, aged
12, and Wayne, aged 8, attend the Amish
elementary school located 1 mile from thei
r home. Lucille, aged 4, is staying with
Mary’s sister and her family for a w
eek because baby Melvin has been having
respiratory problems and their physician told
the family he will need to be hospitalized
if he does not get better within 2 days.
At the doctor’s office, Mary suggested
to one nurse, who often talks with Mary
about “Amish ways,” that Menno Martin, an
Amish man who “gives treatments,” may
be able to help. He uses “warm hands” to
treat people and is
especially good with

babies because he can feel what is wrong. Th
e nurse noticed that Mary carefully placed
the baby on a pillow as she prepared to leave.
Elmer and Mary do not carry any hea
lth insurance and are concerned about
paying the doctor and hospital bills associat
ed with this complicated pregnancy. In
addition, they have an appointment for Wayne
to be seen at Rile
y Children’s Hospital,
3 hours away at the University Medical Cent
er in Indianapolis, for a recurring cyst
located behind his left ear. Plans are being
made for a driver to take Mary, Elmer,
Wayne, Aaron, Annie, and two of Mary’s sist
ers to Indianapolis
for the appointment.
Because it is on the way, they plan to stop in
Fort Wayne to see an Amish healer who
gives nutritional advice and does “treatment
s.” Aaron, Annie, and Elmer have been
there before, and the other women are considering having treatments, too. Many
Amish and non-Amish go there and tell others
how much better they feel after the
treatments.
They know their medical expenses seem minor in comparison to the family
who last week lost their barn in a fire
and to the young couple whose 10-year-old child
had brain surgery after a fall from the hayl
oft. Elmer gave mone
y to help with the
expenses of the child and will go to the barn raising to help rebuild the barn. Mary’s
sisters will help to cook for the barn raisi
ng, but Mary will not help this time because
of the need to care for her newborn.
The state health department is concer
ned about the low immunization rates in
the Amish communities. One community-health nurse, who works in the area where
Elmer and Mary live, has volunteered to talk
with Elmer, who is on the Amish school
board. The nurse wants to learn how the health
department can work more closely with

the Amish and also learn more about what
the people know about immunizations. The
county health commissioner thinks this is a wast
e of time and that what they need to do
is let the Amish know that they are creating
a health hazard by ne
glecting or refusing
to have their children immunized.
Study Questions
1.
Develop three open-ended questions or
statements to guide you in your
understanding of Mary and Elmer and what
health and caring mean
to them and to
the Amish culture.
2.    List four or five areas of perinatal
care that you would want to discuss with Mary.
3.    Why do you think Mary placed the baby
on a pillow as she was leaving the doctor’s
office?
4.     If you were the nurse to whom Mrs. Mill
er confided her interest in taking the baby
to the folk healer, what would you do to le
arn more about their simultaneous use of
folk and professiona
l health services?
5.     List three items to discuss with the M
illers to prepare them fo
r their consultation at
the medical center.
6.    If you were preparing the reference fo
r consultation, what would you mention about
the Millers that would help to promote cu
lturally congruent ca
re at the medical
center?
7.    Imagine yourself participa
ting in a meeting with state
and local health department
officials and several local physicians and nur
ses to develop a plan to increase the

immunization rates in the
counties with large Amish
populations. What would you
suggest as ways to accomplish this goal?
8.
Discuss two reasons why many Old Orde
r Amish choose not to carry health
insurance.
9.
Name three health problems with genetic
links that are prevalent in some Amish
communities.
10.
How might health-care providers use the
Amish values of the three-generational
family and their visiting patterns in pr
omoting health in the Amish community?
11.   List three Amish values to consid
er in prenatal education classes.
12.
Develop a nutritional guide for Amish wome
n who are interested in losing weight.
Consider Amish values, daily lifestyl
e, and food production and preparation
patterns.
13.   List three ways in which Amish express caring.

APPALACHIAN CASE STUDY #1
William Kapp, aged 55 years, and his wife, Gloria, aged 37, have recently moved from an
isolated rural area of northern Appalachia
to Denver, Colorado, because of Gloria’s
failing health. Mrs. Kapp has had pulmonary t
uberculosis for several years. They decided
to move to New Mexico because they heard that the climate was better for Mrs. Kapp’s
pulmonary condition. For an unknown reason, they stayed in Denver, where William
obtained employment making machine parts.
The Kapp’s oldest daughter, Ruth, ag
ed 20, Ruth’s husband, Roy, aged 24, and
their daughter, Rebecca, aged 17 months, moved with them so Ruth could help care for
her ailing mother. After 2 months, Roy return
ed to northern Appalachia because he was
unable to find work in Denver. Ruth is 3 months’ pregnant.
Because Mrs. Kapp has been feeling “mor
e poorly” in the last few days, she has
come to the clinic and is accompanied by her husband, William, her daughter Ruth, and
her granddaughter, Rebecca. On admission, Glor
ia is expectorating greenish sputum,
which her husband estimates to be about a teac
upful each day. Gloria is 5 ft 5 in. tall and
weighs 92 pounds. Her temperature is 101.4°F,
her pulse is regular at 96 beats per
minute, and her respirations are 30 per minute
and labored. Her skin is dry and scaly with
poor turgor.
While the physician is examining Mrs. Kapp, the nurse is taking additional
historical and demographic da
ta from Mr. Kapp and Ruth. Th
e nurse finds that Ruth has
had no prenatal care and that her first chil
d, Rebecca, was delivered at home with the
assistance of a neighbor. Rebecca is pale and
suffers from frequent bouts of diarrhea and

colicky symptoms. Mr. Kapp declines to offer in
formation regarding his health status and
states that he takes care of himself.
This is the first time Mrs. Kapp has s
een a health-care provider since their
relocation. Mr. Kapp has been treating his wife
with a blood tonic he makes from soaking
nails in water; a poultice he ma
kes from turpentine and lard,
which he applies to her chest
each morning; and a cough medicine he makes from rock candy, whiskey, and honey,
which he has her take a tablespoon of four
times a day. He feels this has been more
beneficial than the prescription medicati
on given to them before they relocated.
The child, Rebecca, has been taking a
cup of ginseng tea for her colicky
symptoms each night and a cup of red ba
rk tea each morning for her diarrhea.
Ruth’s only complaint is the “sick headach
e” she gets three to four times a week.
She takes ginseng tea and Epsom salts for the headache.
Mrs. Kapp is discharged with prescr
iptions for isoniazid, rifampin, and an
antibiotic and with instructions to return in
1 week for follow-up based on the results of
blood tests, chest radiograph, and sputum cultures.
She is also told to return to the clinic
or emergency department if her symptoms
worsen before then. The nurse gives Ruth
directions for making appointments with the pr
enatal clinic for herself and the pediatric
well-child clinic for Rebecca.
Study Questions
1.
Describe the migration patterns of
Appalachians over the last 50 years.
2.
Discuss issues related to autonomy
in the workforce for Appalachians.

 
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