NR 446 WEEK 4 COMMUNITY EDAPT NOTES
WEEK 4 COMMUNITY EDAPT NOTES
HEALTH DISPARITIES:
Vulnerable population:
Which groups are considered vulnerable populations?
Older adults, racial and ethnic minorities, the LGBTQ population, people experiencing
homelessness, and veterans are all considered vulnerable populations. Vulnerable
populations are those that are susceptible to poor health, chronic disease, disability, and
early mortality. They may have cumulative risk factors that lead to poor health outcomes,
and they may have limited resources to address their health problems.
When caring for a vulnerable population, it is important for the nurse to understand the
unique disparities of the population. Vulnerable populations are more likely to develop
health-related problems, have multiple health problems, and have limited resources to
address those health problems.
The lesbian, gay, bisexual, transgender, and queer populations are at higher risk for
which problems?
The lesbian, gay, bisexual, transgender, and queer populations are at higher risk than
heterosexual people for bullying, suicide, drug abuse, human immunodeficiency virus (HIV),
and chronic diseases.
Vulnerable populations are those that are susceptible to poor health, chronic
diseases, disability, and early mortality. They may have cumulative risk factors that lead to
poor health outcomes, and they may have limited resources to address their health
problems. Some vulnerable populations include people experiencing homelessness, older
adults, racial and ethnic minorities, the unemployed, the uninsured, the lesbian, gay,
bisexual, transgender, and queer (LGBTQ) population, or refugees.
When caring for vulnerable populations, nurses may need to first address underlying social
and support system issues before health issues, and then preventative strategies can be
implemented to avoid the development of more complex health problems.
NURSING CODE OF RTHICS:
• Provision 1: The nurse practices with compassion and respect for the inherent
dignity, worth, and unique attributes of every person.
• Provision 2: The nurse’s primary commitment is to the patient, whether an
individual, family, group, community, or population.
• Provision 3: The nurse promotes, advocates for, and protects the rights, health, and
safety of the patient.
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• Provision 8: The nurse collaborates with other health professionals and the public
to protect human rights, promote health diplomacy, and reduce health disparities.
• Provision 9: The profession of nursing, collectively through its professional
organizations, must articulate nursing values, maintain the integrity of the
profession, and integrate principles of social justice into nursing and health policy.
As the baby boomers age, the number of older adults is increasing dramatically. Older
adults are at higher risk for having one or more chronic diseases such as diabetes,
osteoporosis, and Alzheimer’s disease; injuries related to falls; and elder abuse.
Healthy People Goal: Improve Health and Well-Being for Older Adults
Healthy People (n.d.) outlines some objectives related to the older adult population.
• Older adults are more likely to be hospitalized for conditions such as diabetes,
dementia, urinary tract infections, and pneumonia. Several objectives are related to
reducing the rates of hospital admissions. Education about diabetes and urinary
tract infections, increasing rates of flu and pneumococcal vaccinations, and
improved management in primary care for dementia can reduce hospitalizations of
older adults.
• Older adults have a high risk for injury and death from falls. Strategies to help
improve in this area include increasing physical activity of older adults and
implementing safety interventions at home. In addition, health care providers
should follow guidelines when prescribing medications for older adults because of
the increased risk of side effects for this population.
• Older adults are at higher risk for having oral health problems including untreated
decay, losing all their teeth, and periodontitis. Improving preventative oral health
care can reduce these risks.
Older adults are at risk for elder abuse. There are four common types of elder abuse:
physical abuse, psychological/emotional abuse, financial or material exploitation, and
neglect. The abuser is often the spouse, adult child, sibling, friend, or caregiver. Nurses who
suspect elder abuse must report it to Adult Protective Services. Assessment of elder abuse
may include the following questions:
• Has anyone limited your daily activities?
• Has anyone talked to you in a threatening way?
• Has anyone forced you to give them money or sign strange papers?
• Has anyone touched you without your consent or hit you?
Emotional Abuse – infliction of pain or distress via verbal or nonverbal means
Sexual Abuse – non-consensual sexual contact of any kind with a vulnerable elder
,NR 446 WEEK 4 COMMUNITY EDAPT NOTES
Financial Exploitation – illegal or improper use of a vulnerable elder’s property, funds, or
assets.
Neglect – refusal or failure of those responsible to provide life necessities for a vulnerable
elder
Abandonment – desertion of a vulnerable elder by the person who assumed responsibility
for that elder
Physical Abuse – physical force resulting in physical injury, pain, or impairment to a
vulnerable elder.
When caring for an older adult, the nurse educates the client and family about home
safety because the client is at highest risk for which problem?
Older adults are at high risk for injury or death from falls, particularly if they have a history
of falling.
Older adults are also at risk for burns, abuse, and poisoning.
Which assessment questions should the nurse ask a client who identified themselves
as a veteran?
The nurse should ask all these questions to understand what risks the client may have
related to their military service.
• When did you serve?
• Did you serve in combat?
• What was your job in the military?
• Did you have any injuries related to your military service?
• Were you exposed to noise, chemicals, gasses, or other hazardous substances?
Reduce bullying among LGBTQ students: High school students who identify as LGBT are
more likely to be bullied than students who identify as heterosexual. Students who are
bullied are more likely to have depression, anxiety, and drop out of school. Interventions
aimed at reducing school bullying are needed.
Reduce suicidal thoughts of LGBTQ students: High school students who identify as LGBTQ
are more likely to have suicidal thoughts than students who identify as heterosexual.
Interventions to improve family acceptance and reduce the use of drugs and alcohol are
needed.
Reduce the use of drugs among LGBTQ students: Highschool students who identify as
LGBTQ are more likely to use drugs than students who identify as heterosexual. Using
, NR 446 WEEK 4 COMMUNITY EDAPT NOTES
drugs is linked to risky sexual behaviors, violence, health issues, and problems at school.
Interventions to increase family acceptance can help reduce the use of drugs.
Increase the number of national surveys collecting data on the LGBTQ population: Few
national surveys ask questions about gender identity, so collecting data to identify how to
meet their health needs is needed.
Reduce the rates of new human immunodeficiency virus (HIV) diagnoses and improve care:
The LGBTQ population is at risk for contracting HIV. Increasing awareness of HIV status,
improving medication adherence for those who are positive, and increasing the use of pre-
exposure prophylaxis (PrEP) to prevent HIV is needed.
The school nurse is working to support the lesbian, gay, bisexual, transgender, and
queer students in the school. What action(s) should the nurse take?
The nurse should encourage teachers to designate their classrooms as a “safe space” so
students know the teacher is supportive and open to discussion. The nurse should assess
school policies and curriculum to inclusivity, so this vulnerable population is represented.
The nurse should start or encourage a lesbian, gay, bisexual, transgender, and queer
extracurricular organization to reduce discrimination, promote well-being, and foster safe
and affirming school environments. The nurse should always maintain confidentiality of
students who “come out”.
The nurse should not expect one person to represent the whole community because their
experience is not the same as others’ experiences.
The nurse is caring for a veteran with suicidal ideations. The nurse is implementing a
crisis response plan. Indicate whether each nursing action is indicated or
contraindicated:
The veteran with suicidal ideation is not at risk and did not verbalized intent. The nurse
should interview the client about recent suicide ideation, assess recent stressors, identify
with the client skills to self-manage stress, and address barriers to care.
The nurse should not recommend inpatient treatment because the client is not at
immediate risk.
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