Application of Nursing Practice in the Primary Health Care Setting
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This article discusses nursing practice in primary health care, including prevention strategies for asbestosis and melanoma, signs and symptoms of coronary heart disease, community resources for coronary heart disease, and dementia care.
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1 APPLICATION OF NURSING PRACTICE IN THE PRIMARY HEALTH CARE SETTING Student’s Name Institution Course Date
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2 Application of Nursing Practice in the Primary Health Care Setting Assessment Task 1 Question 1 Primary health care refer to care provided in the community for individuals making first approach or appearance to a care provider for treatment or advice. Primary health care entails caring for persons instead of simply treating particular conditions or diseases(Brownson et al. 2017, p. 17). On the other hand, the philosophy of health care involves the study of people, processes, and ethics that constitute the maintenance of health for humans. The philosophy of health care is principally concerned with administration of health care, fundamental rights of all individuals, cost of treatments, drugs, and hospital, and clinical trials. Question 2 Health refers to the state of an individual being free from injury and morbidity or illness or a state of complete social, mental, and physical wellbeing. Health illness continuum refers to a graphical representation of well-being concept (Schomerus et al. 2016, p. 23). It suggests that well-being encompasses emotional and mental health and absence or presence of illness. Additionally, it posits that people can move farther to the right, toward greater well-being and health, passing via the phases of growth, education, and awareness. According the health illness continuum, a negative outlook hinders wellbeing and health while a positive outlook enhances wellbeing and health. Question 3 Primary health prevention strategies for asbestosis include eliminating the exposure via substitution with other materials (Shin et al. 2018, p. 918). This would eradicate the risks of developing pleural-related changes and asbestosis. Additionally, asbestosis can be prevented
3 through minimizing exposure through engineering controls. Secondly, asbestosis can be prevented through immunization against influenza and pneumococcal pneumonia (Shin et al. 2018, p. 918). On the other hand, melanoma can be prevented through wearing sunscreen and avoid peak rays (Chen et al. 2015, p. 336). Question 4 a)Some of the signs and symptoms for coronary heart disease include chest pain, shortness of breath, and heart attack. The patients suffering from coronary heart disease feel tightness and pressure in their chests (Anderson et al. 2016, p. 5). The pain is known as angina and always occurs on the left side or middle of the chest. The shortness of breath occurs when the heart cannot pump sufficient blood to meet the body’s needs. b)The physical impact of coronary heart disease includes unstable or week health or immune system leading to lack of strength to perform daily activities. Conversely, the psychological impacts of coronary heart disease include depression and stress (McClelland et al. 2015, p. 1646). Patients get psychologically impacted by things like embarrassment due to surgery scars, stigma, feeling helpless, worrying about the future, and feeling that life is unfair. Equally, coronary heart disease also has social impacts on the patients including decreasing the overall well-being of the society through general increased depression making the society less happy. The society also spends a lot to finance coronary heart disease treatment such as high cost regarding surgery. c)Cardiac rehabilitation is the best form of service delivery to individuals with coronary heart disease (Mega et al. 2015, p. 2266). The program aids to make potential and practical life-saving changes to the manner in which the patients live. The program helps the patient and family to deal with psychological, emotional, and physical issues. Cardiac
4 rehabilitation also complements the cardiologist or doctor’s advice (Jousilahti et al. 2016, p. 367). In contrary, the preventive forms of service delivery to people with coronary heart disease include control of cholesterol and blood pressure, smoking cessation, physical activity, and nutritious eating. Lastly, the curative forms of service delivery to coronary heart disease patients include taking the drugs such as aspirins, beta-blockers, clopidogrel, and ACE inhibitors as prescribed by the doctor. d)Some of the community resources for individuals with coronary heart disease include development of supportive environment for healthy eating and physical activity. The community provides large field where the patients can do exercise, for example, ride bicycles. The community also offers healthy eating through availing fruits and vegetables for the patients. Fruits and vegetables are rich in important minerals such as calcium which help in formation of bones hence immune strengthening. Contrariwise, the in- hospital resources for patient with coronary heart disease include professionals such as doctors who offer interventional treatment. The hospitals also have drugs such as aspirins which help in coronary heart disease cure. Question 5 The primary literatures associated with the primary health care management of coronary heart disease include the Nursing in Primary Health Care (NiPHC) and “My Heart, My Life- which refers to a guide for individuals living with coronary heart disease. The literatures offer an interactive self-management resource for individuals with coronary heart disease or have high risks of coronary heart disease. They reflect on the content of eradicating the risks in heart disease and offer psychosocial, medical, and lifestyle strategies to decrease the risks of further heart problem. On a similar note, some of the professional bodies associated with
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5 the primary care management of coronary heart disease include the Australian Cardiovascular Health and Rehabilitation Association and the World Health Organization. The two bodies aim at lowering the contraction of coronary heart disease and providing appropriate strategies to reduce the risks of coronary heart disease among individuals. Assessment Task 2 Question 1 Dementia is a pool of symptoms which can occur as a result of various possible disorders. Its symptoms include impairments in memory, communication, and thought (Jennings et al. 2015, p. 283). Cartia is used to treat chest pain or angina and high blood pressure or hypertension. On the other hand, atorvastatin is used to reduce the risk of stroke and heart attack in the patient. It is also prescribed for Mrs. Leitha to enhance cholesterol levels. It aids to prevent cholesterol from building up in the patient’s arteries. The patient should use the drug together with exercising and eating a nutritious diet. Atorvastatin would also alter the expression of genes and production of isoprenoids. Question 2 One of the tests which Leitha could have attended includes General Practitioner Assessment of Cognition (GPCOG). This test can aid to show the memory difficulties the patient might be having and can assess different mental abilities such as language and communication skills, concentration and attention span, awareness of place and time, and long-term and short- term memory (Beertens et al. 2014, p. 55). Leitha could also have undergone blood and urine tests. Blood test would help to check conditions such as thyroid, kidney, and liver functions and hemoglobin while urine tests to assess infections. Conversely, the patient could have undergone
6 investigations such as her history, for example, when the symptoms started and whether she has diseases such as depression or diabetes. Question 3 To care for Leitha, it is important to first obtain information about her including present and past information, for example, interests, lifestyle, and personal history. Subsequently, it is vital to build an understanding and emphatic bond with the patient to spark positive interest and evoke interesting memories (Dewing & Dijk 2016, p. 108). The next step should involve evaluation of the patient’s cognition, behavior, and mood over a 20-hour period to establish how she copes throughout the moment. In the morning, the patient should get up, bath, brush teeth, take breakfast, discuss the newspaper, take break, take a walk, and have some quiet time. In the afternoon, the patient should eat lunch, listen to music, watch television, do crossword puzzle, visit a friend and take a nap. In the evening, she should take dinner, reminisce over desert and coffee, play cards, give a message, and retire to bed. The actual problems of dementia include short-term memory and keeping track of things while the potential problems include remembering appointments and judgment and reasoning. These problems are associated with cell damage in the brain. Question 4 Some of the community resources available for Leitha include educational groups, caregiver resources, support groups, and hospitals. The caregivers and support groups can develop new sets of skills which can aid Leitha more resilient, strong and be grounded on her new life (Worden 2018, p. 57). The caregivers would offer educational support to the patient.
7 Reference List Anderson, L., Oldridge, N., Thompson, D. R., Zwisler, A. D., Rees, K., Martin, N., & Taylor, R. S. (2016). Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. Journal of the American College of Cardiology, 67(1), 1-12. Beerens, H. C., Sutcliffe, C., Renom-Guiteras, A., Soto, M. E., Suhonen, R., Zabalegui, A., ... & RightTimePlaceCare Consortium. (2014). Quality of life and quality of care for people with dementia receiving long term institutional care or professional home care: the European RightTimePlaceCare study.Journal of the American Medical Directors Association, 15(1), 54-61. Brownson, R.C., Deshpande, A.D. and Gillespie, K.N., 2017.Evidence-based public health. Oxford university press. Pp. 2-22 Chen, Y., Peng, J., Han, M., Omar, M., Hu, D., Ke, X., & Lu, N. (2015). A low-molecular- weight heparin-coated doxorubicin-liposome for the prevention of melanoma metastasis. Journal of drug targeting, 23(4), 335-346. Dewing, J., & Dijk, S. (2016). What is the current state of care for older people with dementia in general hospitals? A literature review. Dementia, 15(1), 106-124. Jennings, L. A., Reuben, D. B., Evertson, L. C., Serrano, K. S., Ercoli, L., Grill, J., ... & Wenger, N. S. (2015). Unmet needs of caregivers of individuals referred to a dementia care program.Journal of the American Geriatrics Society, 63(2), 282-289. Jousilahti, P., Laatikainen, T., Peltonen, M., Borodulin, K., Männistö, S., Jula, A., ... & Vartiainen, E. (2016). Primary prevention and risk factor reduction in coronary heart
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8 disease mortality among working aged men and women in eastern Finland over 40 years: population based observational study. bmj, 352, i721. McClelland, R. L., Jorgensen, N. W., Budoff, M., Blaha, M. J., Post, W. S., Kronmal, R. A., ... & Folsom, A. R. (2015). 10-year coronary heart disease risk prediction using coronary artery calcium and traditional risk factors: derivation in the MESA (Multi-Ethnic Study of Atherosclerosis) with validation in the HNR (Heinz Nixdorf Recall) study and the DHS (Dallas Heart Study). Journal of the American College of Cardiology, 66(15), 1643- 1653. Mega, J. L., Stitziel, N. O., Smith, J. G., Chasman, D. I., Caulfield, M. J., Devlin, J. J., ... & Poulter, N. R. (2015). Genetic risk, coronary heart disease events, and the clinical benefit of statin therapy: an analysis of primary and secondary prevention trials. The Lancet, 385(9984), 2264-2271. Schomerus, G., Angermeyer, M. C., Baumeister, S. E., Stolzenburg, S., Link, B. G., & Phelan, J. C. (2016). An online intervention using information on the mental health-mental illness continuum to reduce stigma. European Psychiatry, 32, 21-27. Shin, H., Choi, Y., Jeon, B., Ha, J., Sun, Y., & Park, W. (2018). Improvement in the prevention of asbestos fibre release from ceiling materials by increasing the penetration of a silicate stabilizer through dilution. Indoor and Built Environment, 27(7), 917-924. Worden, J. W. (2018). Grief counseling and grief therapy: A handbook for the mental health practitioner. Springer Publishing Company. 35-89