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Definition: Topic fACTORS CONTRIBUTIES ETHICS AND RACE CLASS AND INSURANCE COMAPASION WITH DIFFERENT GENERATION DEATH

RATES AND RECOVERY breast cancer incidence and death rates differ for women from different racial or ethnic groups?

The United States population is culturally diverse. Local and environmental health care is based upon this diversity. Choose an environment and population you may encounter as a practicing nurse. Describe the factors that contribute to health disparities with the chosen population and environment. Examine the nursing practices that might reduce health disparities within that population. Discuss ONE: 1. Describe the factors that contribute to health disparities with the chosen population and environment.

Populations with health disparities exist throughout the United States. We are living in a same society but some people tend to be healthy and some tend to be less healthy. Many factors contribute to health status of the population such as individual behaviors, physical environment, education, culture and social environment, and socioeconomic status. Like other health disparities, major factors contribute to the observed disparities in cancer incidence and death among racial, and ethnic groups. Research shows that most prominent factors are associated with all types cancer are lack of health insurance and low socioeconomic status (e.g., education, employment, and income). For example, people have to make decision about the treatment and diagnostics tests based on their health

insurance coverage. Beside the socioeconomic status, some specific racial and ethical groups tend to develop cancer and less chance of survival than other groups. For example Breast cancer is the most common cancer among white women, but their survival rate is high as compared to African women and they are more likely to die at every age compared to nonHispanic white women. Another example of health disparities that African American men have far higher death rates from prostate cancer than any other racial or ethnic group. Elderly minority male are less like to be screened for prostate or colorectal cancer than whites male. (Lewis, 2011) Gene, age environmental and lifestyle are major factors, which can increase risk of being affected by health disparities. Despite the dramatic improvement in treatments to prolong life and improve quality of life for most individuals, racial and ethnic minorities have benefited far less from these advances. (Lewis, 2011)

References Lewis, S., Dirksen, S., Heitkemper, M., Bucher, L., & Camera, I. (2011). Medical surgical nursing: Assessment and management of clinical problems. (8th ed., p. 21 & 33). St. Louis, MI: Elsevier Mosby. Cancer Health Disparities. (2008). Cancer 2008. Retrieved from http://www.cancer.gov/ Health Disparities. (2008). Tic projects 2008. Retrieved from http://tlcprojects.org/

Population in any rural area was more likely to report fair to poor health status than were residents of urban or metro area. Rural residents tend to get health insurance than urban people. Beside this point, rural area s residents traveled greater distances for healthcare settings. Rural residents experience many difficulties in accessing health care services. Overall, shortage of physician, lack of education, environment and lifestyle are major factors, which can increase risk of being affected by health disparities in rural communities.

Nausea, vomiting, and dizziness are the manifestations of fluid volume deficit. She is likely to have decreased urine output or might produce no urine at all. Excess fluid loss can lead to decreased blood volume, and hypornatremia Loss of body sodium and consequent intravascular water; e.g. excessive sweating, diarrhea or vomiting hypovolemia also lead to hyponatremia which can decreae the blood pressure It is very important for maintaining blood pressure.
Abnormal gastrointestinal (GI) losses: Vomiting, nasogastric suctioning, diarrhea

Abnormal skin losses: Diaphoresis Hemoglobin (Hgb) and hematocrit (Hct)


Hypovolemia: Increased Hgb and Hct Dehydration: Increased (hemoconcentration) Serum osmolarity Dehydration: Increased (hemoconcentration) osmolarity (> 300 mOsm/L) increased

protein, blood urea nitrogen (BUN), electrolytes, glucose


Urine specific gravity and osmolarity Dehydration: Increased (concentration) Serum sodium Dehydration: Increased (hemoconcentration)

Nursing Interventions Report abnormal findings to the primary care provider.

2. As the nurse, what would you anticipate J.G.s laboratory values to show? Why?

Fluid volume deficit means loss of water. Water is the base fluid for all the bodys cells and their surrounding environment. Blood electrolytes (sodium, potassium, chlorides, bicarbonates) may also be abnormal when a fluid imbalance is present. Blood tests that assess kidney function (the ratio of urea nitrogen to creatinine) are often abnormal when other blood or fluid loss is the cause of hypovolemic shock. Body fluids are always in motion, body fluids

transport the nutrients, electrolytes and oxygen to the bodies cells as well as carries waste products away from the cells (Lewis, Dirksen, Heitkemper, Bucher, Camera, 2011). In this scenario, Nurse will anticipate the lab value for fluid volume deficit. Lab values may include a serum sodium level above 150mEq/L and Serum osmolality above 300 mOsm/L. A BUN test should to done to see the severity of dehydration. Dehydration generally causes BUN levels to rise more than creatinine levels. This causes a high BUN-to-creatinine ratio. Hemoglobin and hematocrit s test also be order because hemoglobin and hematocrit are based on whole blood and are therefore dependent on plasma volume. J.G is showing the symptoms of fluid deficit so she must have high hemoglobin (Normal Adult Female Range: 12.0 - 16.) and high hematocrit (Normal Adult Female Range: 36 - 46 percent) J.G input and output should be monitored very closely. Nurse should consider foley catheter to monitoring urine output every 2 hours for 12 hours. Other than lab values, Nurse should also check vital signs every 20 minute, keep an eye on heart rhythm, volume assessments (skin turgor, Jugular Venous Pressure) and oxygen saturations. Monitor and document the Lab and vital sign change.

References:

1) Lewis, S.L., Dirksen, S.R., Heitkemper, M.M., Bucher, L., Camera, I.M. (2011). Medical Surgical Nursing (8th ed.). St. Louis, Missouri: Elsevier Mosby. 2) 3) Story, L. (2012). Pathophysiology A Practical Approach. Sudbury, MA: Jones & Bartlett Learning.

3) Hypovolemic shock, MD Guidlines Retrieved from www.mdguidelines.com

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