Category: Nursing

Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders

CASE STUDY: Patient HL comes into the clinic with the following symptoms: nausea, vomiting, and diarrhea. The patient has a history of drug abuse and possible Hepatitis C. HL is currently taking the following prescription drugs:

Synthroid 100 mcg daily

Nifedipine 30 mg daily

Prednisone 10 mg daily

Gastrointestinal (GI) and hepatobiliary disorders affect the structure and function of the GI tract. Many of these disorders often have similar symptoms, such as abdominal pain, cramping, constipation, nausea, bloating, and fatigue. Since multiple disorders can be tied to the same symptoms, it is important for advanced practice nurses to carefully evaluate patients and prescribe a treatment that targets the cause rather than the symptom. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders.

Once the underlying cause is identified, an appropriate drug therapy plan can be recommended based on medical history and individual patient factors. In this Assignment, you examine a case study of a patient who presents with symptoms of a possible GI/hepatobiliary disorder, and you design an appropriate drug therapy plan.

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To Prepare

Review the case study assigned by your Instructor for this Assignment

Reflect on the patient’s symptoms, medical history, and drugs currently prescribed.

Think about a possible diagnosis for the patient. Consider whether the patient has a disorder related to the gastrointestinal and hepatobiliary system or whether the symptoms are the result of a disorder from another system or other factors, such as pregnancy, drugs, or a psychological disorder. Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders.

Consider an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

By Day 7 of Week 4

Write
 a 2-page paper that addresses the following:

Explain your diagnosis for the patient, including your rationale for the diagnosis.

Describe an appropriate drug therapy plan based on the patient’s history, diagnosis, and drugs currently prescribed.

Justify why you would recommend this drug therapy plan for this patient

five references not more than 5 years

zero plagiarism Pharmacotherapy For Gastrointestinal And Hepatobiliary Disorders

Collaborative Decision Making Through Shared Governance

Attend a committee meeting in your health care organization. If you are not currently employed in a health care setting, you may elect to attend a committee meeting at another company, a community center, a local school, local chamber of commerce or other professional organization.

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Observe the interactions between committee members and the process used by the committee to arrive at decisions.

In 500-750 words, describe the function of the committee and the roles of those in attendance. Describe your observations of the interactions between members of the committee and determine whether the process used to arrive at decisions is a form of shared governance.

A minimum of two academic references from credible sources are required for this Collaborative Decision Making Through Shared Governance assignment.

Submit the completed “Collaborative Committee Meeting Verification Form” with the assignment.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite. Refer to the 
LopesWrite Technical Support articles
 for assistance.

Attachments
AMP450.R.CollaborativeMeetingVerificationForm_11-18-13.doc
  Collaborative Decision Making Through Shared Governance

Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences):

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Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

 

 

Article Title and Year Published

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

 

Design (Type of Quantitative, or Type of Qualitative)

 

Literature Evaluation Table

Setting/Sample

 

Methods: Intervention/Instruments

 

Analysis

 

Key Findings

 

Recommendations

 

Explanation of How the Article Supports EBP/Capstone Project

 

 

 

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

 

 

Article Title and Year Published

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

 

Literature Evaluation Table

Design (Type of Quantitative, or Type of Qualitative)

 

Setting/Sample

 

Methods: Intervention/Instruments

 

Analysis

 

Key Findings

 

Recommendations

 

Explanation of How the Article Supports EBP/Capstone

 

Literature Evaluation Table

 

 

 

Literature Evaluation Table

In nursing practice, accurate identification and application of research is essential to achieving successful outcomes. Being able to articulate the information and successfully summarize relevant peer-reviewed articles in a scholarly fashion helps to support the student’s ability and confidence to further develop and synthesize the progressively more complex assignments that constitute the components of the course change proposal capstone project. Literature Evaluation Table.

For this assignment, the student will provide a synopsis of eight peer-reviewed articles from nursing journals using an evaluation table that determines the level and strength of evidence for each of the eight articles. The articles should be current within the last 5 years and closely relate to the PICOT statement developed earlier in this course. The articles may include quantitative research, descriptive analyses, longitudinal studies, or meta-analysis articles. A systematic review may be used to provide background information for the purpose or problem identified in the proposed capstone project. Use the “Literature Evaluation Table” resource to complete this assignment.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are not required to submit this assignment to LopesWrite.

Attachments
NRS-490-RS-LiteratureEvaluationTable.docx

RUBRIC

Attempt Start Date:
 
16-Dec-2019 at 12:00:00 AM

Due Date:
 
22-Dec-2019 at 11:59:59 PM

Maximum Points:
 
75.0

Literature Evaluation Table – Rubric

No of Criteria: 13 Achievement Levels: 5
CriteriaAchievement LevelsDescriptionPercentageUnsatisfactory 0-71%0.00 %Less Than Satisfactory 72-75%75.00 %Satisfactory 76-79%79.00 %Good 80-89%89.00 %Excellent 90-100%100.00 %Article Selection100.0
    Author, Journal (Peer-Reviewed), and Permalink or Working Link to Access Article5.0Author, journal (peer-reviewed), and permalink or working link to access article section is not included.Author, journal (peer-reviewed), and permalink or working link to access article section is present, but it lacks detail or is incomplete.Author, journal (peer-reviewed), and permalink or working link to access article section is present.Author, journal (peer-reviewed), and permalink or working link to access article section is clearly provided and well developed.Author, journal (peer-reviewed), and permalink or working link to access article section is comprehensive and thoroughly developed with supporting details.Article Title and Year Published 5.0Article title and year published section is not included.Article title and year published section is present, but it lacks detail or is incomplete.Article title and year published section is present.Article title and year published section is clearly provided and well developed.Article title and year published section is comprehensive and thoroughly developed with supporting details.Research Questions (Qualitative) or Hypothesis (Quantitative), and Purposes or Aim of Study10.0Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is not included.Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is present, but it lacks detail or is incomplete.Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is present.Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is clearly provided and well developed.Research questions (qualitative) or hypothesis (quantitative), and purposes or aim of study section is comprehensive and thoroughly developed with supporting details.Design (Type of Quantitative, or Type of Qualitative)5.0Design (type of quantitative, or type of qualitative) section is not included.Design (type of quantitative, or type of qualitative) section is present, but it lacks detail or is incomplete.Design (type of quantitative, or type of qualitative) section is present.Design (type of quantitative, or type of qualitative) section is clearly provided and well developed.Design (type of quantitative, or type of qualitative) section is comprehensive and thoroughly developed with supporting details.Setting or Sample5.0Setting or sample section is not included.Setting or sample section is present, but it lacks detail or is incomplete.Setting or sample section is present.Setting or sample section is clearly provided and well developed.Setting or sample section is comprehensive and thoroughly developed with supporting details.Methods: Intervention or Instruments5.0Methods: Intervention or instruments section is not included.Methods: Intervention or instruments section is present, but it lacks detail or is incomplete.Methods: Intervention or instruments section is present.Methods: Intervention or instruments section is clearly provided and well developed.Methods: Intervention or instruments section is comprehensive and thoroughly developed with supporting details.Analysis10.0Analysis section is not included.Analysis section is present, but it lacks detail or is incomplete.Analysis section is present.Analysis section is clearly provided and well developed.Analysis section is comprehensive and thoroughly developed with supporting details.Key Findings10.0Key findings section is not included.Key findings section is present, but it lacks detail or is incomplete.Key findings section is present.Key findings section is clearly provided and well developed.Key findings section is comprehensive and thoroughly developed with supporting details. Literature Evaluation Table. Recommendations10.0Recommendations section is not included.Recommendations section is present, but it lacks detail or is incomplete.Recommendations section is present.Recommendations section is clearly provided and well developed.Recommendations section is comprehensive and thoroughly developed with supporting details.Explanation of How the Article Supports EBP or Capstone10.0Explanation of how the article supports EBP or capstone section is not included.Explanation of how the article supports EBP or capstone section is present, but it lacks detail or is incomplete.Explanation of how the article supports EBP or capstone section is present.Explanation of how the article supports EBP or capstone section is clearly provided and well developed.Explanation of how the article supports EBP or capstone section is comprehensive and thoroughly developed with supporting details.Presentation10.0The piece is not neat or organized, and it does not include all required elements.The work is not neat and includes minor flaws or omissions of required elements.The overall appearance is general, and major elements are missing.The overall appearance is generally neat, with a few minor flaws or missing elements.The work is well presented and includes all required elements. The overall appearance is neat and professional.Mechanics of Writing (includes spelling, punctuation, grammar, and language use)10.0Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is employed.Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register) or word choice are present. Sentence structure is correct but not varied.Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct and varied sentence structure and audience-appropriate language are employed.Prose is largely free of mechanical errors, although a few may be present. The writer uses a variety of effective sentence structures and figures of speech.The writer is clearly in command of standard, written, academic English.Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)5.0Sources are not documented.Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors.Sources are documented, as appropriate to assignment and style, although some formatting errors may be present.Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Percentage  100 Literature Evaluation Table

Literature Evaluation Table

Student Name:

Change Topic (2-3 sentences):

 

Criteria

Article 1

Article 2

Article 3

Article 4

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

 

 

Article Title and Year Published

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

 

Design (Type of Quantitative, or Type of Qualitative)

 

Setting/Sample

 

Methods: Intervention/Instruments

 

Analysis

 

Key Findings

 

Recommendations

 

Explanation of How the Article Supports EBP/Capstone Project

 

 

 

Criteria

Article 5

Article 6

Article 7

Article 8

Author, Journal (Peer-Reviewed), and

Permalink or Working Link to Access Article

 

 

 

Article Title and Year Published

 

Research Questions (Qualitative)/Hypothesis (Quantitative), and Purposes/Aim of Study

 

Design (Type of Quantitative, or Type of Qualitative)

 

Setting/Sample

 

Methods: Intervention/Instruments

 

Analysis

 

Key Findings

 

Recommendations

 

Explanation of How the Article Supports EBP/Capstone

 

 

Delusional Disorders

Examine Case Study
:
 
Pakistani Female With Delusional Thought Processes

BACKGROUND:

The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her since she was 9 years old). She presents to your office today following a 21 day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month.

Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.

During today’s assessment, she appears quite calm, and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She tells you that she knows this because the television is telling her so.

She currently weighs 140 lbs, and is 5’ 5”

SUBJECTIVE:

Client reports that her mood is “good.” She denies auditory/visual hallucinations, but believes that the television does talk to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards the PMHNP, but then calms down.

You reviewed her hospital records and find that she has been medically worked up by a physician who reported her to be in overall good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM:

The client is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described, above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.

The PMHNP administers the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis:
 Schizophrenia, paranoid type

The Assignment
:

With Introduction and a Conclusion.

Examine Case Study: Pakistani Woman with Delusional Thought Processes.
 You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

· 
Decision #1

o Which decision did you select?

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

· 
Decision #2

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

· 
Decision #3

o Why did you select this decision? Support your response with evidence and references to the Learning Resources.

o What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

o Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients.

Note: Support your rationale with a minimum of three to five academic resources no more than five years old.

Nursing and counseling theories in psychotherapy essay

Theory in Psychotherapy

Student’s Name

Institution of Affiliation

Course Name

Date

In this practicum, I look forward to using the Modeling and Remodeling theory by Helen Erickson, Mary Ann and Evelyn Tomlin that was developed the year 1983 to guide my practice. This theory promotes nurses ability to take care of and nurture patients with a lot of respect and awareness based on individual needs, beliefs, cultural and religious values (Erickson, 2010). The modeling and remodeling theory draws its concepts from Piaget’s theory of cognitive development, Maslow’s theory of hierarchy of needs and Erikson’s theory of psychosocial stages. I chose this nursing theory since it approaches to care based on the differences and commonalities that exist among people. Using these characteristics, nurses can understand a client’s needs and appropriately intervene to achieve health-directed goals.

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The counseling theory of choice for use in my practicum is the cognitive-behavioral theory which holds diverse views on the role of cognition in behavior change. The cognitive-behavioral theory has proven to be highly effective in helping patients to explore and understand their thoughts, fears and how negative behaviors and emotions impacts psychological functioning (Beck & Haigh, 2014). The theory purposes to increase patient awareness when they negatively interpret situations and adopt bad behavioral patterns that promote distorted thoughts. The theory has three major assumptions: faulty cognitions about other people causes abnormality, the cognitions result to distorted thinking and inaccuracies in thought processes lead to disordered behavior and emotions (Beck & Haigh, 2014). Using this theory, it will be easier to help clients to differently analyze situations and understand how alternative behaviors and thoughts can positively impact emotions, behaviors, and decisions hence reducing psychological distress. nursing and counseling theories in psychotherapy essay.

 

References

Beck, A. T., & Haigh, E. A. (2014). Advances in cognitive theory and therapy: The generic cognitive model.
Annual review of clinical psychology
,
10
, 1-24.

Erickson, H. L. (2010). Helen Erickson, Evelyn Tomlin, and Mary Ann Swain’s Theory of Modeling and Role Modeling.
Nursing theories and nursing practice
, 202-223. nursing and counseling theories in psychotherapy essay

4. Create your Nursing Informatics Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Signature Assignment Title:
 
Informatics in Healthcare

Signature Assignment Description/Directions:

Beginning in Module 1 of this course you have been researching a healthcare informatics topic of your choice. Now you will present your findings in a 7 to 12 minute recorded presentation complete with PowerPoint slides (no length requirement).

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Discuss your topic and its relationship to your current (or future) practice. Discuss why the topic is important in healthcare informatics. Nursing Informatics.

What research have you have found on the topic? Describe how each scholarly article relates to the topic and your current (or future) practice. Describe what conclusions you have drawn based on your research of the topic.

What ethical or legal issues does this topic present?

Create a plan for implementing a change (or justify the need for no change). Who needs to be involved? What training programs are needed? Is there a need for on-going training? Discuss how you would evaluate the success of the change (or the continued success of what you are currently doing). What is the cost to implement or maintain this change? Who will be financially responsible? How feasible is this change? Nursing Informatics

Finally, identify how changes in public policy and technological advances in the future could impact this topic. What would those changes mean to the healthcare industry?

Nursing Informatics Assignment Expectations

Length
: Recorded presentation between 7 and 12 minutes in length. The presentation should include a PowerPoint and oral presentation of the slides. There is no slide number requirement. Answer all questions thoroughly with the allotted time. Use a recording platform of your choice and either upload as an mp4 or share the link directly to the video in the dropbox.

Structure
: Include a title slide, objective slide, content slides, reference slide in APA format.

References
: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Rubric
: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level. Nursing Informatics

Format
: Save your assignment as an mp4 document (.mp4) or share the link to the recording Nursing Informatics

File name
: Name your saved file according to your first initial, last name, and the module number (for example, “RHall Module 1.mp4”)

Presentation
: Use presentation software (ex. PowerPoint, Google Slides) to create a visual presentation. Then use a recording program to record a 7 and 12 minutes in length presentation.
 ***Please do not record as voice-over PowerPoint because this cannot be saved in mp4 format or a link.*** 
If you submit your assignment as a PowerPoint with voice over recording you will not receive credit for your assignment (or partial credit as you did not meet the full requirements of the assignment.)

Total Point Value of Nursing Informatics Assignment
:
 
500 points

Cultural Self-Assessment Essay Assignment – N512 Diverse Populations & Health Care

N512 Diverse Populations & Health Care

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Module 2 Assignment  

Conduct a cultural self-assessment. In order to understand culture and cultural diversity, it is important that you understand your own culture and heritage. Using the tables that are located throughout Chapter 2 of your textbook (one for each domain of the Purnell Model for Cultural Competence, Table 2-1 to Table 2-12), answer these questions as they relate to you. Remember, you are answering these questions from your personal perspective, so there is no right or wrong response. Explain why you do or do not adhere to the dominant cultural practices and beliefs of the ethnic group(s) with which you primarily identify. Although the information on this self-assessment paper is strictly confidential, if you do not wish to self-disclose a specific area from the Organizing Framework, indicate so instead of just not addressing it. You are not required to provide citations/references in this paper. Attention should be paid to grammar, spelling, and punctuation. Write a 3-4 page APA essay. cultural self-assessment essay assignment – N512 Diverse Populations & Health Care

Appalachian and African-American case studies – N512 Diverse Populations & Health Care

Question

N512 Diverse Populations & Health Care

Module 3 Assignment  

Complete the following Case Studies:

African-American case study #2

Appalachian case study #1

Write a 3-4 page APA essay, using two scholarly sources in addition to the textbook.

APPALACHIAN CASE STUDY #1

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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 tuberculosis 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, aged 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 returned to northern Appalachia because he was unable to find work in Denver. Ruth is 3 months’ pregnant. Because Mrs. Kapp has been feeling “more 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, Gloria is expectorating greenish sputum, which her husband estimates to be about a teacupful 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. Appalachian and African-American case studies – N512 Diverse Populations & Health Care.

While the physician is examining Mrs. Kapp, the nurse is taking additional historical and demographic data from Mr. Kapp and Ruth. The nurse finds that Ruth has had no prenatal care and that her first child, 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 information regarding his health status and states that he takes care of himself. This is the first time Mrs. Kapp has seen 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 makes 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 medication 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 bark tea each morning for her diarrhea. Ruth’s only complaint is the “sick headache” she gets three to four times a week. She takes ginseng tea and Epsom salts for the headache. Appalachian and African-American case studies – N512 Diverse Populations & Health Care.

Mrs. Kapp is discharged with prescriptions 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 prenatal 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.

3. Identify high-risk behaviors common in the Appalachian region.

4. Describe barriers to health care for people living in Appalachia.

5. What might the nurse or physician do to encourage Mrs. Kapp to comply with her prescription regimen?

6. What would your advice be regarding each of the home remedies that Mrs. Kapp is taking? Would you encourage or discourage her from continuing them? Appalachian and African-American case studies – N512 Diverse Populations & Health Care

7. What might the nurse have done to help ensure that Ruth would make the appointments for herself and her daughter?

8. What advice would you give Ruth regarding the home remedies that she and her daughter are currently taking? Would you encourage or discourage their use?

9. Do you think Mrs. Kapp will return for her appointment next week? Why? What would you do if she did not return for her appointment?

10. Do you think that Ruth will make and keep appointments for herself and her daughter?

11. What would you do to encourage Mr. Kapp to consent to a health assessment?

12. What additional services could you suggest to assist the Kapp family at this time?

13. What additional follow-up do you consider essential for the Kapp family?

14. What advice would you give Ruth regarding her daughter’s frequent bouts of diarrhea?

 

AFRICAN 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 and 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 grandchildren, aged 25, 20, 19, and 18; and their 2- year-old great-grandson. Anna and Dorothy 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, other sons and daughters, grandchildren, and great-grandchildren who live across 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 family 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, San 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 medication. Within the last 5 years, Mr. Evans has had several relatives 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 license that she is an organ donor. Appalachian and African-American case studies – N512 Diverse Populations & Health Care.

Sources of income for Mr. and Mrs. Evans 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 brothers must assume responsibility for their mother’s medical bills and medication. Although she has Medicare parts A and B, many of her expenses are not covered.

Mr. and Mrs. Evans, all members of their household, and all other extended family in the community attend a large Baptist 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. Appalachian and African-American case studies – N512 Diverse Populations & Health Care.

Study Questions

1. Describe the organizational structure of this family and identify strengths and limitations of this family structure.

2. Describe and give examples of what you believe 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 hypertension, 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 family 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 Americans have about advanced directives. Appalachian and African-American case studies – N512 Diverse Populations & Health Care.

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 African Americans may have about pregnancy. Appalachian and African-American case studies – N512 Diverse Populations & Health Care

Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment

Question

N512 Diverse Populations & Health Care

Module 4 Assignment  

Complete the following Case Studies :

Mexican case study #2

Puerto Rican case study #2

Write a 3-4 page APA essay, using two scholarly sources in addition to the textbook.

MEXICAN CASE STUDY #2

Pablo Gaborra, aged 32, and his wife, Olga, aged 24, live in a migrant-worker camp on the eastern shore of Maryland. They have two children: Roberto, aged 7, and Linda, aged 18 months. Olga’s two younger sisters, Florencia, aged 16, and Rosa, aged 12, live with them. Another distant relative, Rodolpho, aged 28, comes and goes several times each year and seems to have no fixed address. Pablo and Olga, born in Mexico, have lived in the United States for 13 years, first in Texas for 6 years and then in Delaware for 1 year, before moving to the eastern shore of Maryland 5 years ago. Neither of them have U.S. citizenship, but both children were born in the United States. Pablo completed the sixth grade and Olga the third grade in Mexico. Pablo can read and write enough English to function at a satisfactory level. Olga knows a few English words but sees no reason for learning English, even though free classes are available in the community. Olga’s sisters have attended school in the United States and can speak English with varying degrees of fluency. Roberto attends school in the local community but is having great difficulty with his educational endeavors. The family speaks only Spanish at home. Not much is known about the distant relative, Rodolpho, except that he is from Mexico, speaks minimal English, drinks beer heavily, and occasionally works picking vegetables. The Gaborra family lives in a trailer on a large vegetable farm. The house has cold running water but no hot water, has an indoor bathroom without a shower or bathtub, and is heated with a wood-burning stove. The trailer park has an outside shower, which the family uses in the summer.  The entire family picks asparagus, squash, peppers, cabbage, and spinach at various times during the year. Olga takes the infant, Linda, with her to the field, where her sisters take turns watching the baby and picking vegetables. When the vegetablepicking season is over, Pablo helps the farmer to maintain machinery and make repairs on the property.Their income last year was $30,000. From the middle of April until the end of May, the children attend school sporadically because they are needed to help pick vegetables. During December and January, the entire Gaborra family travels to Texas to visit relatives and friends, taking them many presents. They return home in early February with numerous pills and herbal medicines. Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment.

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Olga was diagnosed with anemia when she had an obscure health problem with her last pregnancy. Because she frequently complains of feeling tired and weak, the farmer gave her the job of handing out “chits” to the vegetable pickers so that she did not have to do the more-strenuous work of picking vegetables. Pablo has had tuberculosis for years and sporadically takes medication from a local clinic. When he is not traveling or is too busy picking vegetables to make the trip to the clinic for refills, he generally takes his medicine. Twice last year, the family had to take Linda to the local emergency room because she had diarrhea and was listless and unable to take liquids. The Gaborra family subscribes to the hot and cold theory of disease and health-prevention maintenance.

Study Questions

1. Identify three socioeconomic factors that influence the health of the Gaborra family.

2. Name three health-teaching interventions the health-care provider might use to encourage Olga to seek treatment for her anemia.

3. Identify strategies to help improve communications in English for the Gaborra family.

4. Identify three health-teaching goals for the Gaborra family. Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment

5. Name three interventions Olga must learn regarding fluid balance for the infant, Linda.

6. Discuss three preventive maintenance–teaching activities that respect the Gaborra family’s belief in the hot and cold theory of disease management. Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment

7. Identify strategies for obtaining health data for the Gaborra family.

8. Identify four major health problems of Mexican Americans that affect the Gaborra family.

9. If Olga were to see a folk practitioner, which one(s) would she seek?

10. Explain the concept of familism as exhibited in this family.

11. Distinguish between the two culture-bound syndromes el ataque and susto.

12. Discuss culturally conscious health-care advice consistent with the health belief practices of the pregnant Mexican American woman.

13. Discuss two interventions to encourage Mexican American clients with tuberculosis to keep clinic appointments and to comply with the prescribed medication regimen.

14. Identify where the majority of Mexican Americans have settled in the United States.

PUERTO RICAN CASE STUDY #2

Carmen Medina, aged 39, lives with her husband, Raúl, aged 43, who works as a mechanic in a small auto shop.Mr. Medina has worked in the same place since he and his wife came to the United States from Puerto Rico 15 years ago. The Medinas have a 4-year-old son, José; a 16-year-old daughter, Rosa; and an 18-year-old son, Miguel. The Medinas both attended vocational school after completing high school. Mrs. Medina is employed 4 hours a day at a garden shop. She stopped working her full-time job to care for her ill mother and aged father, who do not speak English and depend on government assistance. The family income last year was $28,500. The family has health insurance through Mr. Medina’s job. Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment. They live in a threebedroom apartment in a low-income Illinois community. Miguel works in a fast-food store a few hours a week. Because Rosa has responsibilities at home, the Medina’s do not allow her to work outside the home. She is very close to her grandmother but avoids talking with her parents. Both Rosa and Miguel are having difficulties in school. Rosa is pregnant and the family does not know. She is planning to drop out of school, get a job in a beauty shop, and leave home without telling the family. Miguel frequently comes home late and, on occasion, sleeps out of the home. He is beginning college next semester and has plans to move out of the house during the summer. The family is having difficulty dealing with Rosa’s and Miguel’s developmental and behavioral challenges. Although Mrs. Medina is outspoken about these concerns, Mr.Medina is quiet and not actively involved in the discussion. He is more preoccupied with the family’s financial situation. Mrs. Medina’s parents are encouraging them to return to Puerto Rico.

Mr. Medina was diagnosed with hypertension 2 months ago, when he went to the emergency room for a respiratory infection. He smokes cigarettes and drinks two to three beers every evening after work. He has not followed up on his blood pressure treatment. Miguel is beginning to smoke, but not at home. José has had frequent colds and sinus allergies. He has been to the emergency room three times during the past year for respiratory infections. Mrs. Medina’s last physical examination was after she had José. She is experiencing insomnia, tiredness, headaches, and gastrointestinal problems. She is very concerned about Rosa and Miguel, her parents, and the family’s finances. Mrs. Medina is Catholic and recently has been visiting her church more often. Study Questions

1. Explain Mrs. Medina’s attitude in her relationship with her adolescent daughter.

2. Identify strategies to ensure that Rosa seeks prenatal care.

3. Identify barriers to accessing health care for the Medina family. Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment.

4. What are the high-risk behaviors exhibited by this family?

5. What communication barriers exist in this family that affect care delivery?

6. Discuss gender and family roles in the context of traditional Puerto Rican culture.

7. Identify socio demographic factors affecting the physical- and mental health well-being for this family.

8. Identify Puerto Rican folk practices appropriate for this family.

9. If the Medina family chose to visit a folk healer, which one(s) do you think they might visit? Why?

10. If Mrs. Medina’s parents visit a health-care provider, what might they expect?

11. Identify culturally congruent interventions to ensure compliance with Western health prescriptions for Mr. Medina.

12. Discuss the importance of respeto and familism in the Medina family.

13. Identify culturally congruent interventions for Rosa’s pregnancy.

14. Identify health-promotion and disease-prevention interventions needed for José. Pablo Gaborra and Carmen Medina Case studies – N512 Diverse Populations & Health Care week 4 Assignment

Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment

Question

N512 Diverse Populations & Health Care

Module 5 Assignment  

Complete the following Case Studies:

Amish case study

Jewish Case study #1

Write a 3-4 page APA essay, using two scholarly sources in addition to the textbook.

AMISH CASE STUDY

Elmer and Mary Miller, both 35 years old, live with their five children in the main house on the family farmstead in one of the 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 eight 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.  Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment. Eight years ago, they traded living space. Now, Aaron continues to help with the farm work, despite increasing pain in his hip, which the doctor advises should be replaced. Most of Mary’s and Elmer’s siblings 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.

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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 their home. Lucille, aged 4, is staying with Mary’s sister and her family for a week 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. The nurse noticed that Mary carefully placed the baby on a pillow as she prepared to leave. Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment. Elmer and Mary do not carry any health insurance and are concerned about paying the doctor and hospital bills associated with this complicated pregnancy. In addition, they have an appointment for Wayne to be seen at Riley Children’s Hospital, 3 hours away at the University Medical Center 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 sisters 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 “treatments.” 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 hayloft. Elmer gave money 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 raising, but Mary will not help this time because of the need to care for her newborn.  The state health department is concerned 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 waste of time and that what they need to do is let the Amish know that they are creating a health hazard by neglecting or refusing to have their children immunized. Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment.

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. Miller confided her interest in taking the baby to the folk healer, what would you do to learn more about their simultaneous use of folk and professional health services? Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment

5. List three items to discuss with the Millers to prepare them for their consultation at the medical center.

6. If you were preparing the reference for consultation, what would you mention about the Millers that would help to promote culturally congruent care at the medical center?

7. Imagine yourself participating in a meeting with state and local health department officials and several local physicians and nurses 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 Order 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 promoting health in the Amish community?

11. List three Amish values to consider in prenatal education classes.

12. Develop a nutritional guide for Amish women who are interested in losing weight. Consider Amish values, daily lifestyle, and food production and preparation patterns.

13. List three ways in which Amish express caring.

JEWISH CASE STUDY #1

Selecting a “typical” Jewish client is difficult. An ultra-Orthodox Jew has a particular set

of special needs. Yet, it is more common to see a Jew who is a middle-of-the-road

Conservative.

Sarah is an 80-year-old woman who is a first-generation American. She was

raised in a traditional Conservative home. Her husband died after 50 years of a strong

marriage. She has three children. Although her home is not kosher, she practices a

variation of kosher-style eating, avoiding pork and not making dishes that combine

meat and milk. Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment

Two months ago, she was diagnosed with pancreatic cancer. Surgery was

attempted, but the cancer was already in an advanced stage. Chemotherapy was started,

but the cancer has progressed and is not responding to the medications. She is having

difficulty eating because of the pressure of the tumor on the gastrointestinal tract.

Discussions are being held to determine whether or not treatments should be stopped

and whether hospice care should be initiated.

Her hospital room is always filled with visitors.

Study Questions

1. What must you anticipate in discussing with Sarah her wishes regarding the continuation of medical care?

2. How would you respond to her initial decision to have surgery and initiate chemotherapy?

3. What questions do you need to ask in the initial patient interview to assess her degree of religious practice? How will you determine her spirituality needs?

4. What is your understanding of the reason she has so many visitors in her room?

5. Is hospice care appropriate for this patient?

6. Sarah dies with her family at her bedside. What interventions can you take at the time of death to demonstrate religious sensitivity to the family? What questions do you need to ask the family?

7. Describe three genetic or hereditary diseases common with Ashkenazi Jews.

8. Describe Jewish burial rituals and grieving process. Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment

9. Discuss the laws of Kashrut in regard to food practices for observant Jewish clients.

10. What should the health-care provider keep in mind when entering a Jewish home to provide care?

11. Distinguish between the terms Sephardic and Ashkenazi.

12. How might a non-Jewish and a Jewish coworker share holidays in the workforce?

13. What is the official language the Jewish people use for prayer? Amish and Jewish Case studies – N512 Diverse Populations & Health Care week 7 Assignment

Japanese and Chinese Case studies – N512 Diverse Populations & Health Care week 7 Assignment

Question

N512 Diverse Populations & Health Care

Module 6 Assignment  

Complete the following Case Studies:

Chinese case study #1

Japanese case study #1

Write a 3-4 page APA essay, using two scholarly sources in addition to the textbook.

CHINESE CASE STUDY #1

An elderly, Asian-looking man is admitted to the emergency room with chest pain; difficulty breathing; diaphoresis; vomiting; pale, cold, clammy skin; and apprehension. Three people, speaking a mixture of English and a foreign language to one another, accompany him. The nurse tries to speak English with the man, but he cannot understand anything she says. Accompanying the elderly man are two women (one elderly and very upset and one younger who stands back from the other three people) and one younger man.

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The younger man states that the elderly man, whose name is Li Ying Bin, is his father; the elderly woman, his mother; and the younger woman, his wife. The son serves as the translator. Li Ying Bin comes from a small village close to Beijing. He is 68 years old, and he has been suffering with minor chest pain and has had trouble breathing for 2 days. He is placed in the cardiac room, and the assessment continues. Mr. Li is on vacation, visiting his son and daughter-in-law in the city. His son and daughter-in-law have been married for only 1 year, but the son has lived in the West for 7 years. Japanese and Chinese Case studies – N512 Diverse Populations & Health Care week 7 Assignment. Mr. Li’s daughter-in-law looks Chinese but was born in the United States. She does not speak very many words of Chinese. Further physical assessment reveals that Mr. Li has a history of “heart problems,” but the son does not know much about them. Mr. Li had been to the hospital in Beijing but did not like the care he received there and returned home as soon as possible. He goes to the local clinic periodically when the pain increases, and the health-care provider in China used traditional Chinese medicine, herbs, and acupuncture. In the past, those  treatments relieved his symptoms. Medications are ordered to relieve pain, and Mr. Li undergoes diagnostic procedures to determine his cardiac status. The studies reveal that he did sustain massive heart damage. Routine interventions are ordered, including heart medications, anticoagulants, oxygen, intravenous fluids, bedrest, and close monitoring. His condition is stabilized, and he is sent to the cardiac intensive-care unit. In the cardiac unit, the nurse finds Mrs. Li covering up Mr. Li until he sweats, and Mrs. Li argues with the nurse every time her husband is supposed to dangle his legs. She complains that he is too cold and brings in hot herbal beverages for him to drink. She does not follow the nurse’s and physician’s orders for dietary restrictions, and she begins to hide her treatments from the staff. Her son and daughter-in-law try to explain to her that this is not good, but she continues the traditional Chinese medicine treatments. Mr. Li is a very quiet patient. He lies in bed and never calls for help. He frequently seems to be meditating and exercising his arms. When he does talk to his son, he speaks of the airplane ride and the problems of being so high. He believes that may have caused his current heart problem. Mr. Li also wonders if Western food could be bad for his system. Mr. Li’s condition gradually deteriorates over the next few days. Nurses and physicians attempt to tell the family about his condition and possible death, but the family will not talk with them about it. Mr. Li dies on the 5th day.

Study Questions

1. If you were to go to China on a business trip, how would you design your name card so that the Chinese would not be confused?

2. If you wished to have a meeting with a Chinese delegation of health-care providers, would you expect them to be on time? Why?

3. If the meeting included a meal with Chinese food, what kinds of food would you expect to be served? How would it be presented? If something were served that you do not like, would you eat it anyway?

4. Compare and contrast the Chinese meaning of life and way of thinking with the Western meaning of life and way of thinking.

5. What are the common health risks for the development of chronic obstructive pulmonary disease among Chinese people?

6. What are some of the reasons that Mr. Li waited so long to enter the hospital? Japanese and Chinese Case studies – N512 Diverse Populations & Health Care week 7 Assignment.

7. Mr. Li did not complain of chest pain in the cardiac intensive-care unit. Is this a common behavior? Why?

8. True or False: The Chinese family will expect health-care providers at the hospital to provide most of the care for Mr. Li.

9. Why must the physician be careful with the amounts of medication ordered?

10. Mrs. Li is curt, demanding, and disagreeable toward her daughter-in-law. Why does she act this way?

11. Explain why Mr. Li blames the airplane ride and the Western food for his heart attack. Why does he meditate and do exercises?

12. Is Mr. Li’s stoicism during dying surprising? Why do the family members refuse to discuss his health and possible death?

13. What is the preferred method for handling the remains of a deceased Chinese person?

14. Describe common mourning rituals for the Chinese.

15. Describe bereavement in a Chinese family.

16. Describe a common view of death among Chinese.

 

JAPANESE CASE STUDY #1

This case study is a composite of actual situations. Marianne, who is American, and Ken Shimizu, who is Japanese, have worked in Tokyo for over 30 years as Methodist missionaries. They have annual furloughs and occasional sabbaticals, during which they visit relatives and sponsoring organizations and engage in continuing education in the United States. They met as college students in the United States, and their three grown children have established their own careers in the United States. Ken’s 98-year-old mother resides with Marianne and Ken. She is not Christian Japanese and Chinese Case studies – N512 Diverse Populations & Health Care week 7 Assignment.

but has always been extremely supportive of Ken and Marianne’s work. Ken teaches at a large Christian university, whereas Marianne has served in various church-related positions over the years. As missionaries, they live in  ubsidized post–World War II housing near Ken’s university. Marianne has been a frugal housewife, preparing local foods in the Japanese style for her family. Ken, who is nearly 60, recently learned that he has glaucoma. By the time it was discovered, he had lost a significant amount of peripheral vision. Although Marianne delivered all three children at a Christian hospital in Tokyo, she gets her annual physical examination when visiting relatives in the United States. She has never believed that the Japanese health system is as proactive as that in the United States. On her most recent visit to the United States, Marianne learned that she has hypertension. Her physician prescribed a medication that is readily available in Japan, but the physician was concerned about the level of stress in Marianne’s life. Mother Shimizu is quite confused and requires considerable care, but it is unthinkable for Ken, the only child, to put his mother in a long-term-care facility. Even if he would, the  quality of facilities in Japan leaves much to be desired. Most of the responsibility for Mother Shimizu falls on Marianne, in addition to her work.Marianne’s relatives are urging her to consider placing Mother Shimizu in a church-related life-care community near Marianne’s family in the United States, where Marianne and Ken would like to retire. Marianne’s own parents lived in this facility at the end of their lives. She is considering these issues as she returns to Tokyo.

Study Questions

1. Identify some of the cultural issues that may lead to conflict in this international family.

2. What are the family resources for this international family?

3. What factors within the Japanese health system may account for the late diagnosis of Ken’s glaucoma?

4. What practical issues might arise for the Shimizus if Mother Shimizu were placed in a long-term-care facility in the United States?

5. What dietary factors may contribute to Marianne’s hypertension? Japanese and Chinese Case studies – N512 Diverse Populations & Health Care week 7 Assignment.

6. In what ways might you consider Ken to be countercultural as a Japanese man?

7. What social pressures might Marianne have faced, given some of her choices, as a housewife in Japan?

8. What pressures will Ken likely experience as he considers how to meet the needs of both his mother and his wife?

9. Compare and contrast the fertility and mortality rates of Japan and the United States.

10. Do the traditional Japanese maintain sustained eye contact with strangers? Why or why not?

11. To which drugs might Japanese people have greater sensitivity than that of white ethnic populations?

12. How do most Japanese people meet their need for calcium? Japanese and Chinese Case studies – N512 Diverse Populations & Health Care week 7 Assignment