Swift River Community Health Question and Answers

Carlos Mancia, 48 y/o Spanish speaking male; he and his wife have TB and have educated themselves by video for meds

health promotion: increased
risk reduction: increased
community assessment: increased
culture/beliefs/spirituality: increased
disease/illness prevention: increased
education/counseling: increased
resource id: increased
self-management: increased
social determinants of health: increased
surveillance: increased

Suzanne Olsen, 24 y/o female; increased vaginal discharge, pain w/ intercourse, five abortions, two deliveries (gave up for adoption)

health promotion: increased
risk reduction: increased
community assessment: increased
culture/beliefs/spirituality: normal
disease/illness prevention: increased
education/counseling: increased
resource id: increased
self-management: increased
social determinants of health: increased
surveillance: increased

Kenny Barrett, 64 y/o male; undiagnosed HTN r/t vasculitis, Buerger's disease, smokes one pack/day, country boy (far from doctors)

Arthur Silverstein, 68 y/o male; Vietnam vet dx: PTSD r/t abuse during imprisonment from war, lives in homeless shelter, alcohol addiction, hyper-vigilant and gets anxious in crowds, has not seen kids in years

Mary Jane, 21 y/o female; self-mutilation, anxiety, dx: major depressive disorder, anxiety/depression r/t unemployment, lives with parents, dropped out of college

Jenny Smith, 23 y/o G2P1; dilatation and curettage (D&C) following miscarriage at 10 wks, "felt fine" so cancelled follow-up appt; has lower abd pain, generalized malaise, body aches, has 4 y/o son and is a teacher

Antel Musaka, 13 y/o male; cerebral anoxia during prolonged L&D which caused cerebral palsy, quadriplegia & developmental delay, attends school, has GERD and PEG tube for meds (still eats by mouth), has seizure history; lives w/ parents (mom is sole care provider)

health promotion: increased
risk reduction: normal
community assessment: increased
culture/beliefs/spirituality: increased
disease/illness prevention: increased
education/counseling: increased
resource id: increased
self-management: increased
social determinants of health: increased
surveillance: normal

Gina Smith, 56 y/o female; alcohol and IV drug addiction, hospitalized for gastric pain, elevated liver enzymes, prescribed disulfiram, takes fluoxetine for depression/anxiety; lost job, evicted from apt, shelter/couch surfing

Dominic Antelli, 9 y/o male; foster care (4th placement), autism, pale and lethargic -- being treated for lead poisoning, having periods of enuresis, sometimes self-injurious, above grade-level intelligence

Ann Rails, 38 y/o female; domestic violence shelter, afraid to go home, tx: pain mgmt and restoration of gait

Genevieve (Genny) Osaka, 14 m/o infant female; MVA at 4 m/o causing C4 spinal fracture and SCI, lives w/ mom, has trach and on mech vent, has J-tube for feedings and meds; mom is finalizing things for childcare

health promotion: increased
risk reduction: normal
community assessment: normal
culture/beliefs/spirituality: normal
disease/illness prevention: increased
education/counseling: increased
resource id: increased
self-management: increased
social determinants of health: increased
surveillance: normal

Richard Dominec, 47 y/o male; emergent appendectomy recent, HIV+ and recently converted to AIDS w/ Kaposi sarcoma, has dry nonproductive cough and oral candida infx; married to Jim for 10 years, Jim is HIV-, have three kids

health promotion: normal
risk reduction: increased
community assessment: increased
culture/beliefs/spirituality: normal
disease/illness prevention: increased
education/counseling: increased
resource id: increased
self-management: increased
social determinants of health: increased
surveillance: increased

Maria Sanchez, 20 y/o female G1 T1 P0 A0 L1; uncomplicated pregnancy and vag delivery at 39 wks, feeling anxious and overwhelmed with 6 wk baby and quit breastfeeding; family speaks primarily Spanish

Judith Hanks, 64 y/o woman; d/c 1 year ago following discectomy for herniated disc, went though alcohol withdrawal, hx of HF, both her and husband are back and forth between sober and not

Roger McClusky, 70 y/o male; Alzheimer's; active in church

Ramona Stukes, 69 y/o female; failed cholecystectomy and subsequent ileostomy, ostomy been leaking

Jack Storis, 39 y/o male; dx GBM, craniotomy 1 year ago, intermittent home hospice care, neuro fx rapidly declined past 4-6 wks; currently unemployed, has had seizures, lives w/ wife and 5 y/o son

health promotion: normal
risk reduction: increased
community assessment: normal
culture/beliefs/spirituality: normal
disease/illness prevention: normal
education/counseling: increased
resource id: increased
self-management: increased
social determinants of health: normal
surveillance: normal

Hildegard Lowe, 69 y/o female; hx granulomatosis, pulm HTN; widowed and lives alone, has strong social support group

Jim Goodman, 77 y/o male; end-stage COPD; lives w/ wife, smokes 15 cigs/day

health promotion: increased
risk reduction: increased
community assessment: increased
culture/beliefs/spirituality: normal
disease/illness prevention: increased
education/counseling: increased
resource id: normal
self-management: increased
social determinants of health: increased
surveillance: normal

Charles Wheeler, 18 y/o male; acting out, ADHD; lives at home with parents, lots of conflict w/ them, works at auto parts store 15 hrs/wk

Janeya Stone, 5 y/o female; hydrocephalus, has had shunts; more tired than usual, pale, doesn't eat much, lots of family stress (strong religious beliefs against same-sex marriage)

Bridgett Allen, 17 y/o female; Down Syndrome; can care for self, struggles w/ impulse and emotional control sometimes

Edward Martin, 44 y/o male; schizophrenia; has short-term disability

Ann Rails

Scenario 1: counseling, vocational training and employment, transportation, court advocacy and protection, PT

Scenario 2: actively listen to story, reassure abuse is not her fault, let ann know this info is appropriate for counselor, acknowledge how difficult

Scenario 3: safety and privacy, respect and empowerment, mental health assessment and support, validation and support, legal support

Scenario 4: bedtime routine, aromatherapy, refer to provider, relaxation techniques, toenail length, referral services

Scenario 5: hydrocodone, schedule appt for STI screening, share pain with PT

Antel Musaka

Scenario 1: verbalize feelings, community resources, friends and family, new ways to organize care

Scenario 2: watery stool means feeding went too fast, use comm board, check residual, should be calm

Scenario 3: loosen restrictive clothing, record time, remove from wheelchair, describe behaviors

Scenario 4: elevate HOB, frequent oral hygiene, feed slowly, use suctioning, administer glycopyrolate

Scenario 5: frequent position changes, specially designed gel packs, frequent skin assess, WOC nurse

Bridgett Allen

Scenario 1: ten day course, note diarrhea

Scenario 2: hold breath and bear down, put ice bag on face, blow on thumb

Scenario 3: pill given at same time, pills have fewer SE

Scenario 4: establish behavioral contracts, allow for choices, create reward system, establishing of ground rules

Scenario 5: health, low cal snacks, write down foods, nightly walking

Carlos Mancia

Scenario 1: allow family to finish prayer, ask interpreter

Scenario 2: TB caused by, most kids asymptomatic, symptoms of TB, only ppl with active TB can spread, adherence to meds

Scenario 3: complete med, avoid tyramine foods, increase fluids, urine orange

Scenario 4: basing efforts of knowledge, using effective interview skills, understanding test options, data

Scenario 5: daycare, senior center

Charles Wheeler

Scenario 1: ask if he feels safe, has been taking meds

Scenario 2: not completing assigns, impulsive, lack of organizational skills, difficult conversations, difficult relationships

Scenario 3: CBT, psychoeducation, exercise program, balanced diet, neurofeedback

Scenario 4: family therapy, support groups, mentoring programs

Scenario 5: refer to counselor, weekly visit, reinforce success in HS, classroom mgmt, obtaining docs for accomodations

Dominic Antelli

Scenario 1: assess renal fxn, adequate hydration, prepare for several, talk with dom and family, administer BAL with anesthetic

Scenario 2: seek expert counseling, routine, highly structured plan, positive reinforcement

Scenario 3: give choice for fluid, allow to insert syringe

Scenario 4: local hospital websites, advocacy groups, autism support groups, librarian

Scenario 5: emotional issues, bedtime routine, reward

Edward Martin

Scenario 1: health surveillance, strategies addressing coworkers, short-term disability comp, work-related stress

Scenario 2: med adherence, social skills, symptom ID

Scenario 3: med SE, low level of social involvement, finance, living alone, lack of awareness

Scenario 4: remove from line, come to clinic, report symptoms, inquire about symptoms

Scenario 5: CBT, motivational interviewing, cog adaptation training, adherence therapy, support services

Gina Smith

Scenario 1: alcohol withdrawal, test for pathogens, body cavity search, self-injury, prepare for detoxification

Scenario 2: first point of contact, autonomous role, understanding of vulnerable pops

Scenario 3: respond to kite, recognize symptoms consistent w/ alcohol

Scenario 4: minor symptoms, develop while having significant BAC, seizures usually between 12-48 hrs, delirium, often associated w/ F&E

Scenario 5: non-suicidal injury, appropriate mgmt, miscalculate lethality

Hildegard Lowe

Scenario 1: ask what meds taking, request list, initiate reconciliation, inquire OTC

Scenario 2: request to see bottles, contact pharm, contact providers, clarify

Scenario 3: formal process, done at every transition, avoid errors, level of acuity

Scenario 4: update info, compare med info, provide written, explain importance

Scenario 5: CBD oil, gaba should be taken, viagra for pulm HTN, advil can reduce lisinopril, importance of up-to-date meds

Jack Storis

Scenario 1: nursing care, home health aide, med supplies

Scenario 2: morphine, music therapy, aromatherapy, spiritual care

Scenario 3: positioning, apply cool compresses, apply O2, talk to client

Scenario 4: reassure family, encourage fam, moisten, raise HOB, turn

Scenario 5: provide emotional support, inform family, inquire if family, encourage family, continue to provide comfort

Janeya Stone

Scenario 1: behavior changes, headache, bradycardia, vomiting

Scenario 2: use alternating feet, hold pencil, preference for R or L

Scenario 3: flushing of skin

Scenario 4: urine specimen cup

Scenario 5: play therapy

Jenny Smith

Scenario 1: additional reading

Scenario 2: chlamydia

Scenario 3: HSV

Scenario 4: oral HSV transmission

Scenario 5: etonogestrel implants

Jim Goodman

Scenario 1: introduce to jim and jean

Scenario 2: assess for hypoxia

Scenario 3: small frequent meals

Scenario 4: dietary consult

Scenario 5: cane when walking

Judith Hanks

Scenario 1: daily weight

Scenario 2: weight increased

Scenario 3: fever with hard abdomen

Scenario 4: assisting judith

Scenario 5: liberal use

Scenario 6: encouraging high protein

Scenario 7: uploading pics

Kenny Barrett

Scenario 1: introduce self

Scenario 2: explain he has paresthesia

Scenario 3: increase vascularity

Scenario 4: explore tech solutions

Scenario 5: wear comfy shoes

Maria Sanchez

Scenario 1: assess meaning of score 17

Scenario 2: do you feel like hurting yourself

Scenario 3: history of depression

Scenario 4: take med til feeling better

Scenario 5: playing with Juan

Mary Jane

Scenario 1: psychotherapy

Scenario 2: self-harm is

Scenario 3: social isolation

Scenario 4: reduce fluids

Scenario 5: men experience major

Ramona Stukes

Scenario 1: ask to speak directly with Ramona

Scenario 2: wrong size ostomy

Scenario 3: provide correct size

Scenario 4: dietary care

Scenario 5: call 911

Scenario 6: opioid use disorders don't discriminate

Richard Dominec

Scenario 1: AIDS is most advanced stage

Scenario 2: consistent use of condoms

Scenario 3: AIDS defining condition

Scenario 4: knowledge of HIV and STI modes of transmission

Scenario 5: same sex couples are as capable

Roger McClusky

Scenario 1: case management

Scenario 2: loss of sensation

Scenario 3: parish nurses

Scenario 4: main routes of pesticide entry

Scenario 5: relocation

Suzanne Olsen

Scenario 1: food security

Scenario 2: crown tattoo

Scenario 3: hurt or threatened?

Scenario 4: few or no personal possessions

Scenario 5: call national human trafficking resource center