FOUNDATIONS OF COMMUNITY HEALTH/PUBLIC HEALTH NURSING
Case Study:
During her regularly scheduled visit to a blood pressure clinic in a local apartment cluster, a Hispanic resident, Mrs. B., 45 years old, complained of feeling dizzy and forgetful. She could not remember which of the six medications she had taken during the last few days. Her blood pressure readings on reclining, sitting, and standing revealed gross elevation. The nurse and Mrs. B. discussed the danger of her present status and the need to seek medical attention. Mrs. B. called her physician from her apartment and agreed to be transported to the emergency department.
In the urgent care clinic, Mrs. B. manifested the progressive signs and symptoms of a cerebrovascular accident. She was transferred to a local hospital. During hospitalization, she lost her capacity for expressive language and demonstrated hemiparesis and loss of bladder control. Her cognitive function became intermittently confused, and she was slow to recognize her physician and neighbors who came to visit. The utilization review/discharge planning nurse at the hospital contacted the case manager from the health department to screen and assess for the continuum of care needs as early as possible, because Mrs. B. lived alone, and family members resided out of town.
It became apparent that family caregiving in the community could only be intermittent because family members lived too far away. Mrs. B. had residual functional abilities for ADL’s, but cognitive deficits that would demand longer-term care.
- What would be the actions you would take to construct a case management plan?
- State your opinions about the similarities and differences between a clinical nursing role and a population-focused role of the public-health nursing specialist.
- What are some of the complex issues between these roles? Be specific