Describe the key concepts underlying community activism and give examples of how each of these concepts applies to a specific context. Examine how advanced practice nurses can engage in community activism to limit further negative health impacts from Big Tobacco in their respective health communities.

Attached below is an additional resource, an article, that details various ways by which nursing professionals can engage in community activism.

Patient Advocacy and in the Community and Legislative Arena: http://nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-17-2012/No1-Jan-2012/Advocacy-in-Community-and-Legislative-Arena.html?css=print

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Mrs. Davies is a 70-year-old white woman who presented to the emergency department because of a 4-day history of increased shortness of breath and generalized weakness. Mrs. Davies stated that she has been able to do her daily chores at home independently, but for the last few days it was getting difficult for her to get around and that she needed to take frequent breaks because she was short of breath and had no energy. She has a long history of heart failure, diabetes mellitus type 2, and hypertension. She is admitted with a tentative diagnosis of acute kidney injury (AKI).

Subjective Data

Has been having headaches on and off, with nausea and dizziness

Reported that she hadn’t been taking her medications regularly at home because of ‘forgetfulness’

Has not been urinating a lot

Feels ‘puffy’ in her legs and hands

Objective Data

Physical Examination

Blood pressure 178/96, pulse 110, temperature 98.9° F, respirations 24

Alert and oriented to person, place, and time

Mild jugular venous distention

Fine crackles in bilateral lower lobes

Heart rate regular, no murmurs

Bowel sounds normoactive and present in all four quadrants

2+ edema bilateral lower extremities and hands

Diagnostic Studies

Echocardiogram shows decreased left ventricular function

Urinalysis: Urine dark yellow and cloudy, protein 28 mg/dL, negative for glucose and ketones, positive for casts, red blood cells and white blood cells

24-hour urine output = 380 mL

Laboratory Tests:

Hemoglobin 8 g/dL

Hematocrit 23.8%

RBC 2.57 million/mm3

WBC 4.7 mm3

Sodium 132 mEq/L

Potassium 5.2 mEq/L

Calcium 9 mg/dL

BUN 36 mg/dL

Creatinine 4.9 mg/dL

BNP 182 pg/mL

Question 1

Interpret Mrs. Davies’s laboratory test results and describe their significance.

Question 2

What is the most likely cause of Mrs. Davies’s AKI?

Question 3

What additional tests, if needed, could be done to determine the cause of AKI?

Question 4

What are the priority nursing diagnoses to address the concern of fluid retention?

Question 5

What are the priority nursing interventions for these nursing diagnoses?

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Patient Profile

Mr. Artuso is a 63-year-old electrician who came to the emergency department complaining of shortness of breath, morning cough, and swelling in his lower extremities.

Subjective Data

Has smoked one pack of cigarettes daily for over 30 years

Has difficulty breathing when he walks

Has been sleeping in a recliner to make it easier to breathe

His shoes are tight at the end of the day

Objective Data

Physical Examination

Blood pressure 125/90, pulse 90, temperature 98.4° F, respirations 32

Increased anterior-posterior diameter

Breath sounds diminished with prolonged expiration

2+ peripheral edema bilateral lower extremities

Thin with muscle wasting

Respirations labored

Diagnostic Studies

Arterial blood gases: pH 7.32, SaO2 86%, PaCO2 55 mm Hg, PaO2 70 mm Hg

Chest x-ray shows hyperinflation of lungs

FEV1 65%

Question 1

What in Mr. Artuso’s history is commonly associated with pulmonary problems?

Question 2

Interpret Mr. Artuso’s arterial blood gases.

Question 3

What is a likely medical diagnosis for Mr. Artuso?

Question 4

What assessment data and diagnostic study results led you to this diagnosis?

Question 5

What complication associated with this diagnosis does Mr. Artuso also have? What clinical manifestation led you to that and what is the cause of it?

Question 6

What are the priority nursing diagnoses for Mr. Artuso at this time?

Question 7

What interventions are indicated for Mr. Artuso and what outcome is expected for each intervention?

Question 8

As part of patient teaching, is it “too late” to encourage Mr. Artuso to stop smoking? Why?

Question 9

What other teaching needs would you review with Mr. Artuso while he is hospitalized?

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This post has 2 parts; both are required.

Part One: Student can learn from the Quality Improvement projects of other nurses. In light of what you previously learned in Evidence-based Practice, review this project in the published nursing literature:

( Promoting quiet article)

Comment on:

· the aim

· the methods

· the findings

· the clinical implications

· what you learned about project implementation

Part Two: Recall the Call to action from the IHI. Article

(Institute for Healthcare article)

Your clinical problems should be addressing one of these issues, as healthcare should be: SAFE, EFFECTIVE, PATIENT-CENTERED, TIMELY, EFFICIENT, & EQUITABLE. 

Comment on the QI project you evaluated in part one- how did these authors address the IHI’s call to action for changing the U.S. healthcare system? Justify your answer.

Please cite in APA format

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