2 postsRe: Topic 1 DQ 2

     There are three elements the public health nurse (PHN) must consider when performing a community assessment.These elements include the population, location and social system (Green, 2018).When considering the focus of the assessment in the nursing process the PHN sets borders in order to assess the members within the community and the environment, determining variables and examining groups of people in different data sets.Outlining and identifying features of the population being assessed is the initial step the PHN completes when performing a focused assessment on a population (Green, 2018).Characteristics of the population’s demographic composition are the key elements for evaluating the needs within the defined group.

     PHN need to consider how the environment impacts the health for the population being assessed.The geopolitical place should be factored into a population assessment.The geopolitical place comprises the boundaries of the community, availability of public or private transportation, the characteristics of the geographic area, the climate, housing and native plants and animals (Green, 2018).How each of these elements potentially affects health can all be considered in the assessment.Geopolitical borders include ZIP codes, neighborhoods and school and health districts while man-made borders include streets, bridges and structures.These borders are utilized in epidemiologic studies to establish the demographics and health services/resources.Geographical informational systems are useful to establish patterns of health, inequalities in health within a setting that may be a result of the geographical influences (Green, 2018).By considering the geopolitical influences on a population, the PHN can plan interventions to be implemented.

     In contrast to the geographical and geopolitical location, a phenomenological place is the considers the history, cultures, spiritual beliefs, values and economics of a population (Green, 2018).The phenomenological characteristics of a population are what creates the sense of belonging for members in the community.Individuals may be part of different phenomenological places based on their individual religious, political and cultural beliefs.The PHN should consider the relationships, similar beliefs and goals when performing the assessment in order to establish the health status and needs of the community.

     Following the assessment, the nurse then can determine the needs and risks within the population, set goals, plan interventions to be implemented and then evaluate the outcome.For example, an elementary school nurses assesses the students and finds a large amount to be overweight.After a comprehensive assessment, the nursing diagnosis impaired nutrition: more than bodily requirements is selected.The nurse can than set the realistic goal with the students that they will be able to select 3 healthy foods when presented with different options.Interventions would include education about healthy diet and exercise and the importance of health promotion and healthy lifestyle to prevent disease, taught at the students knowledge level.After the educational sessions are implemented, the nurse can then evaluate and reassess the need for further interventions.

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1 postsRe: Topic 1 DQ 2

The geopolitical area contains community boundaries, environmental elements, plant life, weather, public transport, wildlife, facilities and homes. The community may be enveloped by mountains or wilderness. Natural disasters and injuries may arise and fluctuate with geographic areas. A geographic information system can be useful for healthcare specialists when identifying geographic or population boundaries. According to Green (2018), Geographic Information System (GIS) “helps to determine where there are disparities, health behaviors, or health deficits in an environment related to the geography of the area.” A phenomenological place is a mental place rather than a geographical place. This place concentrates on history, culture, economics, education, spiritual beliefs, values and common characteristics (GCU, 2018). These ideas establish a perspective in which the participants of the community feel as though they fit in. The community elements are the bases when identifying the community assessment.

According to Green (2018), “Public health nursing focuses on groups, populations, or the health of an entire geographical sector.” Therefore, whole public health utilizes the knowledge to push interventions to enhance stated health disparities. Public health demands are constantly changing and are what make the advancement of programs to enhance public health.

The community assessment involves studying the protection and wellbeing of a community to comprehend the connections among the people, environment, and resources. The nurse uses various methods of assessment of the environment and population before starting programs. The nurse prepares nursing diagnoses for the community created on the results and challenges decided from the community assessment. Public health nursing is motivated by the demands of the population for the prevention of disease and the development of the communities’ health.

The community health nurse must perform a series of actions to identify subjective and objective data and evaluate the information. After understanding the information, the nurse must recognize the demands and create a plan, an intervention and evaluate the data collected.

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2 postsRe: Topic 2 DQ 1

Social determinants of health are factors affecting peoples’ health, functioning and well-being, such as environmental conditions, social, and economic variables. Socioeconomic environmental factors contributing to infectious disease occurrence include crowding, unsanitary, unavailability of uncontaminated foods and water. These conditions provide an environment required for continuous chain of infection; the process required for transmission of disease. There are 6 components in the chain, or a cycle, of infection: organisms, reservoir, portal of exit, transmission, portal of entry, and a suspectable host (Green, 2018). To stop spreading of a communicable disease, the process has to interrupted or the chain of infection has to be broken at any point. Nurses, working in communities can decrease of the infectious diseases spreading. Promoting vaccination to lowering susceptible hosts number; and educating on sign and symptoms for early self-isolation to protect one’s family members from getting sick, breaking the transmission link. Educating on thorough hand hygiene and reducing face touching may protect one from getting sick eliminate portal of entry link. Proper respiratory hygiene, such as using disposable tissues and covering the mouth when sneezing, may stop the transmission on the stage of the pathogen leaving the reservoir via portal of exit (CDC.gov).

Noncommunicable chronic diseases, such as type 2 diabetes, have grown in endemic and epidemic proportions, are developing from a combination of determinants including environmental, physiological, and behavioral factors, additionally to genetic disposition (Green, 2018). Lack of knowledge and motivation, unavailability of healthcare services and financial resources contribute to developing of such diseases.q

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“Social determinants of health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks (Office of Disease Prevention and Health Promotion, 2019)”. The types of conditions may be in social, economic, and physical environment. Social determinants examples are; availability of resources to meet daily needs, educational and job opportunities and access, health care services access, patient safety, social support, social norms, exposure to crime, socioeconomic conditions, residential segregation, literacy or language, mass media access, and culture. The physical determinants examples are; green space or natural environment, built environment, recreational, work sites, schools, exposure to toxic substance, physical barriers, and aesthetic elements. Settings could be pertaining to school, church, workplace, and neighborhood, any type of setting that can be considered their “place”. Healthy People 2020 established five key areas of social determinants; economic stability, education, social and community context, health and health care, neighborhood and build environment. “

“Social determinants of health are economic and social conditions that influence the health of people and communities (Centers for Disease Control and Prevention, 2014)”. The social determinants of health contribute to the development of disease. The factors may be social in nature, biological, psychosocial, behavioral, and socioeconomic. For example, genes and biology such as sex and age, health behaviors such as EtOH abuse, social environment – discrimination, income, physical environment; where a person lives and type of condition, and health services – access to health care or not having insurance. “Each person’s health is affected by the person’s behavior, which, in turn, is associated with his or her social or economic status (e.g., income, education, and marital status) and the corresponding environmental conditions (e.g., the proportion of people in a neighborhood who live below the federal poverty level [FPL] or who do not have a high school education) (Ruiguang Song, 2011)”.

The fundamental idea of what the communicable disease chain model represents is composed of three elements; infectious agent, host and environment. The infectious agent must be present for the disease to occur or developed. Examples of infectious agents are bacteria, viruses, and parasites. The host can be any susceptible organism. Examples of hosts are plants, animals, and humans. The environment are all other possible factors that promote or prohibit the disease transmission.

Examples of steps a nurse may take to break the link within communicable disease chain is by simply disrupting or interrupting the chain at any link. Examples are; correctly washing hands often, vaccinations, staying at home when ill, abiding by regulations for standard and contact isolation, implementing personal protective equipment appropriately, cleaning and disinfecting the area, sterilizing medical equipment, following safe practices, utilizing antibiotics appropriately in order to prevent antibiotic resistance.

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1 postsRe: Topic 2 DQ 2

Climate change is something we have heard about for years. One thing I did not realize is how much it affects our global health. The World Health Organization states that the earth temperature has increased 0.85 degrees censuses, which is 33.5 degrees Fahrenheit, over the last 130 years. “Over the last 50 years, human activities – particularly the burning of fossil fuels – have released sufficient quantities of carbon dioxide and other greenhouse gases to trap additional heat in the lower atmosphere and affect the global climate” (World Health Organization, 2018). With the rising temperatures our ice glaciers continue to melt causing rising in sea levels which in result are causing increasing in precipitation and extreme weather conditions. “Climate change affects social and environmental determinants of health – clean air, safe drinking water, sufficient food and secure shelter” (World Health Organization, 2018).

Higher temperatures are causing increased levels of ozone and other pollutants in the air and are resulting in higher incidence in respiratory and cardiovascular disease. It is also causing increased natural disasters which are leading to increased deaths due to homes, medical facilities, and other essential facilities being destroyed. Another affect of climate change is variable rainfall which can cause drought and higher incidence of floods which contaminate drinking water. “Climatic conditions strongly affect water-borne diseases and diseases transmitted through insects, snails or other cold blooded animals” (World Health Organization, 2018). According to the World Health Organization, Malaria is strongly related to climate causing 400,000 deaths per year.

The World Health Organization continues to work on ways to prepare its communities to protect against climate change. They also state, “Many policies and individual choices have the potential to reduce greenhouse gas emissions and produce major health co-benefits. For example, cleaner energy systems, and promoting the safe use of public transportation and active movement – such as cycling or walking as alternatives to using private vehicles – could reduce carbon emissions, and cut the burden of household air pollution, which causes some 4.3 million deaths per year, and ambient air pollution, which causes about 3 million deaths every year” (World Health Organization, 2018). What we can do to help is to talk to our patients about how climate change effects their health and how they can help and try to protect themselves, use more economical friendly equipment and limit medical waste to decrease pollution and teach patients and families how to prepare and protect themselves from natural disasters

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