Students are required to submit weekly reflective narratives throughout the course that will culminate in a final, course-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses, and additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge and skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission, each of the areas below should be addressed as part of the summary submission.

1. New practice approaches
2. Interprofessional collaboration
3. Health care delivery and clinical systems
4. Ethical considerations in health care
5. Practices of culturally sensitive care
6. Ensuring the integrity of human dignity in the care of all patients
7. Population health concerns
8. The role of technology in improving health care outcomes
9. Health policy
10. Leadership and economic models
11. Health disparities

Understand & explain first line treatment for the disease.

Understand & explain second line treatment and why you would use second line treatment.

Explain the patient’s medication: minimum of 3-5 medications.

Explain the class of medication.

Explain alternative therapies.

Explain any Black Box warnings, contraindications, and nursing considerations for the medications.

Identify 3-5 common side effects.

Identify any medication interactions

State the common indication for the prescribed medication.

Explain 2 challenges that might prevent them from taking medication as prescribed.

Cite sourcesProvide 3 nursing diagnosis for the patients (primary physical, psychosocial and education) pertinent to this client’s medical diagnosis.

List health assessment priorities for the nursing diagnosis.

State 5 or more appropriate interventions with evidence-based practiced rationale for each action stated for each of the 3 primary nursing diagnosis (cite sources).

Explain relevant lab work that is required with this medical diagnosis.

Working with Families: Applying the Nursing Process
The student nurses are reviewing key concepts about working with families in the community and how to best the steps of the nursing process. The student nurses are quizzing each other about these important concepts for the topic. The student nurses quickly acknowledged that the family unit is the focus of service in community health nursing.
1. It is important for the nurse to understand healthy family characteristics and to use a variety of tools so that family assessments are thorough. What six important characteristics do healthy families demonstrate?
2. The six characteristics of a healthy family provide one assessment framework that community health nurses can use. What three key things must be present in order to assess a family’s health systematically?
3. What are the 12 main categories of family dynamics for which the nurse must collect data?
4. Community health nurses enhance their practices with families by observing five principles. What are the five key principles that enhance their practices with families?

question 2:

Epidemiology in Community Health Care
The community health nurse is reviewing several epidemiologic research studies with student nurses that are beginning a 6-month community health rotation. Epidemiology offers community health nurses a specific methodology for assessing the health of aggregates. The nurse has requested that the student participate in a semester long epidemiologic research study
1. Why is it important that community health nurses review epidemiologic research?
2. What are the seven steps that student nurses must consider when participating with the community health nurse in the epidemiologic research study?
3. The goals of epidemiologic investigation are to identify the causal mechanisms of health and illness states and to develop measures for preventing illness and promoting health. Epidemiologists employ an investigative process that involves a sequence of three approaches that build on one another. What are the three investigate approaches?
4. The community health nurse has been requested to figure out the prevalence rate and the incidence rate of influenza for a 1-month period of time. There were 1,000 students who reported flu-like symptoms during 1 month in a population of 5,000 students at the local community college, and during the same month, 500 individuals developed influenza. What is the prevalence rate and incidence rate?

Hello, I am Isabella. I am 72 years old and a recent widow after the death of my husband Ben, 6 months ago. I have to tell you, things have not been easy for me in this life. But I have always believed you have to take care of yourself.

Even when times get rough, I do as much as I can. I might be a little unorganized sometimes so don’t ask me what day it is!

Back when Ben got
really sick, we decided it was best for me to stop working so I could
take care of him. I loved my job at Sears. I had worked there more than
20 years, ever since Sandra my daughter was in high school. I loved
being with people and helping them find just exactly what they were
looking for.

undefined

At first, Ben could
still do things for himself. He had his little daily routine of things
to do. He would get up and read the paper, walk down to the little
breakfast diner to have some coffee and talk to all his friends there.
In the afternoon we would go to doctor’s appointments and do the
shopping and other errands. He was still real handy around the house. As
time went on, Ben got a little sicker everyday, to the point where in
the last year I was doing everything for him. I have to tell you, I was
getting so tired and run down, never being able to sleep the night
through or have a restful meal.

undefined

Our daughter Sandra,
as busy as she was with her own life—it being a mess and all—would
still try to help out as much as she could. Usually, she would come over
with a meal once a week, and stay with her Daddy while I went to mass
or had a cup of tea with a friend. Her daughters would come and read
stories to their “pa-pop” and sit near him. The smile on his face during
those visits made the whole day better.

undefined

Ben’s medications
and equipment were really, really expensive. Now, since he worked for
the Railroad he had a pretty good pension and health benefits in
retirement, but they would not cover the cost of everything, even after
he got Medicare when he retired. Pretty soon we were nearly completely
out of money. Outside of the house, we owned an old car.

undefined

One day, one of the
neighbors told me about a program which was helping one of her sisters
in another state, PACE. She said they did wonderful things for both the
patient and wife. Well, I asked Sandra about it, and she looked on the
computer at the library and found out that PACE had a program here,
Total Longterm Care. Well, Ben called TLC and someone came out to the
house to talk with us about it. We filled out the form to see if we were
eligible, and we were! Everyone there was so helpful!

undefined

They told us that
TLC would take care of Ben’s medication and equipment, his doctors would
even give him a place to go visit and spend a few hours when he wanted.
To top it off, they would come pick him up for visits or doctor’s
appointments and bring him home. The social worker, Cindy, also told me
that they would send someone to help clean up the house a little and
take care of some of his needs on days he was at home. They helped out
so much let me tell you!

undefined

But now I’m back to
watching every penny since Ben’s death. Just my arthritis medication is
over a hundred dollars a month. I try to stay with the pills. But if I
bought them all like the doctor says, I’d be broke. So I break them in
half or skip a day here and there to help stretch them out. Sandra has
told me I should get Part D insurance for my medications, but it is just
too confusing and overwhelming to me.

undefined

See, since my Ben
died, Sandra has been helping me. I never even wrote a check before
because Ben always did that. But now that he is gone, there just isn’t
enough money for food and medicine and taxes and everything. I think
Sandra is stealing from me though because I think I should have enough
money. But since I don’t know much about the bank account, I can’t argue
much and have to do what she says.

undefined

Sandra and the girls
moved in just last week. But now I think Sandra is stealing from me.
She came home from shopping or work or something, I don’t remember for
sure right now. Well it must have been shopping because she was going to
get her shopping bags out of the trunk. I came to the door to see what
she was doing. I noticed the mail was in the box by the front door. I
opened one bill and it said over $100 was due! How could it be $100? She
must not be paying the bills. So when she was buying more stuff but not
paying my bills, I just had to tell her off.

undefined

See, she keeps
telling me lies. I just can’t take it anymore. She is just getting too
big for her britches I tell you because she told me if I didn’t like it I
could leave. Right then and there I told her she needed a good
spanking. Oh the neighbors heard it alright. And they called the police
for me too. They know. I bet one of their children is stealing from them
too. But Sandra got to talk to the police first. And get this, they
arrested me! How humiliating!

I spent the night in
jail. I was so mad and scared. My sister, Rosella, came and got me from
jail —which was Sandra’s fault in the first place—and then Sandra made
it so I couldn’t go into my own house! That was the last straw. I
fainted and was taken to the emergency room. They said I had a panic
attack this morning. Somebody from social services came while I was at
the jail, but I said I’d rather live with my sister than to go with
them. Now my sister’s husband won’t let me stay there. The only thing I
could think to do was call Cindy, the woman at TLC who was so helpful
with Ben. She is going to meet with me and Sandra at the house this
afternoon.

undefined

Instructions:

undefined

Your paper should be:

• One (1) page or more.

1. Read the scenario above, and then answer the following questions:
   1. What problems are specifically Alison’s as far as her caregiving role?
   2. What describes the health prevention/promotion interventions that Alison needs to consider for her mother?
   3. What specific assessments should Alison consider that she can find on Hartford Institute for Geriatric Nursing (name and describe at least six)
   4. Should Alison
      try to make any adjustments to repair her relationship with her mother?
      How will this help to fulfill her role as a caretaker for her mother?