Develop a 1,250 written project on the topic Fall Prevention in Healthcare facilities that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Clinical problem statement.
3. Purpose of the change proposal in relation to providing patient care in the changing health care system.
4. PICOT question.
5. Literature search strategy employed.
6. Evaluation of the literature.
7. Applicable change or nursing theory utilized.
8. Proposed implementation plan with outcome measures.
9. Discussion of how evidence-based practice was used in creating the intervention plan.
10. Plan for evaluating the proposed nursing intervention.
11. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome.
12. Appendix section, if tables, graphs, surveys, educational materials, etc. are created.

Prepare this assignment according to the guidelines found in the APA Style Guide.

1. What role can providers play as advocates for the vulnerable populations.
2.After reading the posted article, “Nurses Need Not be Guilty Bystanders: Caring for Immigrant Populations”. What did you learn from this article and how can you affect change for the better to help eliminate stereotyping based on ethnicity?
3.Define what you think constitutes a vulnerable population and give 3 examples.
4.What is RAM and who founded it. Explain the purpose it serves and the population.
5..Does Medicaid provide dental and vision care for adults? What impact does this have on that population and health outcomes?

6.The article Development of a Community Nurse-Managed Health center there are 3 goals listed in establishing the clinic. What are they?
7.How do you think low literacy impacts a person’s ability to seek health care? What are the long range health problems that can develop without preventive health care?
8.In the video on government and health care there is some discussion about 3rd party purchases related to health care. What does this mean?
9.In the RAM videos what is the greatest need that people seek care for and what could help solve this problem?
10.After watching the video on the Affordable Care Act. What do you think are positives and negatives of the Act?

11.For extra credit tell me what you think is wrong with our health care system and what could be done to fix it.

Case Study, Chapter 5, Adult Health and Nutritional Assessment

1. Mrs. Jones, a 40-year-old female patient, is presenting for a history and physical. The nurse gathers a family history from the patient. She shares that her mother died at 70 years of age of colon cancer and had adult onset diabetes controlled with oral agents, hypercholesterolemia, and hypertension. She had a stroke before passing away. Her father died at 67 years of age from a stroke. He had a long history of alcoholism and smoked two packs per day of cigarettes for 50 years. He had hypertension, hypercholesterolemia, and two heart attacks; the first heart attack was at 30 years of age and the second at 52 years of age. He had adult onset diabetes controlled with oral agents since 50 years of age.

He had renal stenosis that was unsuccessfully treated with a renal angioplasty and he developed end-stage renal failure requiring hemodialysis. Mrs. Jones has two brothers. One brother developed hypertension, hypercholesterolemia, and adult onset diabetes controlled with oral agents at 50 years of age. The second brother has no health problems. The maternal grandmother died at 88 years of age of a stroke and had hypertension. The maternal grandfather died at 70 years of age of a massive heart attack and had a history of hypertension. The paternal grandmother died at 80 years of age of a heart attack.

bleeding esophageal varices

The paternal grandfather died at 50 years of age from bleeding esophageal varices related to long-standing alcoholism. The patient shares that her mother’s first cousin, George, died at 52 years of age of Hodgkin lymphoma. She has another first cousin Mabel, 72 years of age, who is alive but has had cancer of the colon and had a recent stroke, and has a history of hypertension, hypercholesterolemia, and adult onset diabetes controlled with diet.

Her mother’s sister, who is 68 years of age, is alive and has a history of hypertension and hypercholesterolemia. Her mother’s brother died at 68 years of age of renal cancer and had a history of hypertension, hypercholesterolemia, and adult onset diabetes controlled with oral agents. He also had a heart attack at 45 years of age and a coronary artery bypass graft operation of three vessels at 55 years of age. He smoked cigarettes for 50 years. The patient’s father was an only child and her father’s family all lived to be over 80 years of age. (Learning Objective 5)

history of hypertension and hypercholesterolemia

1. What genetic-related diseases do the patient’s first-order relatives have?
2. What genetic-related diseases do the patient’s second-order relatives have?
3. Optional: Draw a genogram of the patient’s family’s health history using the example in the textbook (see Fig. 5-2) as a guide.

2. The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8)

1. What is the rationale for computing body mass index? What is Mrs. Varner’s BMI?
2. Calculate her ideal body weight. What is your assessment of her BMI and weight?
3. Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment.
4. Mrs. Varner’s waist circumference is 38 inches. What is your assessment?
5. What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?

Case Study, Chapter 6, Individual and Family Homeostasis, Stress, and Adaptation

1. Mr. Smith, a 52-year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. The patient has a history of smoking two packs per day of cigarettes for 35 years, and he drinks a six-pack of beer on weekend nights, but does not drink the rest of the week. He is the sole financial support for his family. He is a consultant for a company and is out of town during week days. Over the past year, Mr. Smith has gained 20 pounds. He is 5 foot 6 inches, weighing 200 pounds. His diet consists mostly of fast food. He rarely exercises. His wife cares for their three teenage children.

The eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children’s hospital in the intensive care unit in critical condition. Mr. Smith developed chest pain and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pills. The wife is in the waiting room while the nurses settle Mr. Smith into his room. The youngest son, 13 years of age, is at a friend’s house. The teenage daughter is staying at the bedside of the critically ill eldest son. The wife blames her eldest son for her husband’s heart attack and told the emergency department nurse that she does not care to see her son at all. (Learning Objectives 6, 10, and 11)

1. What maladaptive responses to stress may have contributed to Mr. Smith’s development of an illness?
2. Based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family in crisis?
3. What nursing interventions should be used to promote effective coping for the patient and his family?

2. Mary Turner stepped on a nail 5 days ago and sustained a puncture about 1 inch deep. She immediately cleaned the area with soap and water and hydrogen peroxide, and applied triple antibiotic ointment to the site. Today she comes to the clinic with complaints of increased pain and swelling in her foot. On assessment, the nurse notes that the puncture site is red and edematous, and has a moderate amount of yellowish drainage. (Learning Objective 9)

1. Describe the sequence of events that caused the local inflammation seen in Mary’s foot.
2. What is the role of histamine and kinins in the inflammatory process?
3. Which of the five cardinal signs of inflammation does Mary exhibit?
4. Because Mary’s injury occurred 5 days ago, the nurse should assess for what systemic effects?