A new mother has brought her 6-week-old infant into the pediatric ...

[shofmannx20]

A new mother has brought her 6-week-old infant into the pediatric clinic for a routine checkup. She appears anxious and expresses several concerns regarding her infant's care.
 
  a. The mother is confused about the need for immunizations as she has been told that there is a link between autism and certain immunizations. What would you say to the mother regarding the importance of immunizations?
  b. The mother tells the nurse that she is concerned that her infant is not feeding well. She has been breast-feeding primarily, but supplementing with formula, and says her infant has been spitting up frequently. What questions would you ask the client?

Question 2

A community organization has decided to launch a campaign that aims to eradicate high blood pressure through a comprehensive program of primary, secondary, and tertiary prevention.
 
  a. How might statistical reports on the incidence, prevalence, morbidity, and mortality of high blood pressure in the target community be helpful in planning a comprehensive prevention program? What are the potential limitations of using such reports for assessing and addressing the health care needs of a community?
  b. Outline a plan that includes possible activities that could be included in the primary, secondary, and tertiary prevention arms of this program.

[14vl19]

Answer to Question 1

- A discussion of the positive effects of immunization, such as a decrease in childhood communicable diseases, which leads to a decrease in infant morbidity and mortality
- Discussing that these effects are only seen if all children receive the immunizations
- Discussing that there is no evidence at this time linking autism to childhood immunizations

b.
- The nurse should perform an assessment to determine if the infant has colic, which includes crying for more than 3 hours, more than 3 days per week, for more than 3 weeks.
- Reassuring that spitting up is common and as long as the infant is gaining weight, this is normal

Answer to Question 2

- Assuming that sound epidemiological methods were used, statistical reports will be helpful in determining whether high blood pressure is a problem in this community. Such reports could provide the following information:
o Incidence of high blood pressure, that is, number of people newly diagnosed with high blood pressure in the past year
o Prevalence of high blood pressure, that is, number of people who currently have high blood pressure
o Factors, such as age or sex, that might affect an individual's susceptibility to high blood pressure or response to treatment
o Factors, such as average educational or income level in the target community, that would be helpful for program planners to know as they develop educational and treatment strategies
- Limitations of such reports include potential inaccuracies due to faulty methods of data collection. Also, epidemiological data provide information about groups, but health care providers must consider the unique needs of the individual.

b.
- Primary Prevention--preventing the development of high blood pressure in patients with normal blood pressure by reducing or eliminating risk factors. Activities might include but are not limited to
o Blood pressure screening for healthy adults or children
o Educational programs about identifying and reducing risk factors for high blood pressure
o Programs to promote healthy lifestyles--such as heart healthy diet, exercise, stress reduction
- Secondary Prevention--preventing disease progression in asymptomatic individuals who have high blood pressure. Activities might include but are not limited to
o Weight reduction, smoking cessation, and exercise programs
o Referral to health care provider to evaluate need for high blood pressure medications
- Tertiary Prevention--preventing complications and deterioration in patients who have symptoms or disease conditions (such as heart attack or stroke) due to their high blood pressure. Activities include but are not limited to
o Educational programs about early signs and symptoms of heart disease, stroke, and other possible complications of high blood pressure
o Medications or treatments that offset the increased cardiac workload caused by high blood pressure
o Development of an individualized nutritional and exercise program
o Financial counseling for the economic consequences of high blood pressure