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Community Health Practice B
Community Health Nursing Theory & Application (NUR 426)
Arizona College of Nursing
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RN Community Health
Online Practice 2019 B
Remediation
July 19, 2023
Chapter 4: Community Assessment
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● The role of a community health nurse is to collaborate and lead health program planning and evaluation. ● These nurses must be prepared to regularly provide health education to promote, maintain and restore the health of the community. ● The community health nurse is a key player in assessing the needs of the community ○ Interact and establish contracts to serve the community ○ Witness interactions ○ Identify future services based on needs.
Underlying Principles
####### ● Community assessment is a
####### comprehensive approach
####### that views the community as
####### a patient.
####### ○ The goal of community
####### assessment is to
####### provide services and
####### help to the people in
####### the community rather
####### than just individuals.
####### ● In order to start this
####### assessment, the community
####### itself needs to be defined.
####### The community can be:
####### ○ Geographic
####### ○ Demographic
####### ○ Functional
Nursing Interventions
● Informant interviews ○ Direct discussion with community members for the purpose of obtaining ideas and opinions from key informants ○ This interaction can obtain more detailed responses to community needs. ● Community forum ○ Open public meeting ○ May be difficult to find a time and place, but is an opportunity for input from the community. ● Focus groups ○ Direct communication with a group of people ■ “Representative sample”
Basic Concept
Chapter 36: Palliative Care
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####### ● Clients experience loss in
####### many aspects of their lives.
####### ● Grief is the inner emotional
####### response to loss and is
####### exhibited through
####### thoughts, feelings, and
####### behaviors.
####### ● Bereavement is the outward
####### display of loss and inculdes
####### both grief and mourning
####### ● Advance directives are
####### legal documents that direct
####### end-of-life issues
####### ○ Living will
####### ○ Health care proxy
####### ● Types of loss: necessary,
####### actual, perceived,
####### maturational, situational,
####### anticipatory
Underlying Principles
● Kubler Ross Model ○ Denial ○ Anger ○ Bargaining ○ Depression ○ Acceptance ● The nurse serves as an advocate for the clients sense of dignity and self esteem by providing palliative care at the end of life ● Use for clients who are dying regardless of the stage of disease process ● Focus on the relief of physical manifestations as well as addressing spiritual, emotional, and psychosocial aspects of the client’s life ● Hospice is used when the client is not expected to live longer than 6 months
Nursing Interventions
● Determine the client’s source of strength and hope ● Identify the desires and expectations of the client and family for end of life care ● Assess for discomfort ○ Pain ○ Anxiety ○ Restlessness ○ Dyspnea ○ Nausea ○ Vomiting ○ Dehydration ○ Diarrhea ○ Constipation ○ Inability to perform ADLs ○ Incontinence ● Promote continuity of care by limiting assigned staff changes ● Assist the client and family to set priorities for end of life care ● Administer medications that manage pain, air hunger, and anxiety.
Basic Concept
Nursing Skill
Description of Skill ● A tracheostomy can be an emergency or a scheduled surgical procedure. It can be temporary or permanent. ● It is a sterile surgical incision into the trachea through the skins and the muscles for the purpose of establishing an airway. ○ As nurses, we are responsible for the care and suctioning of tracheostomies. Indications ● Might be emergent or scheduled ● Unaccessible or non patent airway ● Chronic ventilation ● Life support
####### Outcome/Evaluation
● Patient will remain adequately oxygenated ● Infection will no be present ○ Pneumonia not present ● Any emergency situations will be addressed promptly and correctly ● The trach will fit the patient’s needs. Potential Complications ● Infection ● Damage to the trachea ○ Stenosis ○ Necrosis ● Accidental decannulation
####### Client Education
● Clear your oral secretions with a yankauer ● Press the call light if you need assistance or need to be suctioned. ● Ensure that the cuff is inflated if there is a cuff on your tube. ● Ensure that oral care is provided every 2 hours Nursing Interventions ● Pre ○ Keep two extra trach tubes at the client's bedside ■ Client’s size and one size smaller ○ Keep an oxygen source, suction catheters, and a suction source at the bedside. ● Intra ○ Suction the trach tube using sterile suctioning supplies ○ Apply a oxygen source looses if the oxygen sat drops during the procedure ○ Use a new inner cannula if it is disposable ○ Remove and clean the inner cannula ○ Never cut your own split gauze ○ Tie a square knot that is visible on the side of the neck ○ Remove old ties when new ties are already applied ● Post ○ Change any non disposable trach tube every 6-8 weeks ○ Reposition the client every 2 hours ○ Minimize dust in the room ○ Do not shake bedding ○ Assess the client for aspiration
Chapter 53: Airway Management
Community Health Practice B
Course: Community Health Nursing Theory & Application (NUR 426)
University: Arizona College of Nursing
