NRS-434VN- Health Assessment
Tutor- White, Sandra
Dq1
Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and
preterm births. Describe the impact of extremely low birth weight babies on the family and on
the community (short-term and long-term, including economic considerations, on-going care
considerations, and co-morbidities associated with prematurity). Identify at least one support
service within your community for preterm infants and their family. Provide the link for your
colleagues to view. Does the service adequately address needs of this population? Explain your
answer.
The rates associated with low birth weight and preterm birth indicates the existence of disparities
though the risk factors are well known. They include obesity, smoking, and hypertension. The
low birth weight and preterm births rates are high among the black non-Hispanic as opposed to
the white non-Hispanic. By 2013, the rate was at 60% higher for the blacks in relation to the non-
Hispanic whites. By then, it was higher by 44% as compared to the Hispanics. In the same case,
the rate of low birth weight was double that of the Hispanics at 13.1% as compared to 7.0%
(Martin, et al., 2015.).
Infants with extremely low weight indicate an increased risk of death in the first year of their
life. They are vulnerable to several morbidities of childhood like chronic lung disease,
hyperactivity, as well as cerebral palsy. Abnormal rate of brain development is another risk in
addition to problems of cognitive behaviors in their teenage. There are increased adulthood
difficulties in their adulthood to diabetes type ii, cardiovascular disease and hypertension. The
death of a baby due to these cases negatively affects the well-being of a family and also strains in
their financial status. This is due to the medical care which may be expensive. There are several
services that contain important information relating on how to end the issue of preterm
deliveries.
Helping families undergoing the effects of preterm births is imperative. This calls for
interventions that would aid in coping with emotional, financial as well as medical burdens they
are facing. The CDC website is a treasured resource found at www.cdc,gov as well as the Infant
Health and Development Program (IHDP) (CDC, 2013). This program offers services like home
visits, center-based early education, and family support. March of Dime is a non-profit
organization that assists mothers as well as their babies (March of Dimes, 2015). It is found
under http://www.marchofdimes.org/mission/prematurity-campaign.aspx. In the West Palm
Beach area, another non-profit organization The Children’s Healing Institute works in preventing
extreme effects to families. It has numerous interventions, support, and prevention programs that
ensure that families with premature infant’s cases get help. They sufficiently address the needs of
the low-income earners like the African Americans, Asians, and the Hispanics (The Children's
Health Institute, 2015). It is found using the link http://www.childrenshealinginstitute.org/#!
programs/cee5
Reference
,Centers for Disease control and Prevention (CDC) (2013). Preterm birth. Retrieved from
http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.html
March of Dimes. (2015, February 27). Racial and Ethnic Disparities in Birth Outcome. Retrieved
October 16th , 2017, from March of Dimes: http://www.marchofdimes.org/materials/March-of-
Dimes-Racial-and-Ethnic-Disparities_feb-27-2015.pdf
Martin, J. A., Hamilton, B. E., Osterman, M. J., Curtin, S. C., & Matthews, T. J. (2015). Births:
final data for 2013. National vital statistics reports: from the Centers for Disease Control and
Prevention, National Center for Health Statistics, National Vital Statistics System, 64(1), 1-65.
The Children's Health Institute. (2015, November 24). How We Help. Retrieved October 16th ,
2017, from The Children's Health Institute: http://www.childrenshealinginstitute.org/#!
programs/cee5
Dq 2
You are the registered nurse performing a health assessment on a newborn infant. From the
functional health pattern portion of the assessment, you learn the mother is reluctant to
breastfeed her baby. How do you respond? Explain the approach you will take to ensure adequate
nutrition for the newborn, with or without breastfeeding. Provide rationale for your answer.
t he principal and the most critical stride that can be used in approaching the mother on
breastfeeding are the reasons for her actions. More than a few reasons exist as to why parents
may be unwilling to breastfeed their children. The first part of the conversation and healing
process would be to know the main motive behind her action. Supporting the mother and
avoiding judging her would be of supreme importance. It is essential and helpful for nurses to
connect with patients to share the reality with them which is better compared to the use of
medical statistics. In many cases and from familiarity, I have come to comprehend that first
mother have a hard time while breastfeeding. One of my best friend’s baby was latching
correctly, though her milk was not coming. She first hated to do it. Sharing on this first-hand
experience with the mother would assist in making her believe that I fully recognize her needs.
She will then open up as well as understand that the problems witnessed during breastfeeding
can be dealt with completely.
Many sources have occasioned in showing the physical, nutritional, emotional, and financial
paybacks that are linked with breastfeeding. Joining the mother to a lactation consultant at the
hospital would also be important. In the case of an absence of an expert, I would refer her to the
Le Leche League. This is an association that offers remarkable resources in assisting the
breastfeeding mothers. However, I would not take her there if she insists that she does not want
to breastfeed. There has been information that the organization is very hard on those who do not
breastfeed. If she denies breastfeeding completely, I will ensure that she gets the mechanics of
feeding by the use of a bottle. In the case of any additional assistance being needed, I will refer
her to WIC. Finally, I would instruct her on the benefits of being a good mother by ensuring that
her baby is well fed.
,Reference
The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies. (2014). Retrieved
October 16th, 2017, from https://www.cdc.gov/breastfeeding/resources/guide.htm
Women, Infants, and Children (WIC). (2016). Retrieved October 16th, 2017, from
http://www.fns.usda.gov/wic/women-infants-and-children-wic
Environmental Factors and Health Promotion Pamphlet: Accident Prevention and Safety
Promotion for Parents and Caregivers of Infants
Part II: Pamphlet Sharing Experience
I shared the pamphlet with one of the young women who happen to attend the same
church as I do. Her husband has been a heavy smoker since she got married and have been
blessed with one child currently aged eight months. She, therefore, qualified to be one of
the most suitable clients for sharing my pamphlet. She was an active participant during the
sharing period having to listen carefully and ask important questions where she needed
clarifications. She indicated a sense of interest by keeping eye contact throughout the
presentation. She, therefore, facilitated the saving of time as she followed keenly especially
when discussing the effects of second-hand smoke. She was prepared with a pen and a
notebook where she noted important points that we discussed. Even without asking, she
indicated that she had attained college education where many of her peers were smokers.
She also informed me that she could not wish to see her family perish at her young
age of 28 years. I had known her for several years and therefore she was free to give me a
history of how she used to see many of the African parents smoking heavily. She, therefore,
subscribes to the African American heritage. Her interest in the issue of second-hand
smoke was evident in how she kept interjecting politely with questions. Many of her queries
concentrated on the effects and risks associated with second-hand smoke. She wore a
worried face when I named one after the other risks and complications brought forth by
the smoke. This proved to me that she was really concerned about the welfare of her family.
Later, she enquired on the possible ways to prevent against the effects of the smoke.
She kept nodding while I explained a factor that motivated me to continue
explaining. To evaluate her understanding of our discussion, I ensured that I kept her busy
with questions. To my satisfaction, she answered with a lot of ease. She later assured me
that she would ensure that all is well with her family. This made me want to know how she
will make sure that she stops a perennial smoker from going on with his addictive behavior.
I was amazed when she smiled and told me “I will use the power of a woman”. The whole
experience enabled me to weigh on my skills in communication. It taught me that I can
interact and convince my patients towards bettering their health. The fact that I answered
with ease all her questions gave me the courage to perform my duties with prior
preparation.
, I was happy to hear her say that the sharing experience would not be in vain as she
learned important issues relating to the topic under discussion. I would consider selecting a
quiet place in my next sharing experience. This is because there were instances we had to
cut short our interaction due to high volumes of noise. Everything else went well as planned
and the minor disturbances did not distract us from the main agenda.
WEEK 2
DQ 1
Child abuse and maltreatment is not limited to a particular age and can occur in the infant,
toddler, preschool, and school-age years. Choose one of the four age groups (infant, toddler,
preschool, or school age) and discuss the types of abuse that are most often seen in this age.
Discuss warning signs and physical and emotional assessment findings the nurse may see that
could indicate child abuse. Discuss cultural variations of health practices that can be
misidentified as child abuse. Describe the reporting mechanism in your state and nurse
responsibilities related to the reporting of suspected child abuse.
Maltreatment takes different arrangements about suffering in children. These include issues like
sexual abuse, medical neglect, emotional and psychological abuse, abandonment, and physical
abuse. Victimization is principally high among the youngest population aged three years and
below (Harris, 2013). Children with disability are twice likely to experience forms of abuse or
neglect. The parents with disorders in substance abuse are likely to be most likely offenders. In
Arizona, any case of child abuse alleged by the nurses is reported to the local CPS agency acting
as a good example. Whenever there is a case of child abuse, a scar is left. Some may be
emotional hence durable with effects that affect them throughout their lives.
Psychological effects also harm a sense of self of the child as well as their ability to have healthy
relationships as well as capability to function properly as opposed to physical effects. Some of
the central effects include relation difficulties and lack of trust, problems trying to regulate
emotions, and feelings of being damaged or worthless (Harris, 2013). Assessing a school age
child, there are definite warning signs that indicate abuse. Emotionally, the child will be
extremely withdrawn, anxious on doing the wrong, and being fearful. The child may also lead to
excesses in behavior and a likelihood of not being committed to the caregiver or the parent.
Examples of these warnings in physical abuse evident in a school-aged child would include
frequent and mysterious injuries; watchful alert as if waiting for a bad thing to occur; afraid to go
back home; flinches arising from unexpected touch or movement; wearing inappropriate clothing
to cover up for injuries among many more.
Warning signs that may be looked by a nurse throughout an assessment include filthyclothes, ill-
fitting, or even inappropriate for a precise weather. Others would include the level of hygiene:
matted as well as sordid hair and body odor; physical injuries and untreated illnesses. On sexual
abuse, there may be difficulties in walking or an interest in sexual activities beyond their age.
Others include STD or pregnancy while under the age of 14 as well as running away from home
Tutor- White, Sandra
Dq1
Discuss disparities related to ethnic and cultural groups relative to low birth weight infants and
preterm births. Describe the impact of extremely low birth weight babies on the family and on
the community (short-term and long-term, including economic considerations, on-going care
considerations, and co-morbidities associated with prematurity). Identify at least one support
service within your community for preterm infants and their family. Provide the link for your
colleagues to view. Does the service adequately address needs of this population? Explain your
answer.
The rates associated with low birth weight and preterm birth indicates the existence of disparities
though the risk factors are well known. They include obesity, smoking, and hypertension. The
low birth weight and preterm births rates are high among the black non-Hispanic as opposed to
the white non-Hispanic. By 2013, the rate was at 60% higher for the blacks in relation to the non-
Hispanic whites. By then, it was higher by 44% as compared to the Hispanics. In the same case,
the rate of low birth weight was double that of the Hispanics at 13.1% as compared to 7.0%
(Martin, et al., 2015.).
Infants with extremely low weight indicate an increased risk of death in the first year of their
life. They are vulnerable to several morbidities of childhood like chronic lung disease,
hyperactivity, as well as cerebral palsy. Abnormal rate of brain development is another risk in
addition to problems of cognitive behaviors in their teenage. There are increased adulthood
difficulties in their adulthood to diabetes type ii, cardiovascular disease and hypertension. The
death of a baby due to these cases negatively affects the well-being of a family and also strains in
their financial status. This is due to the medical care which may be expensive. There are several
services that contain important information relating on how to end the issue of preterm
deliveries.
Helping families undergoing the effects of preterm births is imperative. This calls for
interventions that would aid in coping with emotional, financial as well as medical burdens they
are facing. The CDC website is a treasured resource found at www.cdc,gov as well as the Infant
Health and Development Program (IHDP) (CDC, 2013). This program offers services like home
visits, center-based early education, and family support. March of Dime is a non-profit
organization that assists mothers as well as their babies (March of Dimes, 2015). It is found
under http://www.marchofdimes.org/mission/prematurity-campaign.aspx. In the West Palm
Beach area, another non-profit organization The Children’s Healing Institute works in preventing
extreme effects to families. It has numerous interventions, support, and prevention programs that
ensure that families with premature infant’s cases get help. They sufficiently address the needs of
the low-income earners like the African Americans, Asians, and the Hispanics (The Children's
Health Institute, 2015). It is found using the link http://www.childrenshealinginstitute.org/#!
programs/cee5
Reference
,Centers for Disease control and Prevention (CDC) (2013). Preterm birth. Retrieved from
http://www.cdc.gov/reproductivehealth/maternalinfanthealth/pretermbirth.html
March of Dimes. (2015, February 27). Racial and Ethnic Disparities in Birth Outcome. Retrieved
October 16th , 2017, from March of Dimes: http://www.marchofdimes.org/materials/March-of-
Dimes-Racial-and-Ethnic-Disparities_feb-27-2015.pdf
Martin, J. A., Hamilton, B. E., Osterman, M. J., Curtin, S. C., & Matthews, T. J. (2015). Births:
final data for 2013. National vital statistics reports: from the Centers for Disease Control and
Prevention, National Center for Health Statistics, National Vital Statistics System, 64(1), 1-65.
The Children's Health Institute. (2015, November 24). How We Help. Retrieved October 16th ,
2017, from The Children's Health Institute: http://www.childrenshealinginstitute.org/#!
programs/cee5
Dq 2
You are the registered nurse performing a health assessment on a newborn infant. From the
functional health pattern portion of the assessment, you learn the mother is reluctant to
breastfeed her baby. How do you respond? Explain the approach you will take to ensure adequate
nutrition for the newborn, with or without breastfeeding. Provide rationale for your answer.
t he principal and the most critical stride that can be used in approaching the mother on
breastfeeding are the reasons for her actions. More than a few reasons exist as to why parents
may be unwilling to breastfeed their children. The first part of the conversation and healing
process would be to know the main motive behind her action. Supporting the mother and
avoiding judging her would be of supreme importance. It is essential and helpful for nurses to
connect with patients to share the reality with them which is better compared to the use of
medical statistics. In many cases and from familiarity, I have come to comprehend that first
mother have a hard time while breastfeeding. One of my best friend’s baby was latching
correctly, though her milk was not coming. She first hated to do it. Sharing on this first-hand
experience with the mother would assist in making her believe that I fully recognize her needs.
She will then open up as well as understand that the problems witnessed during breastfeeding
can be dealt with completely.
Many sources have occasioned in showing the physical, nutritional, emotional, and financial
paybacks that are linked with breastfeeding. Joining the mother to a lactation consultant at the
hospital would also be important. In the case of an absence of an expert, I would refer her to the
Le Leche League. This is an association that offers remarkable resources in assisting the
breastfeeding mothers. However, I would not take her there if she insists that she does not want
to breastfeed. There has been information that the organization is very hard on those who do not
breastfeed. If she denies breastfeeding completely, I will ensure that she gets the mechanics of
feeding by the use of a bottle. In the case of any additional assistance being needed, I will refer
her to WIC. Finally, I would instruct her on the benefits of being a good mother by ensuring that
her baby is well fed.
,Reference
The CDC Guide to Strategies to Support Breastfeeding Mothers and Babies. (2014). Retrieved
October 16th, 2017, from https://www.cdc.gov/breastfeeding/resources/guide.htm
Women, Infants, and Children (WIC). (2016). Retrieved October 16th, 2017, from
http://www.fns.usda.gov/wic/women-infants-and-children-wic
Environmental Factors and Health Promotion Pamphlet: Accident Prevention and Safety
Promotion for Parents and Caregivers of Infants
Part II: Pamphlet Sharing Experience
I shared the pamphlet with one of the young women who happen to attend the same
church as I do. Her husband has been a heavy smoker since she got married and have been
blessed with one child currently aged eight months. She, therefore, qualified to be one of
the most suitable clients for sharing my pamphlet. She was an active participant during the
sharing period having to listen carefully and ask important questions where she needed
clarifications. She indicated a sense of interest by keeping eye contact throughout the
presentation. She, therefore, facilitated the saving of time as she followed keenly especially
when discussing the effects of second-hand smoke. She was prepared with a pen and a
notebook where she noted important points that we discussed. Even without asking, she
indicated that she had attained college education where many of her peers were smokers.
She also informed me that she could not wish to see her family perish at her young
age of 28 years. I had known her for several years and therefore she was free to give me a
history of how she used to see many of the African parents smoking heavily. She, therefore,
subscribes to the African American heritage. Her interest in the issue of second-hand
smoke was evident in how she kept interjecting politely with questions. Many of her queries
concentrated on the effects and risks associated with second-hand smoke. She wore a
worried face when I named one after the other risks and complications brought forth by
the smoke. This proved to me that she was really concerned about the welfare of her family.
Later, she enquired on the possible ways to prevent against the effects of the smoke.
She kept nodding while I explained a factor that motivated me to continue
explaining. To evaluate her understanding of our discussion, I ensured that I kept her busy
with questions. To my satisfaction, she answered with a lot of ease. She later assured me
that she would ensure that all is well with her family. This made me want to know how she
will make sure that she stops a perennial smoker from going on with his addictive behavior.
I was amazed when she smiled and told me “I will use the power of a woman”. The whole
experience enabled me to weigh on my skills in communication. It taught me that I can
interact and convince my patients towards bettering their health. The fact that I answered
with ease all her questions gave me the courage to perform my duties with prior
preparation.
, I was happy to hear her say that the sharing experience would not be in vain as she
learned important issues relating to the topic under discussion. I would consider selecting a
quiet place in my next sharing experience. This is because there were instances we had to
cut short our interaction due to high volumes of noise. Everything else went well as planned
and the minor disturbances did not distract us from the main agenda.
WEEK 2
DQ 1
Child abuse and maltreatment is not limited to a particular age and can occur in the infant,
toddler, preschool, and school-age years. Choose one of the four age groups (infant, toddler,
preschool, or school age) and discuss the types of abuse that are most often seen in this age.
Discuss warning signs and physical and emotional assessment findings the nurse may see that
could indicate child abuse. Discuss cultural variations of health practices that can be
misidentified as child abuse. Describe the reporting mechanism in your state and nurse
responsibilities related to the reporting of suspected child abuse.
Maltreatment takes different arrangements about suffering in children. These include issues like
sexual abuse, medical neglect, emotional and psychological abuse, abandonment, and physical
abuse. Victimization is principally high among the youngest population aged three years and
below (Harris, 2013). Children with disability are twice likely to experience forms of abuse or
neglect. The parents with disorders in substance abuse are likely to be most likely offenders. In
Arizona, any case of child abuse alleged by the nurses is reported to the local CPS agency acting
as a good example. Whenever there is a case of child abuse, a scar is left. Some may be
emotional hence durable with effects that affect them throughout their lives.
Psychological effects also harm a sense of self of the child as well as their ability to have healthy
relationships as well as capability to function properly as opposed to physical effects. Some of
the central effects include relation difficulties and lack of trust, problems trying to regulate
emotions, and feelings of being damaged or worthless (Harris, 2013). Assessing a school age
child, there are definite warning signs that indicate abuse. Emotionally, the child will be
extremely withdrawn, anxious on doing the wrong, and being fearful. The child may also lead to
excesses in behavior and a likelihood of not being committed to the caregiver or the parent.
Examples of these warnings in physical abuse evident in a school-aged child would include
frequent and mysterious injuries; watchful alert as if waiting for a bad thing to occur; afraid to go
back home; flinches arising from unexpected touch or movement; wearing inappropriate clothing
to cover up for injuries among many more.
Warning signs that may be looked by a nurse throughout an assessment include filthyclothes, ill-
fitting, or even inappropriate for a precise weather. Others would include the level of hygiene:
matted as well as sordid hair and body odor; physical injuries and untreated illnesses. On sexual
abuse, there may be difficulties in walking or an interest in sexual activities beyond their age.
Others include STD or pregnancy while under the age of 14 as well as running away from home
