journal entry

I need someone to put a journal entry together based upon these notes please.
07/09/2020 02:08:13 PM,”In this client interaction, you have had an opportunity to observe and participate in many of the ways a nurse case manager can help clients with multiple complex needs that are both psychosocial and physical in nature such as in the case with Maya Steele. Many healthcare providers and specialists are needed to provide holistic care that addresses client needs in a coordinated manner.

Open your Notes to record your thoughts about interventions for Maya that have already occurred or are planned that relate to the green and blue sections of the Public Health Intervention Wheel. If you aren’t sure about application of a given section of the wheel, make an informed suggestion. Be ready to discuss in the debriefing session.

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Click the “Continue” button to return to the discussion with Maya.”
07/09/2020 02:06:30 PM,”In this client interaction, you have had an opportunity to observe and participate in many of the ways a nurse case manager can help clients with multiple complex needs that are both psychosocial and physical in nature such as in the case with Maya Steele. Many healthcare providers and specialists are needed to provide holistic care that addresses client needs in a coordinated manner.

Open your Notes to record your thoughts about interventions for Maya that have already occurred or are planned that relate to the green and blue sections of the Public Health Intervention Wheel. If you aren’t sure about application of a given section of the wheel, make an informed suggestion. Be ready to discuss in the debriefing session.

Click the “Continue” button to return to the discussion with Maya.”
07/09/2020 01:56:04 PM,”Maya needs to be enrolled in a diabetes and CHF management class and he needs a few home health nurse visits to make sure she is properly taking her insulin and weighing herself daily”
07/09/2020 01:56:02 PM,”Now we’ll take a look at the green wedges of the Public Health Intervention Wheel (as a reminder, you can download/view a copy from the materials on thePoint).

When a client is enrolled in a Medical Home model of care delivery, there are a variety of healthcare professionals involved in their care.

Open your Notes to record your thoughts about what possible healthcare roles would be involved in the case management of a client like Maya.

Once you close your Notes, click the Continue button to complete an activity about the various interprofessional roles involved in the case management of a client.”
07/09/2020 01:54:59 PM,”Now we’ll take a look at the green wedges of the Public Health Intervention Wheel (as a reminder, you can download/view a copy from the materials on thePoint).

When a client is enrolled in a Medical Home model of care delivery, there are a variety of healthcare professionals involved in their care.

Open your Notes to record your thoughts about what possible healthcare roles would be involved in the case management of a client like Maya.

Once you close your Notes, click the Continue button to complete an activity about the various interprofessional roles involved in the case management of a client.”
07/09/2020 01:54:42 PM,”I know that it is important to understand the client’s baseline knowledge level before providing additional teaching.”
07/09/2020 01:53:58 PM,”Maya needs to be edeucated on her disease process more than anything. She is confused as to way she has to way herself each day”
07/09/2020 01:53:55 PM,”Open your Notes to record your thoughts about interventions from the blue wedges of the Public Health Intervention Wheel including consultation, counseling, and health teaching that might be helpful for Maya.

Once you complete your Notes, click the Continue button to answer questions about Maya. ”
07/09/2020 01:53:14 PM,”Open your Notes to record your thoughts about interventions from the blue wedges of the Public Health Intervention Wheel including consultation, counseling, and health teaching that might be helpful for Maya.

Once you complete your Notes, click the Continue button to answer questions about Maya. ”
07/09/2020 01:50:07 PM,”Maya Steele is a 70-year-old African American woman who has hypertension, hyperlipidemia, heart failure, type II diabetes, and anxiety. She was just placed on insulin because her diabetes is not well controlled on oral hypoglycemic medications. She was discharged from the hospital to her single-family home in Promise Heights 2 days ago after being admitted for chest pain, which turned out to be related to gastric reflux and anxiety.

Today, Maya has an appointment at the South Street Clinic, which applies the medical home model to care for their patients with multiple chronic health issues. She is being seen today for a follow up regarding her chronic illnesses, and she is especially worried about her heart and her diabetes.”
07/09/2020 01:46:52 PM,”If you quit smoking you might get to the point where you don’t need the oxygen anymore. There are several ways to quit. The patch is just one way. There are other options out there that could decrease your craving and maybe you could stop altogether,”
07/09/2020 01:46:48 PM,”As you are discussing Ed’s current smoking patterns, I get the sense that he is starting to think about quitting.

Open your Notes to record your thoughts about what you might say to Ed about smoking cessation. Apply principles from the blue wedges of the Public Health Intervention Wheel specifically around counseling and health teaching.

Once you complete your Notes, click Continue to answer a question about appropriate referrals for Ed.”
07/09/2020 01:44:59 PM,”As you are discussing Ed’s current smoking patterns, I get the sense that he is starting to think about quitting.

Open your Notes to record your thoughts about what you might say to Ed about smoking cessation. Apply principles from the blue wedges of the Public Health Intervention Wheel specifically around counseling and health teaching.

Once you complete your Notes, click Continue to answer a question about appropriate referrals for Ed.”
07/09/2020 01:43:05 PM,”By pointing out discrepancies between client goals and current behaviors, motivational interviewing can help the client gain insight into how their behavior is keeping them from reaching their goals. Additionally, using motivational interviewing to work with the client to set measurable goals can help them attain those goals. At times, clients may be unable to set their own goals because they may lack insight. If client resistance is directly opposed, the client may become angry and defensive. Using motivational interviewing to adjust to the resistance is a subtle way to help a client move towards his or her goals. To help clients succeed, it is important to support their self-esteem, and promote optimism. However, in motivational interviewing one expresses empathy for the client, not sympathy. Confronting a client may put them on the defensive, and break any trust that has been established. ”
07/09/2020 01:41:58 PM,”Ed might be at risk for falling due to his o2 tubing. He might fall from sitting in a chair without arm rests and small space heaters can cause problems as well. Fires could start. If it catches on fire and ignites with the o2 it could kill Ed”
07/09/2020 01:41:56 PM,”Now that you have completed the activity, open your Notes again to record your thoughts about what you might teach Ed about the connection between health and his environment. Make sure to integrate the health teaching portion of the blue wedge of the Public Health Intervention Wheel.”
07/09/2020 01:40:22 PM,”Now that you have completed the activity, open your Notes again to record your thoughts about what you might teach Ed about the connection between health and his environment. Make sure to integrate the health teaching portion of the blue wedge of the Public Health Intervention Wheel.”
07/09/2020 01:40:11 PM,”Safety hazards for elderly people include clear oxygen tubing, poor lighting in living room, chairs without armrests, and small space heaters. Green oxygen tubing is available to increase the tubing’s visibility, while adequate lighting is important to decrease the falls risk in a population that often has vision and mobility problems. Chairs without armrests require more strength and balance for the person to get out of, so it is important for elderly people to have chairs with armrests. Additionally, space heaters — even when placed away from flammable items such as bedding, curtains, or newspapers — are not considered safe in the home of an elderly person. A slow elevator would not be a safety concern, nor would water heater settings at 120 degrees F/48 degrees C, which would decrease the risk of burns.”
07/09/2020 01:39:36 PM,”Some apartments have stairs. Some low income housing units might not properly be cleaned as it should be. ”
07/09/2020 01:39:33 PM,”Ed has lived in his apartment for about six months. Prior to that, he lived in his own home. When he moved, neither he nor his son thought about the possible safety issues that may be found in a typical apartment.

Open your Notes to record your thoughts about what possible safety issues you might find in an apartment that is not set up for an elderly person.

After typing your notes, click the Continue button to complete an activity.”
07/09/2020 01:38:34 PM,”Ed has lived in his apartment for about six months. Prior to that, he lived in his own home. When he moved, neither he nor his son thought about the possible safety issues that may be found in a typical apartment.

Open your Notes to record your thoughts about what possible safety issues you might find in an apartment that is not set up for an elderly person.

After typing your notes, click the Continue button to complete an activity.”
07/09/2020 01:37:27 PM,”The first step in managing the care of high risk populations is to identify which clients need to be followed. Additionally, performing comprehensive assessments helps the case managers identify which health issues may be problematic. Moreover, working within an interprofessional care team offers the best support for the client and any transitions of care they experience. Finally, by responding quickly to any changes in a client’s health, the client can be treated before his/her condition worsens and a hospitalization or Emergency Department evaluation is indicated. However, acknowledging that risky behaviors are ok is providing validation to the client and may encourage him or her to continue with these behaviors.”
07/09/2020 01:36:36 PM,”Because Ed does not have his own car or reliable family members to help him to get to his medical appointments and to the grocery store, this is the priority intervention at this time. ”
07/09/2020 01:36:09 PM,”Ed could benefit from having a social worker. Ed needs a free bus pass so he can make it to his appointments when he has them. He might benefit from having a home health nurse come out for a few visits just to make sure he is able to manage his COPD”
07/09/2020 01:36:06 PM,”As we listen to Ed’s story, it is clear he could use some help from the green wedges of the Public Health Intervention Wheel, including referral and follow-up, case management, and delegated functions.

Open your Notes to record your thoughts about what possible interventions related to these wedges of the Public Intervention Wheel might be helpful for Ed.

After typing your notes, click the “Continue” button to answer a question about case management, referral and follow-up, and delegation.”
07/09/2020 01:34:35 PM,”As we listen to Ed’s story, it is clear he could use some help from the green wedges of the Public Health Intervention Wheel, including referral and follow-up, case management, and delegated functions.

Open your Notes to record your thoughts about what possible interventions related to these wedges of the Public Intervention Wheel might be helpful for Ed.

After typing your notes, click the “Continue” button to answer a question about case management, referral and follow-up, and delegation.”
07/09/2020 01:32:30 PM,”Ed Rheingold is an 85-year-old Caucasian male who lives in the low-income elderly apartments in Promise Heights. His wife died recently, and Ed has moved from his own home to the apartment because he couldn’t take care of his house any longer. He has one son, Jeffrey, who lives nearby and has not been trustworthy regarding Ed’s finances. Jeffrey has not provided reliable transportation to Ed to his medical appointments. Ed has mild hypertension, COPD, and acute myeloid leukemia (AML). He was recently hospitalized because of a COPD exacerbation, along with community-acquired pneumonia. Ed is very thin and has a hard time maintaining his weight. He lost another few pounds while he was in the hospital.

Today, Ed has an appointment for follow up after being discharged from the hospital. He is being seen at the South Street Clinic, which is his Medical Home clinic, for a follow up regarding his COPD, pneumonia, and nutritional status. He is currently on oxygen via nasal cannula as he recovers from the pneumonia.”
07/09/2020 01:31:30 PM,”Tallulah has suggested a big change in her diet that will significantly decrease her sodium intake. She needs to be commended on her choice. ”
07/09/2020 01:30:34 PM,”Patient teaching is a public health intervention that is focused on the individual, while posters placed in public places are an example of a community-based intervention. Additionally, teaching healthcare providers about smoking cessation techniques is a systems-based intervention. However, legislation that restricts where tobacco products are sold is considered a primary prevention because it prevents tobacco use. Grant funding that provides access to nicotine replacement products for tobacco users is considered a secondary prevention because it targets those who already smoke.”
07/09/2020 01:27:03 PM,”Miss Cruise definatly needs some couseling. She is very non-complaint with her own care and is causing damage to herself. She may also benefit from a detox program and a consult with a nutritionist to determine what type of foods she needs to eat and vouchers to help her pay for the healthy food.”
07/09/2020 01:27:01 PM,”As you can see, we are working within the blue wedges of the PH Intervention Wheel. This section of the wheel includes the topics of consultation, counseling, and health teaching.

Open your Notes to record your thoughts about which nursing interventions you would choose from the 3 sections of the blue wedge.

Once you complete your Notes, click the Continue button to answer the questions related to the blue wedge of the wheel.”
07/09/2020 01:25:09 PM,”As you can see, we are working within the blue wedges of the PH Intervention Wheel. This section of the wheel includes the topics of consultation, counseling, and health teaching.

Open your Notes to record your thoughts about which nursing interventions you would choose from the 3 sections of the blue wedge.

Once you complete your Notes, click the Continue button to answer the questions related to the blue wedge of the wheel.”
07/09/2020 01:24:55 PM,”Hi, I’m Tallulah. I guess you’re assigned to me because I just got out of the hospital, AGAIN.

I just don’t know why I keep having problems. It’s not like I do anything to deserve this. They tell me that my problem with my pancreas is because I drink too much. I guess being in the hospital twice in one month is a problem, although I kind of like the food there. The doctor told me if I don’t stop drinking I may get diabetes, or die. I think he was just being overdramatic because he just doesn’t want me to drink.

I can’t imagine having to drink water or lemonade when I go to parties. YUCK. All my friends like to party, so what would I do if I don’t drink?

I kind of like to smoke, too. Sometimes I get into trouble because I have loud parties, and people are smoking pot. I wish my neighbors would just mind their own business. Why do they care what I do in my own apartment?

My doctor told me I should quit smoking too. My blood pressure is a little high, and he said I could hurt my heart. They told me I need to eat better, too. I just like macaroni and cheese, and picking up a burger when I’m downtown. I don’t really like salad or fruit. Besides, it’s hard to get to the grocery store since I don’t have a car, and the food I can get at Greg’s Corner Store isn’t always fresh.

I guess I will see what they tell me here at the clinic tomorrow. Sometimes I cancel my appointments because I don’t want to get a lecture, and they always have so many rules for me to follow. But, tomorrow I better go. Today I am here. I was really sick last week. I better see what they think about how I am doing. ”
07/09/2020 01:23:20 PM,”Tallulah Cruz is a 45-year-old American Indian woman with alcoholism, hypertension, and chronic pancreatitis. She has been hospitalized twice in the last month for pancreatitis, and currently lives in a low-income apartment building in Promise Heights. She has been given two warnings from the apartment manager for having loud, rowdy parties, and if it happens again Tallulah will be evicted from her apartment.

Yesterday, Tallulah came home from the hospital after another exacerbation of her chronic pancreatitis. She has been assigned a PHN Case Manager to address chronic illness management.”
07/09/2020 01:22:44 PM,”Because Ned has a long history of medical and psychiatric needs, a case manager can help him bridge relationships with the various healthcare professionals with whom he interacts.”
07/09/2020 01:22:02 PM,”Developing resources with community partners is a good example of a public health intervention at the systems and community levels of practice.”
07/09/2020 01:21:13 PM,”Ned may possibly need to be on some sort of detox program, after rehabilitation we need to help Ned find work with insurance so he will be able to aford his meds and find a decent place to stay”
07/09/2020 01:21:11 PM,”When planning care for Ned today, we will be working within the green wedges of the PH Intervention Wheel. This section of the wheel includes interventions related to case management, referral and follow-up, and delegation.

Open your Notes to record your thoughts about possible public health nursing interventions for Ned that correlate with the green sections of the wheel.

Once you complete your Notes, click the Continue button to answer the questions related to the green section of the wheel.”
07/09/2020 01:19:12 PM,”Hello, I’m Ned. I just moved to the shelter after being in the hospital, and well, I’ve got to say, I am glad to have a bed to sleep in with the weather not being so good right now. I’m a Vietnam War vet, and when I got home, well, I had a lot of problems. I was overwhelmed by everything that happened to me over there, and well, not long after I got home I ended up in the hospital because I was hearing voices. If I take my medicine, I don’t hear the voices. Well, sometimes I forget or lose my medicine, and then I hear voices again.

Well, I used to live in an apartment. But well, I got kicked out because I was smoking pot and some people complained. I can’t even count how many times I have been in and out of the shelter and the hospital. I got to say, I don’t like living places where I can’t do what I want to do. I don’t like rules. The food shelf has got some good food, and I have some good friends who are out and about with me.

Sometimes, well, I have troubles with my lungs and I can’t breathe. I suppose it is from smoking all kinds of things, but maybe I would have bad lungs anyway. People try to help me, and my social worker is really nice, but sometimes I get tired of talking to her. I really don’t like to go into the hospital either, too many rules about everything, but well sometimes I forget to take my meds and I get sick and it just happens. I think I’m told I have an appointment here at the clinic where they are going to try to help me. I don’t know if it will do any good. I guess it’s okay that people try to help me.”
07/09/2020 01:17:41 PM,”Ned Horsley is a 69-year-old Caucasian male with PTSD from the Vietnam War. In addition, he suffers from schizophrenia, COPD, and hypertension. Ned has been in and out of the hospital for his medical and mental health issues. At times, he has lived in local apartment buildings, but has been mostly homeless. He was discharged from the hospital yesterday, and was admitted to the transitional housing section of the Promise Heights Shelter where he can stay for one month. The social worker staff will work with him to find permanent housing.

Ned has an appointment at the clinic today for a follow up after being discharged from the hospital.”
07/09/2020 01:17:12 PM,”Welcome to Promise Heights Clinic. I’m Richard Strom, one of the PHNs at the clinic. Upstairs in the Public Health Clinic we provide a variety of services to individuals and families. Most of our clients are on a sliding-fee scale, and are charged according to their income level. Other clients have Medical Assistance, you might know it as Medicaid, which covers their medical services. Among the services we offer at our clinic are family planning, abuse and neglect screening, WIC services, sexual health counseling, health education, and help with access to healthcare.

In this part of the clinic we focus on primary care and case management. PHNs in this clinic work with the parts of the Public Health Intervention Wheel that include consultation, counseling, health teaching, case management, referral and follow up. We want to make sure our clients have access to appropriate healthcare to meet their needs and to educate families on ways to improve health. We also connect them with resources and providers in the community. One of our goals when working with care transitions is to help high-risk populations with the services they need to keep them as healthy as possible, and out of the hospital. Part of case management and transitions of care includes the involvement of a variety of interprofessional roles. It is essential for the various roles to work well together to ensure safe transitions between professionals and care providers.

We will be working with the Public Health Intervention Wheel. You will be applying information from the green and blue wedges of the PH Intervention Wheel to the clients we see today. The green wedge covers case management, referral and follow up, and delegation, while the blue wedge addresses consultation, counseling, and health teaching.”

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