Community Health Planning, Implementation and Evaluation

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Running head: Week 12 community health Care Plan 1

Week 12 community health Care Plan 2

Danisse Gonzalez

Florida National University

Nursing Program

NUR-4636 Community Nursing

Prof. Eddie Cruz, RN, MSN

November 18th , 2018

Community Health Planning, Implementation and Evaluation

Care plans

Attention Deficit Hyperactivity Disorder(ADHD): A syndrome characterized by degrees of inattention, impulsive behavior, and hyperactivity.

Assessment

· Identify the presence of other illnesses with symptoms that overlap with those of ADHD

· Inspect for vision or hearing impairments

· Social interaction with peers

· Gather information about client’s behavior

· Inspect for neurodevelopmental immaturity in relation to gross and fine motor functions and motor or vocal tics, and retardation.

· Gather data of the person with suspected ADHD for example anxiety

· Interview a relevant family member, partner, including teachers to ascertain observations of symptoms/behaviors in different settings

· Gather developmental, medical and psychiatric history of the client

· Collect information about related comorbidities present in the family.

Diagnosis

· Impaired social interaction

· RT developmental disabilities (hyperactivity)

· AEB feelings of inadequacy and need for acceptance from others.

Planning

· Implement appropriate memory retraining techniques, such as keeping calendar, writing list, memory cue games, mnemonic device using computers, and so forth.

· Encourage ventilation of feelings of frustration helplessness, anxiety and so forth.

· Refocus attention to areas of control and progress.

· Provide emphasize importance of pacing learning activities and having appropriate rest.

· Monitor client’s behavior by educating and assisting in using stress management techniques.

Implementation

· The nurse will consider patient’s condition and communicating with him as an equal.

· The nurse will not use baby talk nor direct him as to his chronological age; encourage him to express his thoughts or emotions and respond to him therapeutically.

· The nurse will use simple and direct instructions if needed, the nurse may utilize visual aids or pictures in order for him to relate well; in educating the child, the lessons should only be brief in duration due to his short attention span.

· The nurse will implement scheduled routine every day making his routine predictable and something like ritualistic so that it will only be easy for him to grasp for his independent functioning.

· The nurse will avoid stimulating or distracting settings. Also involve the child in his daily activities in a quiet and non-stimulating area to prevent him from becoming easily distracted and hyperactive.

· The nurse will give positive reinforcements for example every good deed done should be rewarded even with a simple smile, nod or a star’ praise him for achieving his goals for the day or a task that was finished; it is also advisable to provide immediate reinforcement since they sometimes have decrease tolerance to frustration.

· The nurse will encourage physical activity that he likes as this may also help him make friends with other children; allow him to exert his energy productively but do not let him get over fatigued, too; physical activity helps in getting good sleep but over fatigue fight as well make him uneasy and irritable.

Evaluation

· The patient know how to Implement appropriate memory retraining techniques, such as keeping calendar, writing list, memory cue games, and/or mnemonic device using computers.

· The patient knows how to cope with his feelings of frustration helplessness, and anxiety by refocusing attention to areas of control and progress.

· The patient understand the importance of pacing learning activities and having appropriate rest.

· The patient practices and uses stress management techniques.

Melanoma: A form of cancer that begins in melanocytes, which are the cells that make the pigment melanin. It may begin in a mole (skin melanoma), but can also begin in other pigmented tissues, such as in the eye or in the intestines.

Assessment

· Asymmetry: two halves of the mole the different?

· Client presents asymmetrical shapes, which are generally more concern.

· Border: are the edges of the mole are poorly defined? Is it ragged, irregular, or blurred?

· Client’s mole is not well define and has irregular edges.

· Color: is the color uneven with shades of tan, brown or black?

· Client presents a mole colored blue, which it brings more concern because those are usually the color of melanomas.

· Diameter: has there been a change, particularly an increase, in lesion size?

· Client’s mole size is over 6mm diameter, and client states that has being increasing in size.

· Elevation/evolution: How melanoma progresses

· Client’s mole is elevated, which according to client’s data history of it, he states mole was flat in the beginning.

· Client states itching, bleeding and scabbing in the mole.

Diagnosis

· Anxiety

· RT Situational crisis (cancer)

· AEB Expressed concerns regarding changes in life events.

Planning

· Clarifies patient’s perceptions and misconceptions based on diagnosis and experience with cancer of any.

· Patient may not feel accepted with present condition, is important to assess feeling of judged to promote sense of dignity and control.

· Coping skills are often stressed after diagnosis and during different phases of treatment. Support and counseling are often necessary to enable individual to recognize and deal with fear and to realize that control and coping strategies are available.

· Treatment may include surgery( curative, preventive palliative), as well as chemotherapy, radiation(internal or external).

Implementation

· The nurse will encourage patient to share thoughts and feelings, which provides opportunity to examine realistic fears and misconceptions about diagnosis

· The nurse will assist patient in recognizing and clarifying fears to begin developing coping strategies for dealing with these fears

· The nurse will reinforce coping skills to minimize stress after diagnosis and during different phases of treatment.

· Support and counseling are necessary to enable individual to recognize and deal with fear and to realize that control and coping strategies are available.

· Explain procedures, providing opportunity for questions and honest answers.

· The nurse will ask if patient want her/him to stay during anxiety-producing procedures and consultations.

· The nurse will provide accurate information that allow patient to deal more effectively with reality of situation, thereby reducing anxiety and fear of the unknown

· The nurse will promote calm, quiet environment to Facilitates rest, conserves energy, and may enhance coping abilities.

· The nurse will encourage patient interaction with support systems.

Evaluation

· The patient Displays appropriate range of feelings and lessened fear.

· The patient is relaxed and reports anxiety reduced to a manageable level.

· The patient demonstrate use of effective coping mechanisms and active participation in treatment regimen.

· The patient understand his/her condition and ask about possible treatments including its benefits.

Diabetes Mellitus (DM): a chronic disease characterized by insufficient production of insulin in the pancreas when the body cannot efficiently use the insulin it produces. This leads to an increased concentration of glucose levels in the blood stream (Hyperglycemia).

Assessment

· Monitor patient’s HbA1c-glycosylated hemoglobin.

· Assess for signs of hyperglycemia.

· Assess for tremors and/or slurring speech( hypoglycemia).

· Assess patient’s current knowledge and understanding about illness.

· Assess patient’s current knowledge and understanding in regard of diet and life change style.

· Assess feet for temperature, pulses, color, and sensation

· Assess the pattern of physical activity.

· Monitor urine albumin to serum creatinine for renal failure.

Diagnosis

· Deficient Knowledge

· RT Dietary modifications

· AEB statements of concerns and requesting information.

Planning

· Adherence to the therapeutic regimen promote tissue perfusion. Keeping glucose in the normal range slows progression of microvascular disease.

· Blood glucose should be monitored before meals and at bedtime.

· The need to check glucose values to adjust insulin doses.

· Keep in mind that Hypertension is a common associated with diabetes. Keep a blood pressure control can prevents stroke, coronary artery disease and/or retinopathy and nephropathy.

· Patients with this disease have decrease sensation in the extremities due to peripheral neuropathy. Is important for these patients to uses thermometers to check the water before bathing, wear shoes at all time, keep a good hygiene and nail control.

· Nonadherence to dietary guidelines can result in hyperglycemia. Every patient should has an individualized diet plan.

Implementation

· The nurse will educate the patient on the importance to follow a diet that is low in simple sugars, low in fat, and high in fiber and whole grains.

· The nurse will show the patient how to use insulin prescribed for example long-acting (Lantus) only need to be injected once daily.

· The nurse will teach patient on how to inject insulin and the importance to rotate sites.

· The nurse will teach patient how to treat hypoglycemia for example eating crackers, a snack, or glucagon injection.

Evaluation

· Patient demonstrated knowledge of insulin injection.

· Patient talked about symptoms and treatment of hypoglycemia.

· Patient gave examples of a diet that he/she is going to follow.

· Patient verbalized the importance of daily exercises.

· Patient demonstrated an adequate skill of taking and checking blood glucose level.

· Patient understands the importance of control the glucose levels for the prevention of other relate diseases.

References

Heinrich, E. (2013). Diabetes self-management: strategies to support patients and health care professionals. Maastricht University

Townsend, M. C. (2017). Nursing diagnoses in psychiatric nursing: care plans and psychotropic medications. FA Davis

Kemp, C., & Kemp. (2015). Terminal illness: a guide to nursing care. Philadelphia: Lippincott.

Rita Miller, R. N. (2018). Implementing a survivorship care plan for patients with skin cancer. Clinical Journal of Oncology Nursing12(3), 479.

Sook, C. (2013). Community Health Nursing: Promoting the Health of Populations. Aorn Journal77(4), 857-858.