Direct Care Project Part 2

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Directions for Part 2

  1. For this part of the direct care project, you will be creating a  PowerPoint presentation based on the topic and problem identified in  Part 1. If you chose air quality as your topic, you will present on the Air Quality Flag Program. If you chose substance use, you will present the SBIRT intervention model.

If you have chosen substance use, you will present to at least 3 practicing RN’s. You can present all at one time or individually. If you chose air quality, you will present to at least one organization leader. See the Direct Care Project module for FAQs.

  1. Each topic has separate directions.

Download the Planning Your Presentation Directions for your corresponding topic.

Air Quality

Substance Use

  1. View the Direct Care Project Part 2 Tutorial (Links to an external site.).
  2. Download the template below and create a PowerPoint presentation for your selected group.
  3. Create speaker notes for the PowerPoint presentation. These will assist you as you present and will be part of your assignment submission.
  4. Utilize your own words and paraphrasing for all presentation content.
  5. The presentation should be no fewer than 8 and no more than 15 slides. This does not include the introduction and reference slides.
  6. Submit presentation in PDF for instructor approval. See Submitting PowerPoint Notes Pages in PDF format (Links to an external site.).
  • You will present the PowerPoint to your audience, not the PDF, as  you do not want the speaker notes to show to your audience members.
  1. Note: You may not present until your presentation has been approved by your instructor.
    • Review comments about your presentation from your instructor in Grades. Please see the Viewing Feedback on Assignments job aid in Resources. Your  instructor will indicate what (if any) revisions are needed in your  presentation and if it is approved to present as-is or once revisions  are made.

**You may be instructed to resubmit depending on the revisions needed.

  1. After your presentation is approved, see Week 5: Direct Care Project Part 3: Implementing Your Presentation. This is where you will find:
  • Attendance form
  • Pre-survey
  • Post-survey

***The surveys you will give your audience pre and post presentation  are already developed. You will submit the attendance form with the Part  4 submission and utilize the survey data in the Part 4 assignment. ***

Templates and Links

Click on the links below to download and view the resources for your project.

PowerPoint Presentation Template (Links to an external site.)

Air Quality Flag Program (Links to an external site.) (website)

SBIRT (Links to an external site.) (website)

Best Practices

  • Please use your browser’s File setting to save or print this page.
  • Include your name and date on the title slide.
  • Check for spelling and grammar errors prior to final submission.
  • Use bullet points instead of long sentences or paragraphs
  • Include graphics, photographs, colors, and themes.
  • Use the rubric as a final check prior to submission to ensure all content is clearly addressed.

Scholarly Sources and Citations

  • Minimum of 3 references. See Presentation Instructions for references needed.
  • Cite all resources in APA format on the slide where content occurs. Cite in lower corner/footer as prompted on template.
  • Reference slide is in template. Hanging indent is not required.

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Capstone Change Project Outcomes

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After working with your preceptor to assess organizational policies, create a list of measurable outcomes for your capstone project intervention. Write a list of three to five outcomes for your proposed intervention. Below each outcome, provide a one or two sentence rationale.

The assignment will be used to develop a written implementation plan.

APA style is not required, but solid academic writing is expected.

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FOCUS

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Comprehensive SOAP Exemplar

 

Purpose: To demonstrate what each section of the SOAP note should include. Remember that Nurse Practitioners treat patients in a holistic manner and your SOAP note should reflect that premise.

 

Patient Initials: _______ Age: _______ Gender: _______

 

SUBJECTIVE DATA:

 

Chief Complaint (CC): Coughing up phlegm and fever

 

History of Present Illness (HPI): Eddie Myers is a 58 year old African American male who presents today with a productive cough x 3 days, fever, muscle aches, loss of taste and smell for the last three days. He reported that the “cold feels like it is descending into his chest and he can’t eat much”. The cough is nagging and productive. He brought in a few paper towels with expectorated phlegm – yellow/green in color. He has associated symptoms of dyspnea of exertion and fatigue. His Tmax was reported to be 100.3, last night. He has been taking Tylenol 325mg about every 6 hours and the fever breaks, but returns after the medication wears off. He rated the severity of her symptom discomfort at 8/10.

 

Medications:

1.) Norvasc 10mg daily

2.) Combivent 2 puffs every 6 hours as needed

3.) Advair 500/50 daily

4.) Singulair 10mg daily

5.) Over the counter Tylenol 325mg as needed

6.) Over the counter Benefiber

7.) Flonase 1 spray each night as needed for allergic rhinitis symptoms

 

Allergies:

Sulfa drugs – rash

Cipro-headache

 

Past Medical History (PMH):

1.) Asthma

2.) Hypertension

3.) Osteopenia

4.) Allergic rhinitis

5.) Prostate Cancer

 

Past Surgical History (PSH):

1.) Cholecystectomy 1994

2.) Prostatectomy 1986

 

Sexual/Reproductive History:

Heterosexual

 

Personal/Social History:

He has never smoked

Dipped tobacco for 25 years, no longer dipping

Denied ETOH or illicit drug use.

 

Immunization History:

Covid Vaccine #1 3/2/2021 #2 4/2/2021 Moderna

Influenza Vaccination 10/3/2020

PNV 9/18/2018

Tdap 8/22/2017

Shingles 3/22/2016

 

Significant Family History:

One sister – with diabetes, dx at age 65

One brother–with prostate CA, dx at age 62. He has 2 daughters, both in 30’s, healthy, living in nearby neighborhood.

 

Lifestyle:

He works FT as Xray Tech; widowed x 8 years; lives in the city, moderate crime area, with good public transportation. He is a college grad, owns his home and financially stable.

 

He has a primary care nurse practitioner provider and goes for annual and routine care twice annually and as needed for episodic care. He has medical insurance but often asks for drug samples for cost savings. He has a healthy diet and eating pattern. There are resources and community groups in his area at the senior center but he does not attend. He enjoys golf and walking. He has a good support system composed of family and friends.

 

Review of Systems:

 

General: + fatigue since the illness started; + fever, no chills or night sweats; no recent weight gains of losses of significance.

 

HEENT: no changes in vision or hearing; he does wear glasses and his last eye exam was 6 months ago. He reported no history of glaucoma, diplopia, floaters, excessive tearing or photophobia. He does have bilateral small cataracts that are being followed by his ophthalmologist. He has had no recent ear infections, tinnitus, or discharge from the ears. He reported no sense of smell. He has not had any episodes of epistaxis. He does not have a history of nasal polyps or recent sinus infection. He has history of allergic rhinitis that is seasonal. His last dental exam was 1/2020. He denied ulceration, lesions, gingivitis, gum bleeding, and has no dental appliances. He has had no difficulty chewing or swallowing.

 

Neck: Denies pain, injury, or history of disc disease or compression..

 

Breasts:. Denies history of lesions, masses or rashes.

 

Respiratory: + cough and sputum production; denied hemoptysis, no difficulty breathing at rest; + dyspnea on exertion; he has history of asthma and community acquired pneumonia 2015. Last PPD was 2015. Last CXR – 1 month ago.

 

CV: denies chest discomfort, palpitations, history of murmur; no history of arrhythmias, orthopnea, paroxysmal nocturnal dyspnea, edema, or claudication. Date of last ECG/cardiac work up is unknown by patient.

 

GI: denies nausea or vomiting, reflux controlled, Denies abd pain, no changes in bowel/bladder pattern. He uses fiber as a daily laxative to prevent constipation.

 

GU: denies change in her urinary pattern, dysuria, or incontinence. He is heterosexual. No denies history of STD’s or HPV. He is sexually active with his long time girlfriend of 4 years.

 

MS: he denies arthralgia/myalgia, no arthritis, gout or limitation in her range of motion by report. denies history of trauma or fractures.

 

Psych: denies history of anxiety or depression. No sleep disturbance, delusions or mental health history. He denied suicidal/homicidal history.

 

Neuro: denies syncopal episodes or dizziness, no paresthesia, head aches. denies change in memory or thinking patterns; no twitches or abnormal movements; denies history of gait disturbance or problems with coordination. denies falls or seizure history.

 

Integument/Heme/Lymph: denies rashes, itching, or bruising. She uses lotion to prevent dry skin. He denies history of skin cancer or lesion removal. She has no bleeding disorders, clotting difficulties or history of transfusions.

 

Endocrine: He denies polyuria/polyphagia/polydipsia. Denies fatigue, heat or cold intolerances, shedding of hair, unintentional weight gain or weight loss.

 

Allergic/Immunologic: He has hx of allergic rhinitis, but no known immune deficiencies. His last HIV test was 2 years ago.

 

 

OBJECTIVE DATA

 

Physical Exam:

Vital signs: B/P 144/98, left arm, sitting, regular cuff; P 90 and regular; T 99.9 Orally; RR 16; non-labored; Wt: 221 lbs; Ht: 5’5; BMI 36.78

General: A&O x3, NAD, appears mildly uncomfortable

HEENT: PERRLA, EOMI, oronasopharynx is clear

Neck: Carotids no bruit, jvd or thyromegally

Chest/Lungs: Lungs pos wheezing, pos for scattered rhonchi

Heart/Peripheral Vascular: RRR without murmur, rub or gallop; pulses+2 bilat pedal and +2 radial

ABD: nabs x 4, no organomegaly; mild suprapubic tenderness – diffuse – no rebound

Genital/Rectal: pt declined for this exam

Musculoskeletal: symmetric muscle development – some age related atrophy; muscle strengths 5/5 all groups.

Neuro: CN II – XII grossly intact, DTR’s intact

Skin/Lymph Nodes: No edema, clubbing, or cyanosis; no palpable nodes

 

 

Diagnostics/Lab Tests and Results:

CBC – WBC 15,000 with + left shift

SAO2 – 98%

Covid PCR-neg

Influenza- neg

Radiology:

CXR – cardiomegaly with air trapping and increased AP diameter

ECG

Normal sinus rhythm

Spirometry- FEV1 65%

 

Assessment:

 

Differential Diagnosis (DDx):

1.) Asthmatic exacerbation, moderate

2.) Pulmonary Embolism

3.) Lung Cancer

 

Primary Diagnoses:

 

1.) Asthmatic Exacerbation, moderate

 

PLAN: [This section is not required for the assignments in this course, but will be required for future courses.]

 

 

 

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Assignment Policy Brief

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Suicide Prevention Act

· According to the govtrack website the bill I chose is a Federal bill.

· H.R. 5619, the “Suicide Prevention Act,”

· To authorize a pilot program to expand and intensify surveillance of self-harm in partnership with State and local public health departments, to establish a grant program to provide self-harm and suicide prevention services in hospital emergency departments, and for other purposes.

· This bill is in the first stage of the legislative process and introduced into Congress on May 4, 2021. (GovTrack.us., 2021).

· The bill legislative sponsors are the Representative Chris Stewart (R-UT) and Doris Matsui (D-CA).

· Suicide has become a serious issue in the USA. In the United States in 2019, suicide was the tenth highest cause of death for people of all ages (Hedegaard, M.D et al., 2021). According to the CDC website, symptoms of anxiety disorder and depressive disorder increased considerably in the United States during April–June of 2020, compared with the same period in 2019 (1,2). These symptoms and substance abuse are risks factors that can increase the risk for suicide. The bill would authorize CDC to award grants to State, local, and Tribal health departments to increase observation of self-harm and the second program would authorize the Substance Abuse Mental Health Service Administration (SAMSA) to award grants to hospital emergency departments for programs to prevent self-harm and suicide attempts among patients after discharge (GovTrack.us., 2021). Suicide is a major public health issue that can impact individuals, families, and communities for a long time. The goal of suicide prevention is to decrease risk variables while increasing those that encourage resilience. It will benefit many people once it is approved.

 

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Analyzing Body Lang

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Social Movements are only as important as the person leading them. The person(s) leading a social movement must have charisma and be able to captivate an audience. Political scientists and historians are taught to analyze body language, especially during debates and speeches.

For this assignment, you will watch Dr Martin Luther King’s I Have a Dream (Links to an external site.) speech and a speech by Alicia Garza of the Black Lives Matter movement (Links to an external site.) and answer questions listed below. Pay special attention to the following aspects in the two speeches.

  • Importance of body language while delivering the speech.
  • Gestures, cadence and delivery style.
  1. Provide a summary of the two speeches.
  2. Compare Dr. King’s leadership, charisma, power and passion to capture his audience to Alicia Garza’s speech. What are the similarities, if any? What are the differences, if any?
  3. How does the location of the speeches support their messaging? Dr. King’s speech was held in a church and at the Lincoln Memorial, whereas today we have social networking and more avenues to relay messages. Does messaging make a difference?
  4. Describe how the audience in Dr. King’s speeches relate to the Alicia Garza’s audience. Do you see a similarity or differences in the speeches and in the audience?

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Multidimensional Care 3

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Competency

Compare strategies for safe, effective multidimensional nursing practice when providing care for clients with lower respiratory disorders.

Scenario

You are a nurse on a pulmonary rehabilitation team at an outpatient clinic in your community. You are updating educational resources to educate clients who want to know more about health promotion and maintenance and improving pulmonary health related to their lung conditions.

Instructions

Create an infographic for a lower respiratory system disorder that includes the following components:

  • Risk factors associated with the common lower respiratory system disorder.
  • Description of three priority treatments for the lower respiratory disorder.
  • Description of inter professional collaborative care team members and their roles to improve health outcomes for the lower respiratory system disorder.
  • Description of three multidimensional nursing care strategies that support health promotion and maintenance for clients with the lower respiratory system disorder.
  • Description of a national organization as a support resource for your client specific to the lower respiratory system disorder.
Resources

For assistance creating an infographic, review this FAQ.

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Nursing project

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Using the University Online Library or the Internet, research about EI theories, communication styles, team building, and decision making. Go to the website berkeley.eduand take the quiz.

Based on your research and understanding, create a white paper in a 3- to 4-page Microsoft Word document that:

Describe how your EI level can either enhance or hinder effective leadership in the health care environment.

Discuss the results of the EI Quiz.

Use this APA Citation Helper as a convenient reference for properly citing resources.

This handout will provide you the details of formatting your essay using APA style.

You may create your essay in this APA-formatted template.

Submission Details

  • Support your responses with examples.
  • On a separate references page, cite all sources using APA format.

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Work 9

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Amenorrhea and Dysmenorrhea

 

Amenorrhea, the absence of menstrual flow, is often attributed to anatomic abnormalities, genetic disorders, endocrine disorders, medication use, illegal drug use, or oral contraceptives. The disorder can be divided into primary and secondary disorders. Primary amenorrhea is when menarche never occurred, whereas secondary amenorrhea is the result of a cessation of menstruation in an individual who previously experienced a menstrual cycle (Hubert and VanMeter, 2018). Dysmenorrhea results from painful menstruation and also has primary and secondary features. Primary dysmenorrhea occurs when ovulation starts, and secondary dysmenorrhea develops from pelvic disorders such as endometriosis, uterine polyps or tumors, or pelvic inflammatory disease (Hubert and VanMeter, 2018).

Common Presenting Symptoms

Primary amenorrhea symptoms include the absence of menstruation in which an individual has never had a menstrual cycle. The main symptom is absence of the menstrual cycle, but can also include headache, visual changes, nausea, extra facial hair, hair loss, changes in breast size, and milky fluid or discharge from the breasts (American Academy of Family Physicians, 2020). Secondary amenorrhea is the cessation of menstruation in an individual who previously experienced menstrual cycles. The primary symptom is missing several menstrual cycles in a row, and the same symptoms of primary amenorrhea.

Patients experiencing primary and secondary dysmenorrhea may experience discomfort the day before and during the first 24-48 hours of menses which can be cyclic, acyclic, and/or accompanied by urinary or bowel symptoms; nausea, vomiting, diarrhea, headaches, and muscle cramps can also accompany the disorder (Sachedina and Todd, 2019). Secondary dysmenorrhea symptoms include progressively worsening pain, chronic pelvic pain, midcycle or acyclic pain, and irregular or heavy menstruation (Sachedina and Todd, 2019).

Diagnosis

Primary amenorrhea is routinely diagnosed by performing a history and physical on the patient and collecting a series of labs for evaluation. Providers routinely perform a pregnancy test initially to rule out pregnancy as the underlying cause of amenorrhea. Other labs for evaluation include serum luteinizing hormone (LH), follicle-stimulating hormone (FSH), and thyroid – stimulating hormone (TSH), and prolactin levels (Klein, Paradise, and Reeder, 2019). Providers may decide to perform a pelvic ultrasound or magnetic resonance imaging (MRI) to identify abnormal reproductive anatomy or to detect an androgen-secreting tumor (Klein et al., 2019). If the pregnancy test is negative, evaluation of the hormone levels will assist in diagnosing the cause of amenorrhea, such as hypothalamic dysfunction, outflow tract obstruction, ovarian insufficiency, or chromosomal defects.

Secondary amenorrhea is routinely diagnosed in a similar manner beginning with a complete history and physical, review of medications, including contraceptives and illicit drugs. Patients are also given a pregnancy test and blood collected to evaluate the same hormonal levels as primary amenorrhea. If the pregnancy test is negative, evaluation of the hormone levels is performed to discover a diagnosis. Depending on the results of the hormone levels, the cause of secondary amenorrhea can be attributed to hypothalamic disorder, hyperandrogenism, metabolic syndrome, primary ovarian insufficiency, natural menopause, or chronic disease. Patients could also have other disorders which would be visualized on an ultrasound of MRI, including neoplasm, polycystic ovarian syndrome, or tumors of the adrenal or ovaries (Klein et al., 2019).

Primary and secondary dysmenorrhea are diagnosed in a similar fashion as amenorrhea. The health care provider should begin with a complete history and physical including the age of menarche, duration of menses, amount of bleeding, time elapsed between onset of menarche and dysmenorrhea. An evaluation of pain should include the onset, duration, severity, aggravating and alleviating factors, and when it occurs in relation to the menstrual cycle, dyspareunia, history of sexually transmitted or pelvic infections, and sexual violence (Sachedina and Todd, 2019). Providers would also complete an examination of the pelvis to determine the exact location of the pain and internal pelvic examination for the determination of tenderness on palpation.

Standard Treatment Plan

The standard treatment plan for primary amenorrhea depends on the underlying cause. If the individual does not have any underlying conditions, obstruction or congenital abnormalities, then the provider may recommend waiting for the menstrual cycle to start especially if there is a family history of late onset menstruation. Individuals with genetic or chromosomal abnormalities may require surgery. For secondary amenorrhea, birth control pills or other hormonal medications may be required to restart the menstrual cycle, or medication to stimulate ovulation. Estrogen replacement therapy is an option for women with an imbalance of hormonal levels. Patients experiencing a pituitary tumor may be prescribed medications to shrink it. Surgical management is uncommon but can be performed in the presence of uterine scarring by performing a hysteroscopic resection in order to restore the menstrual cycle (Eunice Kennedy Shriver National Institute of Child Health and Human Development, 2017).

Treatment for primary and secondary dysmenorrhea can include Nonpharmacological and pharmacological regimens such as application of heat, exercise, or medications such as nonsteroidal anti-inflammatory (NSAID) medications such as Ibuprofen or Advil, and oral contraceptives (Hubert and VanMeter, 2018).

Link(s) to Routine Screening and Treatment Guidelines

Routine screening is not recommended for amenorrhea or dysmenorrhea. In primary amenorrhea, individuals are not evaluated for the condition unless there is an absence of menses and secondary sexual characteristics by the age of fourteen; or the absence of menses by the age of sixteen, regardless of the presence of normal growth and development (Lowdermilk, Perry, Cashion, and Alden, 2016). For secondary amenorrhea, evaluation is not completed unless the individual has missed several menstrual cycles in a row unless they are determined to be pregnant.

Primary and secondary dysmenorrhea have the same guidelines as amenorrhea. Routine screening is not recommended. Individuals are evaluated if they exhibit symptoms. Treatment guidelines depend upon the causative factors for the discomfort. Individuals can be referred to the following links for treatment options for primary or secondary dysmenorrhea:

https://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/treatments

https://www.uptodate.com/contents/evaluation-and-management-of-primary-amenorrhea?topicRef=104218&source=see_link

https://www.uptodate.com/contents/dysmenorrhea-in-adult-women-treatment

https://www.acog.org/patient-resources/faqs/gynecologic-problems/dysmenorrhea-painful-periods

Response Two

Breast Cancer

Breast cancer is the malignant growth of abnormal cells in the breast tissue. Most breast cancers begin in the milk ducts that supply milk to the nipple while others may originate in the glands that produce breast milk. Less common breast cancers include phyllodes tumors and angiosarcoma (American Cancer Society, 2020). The majority of breast cancer cases occur in women over the age of fifty. Familial history supports a strong genetic predisposition of the development of breast cancer and is connected to the BRCA-1 and BRCA-2 genes. Hormonal connection, specifically Estrogen is also strongly supported. Experiences such as early onset of menstruation and late onset of menopause, nulliparity, or advanced age with first childbirth all increase length of time to high level Estrogen exposure, increasing risk for developing breast cancer (Hubert &VanMeter, 2020). Early detection is key in treating breast cancer and the prevention of breast cancer spreading to other organs of the body.

Presenting Symptoms

Most patients present due to an abnormal mammogram. However, the presence of a breast mass undetected on a mammogram or formed between screenings account for 45% of identified breast cancer masses (Joe, 2020). The classic characteristics of a cancerous mass are hard, singular, non-moveable with irregular boarders. If the mass advances the patient may present with axillary adenopathy or changes in the skin to include erythema and dimpling of the skin known as peau d’orange (Joe, 2020). A patient may also notice retraction of the nipple or a discharge from the nipple (Hubert & VanMeter, 2018). If a breast mass is identified during a self-breast exam or due to visual changes to the breast or axillary area, the patient will need to see a physician to determine the nature of the mass and malignancy.

Routine Diagnosis

A majority of breast cancer masses are identified via mammography studies. Supplemental mammographic views and possible ultrasound conduction will be used for further identification and characterization. The BI-RADS (Breast Imaging Reporting and Data System) is used to determine the likelihood of a mass being cancerous. If a mammogram is given a zero, further imaging studies are used for characterization. A BI-RADS score of 4-5 denotes that a malignant is highly suspected and further diagnostic studies such as a biopsy is needed (Esserman & Joe, 2019). Part of the course of diagnosis in breast cancer is also to determine the stage of malignancy and the extent of the disease, such as metastasis.

Standard Treatment Plan

Treatments are individualized depending on the stage of progression of the disease and other factors such as risk factors for recurrence and if the patient has other comorbidities. Early stage breast cancer patients may undergo surgery to remove the mass (lumpectomy) or to remove the breast (mastectomy) depending on what option is right for them (Taghian, & Merajver, 2020). In addition, a patient may also be treated adjuvant therapy such as chemotherapy and radiation to resolve any undetected micrometastases that remain after surgery. Other forms of treatment include hormone therapy. If a tumor proves to be responsive to estrogen, then the estrogen hormone stimulation is removed. This is done by way of removal of the ovaries in premenopausal patients and by hormone blocking agents in post-menopausal women (Hubert & VanMeter, 2018).

Links to Routine Screening and Treatment

Breast self-examination is recommended for all women over the age of 20 and for men at high risk for breast cancer (see Surprise Nugget section for more information on male breast cancer). The U.S. Preventive Services Task force recommends biennial screening mammography for women ages 50-74 years, and earlier if at higher risk for breast cancer. All screening recommendations can be found at https://uspreventiveservicestaskforce.org/uspstf/recommendation/breast-cancer-screening. Additional screening tools such as step-by-step instructions on completing a breast self-examination can be found at https://www.breastcancer.org/symptoms/testing/types/self_exam. Routine visits to a primary care physician related to women’s health is also recommended for routine screening support and education.

Surprise Nugget

The incidence of male breast cancer has increased 26% in the past 25 years (Gradishar & Ruddy, 2020). Male breast cancer is often linked with a family history in a first-degree relative and often presents in the same fashion as female breast cancer. Alterations in estrogen and androgen rations may also increase risk for male breast cancer. These alterations could result from hepatic dysfunction, obesity, thyroid disease, marijuana use, and inherited conditions such as Klinefelter syndrome. In Klinefelter syndrome, there is an inheritance of an additional X chromosome causing atrophic tested, gynecomastia, increased levels of follicle-stimulating and luteinizing hormones, and a decrease in testosterone. It is recommended that men with Klinefelter syndrome understand the affiliation and how to conduct self-examinations for breast cancer (Gradishar & Ruddy, 2020).

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Bargaining and the Professional Nurse

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A nurse manager is concerned about a competing hospital in town that is publically hearing a lot about collective bargaining and the steps that the nurses have been taking to start a union. The nurse manager’s organization is aggressively providing in-depth education to all employees about collective bargaining in order to answer numerous questions that have arisen recently.

1. What are reasons that nurses want to join a union?

2. What are the reasons that nurses do not want to join a union?

3. What are the common union organizing strategies?

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recipe from your culture (Philippines)

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Share a recipe from the culture you are writing about this week that could be altered to be a healthy option for that culture…(i.e. encouraging cauliflower rice rather than long grain rice if your Chinese patient was diabetic…).

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