colon cancer six months ago H e a l t h M e d i c a l

DISCUSSION # 1

Scenario #1 – Mental State:

Stacey Brown, an 18-year-old Hispanic female, comes to the Emergency Room with complaints of feeling sad. She states “I don’t want to live anymore”. She states that her boyfriend broke up with her 2 months ago and has a new a girlfriend. She lives at home with her mother and her mother’s boyfriend.

• Based on her presenting signs, what other questions would you elicit?
• How would you demonstrate knowledge of cultural sensitivity/humility in approach to this patient?
• What would you assess?
• What could be the problem?

DISCUSSION # 2

Scenario #2 – Cardiovascular:

Mrs. B, a 62-year-old Asia female, is admitted to the telemetry floor with chest pain unrelieved by rest. She owns her own restaurant and has been working overtime since they are short staffed. Her vital signs are as follow: Temperature 98.8F, Pulse 88 even/irregular, Respiration 22 even/unlabored, Blood Pressure 140/92. She has a history of High blood pressure and states “I ran out of my blood pressure medicine”.

1. Based on her presenting signs, what other questions would you elicit?
2. How would you demonstrate knowledge of cultural sensitivity/humility in approach to this patient?
3. What would you assess?
4. What could be the problem?

DISCUSSION # 3

Scenario #1 – The Breasts and Axillae:

Ms. C., a 50-year-old African American cashier at a major supermarket chain, comes to the clinic because she has a lump in her left breast. She first noticed it 3 months ago. It is tender to touch, and it has increased in size. There are no changes in the skin over her breast. She denies fever or chills, and she is not breast-feeding. Her medical history is unremarkable. She has never had surgery. She drinks socially, and smokes two packs of cigarettes per day. She does not exer.cise. She eats foods high in fat. She is married and has two children, ages 13 and 25. Her mother died of breast cancer at the age of 65.

1. Based on her presenting signs, what other questions would you ellicit?
2. How would you demonstrate knowledge of cultural sensitivity/humility in approach to this patient?
3. What would you assess?
4. What could be the problem?

DISCUSSION # 4

Scenario #1 – Female Genitalia:

Ms. G., a 23-year-old Hispanic female, came to the clinic for an annual Pap Smear and complains of having a thick, cheesy, white vaginal discharge with itching that has been present for one week. She denies burning during urination. Ms. G. is sexually active in a monogamous relationship with her boyfriend of three years. She states that she and her boyfriend have no other sexual partners. She denies fever, chills, abdominal pain, or pelvic pain. Her last menstrual period was three weeks ago. She does not have any children and is currently attending a local community college and does not have any health insurance. She states “I don’t know how this could happen to me; I am only seeing my boyfriend”. She indicates she is satisfied sexually and she uses oral contraceptives.

1. Based on her presenting signs, what other questions would you elicit?
2. How would you demonstrate knowledge of cultural sensitivity/humility in approach to this patient?
3. What would you assess?
4. What could be the problem?

DISCUSSION # 5

Scenario #2 – The Nervous System:

Mr. T, a 67-year-old Asian, is complaining of extreme tiredness and has not been able to focus on his job for the last 2 months. He is wondering if he can take vitamins or energy drinks to get his energy back. He admits that he has some marital problems at home since his wife has cheated on him with another man. He states he is feeling depressed about the whole situation but does not know how to regain his strength. Mr. T has a history of prostate cancer and hypertension. He is currently taking Tamoxifen, Lexapro, and Atenolol.

1. Based on his presenting signs, what other questions would you elicit?
2. How would you demonstrate knowledge of cultural sensitivity/humility in approach to this patient?
3. What would you assess?
4. What could be the problem?

DISCUSSION # 6

Scenario #2 – The Pregnant Woman:

Marsha Jones, a 28-year-old Chinese female, is 6 months pregnant with no health insurance. She did not seek medical attention for prenatal care. She has two children at home ages 7 and 4. She states “I have not been able to eat for the past two days” and complains of feeling dizzy. Her vital signs are as followed: Temperature 98.6 F. Pulse 98, Respiration 20, Blood pressure 140/92. Her medical history reveals that her mother has a history Hypertension.

1. Based on her presenting signs, what other questions would you elicit?
2. How would you demonstrate knowledge of cultural sensitivity/humility in approach to this patient?
3. What would you assess?
4. What could be the problem?

DISCUSSION # 7

2. Write 1-2 paragraphs (100-200 words) briefly stating how you think your specific practice can use EBP. Be sure to address the specific population whom you serve. ( MIAMI SOUTH FLORIDA)
5. DISCUSSION # 8
6. Read the case study below and answer the following questions:
   • What are the socioeconomic and health system factors influencing this situation?
   • What stressors are probably affecting this family?
   • What nursing interventions might you employ to assist this family?
   • How can community resources be a potential help?
   • Case Study
   • Mrs. C is a 45-year-old Hispanic single mother of three children, a girl of thirteen years and two boys of ages nine and six. She has recently divorced her husband. She was diagnosed with colon cancer six months ago and is scheduled to have a bowel resection in three weeks.

     Mrs. C. is also responsible for taking care of her disabled sister who also has a boy of ten years of age.

     Her mother is hospitalized due to a recent stroke and is an insulin-dependent diabetic. She also has Alzheimer’s disease.

     Mrs. C.’s former husband lives in the same community. He provides minimal child support and takes the children every other weekend.

     Mrs. C does not have health insurance because she works part-time at a local grocery store.

     She tells you she does not know how she will pay for her surgery and is worried about the outcome and the care of her family.

   DISCUSSION # 9

12. Read the case study below and answer the following questions:
    • How would you begin to assess this community? (Think about factors such as sexual behaviors, alternative health practices, level of eduction, and health incidence.)
    • What assets are present in this community that might assist with problem-solving?
    • What interventions could be taken to better serve this community?
    • Case Study
      You have been assigned to complete a community needs assessment for a neighborhood in Little Havana with a population of approximately 3,000.

      You find out most of the people who live in the area mostly speak Spanish and do not understand English. The average family income is $18,000, and 85% of the population is living below the poverty level. Half of the population receive some form of aid such as Medicaid or Medicare.

      There are many elderly in the community.

      You are not fluent in speaking Spanish; however, you can understand some Spanish but not as much as you would like to. There are several local clinics and a hospital nearby.