NUR 230 Community Health Nursing

NUR 230 Community Health Nursing: The purpose of this project is to provide an observational experience for the student in the community that meets the needs of the well-elderly and to allow the student a personal insight into the normal aging changes. Nurses need exposure to well-elderly clients to assess all dimensions of health, to evaluate any specific needs, to evaluate what community resources are available, and to describe the nursing practice implications appropriate to the well-elderly client.

Objectives:

Upon completion of the experience the assignment, the nursing student will be able to:

Evaluate a well-elderly client’s health status in all dimensions of health: physical, psychological, social, spiritual, and sexual.
Describe the scope of services available within a specific community providing services to older adults by differentiating among services that are health-promoting, health maintaining, and health restoring.
Using Maslow’s hierarchy of needs, identify one primary health strength, one primary health need, and document one nursing implication needed to maintain and/or strengthen each one.
Delineate appropriate nursing implications for practice that meet well-elderly client’s needs.
Evaluate the well elderly client’s needs in relation to available resources.
Identify one evidence-based content area that will be helpful in your role as the RN with the geriatric client.
Directions for Assignment:

Select an older adult (65 years or older) that is currently in the community you have been assigned and is independent in their living arrangements. The person needs to be able and willing to answer questions.
Also, plan to talk with a community agency representative to get the necessary information for your community agency assessment.
Complete the following assessment. You are interested in the well elders perspective of health.
No physical examination is done. At the end of each subsection, complete the evaluation portion.

4) Summarize your finds on the summative evaluation sheet.

5) Wear professional street clothes (no jeans), and your MPI name tag. Follow dress code guidelines. Report to your assigned placement for one day of clinical experience.

Grading criteria:

You must achieve competency on this project. Points are calculated to determine if you receive 11.25/15 points. You need 75% of the points to achieve competency. You have two chances to achieve competency. This is a double-starred criterion on your clinical evaluation tool.
Instructional Resource: http://consultgerirn.org/topics/age_related_changes/

NUR 230: COMMUNITY HEALTH NURSING

Well Elder Health Assessment and Community Experience

Student Name: ­­­­­­­­­­­­­­____________________________________________

Instructions to cover with the participant:

First, establish your relationship with introductions.
Review the purpose of the interview and the project.
Review the outcome to be achieved.
Share the tool, with the participant prior to another interview.
Clarify that the process is voluntary.
All information is confidential and will only be shared with your instructor via a written tool without any participant name identification. However, if the participant shares any information regarding suicidal thoughts or aspects of abuse, you will need to report such information together to a representative of the community.
The participant has the right to refuse to answer any question.
Well-Elder Demographics:

Age: _________ Sex: _________ Occupation: __________________________

Health Perception and Health Management (½ point)

1a) How would you describe your health status during the past year?

1b) How would you describe your health status during the past 5 years?

What do you do to maintain your health?
In your life, what priority does health play?
In your life, what is more, important than health?
What is your top health concern currently?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE THIS OLDER ADULT CURRENT HEALTH STATUS? USE THE SCALE OF 1 AS POOR AND 5 AS EXCELLENT.

Physical Health Exercise (½ point)

What do you do for exercise?
How often do you exercise?
How long do you exercise?
Would you say that you are an inactive, somewhat active, or active person?
Is this degree of activity a change for you? If yes, since when and why?
Are you satisfied with your level of activity (are you able to do what you need and what you like to do)?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE THIS OLDER ADULT ACTIVITY/EXERCISE STATUS? USE THE SCALE OF 1 IS INACTIVE AND 5 IS ACTIVE.

Spirituality (½ point)

What gives your life meaning?
Do you have any religious or philosophical beliefs which make your life easier?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE THIS OLDER ADULT SPIRITUALITY STATUS? USE A SCALE OF 1 AS NO SPIRITUALITY DIMENSION IN LIFE TO 5 AS SPIRITUALITY PLAYS A SIGNIFICANT PART OF LIFE.

Nutrition (½ point)

How would you rate your nutritional status?
How many meals +/or snacks do you eat a day?
Are there any types of food you are not supposed to eat?
Could you do a 24-hour diet recall including the type and amount of food?
TYPE AMOUNT

Breakfast

Snack

Noon meal

Snack

Dinner meal

Snack

Other:

Who prepares your meals?
How much money do you spend on food for yourself each week?
NURSING EVALUATION: USING THE FOUR MAJOR FOOD GROUPS (MILK PRODUCTS, MEATS, FRUITS AND VEGETABLES, GRAINS) HOW WOULD YOU RATE AND DESCRIBE YOUR OLDER ADULT NUTRITIONAL STATUS? USE THE SCALE OF 1 FOR POOR TO 5 FOR EXCELLENT.

Social Health/Social resources (1 point)

{Student} Now, I would like to ask some questions about your family, friends, and social activities.

What is your current relationship status (single, married, divorced, living together, separated, widowed)?
How many people do you have in your life that you can depend on?
About how many times did you talk to someone (friends, relatives or others) on the telephone in the past week (either you called them, or they called you)?
What type of social activities do you participate in? How often?
What other types of support do you have that are helpful to you (pets, church groups, community services)?
How often do you see relatives or friends?
Is there someone who would help you if you were sick or in need?
How have your social resources changed over the past 5-10 years?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE THIS OLDER ADULT SOCIAL HEALTH STATUS? USE A SCALE OF 1 FOR LIMITED TO 5 FOR EXTENSIVE.

Psychological Health (1 point)

{Student} “Now, I’d like to ask you some questions about how you feel about life.”

In general, do you find life exciting, interesting, routine, or dull?
Taking everything into consideration, how would you describe your satisfaction with life in general at this present time—–Excellent, good, fair, or poor
Are you under any unusual stress in the following areas? Mark if Yes.
___Financial situation ___Home living situation ___Transportation

___Personal health ___Family relationships ___Friend relationships ___Other

How would you rate your mental and emotional health at this present time —-excellent, good, fair, or poor?
How has your mental or emotional health changed in the past 5 years?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE YOUR OLDER ADULT PSYCHOLOGICAL HEALTH? USE A SCALE OF 1 FOR POOR TO 5 FOR EXCELLENT.

Sexuality (2 points)

{Student} “Sexuality is an important dimension of health. In the broadest sense, sexuality is defined as love, warmth, sharing, and touching between people. It can give meaning to life and bolster security, belongingness, and esteem. It has an emphasis on companionship, physical nearness, intimate communication, and a pleasure-seeking physical relationship.”

How would you describe yourself as a sexual being?
Have you noticed any changes about yourself that have impacted how you feel about yourself as a sexual being in the last 5-10 years?
Has your definition of sexuality changed over your life?
Are you currently in a relationship with someone?
NURSING EVALUATION; IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE YOUR OLDER ADULT SEXUALITY STATUS? USE THE SCALE OF 1 UNINVOLVED TO 5 FOR INVOLVED AND FINDS IT SATISFYING.

Medications (1 point)

What medications do you regularly and or occasionally take?
Prescription

Drug

Dose

How often?

Med for?

Over the Counter

Drug

Dose

How often?

Med for?

Are there currently any medications that have been prescribed but that you do not take? Why?
Do you have any drug allergies? If so, what type of reactions did you have?
How much money a month do you spend on medications?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU RATE AND DESCRIBE YOUR OLDER ADULT MEDICATION STATUS (KNOWLEDGE, COMPLIANCE, ETC)? USE A SCALE OF 1 FOR POOR TO 5 FOR EXCELLENT.

{Student} “This ends the formalized interview process. Do you have any questions for me that you would like to discuss? I would like to thank you for helping me with my project. It has been very helpful and useful to me to learn your perspectives on health. Thank you again for such a positive experience. I wish you a year filled with much health.”

(Student: You are to direct the following questions only to a community site where you are completing your project.)

Community Assessment (2 points)

Community (Residential) Facility Name: ________________________________________
What are the community-specific objectives in providing services to older adults?
What are the kinds of activities/services that are provided in this community?
What activities/services are categorized as health-promoting, health maintaining, and health restoring?
What are the eligibility requirements necessary to participate in the community?
How do your potential members qualify for becoming a participant in the community?
NURSING EVALUATION: IN 5 SENTENCES OR LESS, HOW WOULD YOU EVALUATE THE SCOPE OF SERVICES AVAILABLE FOR THE OLDER CLIENT? USE THE SCALE OF 1 FOR NOT WELL MATCHED TO 5 WELL MATCHED.

Summary Evaluation (6 points)

(2 points)
What is this older adult’s primary health strength?
Identify from Maslow’s hierarchy of needs, the area that matches the older adult’s strength.
Document one nursing implication to promote this older adult’s health strength.
(2 points)
What is this older adult’s primary health need?
Identify from Maslow’s hierarchy of needs, the area that matches the older adult’s need.
Document one nursing implication to promote the older adult’s health need.
(1 point)
Using Maslow’s hierarchy of needs, evaluate how well this client’s needs are currently being met.

(1 point)

What one evidence-based content area will be helpful in your role as the RN with the geriatric client?

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