Question

Case Study During her regularly scheduled visit to a blood pressure clinic in a local apartment cluster, an Hispanic resident, Mrs. B., 45 years old, complained of feeling dizzy and forgetful. She could not remember which of her 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 emergency department, Mrs. B. manifested the progressive signs and symptoms of a cerebrovascular accident (a CVA, or stroke). 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 function and cognitive deficits that would demand longer-term care.

As the case manager contracted by the plan, what would be the actions you would take to construct a case management plan?

Questions: 1. please state your opinions about the similarities and /or 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

Answer 1

Similarities:

Both clinical nurse and public health nurse deals with same process of assesment,gathering health history and providing appropriate care of clients as per policy and procedures recommended.

Difference between a clinical nursing role and a population-focused role of the public-health nursing specialist:

Clinical Nurse	Public Helath Nurse
1.Deals with individual priority needs and problems.	1.Deals with individual,family and community which they belongs to.
2.She focused on subjective health issues and direclty can contact physician.	2.She focused on epidemic,issues and she can work alone.

Complex Issues:

• Public health nurse faces more challenges in case finding,preventive and care co-ordiantion aspects,psychological acceptance of care and treatment of client in wide spread community.
• Clinical health nurse dirrectly responsible for the errors in administering medication and care of hospitalized client.
• Both the public health nurse and clinical health nurse faces the risk in handling infectious diseases,radiation issues,toxic substances and stress of shift works and back injuries.