Why is it important to be aware of cultural influences regarding pregnancy and prenatal care?

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1)Why is it important to be aware of cultural influences regarding pregnancy and prenatal care? What resources are available to you as an advanced practice nurse to guide and support you in providing culturally appropriate healthcare services in the pre and interconception timeframe

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For this assignment, answer the following questions based on the case study, “Applying Exercise State of Change to a Low-Income Underserved Population”.

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Case Study

 

Directions: For this assignment, answer the following
questions based on the case study, “Applying Exercise State of Change to a Low-Income
Underserved Population”. Use complete sentences when answering each question.
Answers to each question should be more than one sentence in length.

 

1)     
What was the behavior change theory that was used for
this study? Why was this theory selected? Do you think it was the best choice
for this study design? How was this model measured? (4 points)

 

 

2)     
Who was the target population for this study? Why was
this population group selected? (4 points)

 

 

3)     
Propose how social disparities may have been a factor
in the study results. (4 pts)

 

 

4)     
How can this study be used for future research on
behavioral change within this population group? (4 points)

 

 

5)     
What are some limitations to this study? Will these
limitations affect the applicability of the transtheoretical model to other
low-income populations? (4 points)

 

 

 

Assignment Grading Criteria (Each
question is worth 4 points)

 

Question Grading Criteria

Points Possible

Subject knowledge

2

Mechanics of writing (includes
spelling, punctuation, grammar, language use)

1

Included an example, supporting
evidence, and/or rationale

1

Total

4

 

Score calculation: 
Total earned   / 20 x 10 =

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You May Think Your Current Organization Operates Seamlessly, Or You May Feel It Has Many Issues. You May Experience Or Even Observe Things That Give You Pause.

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Part 1 Discussion:
Workplace Environment Assessment

How healthy is your workplace?

You may think your current organization operates seamlessly,
or you may feel it has many issues. You may experience or even observe things
that give you pause. Yet, much as you wouldn’t try to determine the health of a
patient through mere observation, you should not attempt to gauge the health of
your work environment based on observation and opinion. Often, there are issues
you perceive as problems that others do not; similarly, issues may run much
deeper than leadership recognizes.

There are many factors and measures that may impact
organizational health. Among these is civility. While an organization can
institute policies designed to promote such things as civility, how can it be
sure these are managed effectively? In this Discussion, you will examine the
use of tools in measuring workplace civility.

To Prepare:

  • Review
    the Resources and examine the Clark Healthy Workplace Inventory, found on
    page 20 of Clark (2015).
  • Review
    and complete the Work Environment Assessment Template in the Resources.

By Day 3 of Week 7

Post a brief description of the
results of your Work Environment Assessment. Based on the results, how civil is
your workplace? Explain why your workplace is or is not civil. Then, describe a
situation where you have experienced incivility in the workplace. How was this
addressed? Be specific and provide examples.

 

 

To Prepare:

  • Review
    the Resources and examine the Clark Healthy Workplace Inventory, found on
    page 20 of Clark (2015).
  • Review
    and complete the Work Environment Assessment Template in the Resources.

By Day 3 of Week 7

Post a brief description of the results of your
Work Environment Assessment. Based on the results, how civil is your workplace?
Explain why your workplace
is or is not civil. Then, describe a situation where you have experienced
incivility in the workplace. How was this addressed? Be specific and provide
examples.

Rubric Detail

 

Main Posting

45 (45%) – 50 (50%)

Answers all parts of
the discussion question(s) expectations with reflective critical analysis and
synthesis of knowledge gained from the course readings for the module and
current credible sources.

 

Supported by at
least three current, credible sources.

 

Written clearly and
concisely with no grammatical or spelling errors and fully adheres to current
APA manual writing rules and style.

40 (40%) – 44 (44%)

Responds to the
discussion question(s) and is reflective with critical analysis and synthesis
of knowledge gained from the course readings for the module.

 

At least 75% of post
has exceptional depth and breadth.

 

Supported by at
least three credible sources.

 

Written clearly and
concisely with one or no grammatical or spelling errors and fully adheres to
current APA manual writing rules and style.

35 (35%) – 39 (39%)

Responds to some of
the discussion question(s).

 

One or two criteria
are not addressed or are superficially addressed.

 

Is somewhat lacking
reflection and critical analysis and synthesis.

 

Somewhat represents
knowledge gained from the course readings for the module.

 

Post is cited with
two credible sources.

 

Written somewhat
concisely; may contain more than two spelling or grammatical errors.

 

Contains some APA
formatting errors.

0 (0%) – 34 (34%)

Does not respond to
the discussion question(s) adequately.

 

Lacks depth or
superficially addresses criteria.

 

Lacks reflection and
critical analysis and synthesis.

 

Does not represent
knowledge gained from the course readings for the module.

 

Contains only one or
no credible sources.

 

Not written clearly
or concisely.

 

Contains more than
two spelling or grammatical errors.

 

Does not adhere to
current APA manual writing rules and style.

Main Post: Timeliness

10 (10%) – 10 (10%)

Posts main post by
day 3.

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)

0 (0%) – 0 (0%)

Does not post by day
3.

First Response

17 (17%) – 18 (18%)

Response exhibits
synthesis, critical thinking, and application to practice settings.

 

Responds fully to
questions posed by faculty.

 

Provides clear,
concise opinions and ideas that are supported by at least two scholarly
sources.

 

Demonstrates
synthesis and understanding of learning objectives.

 

Communication is
professional and respectful to colleagues.

 

Responses to faculty
questions are fully answered, if posed.

 

Response is
effectively written in standard, edited English.

15 (15%) – 16 (16%)

Response exhibits
critical thinking and application to practice settings.

 

Communication is
professional and respectful to colleagues.

 

Responses to faculty
questions are answered, if posed.

 

Provides clear,
concise opinions and ideas that are supported by two or more credible
sources.

 

Response is
effectively written in standard, edited English.

13 (13%) – 14 (14%)

Response is on topic
and may have some depth.

 

Responses posted in
the discussion may lack effective professional communication.

 

Responses to faculty
questions are somewhat answered, if posed.

 

Response may lack
clear, concise opinions and ideas, and a few or no credible sources are
cited.

0 (0%) – 12 (12%)

Response may not be
on topic and lacks depth.

 

Responses posted in
the discussion lack effective professional communication.

 

Responses to faculty
questions are missing.

 

No credible sources
are cited.

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The concept of pregnancy planning can be a sensitive topic within women health as it relates to body changes.

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Create a response to the post below by Rosado. Using APA style of writing and minimum of 2 referencese

Question 2 Cultural Influences 

The concept of pregnancy planning can be a sensitive topic within women health as it relates to body changes. In any medical case, cultural considerations are crucial as it contributes to the decision-making process. There are many aspects of a culture that can affect a pregnancy, such as diet and other traditional customs that involve daily activities. According to Carcio and Secor, the preconception goal is to evaluate risk factors and provide counseling that aims to obtain an optimal health status for the mother and fetus (2015). This means that medical history is essential and lifestyle habits. For instance, substance abuse can be a negative impact in maternity that can lead to life threatening complications. Moreover, the assessment should include a nutritional evaluation and cultural preferences within the family environment. The important of cultural influences and awareness relates to maternal safety. This can include concerns within access due to preferences or lack of access. According to Jones, Lattof, and Coast, minority or religious groups commonly have poor access to care, which is linked to poor health outcomes (2017). This is a concern that can be preventable within the community. The community can provide resources with educational handouts that focus on maternity care. Another resource can include a cultural broker or interpreter that revolves around patient needs. Correspondingly, community centers or other organizations within maternal care should include training within cultural awareness. This should emphasize improvements within an understanding and respect toward diversity. As a result, strategies within cultural considerations are crucial for the wellbeing of maternity care.   

 

References: 

Carcio, H. & Secor, M.C. (2015). Advanced health assessment of women: Clinical skills and procedure. 3rd ed. New York: Springer 
Jones, E., Lattof, S. R., & Coast, E. (2017). Interventions to provide culturally appropriate maternity care services: factors affecting implementation. BMC pregnancy and childbirth, 17(1), 267. doi:10.1186/s12884-017-1449-7


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Why is it important to be aware of cultural influences regarding pregnancy and prenatal care?

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Create a response to this post by esteban . Using APA style and minimum 2 references 

Why is it important to be aware of cultural influences regarding pregnancy and prenatal care?

  It has been noted that racial diversity plays a very important part in incidence of birth defects. According to the California Department of Public Health, Hispanic infants were born with Down syndrome at higher rates than other infants. Furthermore, Asians have been shown to be at higher risk for oral-facial clefts, followed by Whites and African Americans. 

    The importance of ethnicity in the prevalence of these defects, possible theories have been put forward asserting the correlation with poverty, racism, environmental exposures, diet, inequalities in access to healthcare and unequal treatment in the health care system.

    Prenatal care in the United States is regarded as an essential part of the pregnancy process. Women who understand the importance of early treatment to ensure adequate fetal development take initiative to monitor their health as well as the fetus.However, prenatal care varies within cultures and ethnicities ( Gabrysch et al. 2009).  The importance of prenatal care has many variations depending on culture and ethnicity. However, depending on the culture pregnancy can be regarded as a normal condition and in the case of some Hispanic or Asian cultures,many women do not believe in early intervention and do not seek until much later in the pregnancy. Additionally in some Asian cultures, they even avoid prenatal vitamins as they are considered too harsh for the fetus based on their philosophy of yin/yang. Although customs and values should be respected; traditional beliefs can stand in the way of early detection and pose potential health risks to both mother and baby.  Understanding cultural differences is the key to explaining the importance of prenatal care.   

    There may be differences between the culture of maternity care services and the cultural practices and preferences of women and communities, in regards to childbirth settings, practices, attitudes towards illness and health, materials and/or language, for example. Perceived cultural insensitivity or poor intercultural competencies of professionals can also lead to discrimination of certain users by providers, resulting in a lack of trust in services and service providers (Gabrysch et al. 2009 ). Cultural beliefs and practices are often framed as a ‘barrier’ to the uptake of maternity care services, rather than a population characteristic which health systems need to consider in order to be responsive to community needs. Providing care that takes people’s cultural preferences into account is an important component of quality of care. The need for ‘culturally appropriate’ maternity care services is core to the World Health Organization’s (WHO) strategy for improving maternal and newborn health (WHO 2003).

 

Gabrysch S Lema C Bedrinana E et al.  . 2009 . Cultural adaptation of birthing services in rural Ayacucho, Peru . Bulletin of the World Health Organization  87 : 724 – 9 

WHO . 2003 . Working with Individuals, Families and Communities to Improve MNH  . Windau-Melmer : Washington, D.C., World Health Organization.


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A cough is a reflex action that clears the airway of mucus and irritants such as smoke and dust. However, coughs can be pathological if they do not resolve within a short period or rather if they become persistent (Weinberger & Lockshin, 2017).

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Differential diagnosis

A cough is a reflex action that clears the airway of mucus and irritants such as smoke and dust. However, coughs can be pathological if they do not resolve within a short period or rather if they become persistent (Weinberger & Lockshin, 2017). The differential diagnosis for coughs include Respiratory tract infections such as laryngitis, bronchitis and pneumonia, gastro-oesophageal reflux disease due to throat irritation by the stomach acid, and side effects of antihypertensive medications particularly the angiotensin-converting enzyme inhibitors. This essay will focus on pneumonia.

Presenting Symptoms

The presenting symptoms of pneumonia include Sharp chest pain when the client coughs or breathes deeply, a cough which may be productive or non-productive depending on the type of pneumonia. A productive cough is indicative of bacterial pneumonia, while a non-productive cough is indicative of viral pneumonia (Cilloniz et al., 2016). Fatigue is a common symptom. Fever and sweating or chills are also present. Moreover, there is shortness of breath while the client is doing daily activities or even at rest.

Diagnostic testing 

The diagnosis of pneumonia starts by auscultation of the chest to assess the lung sounds. Crackling or bubbling sounds are indicative of pneumonia. The various diagnostic tests done are sputum test and pleural fluid culture to confirm the causative organism. Sputum is corrected after a deep cough. A chest X-ray is done to determine the extent and location of the infection. A computed tomography scan can also be done to produce a more detailed image of the lungs.

Treatment

The treatment of pneumonia aims at curing the infection and preventing complications. The medications used depend on the causative organism of pneumonia. Antibiotics are used to treat bacterial pneumonia. Viral pneumonia is treated by using antiviral, while fungal pneumonia is treated by antifungal (Waterer, 2016). Pain medications such as acetaminophen are also administered along with the other medications to relieve fevers.

References

Cilloniz, C., Martinn-Loeches, I., Garcia-Vidal, C., San Jose, A., & Torres, A. (2016). Microbial aetiology of pneumonia: Epidemiology, diagnosis and resistance patterns. International journal of molecular sciences, 17(12), 2120.

Waterer, G. W. (2016, December). Community-acquired pneumonia: a global perspective. In Seminars in respiratory and critical care medicine (Vol. 37, No. 06, pp. 799-805). Thieme Medical Publishers.

Weinberger, M., & Lockshin, B. (2017). When is cough functional, and how should it be treated? Breathe, 13 (1), 22-30.


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A cough is often a presenting chief complaint and has several differential diagnoses.

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A cough is often a presenting chief complaint and has several differential diagnoses.

        Cough is a common complaint that can be caused by upper respiratory cough syndrome, allergic and vasomotor rhinitis syndrome, chronic rhinitis, asthma, and gastroesophageal reflux disease. Other causes include chronic smoking or exposure to smoke, aspiration, bronchiectasis, infections such as pertussis and tuberculosis, non-asthmatic eosinophilic bronchitis, cystic fibrosis, sleep apnea, restrictive lung disease, and bronchogenic or laryngeal neoplasm, among others (Sharma, Hashmi, & Alhajjaj, 2019). In Florida, an important number of non-smoker cough cases are related to allergic rhinitis.

Choose one differential diagnosis for cough and discuss the presenting symptoms, diagnostic testing, and treatment.

          Allergic rhinitis results from a IgE mediated inflammation of the mucosa in the nares after exposure to an allergen (Sharma, Hashmi, & Alhajjaj, 2019). The response to this exposure includes sneezing, congestion rhinorrhea, and mucosa hyperactivity (Sharma, Hashmi, & Alhajjaj, 2019). Allergic rhinitis can be seasonal, which is normally related to outdoor allergens, or perineal, which is normally related to indoor allergens (Sharma, Hashmi, & Alhajjaj, 2019). Risk factors include family history, tobacco smoke exposure, history of asthma, pets in the house, and houses infested with roaches (Sharma, Hashmi, & Alhajjaj, 2019). History and physical exam are crucial to diagnose allergic rhinitis, identifying nature, onset time, and duration of symptoms (Sharma, Hashmi, & Alhajjaj, 2019). Other information that will be significant to allergic rhinitis includes whether the patient has a history of atopic dermatitis or food allergies, or both (Sharma, Hashmi, & Alhajjaj, 2019). History of nasal congestion, itchy nose, watery itching eyes, itching ears, or sneezing is also significant in the diagnosis of the condition.

          Findings during physical exam include dark circles under the eyes, rubbing of the nose, rhinorrhea, clear nasal discharge, blue-gray, pale nasal mucosa, post-nasal discharge, and oropharyngeal lymphoid tissue hypertrophy (Wheatley & Togias, 2015). Differential diagnosis includes infection rhinitis, medication-induced cough, rebound effect after continuous use of decongestants, vasomotor rhinitis, adenoidal hypertrophy, and septal abnormalities (Wheatley & Togias, 2015). The first line of treatment is second-generation antihistamines such as cetirizine and loratadine. The second line of treatment includes nasal antihistamine and first-generation antihistamines.

References

Sharma S, Hashmi MF, Alhajjaj MS. Cough. [Updated 2019 Sep 13]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK493221/

Wheatley, L. M., & Togias, A. (2015). Clinical practice. Allergic rhinitis. The New England journal of medicine, 372(5), 456–463. doi:10.1056/NEJMcp1412282


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John Thomas is a 64-year-old Caucasian male who presents to the emergency room with a two-day history of intermittent substernal chest pressure associated with shortness of breath and diaphoresis.

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STAGE 1

 

John Thomas is a 64-year-old Caucasian male who presents to
the emergency room with a two-day history of intermittent substernal chest
pressure associated with shortness of breath and diaphoresis.  The pain had originally awoken Mr. Thomas
from sleep 2 nights ago and has been intermittently relieved with some
sublingual nitroglycerin tablets that he had received from his physician 3
years ago.  The pain increases with
exertion, but now is constant.  He rates
the pain a “7” on a scale of 1 to 10.

 

Past Medical History:  HTN, Type 2 DM

 

Home Medications:    Lopressor (metoprolol) 50 mg PO daily

                                    Lasix
40 mg PO daily

                                    ASA
325 mg PO daily

                                    Glucophage
50 mg PO BID

 

Vital Signs:  T-98.9 (O)          P=
110             R=28               BP= 90/60       SpO2=88% on RA

 

Physical Exam:

            Neuro:             Anxious, but alert and oriented x3

            Pulm:               Bilateral rales, labored

            CV:                 RRR; S1, S2,
S3; tachycardic; PMI displaced laterally

            ABD:              Active bowel sounds;
soft/non-tender; liver enlarged

            EXT:               2+ lower extremity edema; 1+
peripheral pulses

            INTEG:           Poor capillary refill; nail beds
cyanotic; skin is diaphoretic

 

Lab Results:

Na= 133;         K=5.0;             C1=100;
         CO2=22;          BUN=29;        Cr=1.8; Glucose=183            Hgb=9.2;
        Hct=27.6;        WBC=11.2;     Plt=203

            CPK=2900;     CKMB=432%;                        LDH=972;
     Troponin=6

 

Diagnostic Tests:

            12 lead
ECG; Sinus tachycardia with left ventricular hypertrophy and

ST elevation in leads V1,
V2, V3, & V4

 

            CXR:   Increased vascular markings in both lungs

 

 

Critical
thinking exercises

            1.         List your primary medical and nursing
diagnoses for this patient.

            2.         What area of the left ventricle is
affected by this MI?

            3.         What
is your rationale for EACH of the abnormal physical assessment parameters, the
abnormal laboratory results, and the abnormal diagnostic tests?

            4.         What are your anticipated nursing interventions
for this patient?

 

 


STAGE 2

 

Mr. Thomas is admitted to the CCU with a diagnosis of Acute
MI with congestive heart failure.  The
following orders are obtained:

            Vital Signs
q1h

            Continuous
ECG monitor

            Bedrest

            Foley
catheter

            Nitroglycerin
IV infusion @ 10 mcg/min

            Heparin IV
infusion @ 1000 units/hr

            PTT q6h and
call results if <60 or > 90

            CK
isoenzymes q8h x3

            Troponin
level q12h x2

            O2
at 2 1iters/min per NC—titrate for SpO2>91%

            Lopressor
25 mg PO BID

            Ambien 5 mg
PO qHS PRN sleep

 

CRITICAL THINKING EXERCISE

            1.         What is your rationale for each of the
admitting orders?

 

 

STAGE 3

 

Mr. Thomas’ urine output decreases to 10 ml/hr and is
unresponsive to a dose of IV Lasix.  He
complains of increased SOB and physical exam reveals increasing rales bilaterally.  A pulmonary artery catheter is inserted with
the following parameters obtained:

 

            CVP= 10         PCWP=22       PA
pressure=38/20

            CO=  4.1         CI=1.9             SVR=1872

 

CRITICAL THINKING EXERCISE

 

             1.         What
is the reason for each of the above parameters and what medication do you
anticipate starting?

 

STAGE 4

 

You had provided Mr. Thomas with some IV morphine sulfate
for pain.  You check on him 30 minutes
later and find that he is unresponsive with slow, shallow respirations.  He is diaphoretic.  An ABG on 2L/NC reveals:

 

            pH=7.22          pCO2=50         pO2=82            HCO3=26        SaO2=83%

 

CRITICAL THINKING EXERCISES

            1.         What does the ABG reveal?

            2.         What is the probable cause?

            3.         What are the anticipated medical and
nursing interventions?

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What is the accepted name of the condition with which the child will be born? What are the peri-natal risks to the infant? What are the post-natal risks to the infant?

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APA style with minimum 2 references and not more than 5 yrs old 

Please read the case scenario listed below. In your initial post, address the questions posed at the end of the scenario. In your response post, please address information you learned about available resources in your clinic area and how you would access them. When reading your peer’s posts, what similarities and differences are noted compared to your clinical or community standards of care?  


Detail your approach to care and management for the following case scenario:


A 21-year old woman presents for prenatal visit, her 1st even though she is well into her third trimester and her EDC is predicted to be within a month or so.  He boyfriend, the father of the child, has not been supportive to date of the pregnancy and is also not on good terms with her own parents.  At first, she denies alcohol or drug use but after a while, she opens up and talks about an ongoing opioid addiction.  Most of the time, she takes Percocet bought on the street but due to cost, she has recently begun using heroin.  It becomes clear that she will not be “clean” prior to her delivery and that her child will be born also affected by maternal opiate use.Since she has almost no external support, you know that after she delivers, she will be the primary caregiver of the infant and also hopefully working a detox program.


  • What is the accepted name of the condition with which the child will be born? What are the peri-natal risks to the infant? What are the post-natal risks to the infant? What are the post-natal risks to the mother?
  • Is there any evidence on the long-term risk to the child? 
  • In your response post to a peer:  Please share information on the resources available in your clinical practice to address these concerns.

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Treatment plan using 1st line therapeutic interventions, patient education and follow up expectations

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APA style 

There are many differential diagnoses for chest pain:


  • Acute myocardial infarction
  • Aortic dissection; pericarditis
  • Acute coronary artery insufficiency
  • Pulmonary embolism
  • Pneumothorax
  • Pneumomediastinum
  • Pneumonia
  • Esophageal spasm
  • Esophagitis
  • Biliary colic
  • Acute pancreatitis
  • Peptic ulcer disease


  1. Choose one of the above differential diagnoses.
  2. Discuss the following
    • Presenting/associated symptoms
    • Specific diagnostic tests used in the work up
    • Treatment plan using 1st line therapeutic interventions, patient education and follow up expectations
  3. Support whether or not you would refer the patient to another health care provider for treatment. Include the name of the specialty and your rationale for the referral.

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