Question

Health and Wellness
Preparing for Clinical Practice
Ms. Thom, age 46, works as an RN in the intensive care unit at a large busy medical center. Over the last three years she has gained 30 lbs and quit attending the fitness classes at the local recreation center. Her co-workers keep trying to get her to come back to fitness class, but she says that she is too tired after work and just wants to go home. She has smoked for 15 years, but says that she is trying to cut back on the number of cigarettes each day because she watched her mother die from emphysema. She has picked up some literature from Employee Health on smoking cessation. She was recently diagnosed with hypertension.
1. Using the health belief model, identify the modifying factors impacting Ms. Thom's likelihood of taking a preventive health action.
2. Which primary intervention activities are important for Ms. Thom?
3. Using the transtheoretical model of change, in which stage is Ms. Thom most likely related to her smoking? Explain your answer.
Caring for the Cancer Survivor
1. Do you have a friend or family member who has cancer and is willing to talk about it? If so, ask the individual to tell you what the experience has been like and what he or she would recommend to help you provide better care for survivors.
2. Ms. Ritter is a 32-year-old woman who visits the medical outpatient clinic to discuss her treatment options for breast cancer. She is married and has one child, a daughter, who is 6 years old. She and her husband hoped to have another child in the near future but now wonder if that will be possible. She shares with the nursing staff her concerns about the future and how cancer will affect her and her family. Identify two follow-up care plan components that would be important when considering Ms. Ritter's role as a wife and parent.
3. Ms. Ritter tells her nurse, “This chemotherapy has made me feel so tired, and there are many nights when I can't sleep very well. I'm looking forward to this ending.” What is an appropriate response the nurse might give Ms. Ritter?

Answer 1

1.The modifying factors impacting Ms. Thom's likelihood of taking a preventive health action are :-

- cessation of smoking

- attending fitness classes

- weight loss

2. The Primary Interventions activity is to change the present behaviour .

The main issue in Ms. Thom's case is her unhealthy behaviour including weight gain , cigarette smoking , not attending fitness classes which has lead to development of hypertension .

3. The transtheoritical model of change is the model used to change behaviour . It has five steps :-

- precontemplation ( no need to change the behaviour)

- contemplation( decides to change the behaviour)

- action ( changes the behaviour)

- relaspe ( goes backs to the pre existing conditions)

- maintainence

she is the contemplation stage of transtheoriticalodel model of change means she has determined to change her behaviour because she has watched her mother swing of emphysema .

Caring for cancer survivor

,1. No, I don't have any friends or family member diagnosed with cancer or getting treatment for cancer by god's grace . But I will give you my experience with my patients as I myself work in the oncology department . I see many patients diagnosed with cancer in my daily life from morning to evening . I talk to them , provide them care, counsel them etc . Many of the patients has revealed their experience when they come to know that they have cancer . For them it's like everything is over. They are in the fear of death . They want to know the reason why it happened with them ,what have they done . They just deny it and wents to depression . For them it's all black in their ahead life . They burst out ,cry for their life out of pain . The main loss is the confidence they had . They get psychologically and emotionally disturbed . They are worried about their family members .

The recommended suggestion from the patient to enhance their life with cancer firstly is to reduce the pain , which is relieved by providing palliative care . Secondly , provision of support to the patient and family for survival .