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Nursing assignment 104

Complete the following: African-American case study #2 Appalachian case study #1 Version:1.0 StartHTML:000000480 EndHTML:000083756 StartFragment:000001175 EndFragment:000083724 StartSelection:000001632 EndSelection:000083724 SourceURL:https://classroom.aspen.edu/d2l/common/assets/pdfjs/1.0.0.30/web/viewer.html?file=%2Fcontent%2Fenforced%2F43768-N512-KK8-08-20-19-Sect2%2FCaseStudies.pdf%3Fd2lSessionVal%3DFeuJBWYKC5d0CfstmT4x6NuRM%26ou%3D43768&lang=en-us&container=d2l-fileviewer-rendered-pdf&fullscreen=d2l-fileviewer-rendered-pdf-dialog&height=1186  PDF.js viewer        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. More InformationLess Information Close Enter the password to open this PDF file. 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