Case study #2  ( at least 250 words )

Sandville is a small community in Texas situated 5 miles from the U.S.–Mexico border. The primary industry in the area is cattle ranching. Most of the Anglo residents are descendants of the western cattle barons and make up about 40% of the town’s population of 3,000. Another 25% of the population is composed of long-time Latino residents descended from wranglers who worked on the ranches in the past. Now many work in service occupations. Mexican immigrants who cross the border (legally or illegally) to obtain work make up about 10% of the population. Members of this group return frequently to Mexico, where extended family members continue to reside. The remainder of the town’s population includes a group of newly arrived Asian engineers and their families who have come to staff the recently opened electronics plant and a small group of African Americans who have lived in the area since the end of the Civil War.

Most young people do not stay long in the area and those who do have few children, so the population (with the exception of the Asian families) is aging. Cardiovascular disease and motor vehicle accidents on the two-lane highway passing through town create a booming business for the small local hospital. There are three primary care physicians in the community, one dentist, one pediatrician, and two family nurse practitioners. The county health department maintains a branch office in the town that is staffed by a public health nurse and a sanitation engineer 2 days a week.

Community health problems, in aIDition to cardiovascular disease and accidents, include arthritis and anemia. There is also a high rate of tuberculosis among the Mexican immigrants.

What problems might be present in the community other than those specified? What information in the case study led you to suspect the presence of these problems?

What nursing interventions would you employ as the community health nurse assigned to this community? Why?

Case study #3  ( at least 250 words )

Janice Wu, a community health nurse, is visiting a new client in a nursing home in an inner-city area. As she enters the nursing home, she notices that several of the residents are doing calisthenics in the yard. Some of the residents are sitting on the sidelines and appear quite short of breath. When Janice checks to make sure they are all right, they tell her that they usually have a hard time breathing when they exercise on humid days like today. The residents say that they usually try to continue their exercises because it is one of the few activities that get them out of the building. They also enjoy the social aspects of the exercise sessions. Many of them state that they have always been active and want to maintain their strength and mobility as long as possible. They express fears of being bedriIDen and unable to care for themselves.

After Janice is sure that all of the residents will be all right, she goes on to see her client. When she enters the building, she notices that it is quite hot inside, even though all the windows and doors are open. Although it is only 10 A.M., it promises to be a humid summer day. After seeing her client, Janice talks to the director about the heat in the building. The director tells her that the building is always hot and that the air conditioning has never worked properly. The last time the service people came to fix the air-conditioning unit, they said it could not be repaired and would have to be replaced. The nursing home is run by a large national corporation, and the director says she has been told they will have to wait until the next budget year (October) before money will be available for a new air conditioner. Fortunately, the heating system is separate, so there will be heat when the colder weather starts. The director says that staff members have been particularly careful about maintaining hydration in the residents during the hot weather, but many of the residents seem fatigued and listless with the heat.

What hazards are present in the natural, built, and social environments in this situation? What health effects, if any, are these hazards causing?

What level(s) of prevention is (are) warranted in this situation? What might Janice do to intervene?

Case study #4 ( at least 250 words )

New state legislation has mandated that the majority of funds allocated for public health efforts be devoted to health promotion activities. Some of the major health problems encountered in the state at this time include heart disease, family violence, and social isolation among the elderly

Choose one of the three problems and design a set of interventions to aIDress it. Be creative! How might you employ empowerment strategies to aIDress the problem selected? (Your textbook defines empowerment on page 259.)

What role would health education play in aIDressing the problem selected?

Case study #5  ( at least 250 words)

Jane is an 18-year-old college student. She lives in the dorm with her roommate, Sally. Shortly after Jane returned from Christmas vacation, she developed a fever and a rash. She didn’t feel too bad, but Sally persuaded her to see a doctor. Because it was Saturday, Jane went to the emergency department (ED) of the local hospital. The physician there made a diagnosis of rubella. Later that night, he and the nurses in the ED became very busy with victims of a multivehicle accident. As a result, no one completed the health department form reporting Jane’s rubella until 2 days later.

By the time a community health nurse contacted Jane to complete a rubella case report, Sally and several other girls in Jane’s dorm had also developed rubella. Sally gave it to her boyfriend, who exposed those in his classes. One of the women in his English class is pregnant.

What primary preventive measures could have been employed to prevent this situation? What primary prevention measures are appropriate at this point?

What secondary and tertiary measures by the community health nurse are appropriate at this time?

What roles will the community health nurse perform in dealing with this situation? What other public health personnel might the community health nurse collaborate with in aIDressing the situation?

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