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BASED ON PART 1. which is uploaded below, 

Now that you have genetics and genomic information about your patient. It is time to plan, implement and evaluate and educational strategy for this patient. a) Use the following chart to identify your patient red flags. 18 b) Develop a specific teaching strategy for this patient. The teaching strategy must address specific health promotion activities (exercise, nutrition, environmental risk) as well as emotional support. c) The education also Includes referrals and testing if necessary. d) Set a second meeting with the selected patient to discuss the results of the pedigree analysis. e) 

see page 18 for grading rubic

SYLLABUS

Course Title: Community Health Nursing Practicum

Number: NUR 4636L

Schedule: Monday – Friday TBA

Term: Spring 2021 – Semester 2213

Credits: 3 Credits

Instructor Information

Marie Etienne, DNP, APRN, FNP, PNP, PLNC

Professor

Benjamin Leon School of Nursing – RN-BSN Program

Office Location: 2309

Telephone: (305) 237-4288 Cell: 305-731-7976

Email: [email protected]

(Students, please remember to start the transfer request of the 30 credits for NUR 3997

at the end/completion of this course)

“Due to the present situation, the faculty will be implementing distance learning methods to allow

students to continuity their clinical experiences. A virtual clinical practicum will provide learning

resources utilizing direct and indirect learning simulation experiences to attain overall program objectives

successfully. These experiences include virtual scenarios in which the student will be exposed to various

situations to gain knowledge and the skills to make complex decisions. Students in this course will also

participate in synchronous and asynchronous sessions that will include written exercises, skills training,

skills demonstration by students, and debriefing to evaluate course competencies.”

Course Description

This course focuses on the clinical application of Community Health Nursing Theory. Students will utilize

the nursing process in the delivery of healthcare within the community environment. Students will assess

the individual, family, and community, develop a plan of care, and deliver care to an individual, family and

community within a multicultural envi-ronment. Minimum grade of “C” or better required. Co-requisite:

NUR 4636. (144 hr. Practicum)

Course Competencies: Upon completion of the course, the student will be able to:

1. Apply historical and theoretical concepts to community health nursing practice by:

a. Identifying nurse established community health models in a global society.
b. Relating public health concepts to the practice and delivery of healthcare in the community.
c. Transferring the theoretical role of the professional nurse to the community setting.

2

2. Focus on the relationships between theory, evidence-based practice, and education as

they relate to community health nursing in a global community by:

a. Examining epidemiological concepts as they relate to global health.
b. Justifying the nurse’s role as an educator, counselor, advocate and change agent in the

community.

c. Applying evidence-based principles relating to community health nursing.

3: Transfer theoretical concepts of ethnicity and culture in the provision of nursing care in the

community setting by:

a. Assessing cultural differences by utilizing existing tools.
b. Documenting assessment findings.
c. Utilizing assessment findings while providing culturally competent care.
d. Evaluating the plan of care for effectiveness in a selected population.

4. Transfer concepts of community assessment, planning, education while promoting health

and cultivating empowerment by:

a. Negotiating with community leaders to empower selected underserved groups in the
community.

b. Educating the consumer on using available community resources.
c. Assisting the consumer to navigate through the health care system.

5. Evaluate effectiveness, accessibility and quality of personal and population based health

care services by:

a. Locating existing health promotion programs within a selected community.
b. Comparing disease processes and conditions occurring in underserved populations as

specified by Healthy People 2020 indicators.

c. Examining the effectiveness of existing programs in meeting the Healthy People 2020
initiatives.

Collegewide Student Learning Outcomes:

Upon completion of a program of study at the Medical Campus, graduates from Miami Dade College

should emulate these outcomes. Participants in the community health practicum will incorporate all 10 of

these outcomes in their experiences while in this course.

1. Communicate effectively using listening, speaking, reading, and writing skills.
2. Use quantitative analytical skills to evaluate and process numerical data.
3. Solve problems using critical and creative thinking and scientific reasoning.
4. Formulate strategies to locate, evaluate, and apply information.
5. Demonstrate knowledge of diverse cultures, including global and historical perspectives.
6. Create strategies that can be used to fulfill personal, civic, and social responsibilities.
7. Demonstrate knowledge of ethical thinking and its application to issues in society.
8. Use computer and emerging technologies effectively.
9. Demonstrate an appreciation for aesthetics and creative activities.
10. Describe how natural systems function and recognize the impact of humans on the environment.

*We will address learning outcomes #1, #3, #4, #5, #6, #7, #8, and #10 in this course.

3

Textbooks/Resources/Supplies

Required Textbooks:

Virtual Experiences from

Clark, M., (2015). Population and community health nursing (6th ed.). Philadelphia, PA. Pearson

Education, Inc. ISBN-13:978-0133859591

Clark, M. J. (2015). Community health nursing (Assessment reference guide) (6 th ed.).

Upper Saddle River, N. J.: Pearson/Prentice Hall. ISBN-13:978-0132404006

U. S. Department of Health and Human Services. Healthy people 2020:

Understanding and improving health. Washington, DC: U.S. Department of Health

and Human Services. See website for your specific population info.

Recommended Textbooks:

American Psychological Association. (2010). Publication Manual of the American

Psychological Association (6th ed.). Washington, DC: American Psychological

Association.

Anderson, E. T. & McFarlane, J. (2008). Community as partner: Theory and practice in

nursing (5th ed.). Philadelphia: Wolters-Kluwer/Lippincott Williams & Wilkins.

Friis, R. H. & Sellers, T. A. (2009). Epidemiology for public health practice (4th ed.).

Sudbury, Massachusetts: Jones and Bartlett.

Lowstein, A. J., Foord-May, L. & Romano, J.C. (2009). Teaching strategies for health

education and health promotion: Working with patients, families, and communities.

Sudbury, Massacusetts: Jones and Bartlett.

*Note: Recommended texts are on reserve in the Miami Dade College Medical

Campus 2nd floor library.

4

Course Requirements

1. Develop personal learning objectives for the community practicum experience.
2. Participate in the course discussions.
3. Participate in assigned clinical practicum virtual activities.
4. Written daily journals of community experiences. (See Practicum Professor for further information or

directions).

5. Develop and present a teaching project (s). Cite at least 4-6 relevant EBP journal articles as
references.

6. Develop a Genetic and Genomic Assessment and Teaching plan.
7. Complete all evaluative documentation, including the Midterm and Final Self- evaluation.
8. Reflect on how the course activities impacted your view of the role of the professional nurse in

primary/community setting.

Grading Criteria:

Assignment

Assignment Percentage

Discussions x 5 10%

Journal Entries x 10 30%

Goals and Objectives 5%

Genetics and Genomics Part 1 20%

Community Health Teaching project 20%

Genetics and genomics Part 2 10%

Midterm Clinical evaluation 5%

Final Clinical evaluation 5%

Reflection Paper 5%

Total 100%

Scale Grading:

93-100% A

85-92% B

77-84% C

69-76% D

Below 69% F

Progression:
In order to progress, students must earn a grade of “C” or higher in every nursing course required this

semester.

5

Wee

k

Clinical Calendar Proposed Guideline for Activities/

Discussions or Reading Assignments

1

Mandatory Orientation

Discussion 1
Introduce yourself and tell me about future plans
and how developing knowledge about population
health can help you achieve those goals,

Overview of Course requirements.

Virtual Practicum Orientation. Review of

course syllabus.

2 The Point: Windshield Survey-A Community

Assessment Strategy: Downtown Promise

Heights

Discussion 2 CC2.a

Please access the following

Simulation http://playspent.org/

Discuss how the following factors relate

to the reality of poverty in America. Please,

write a two to three paragraph discussion,

citing your sources, and respond to at

least one of your classmates with a

meaningful response.

1. Subjugation
2. Disadvantaged Areas
3. Work- and Employment-Related

Hardships

4. Lack of Adequate Health and Well-
being

5. Resources
6. Stigma & Shame
7. Social Isolation
8. Unrecognized Voice & Participation
9. The Struggle

Journal Entry #1.CC1.a

(Please see directions in each journal entries.

There are specific questions for each journal

entry)

1. Describe the critical attributes that
define a community.

2. Define community health and goals of
community health practice.

3. Describe primary, secondary and
tertiary levels of prevention.

4. What is the role of the professional
nurse in the community setting?

3 Virtual Meeting

Virtual Simulations

The Point: Family as Client: Public Health

Clinic

The Pediatric Patient

https://de.ryerson.ca/games/nursing/hospital/a

rea.html#3

See the videos in the course

Screening for Trauma 1 and 2

Discuss your personal goals and objectives for

the course.

Journal Entry #2 CC3.c

Please complete the activities for this week

including the point and answer the following in

your journal?

1. Are some children more affected by
violence than others?

2. Can you explain more about the
relationship between violence and

aggressive behavior?

3. Can you give examples on how to
approach children suspected of abuse?

http://playspent.org/

6

4

Virtual Simulation

The Point: Intimate Partner Violence and

Elder Abuse: Heights Shelter

Simulation: Interviewing a victim of domestic

violence

Skills Practice: A Home Visit Simulation

Game

This is a simulation game that promotes the

application of knowledge and skills related to

establishing a therapeutic nurse-client

relationship and completing a mental health

assessment. You will have the opportunity to

do the first interview of the victim of

domestic violence in her home. This is an

interactive case in which you are going to

interact with the victim by asking her

questions and the victim will interact with

you positively or negatively according to your

choice of questions or comments. The case

takes approximately 30 minutes, at the end

you are going to get a report of your

communication abilities please save the PDF

and attach the PDF to your weekly reflective

journal.

Journal Entry#3 CC4.b

First, sign up for the free simulation and access

the following case

https://de.ryerson.ca/games/nursing/hospital/ar

ea.html#2

Second : go to the point and do

The Point: Intimate Partner Violence and

Elder Abuse: Heights Shelter

Answer the following questions:

1. What is the role of the nurses play
in the community setting to assist

women and children victims of

abuse and violence?

2. Do you think nurses need more
preparation on how to assists these

women and children?

3. Please provide example of
strategies that can be used to assist

these women and children?

5

Ethical Behavior in Nursing

Video

Watch Miss Evers’ Boys @

https://www.youtube.com/watch?v=nHP1p9b

RQ3Q

Personal goals & objectives due (see

syllabus for directions).

Journal entry #4 CC2.b

1. Why do you think the filmmakers
began the movie with the Florence

Nightingale pledge?

2. How did Nurse Evers uphold or violate
this Using the ANA Code of Ethics,

discuss at least 2 sections of the Code

and how Nurse Evers acted within or

violated those

sections https://www.nursingworld.org/

practice-policy/nursing-

excellence/ethics/code-of-ethics-for-

nurses/.

3. What advice would you offer Nurse
Evers if she asked how you would have

handled her situation?

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/

7

6 Virtual Meeting with professor

Virtual Simulation

The nurse role in the Opioid crisis

In this simulation, you are going to explore

the care of the patient experiencing addictions

and the nurse response.

Please watch the simulation in the course

Read the following:

https://www.drugabuse.gov/nidamed-
medical-health-professionals/ctn-

dissemination-initiative/engaging-nursing-

community-in-treatment-opioid-use-disorder

Patient Genetic and Genomics Interview

and Education Part 1 CC5.b

Journal entry #5 CC4.b

After completing the activities please answer

the following in your journal:

1. What is the most effective strategy for

treatment of OUD patients?

2. Name common barriers to obtaining

and providing effective OUD treatment

3. Outline ways that a collaborative care

model can improve patient outcomes

and what will be the role of the nurse in

the community setting.

7

Virtual Simulation

Disaster Management

Turbulent Sky

The Point: Public Health Nursing and Post-

Disaster Recovery: Rural Flood Zone

1.

Patient Genetic and Genomics Interview

and Education Part 2 CC4.c

Journal Entry #6 CC1.b

The Role of a Nurse in a Disaster Event

The community health nurse strives to

promote community resilience and helps to

prevent the possibility of illness and injury

during disaster events.

Prevention and Mitigation

The roles of a community health nurse (CHN)

during the prevention and mitigation processes

of Disaster Management are as follows:

1. Reflecting on the simulation, discuss
the role of the nurse in the prevention

and mitigation of Disaster management.

2. Please give examples of prevention and
mitigation in disaster management?

8 MID-TERM EVALUATION

Discussion 3 CC2.c

Choose any topic in Holistic Medicine which

interests you and would be of value to your

colleagues. Topics such as herbs,

acupuncture, coining, intermittent fasting,

water fasting, Keto diet, Mongolian tea, urine

therapy, prayer etc

Please complete the genetics and genomic

assessment and teaching. This is art of your

direct clinical hours and will be used to

evaluate your clinical competencies in the

midterm evaluation.

8

Research your holistic/alternative health

practice or treatment, include:

1. Define/describe practice
2. What the claims or benefits of the

practice

3. What are the risks or side effects?
4. Research articles on the topic?
5. What is the availability and cost?
6. How can the nurse use this

information?

9

Teaching presentation proposals due.

Virtual Simulation

The Point: Case Management: Transitions of

Care: Primary Care Clinic

(The dates for teaching presentation are to be

discussed with your professor and classmates)

Journal Entry#7 CC4.a

Primary care is the foundation of our health

care system and essential to better health

outcomes, lower costs, and healthier families

and communities.

It is:

 The first point of care

 Comprehensive, addressing all that
contributes to a person’s health and

well-being

 The care that follows a person from
childhood through old age

 Coordination of care across settings and
providers

1. What are the challenges to nurses who
are generally seen as having less

authority than doctors in the decision-

making process related to patient care

in primary care?

2. Does this perception increase patient
negative outcomes?

3. Does historical stereotypes that
influence current behaviors?

4. What would equal partnership in an
inter-professional team look like?

10

Virtual Simulation

Communicating with the Patient in Crisis

Please do the following imulation

https://de.ryerson.ca/games/nursing/hospital/a

rea.html#4

Communicating with colleagues

Discussion 4

This week’s discussion includes watching a

short video about a nursing situation

developed by Montgomery College at

https://youtu.be/Wz1xkj-SDZE . After

Journal Entry #8 CC1.c

1. Reflect on your virtual clinical
experience.

2. Explain your patient’s medical
diagnosis.

3. Describe your interaction with the
patient.

4. Was there anything that surprised you
or anything you would do differently?

5. What is your overall reaction to
clinical?

https://www.researchgate.net/post/What_are_the_challenges_to_nurses_who_are_generally_seen_as_having_less_authority_than_doctors_in_the_decision-making_process_related_to_patient_care

https://www.researchgate.net/post/What_are_the_challenges_to_nurses_who_are_generally_seen_as_having_less_authority_than_doctors_in_the_decision-making_process_related_to_patient_care

https://www.researchgate.net/post/What_are_the_challenges_to_nurses_who_are_generally_seen_as_having_less_authority_than_doctors_in_the_decision-making_process_related_to_patient_care

https://www.researchgate.net/post/What_are_the_challenges_to_nurses_who_are_generally_seen_as_having_less_authority_than_doctors_in_the_decision-making_process_related_to_patient_care

https://www.researchgate.net/post/What_are_the_challenges_to_nurses_who_are_generally_seen_as_having_less_authority_than_doctors_in_the_decision-making_process_related_to_patient_care

9

viewing the video using the following

mnemonic to address the nursing situation:

D – Describe the behavior

E – Explain the effect of the behavior

S – State the desired outcome

C – Consequence: say what will happen if the

behavior continues

Some professionals prefer to memorize the

keywords below at representing this model

because it gives them a consistent structure to

follow:

D When . . .

E I feel . . . because…

S Therefore, I want/need …

C So that …

Now in your discussion answer the following

questions and answer at least one of your

classmate’s posting.

1. What emotions did you experiencing
while watching the simulation?

2. Did you believe that anger?
Frustration? Disappointment? played a

role in the disruptive behavior?

3. What story do you think led to these
emotions?

4. What facts do you have that support
this story?

5. Can you retell this story using the
evidence that you have?

6. What information is missing?

6. Please include the PDF completion
certificate.

11

The Point: Home Safety and the Aging

Adult: Elderly Client’s Home
Journal Entry#9 CC3.d

Please go to

Home Safety and the Aging Adult: Elderly

Client’s Home

1. Do the aging population have especial
needs? If so, can you describe one

situation that deserves attention?

2. Will you identify an evidence-based
nursing intervention to address the

issue identified as of major importance?

3. How would you implement the
strategy?

12

Virtual Simulation

Care of the Transgender Patient
Journal Entry#10 CC5.a

After watching the video. Please reflect in the

following questions:

10

Topic Selections for Teaching Projects/presentations-Suggestions:

Please, refer to the following documents to identify a possible topic for the Teaching

projects/presentations.

1. See Healthy People 2020 list of related federal government priority problems to be remedied for
your age group.

2. See the JCAHO list of Safety Problems for this year.
3. Speak with your professor and determine Quality Improvement Projects available, Incident

Reports for the last year.

4. Do a needs survey of your classmates to determine their perception of what they want to learn?

1. When caring for patients who are
transgender, the first step is for the

healthcare professional to self-reflect:

2. “Do I have a potential bias toward a
patient who is lesbian, gay, bisexual, or

transgender?”

3. why Transgender individuals may
delay seeking healthcare ?

13

The Point: Correctional Facility Nursing:

Promise Heights Jail

Discussion 5 CC5.b

These final questions are an overall evaluation

of what you learned about Community/Public

Health Nursing throughout the course.

Instructions:
1. How has this course helped you grow

personally and professionally?

2. What did you expect from this course?

3. How did the course meet or not meet

your expectations?

4. What will you take away with you in

terms of conducting Genetics and

genomics assessment and

education and preparing a teaching

project?

5. Do you feel that you have strengthened

your skills in preparing a presentation

to the community?

6. If so, how?

7. If not, how could the course have better

met your needs?

14 Community Teaching Presentations CC5.a Reflection Paper Due CC5.b

15 Community Teaching Presentations CC5.a

Course Final Evaluation, Virtual meeting with

professor to evaluate completion of course

requirements.

16 Virtual meeting with professor to evaluate

completion of course requirements.

Course Final Evaluation, Virtual meeting with

professor to evaluate completion of course

requirements.

11

Note: Your professor must approve all teaching topics prior to initiating a topic

development/presentation.

The following is a list of suggested special projects/activities:

1. Poster.
2. Games.
3. Bulletin boards.
4. Videos.
5. Flyers.

Students may collaborate on a teaching & learning project. Approval of any joint project will be at the

discretion of your clinical instructor. However, each student must submit their own evidence of active

participation in the preparation, delivery, and evaluation of the project. To get credit, students must be

present on the day of the presentation.

The presentation will evaluate on creativity, achievement of learning objectives, organization, evaluation,

and adherence to the time frame allowed by your professor

Guidelines for Clinical Assignments

Assignments-All written assignments for the course will be submitted and graded by your clinical

instructor. All written documents must be typed double-spaced, in a 12-point, New Times Roman font

using the APA format. Four to six (4-6) evidenced-based references must be included in teaching projects

or as per your professor’s RUBRIC.

Personal Goals & Objectives-Each student is required to submit at least one goal and at least 3

typewritten personal behavioral objectives to his/her clinical faculty. Prior to the due date, a draft copy

may be given to your clinical professor for corrections and/or clarification. All objectives must be

finalized by the end of the third week of clinical. Behavioral objectives may be in the cognitive, affective,

and psychomotor domains. One or more of each is preferable. Document in final journals whether your

goals and objectives for the semester were achieved.

Directions

The Big Goal

To develop the Goals and Objectives for the Community Teaching project follows the following steps:

1. Analyze the problem or the issue
2. Find out what is causing concern, and break the issue down into its components “Patients with

Diabetes.”

3. Identified the Stakeholders (‘key players’ or main stakeholders and invite them to be part of the
project) “Talk to the Diabetes educator,”

4. Know your target group ( a group, for example, adolescents with type I DM)
5. Understand the characteristics of your target group “recently diagnosed diabetes patient” “Pre-

menopausal women at risk for diabetes.”

6. Determine the goals and objectives
7. Determine the result you want from your community education project. Define this in terms of a

goal, educational objectives, and desired outcomes

8. The goal or aim of your project is a broad statement of what you want to achieve

12

Example: My goal this semester is to develop an educational project to assist newly diagnosed diabetic

patients in managing their nutrition and glucose monitoring.”

Objectives

Define your educational objectives in terms of the knowledge, skills, values, beliefs, and practices you

want the target group to adopt to achieve the goal.

Educational objectives:

At the end of the project, participants will:

1. verbalized increased knowledge and understanding of the diabetes disease process.
2. be able to identify the signs and symptoms of hyper and hypoglycemia.
3. be able to identify solutions to the environmental impacts
4. develop an appreciation for glycemic diet and the importance of monitoring blood glucose.
5. use of the American Diabetes Association guidelines for blood glucose control.

Design your educational project (based on evidence)

1. Make an action plan and implement it
2. Evaluate the objectives by testing or surveying the knowledge and attitudes of the participants

concerning the purposes.

Consider This:

SMART:

1. Specific: Clearly state the issue, the target group, the time and place of the activity.
2. Measurable: Be clear in the objective of what will be changed and by how much. Setting this

clearly at the start makes it easier to evaluate: Example of a measurable goal “within the next six

weeks, I will develop a health literacy program for at-risk of amputation diabetic patients in the

community. I will survey at the end of the program, 80% of participants will answer at least five

questions correctly in the survey.”

3. Achievable: Be realistic about what the project achieves in terms of the scale/scope of what is
being done, time, and resources available.

4. Relevant: Objectives need to relate to and be relevant to the goals. Remember objectives are the
building blocks/steps toward meeting the goals

5. Time Specific: Be clear in the objectives about the timeframe in which the program/activities, as
well as expected changes, will take place

Remember that the rest of the course will be used to accomplish your goal by having a clear goal.

1. Goal statements “identify” the specific target group and provide the “what” information as distinct
from the “how” the goal will be achieved or when it will come about.

2. Objectives are the building blocks or steps towards achieving a program’s goals. Objectives are
specific and concise statements that state who will make what change, by how much, where, and

by when.

Identifies the target group

States the result (change)

Specifies the degree of change in measurable terms (degree)

Identifies when the will happen (time)

Reflection Journals-Students are required to maintain a written journal of their activities within the

virtual clinical area. The journal should include meeting both the course and your personal goal (s) and

objectives.

Daily Journal format: Please follow the format and grading rubric for each reflection journal. Each

journal is unique, and the purpose is to critically think about issues that are pivotal in the role of the

13

community health nurse. Reflections must demonstrate a high degree of critical thinking in applying,

analyzing, and evaluating key course concepts and theories from readings, lectures, media, discussions

activities, and/or assignments. Insightful and relevant connections are made through contextual

explanations, inferences, and examples. Thoughtfulness is demonstrated by conveying strong evidence of

reflection on own work with a personal response to the self-assessment questions posed. Demonstrates

significant personal growth and awareness of deeper meaning through inferences made examples, well

developed insights, and substantial depth in perceptions and challenges. Synthesizes current experience

into future implications.

1 point 2 point 3 points

Rudimentary and superficial. No

analysis or insight is displayed.

Substantial information

(describes) but lacks either the

insight or analysis.

Rich in content. Ful of thought,

insight, and analysis.

Discussion Board Assignment

Class participation is an important expectation of this course. Students are expected to offer comments,

questions, and replies to the discussion question that has been posed as well as to classmate postings.

Students are expected to actively participate in EACH discussion throughout the semester.

Evaluation of Assignment:

Postings will be evaluated on the quality of the postings and the degree that the postings promote

discussion with classmates. Participation on 5 forums is and postings will be evaluated per forum on the

below scale. Students can earn the 5 additional points by showing good effort to engage classmates in

discussion comparing activities done on other graded assignments. PA guidelines and references are a

requirement. The discussion assignment will be worth a total of 2 points.

0 points 1 point 2 points

Minimal response to the

question. No references or

meaningful response to

classmate.

Post response to the questions.

But does not contain references

or the response to …

Patient Genetic and Genomics Interview and Education Part 1
Carolina Necastro
MDC

RUNNING HEAD: PATIENT GENETICS AND GENOMICS INTERVIEW AND EDUCATION 4

Patient Genetic and Genomics Interview and Education Part 1

Medications and supplements someone taking sertraline (Zoloft) should avoid

Sertraline, sold under the brand name Zoloft, is an antidepressant of the selective serotonin reuptake inhibitor class. Someone taking Zoloft should avoid NSAIDS (Aspirin). When the serotonin inhibitors like Zoloft and NSAIDS are combined, it increases the risk of upper GI bleed (Staider B, 2017). Another medication the patient should avoid Dextromethorphan, which increases serotonin levels in the body and causes syndrome when combined with other medicines that affect the serotonin. Pseudoephedrine is another supplement that the patient shouldn’t take, well on certain occasions, it can be used but cautiously. SSRI medication, when combined with Sudafed, can worsen the condition (Staider B, 2017).

Case analysis

Carla, who is 60 years old, suffers from depression and takes antidepressants. The condition makes her feel worthless, lacks concentration and confidence in what she does, making mistakes with appointments, and feeling like she can’t please anyone. The patient started having the condition at the age of 30. The disease seems to be genetic, and she might have inherited it from the family. The grandfather died from a car accident, which they think might have been caused by depression, making the accident look suicidal. The aunt also died at the young age of 30, and the family thinks she committed suicide under unclear circumstances. The family also thinks she suffered from depression. The dad, who is 90, suffered depression at the age of 75. He seems to be okay now as he has been on treatment. The mom, who is 88, has dementia. The brother, who is 64 had issues of drug abuse at 20; presumably, he also had problems of depression that pushed him to drugs hence being a drug addict at the age of 20. The sister, who is 55 is healthy and has her own family; she is the only one who seems to be free from the genetic disease (depression). Carla has a daughter who is 37 and not married; she also has a history of depression. She had once tried to commit suicide. She also has a son who is 30 years old; though the son hasn’t experienced any depression, he has a family of his own doing well. It is clear that the depression that Carla is going through is genetic and inherited from the family.
The challenges she faces include her hating her job, which she has done for over ten years, her daughter moving back into her house, which seems to be denying her independence and the biggest challenge is that the patient can’t help out in church as she used to before. She seems to be living a lonely life and can’t talk it out with someone. The patient bears the risk of committing suicide if she does not open up and continues a preserved lifestyle.
She also doesn’t exercise and drinks twice a month; her social life seems lonely. The patient should start having a fun social life like going to the gym at least that will cheer her up, and she will be able to make friends whom she can talk to; thus, the loneliness will be filled up with happiness, and she can be able to build her self-confidence back. She should also try and find the urge to help out in the church activities. She should also seek medical attention and continue taking the drugs as per the prescription; the drugs will make her relax. The family should have some get together to know their whereabouts and have some fun time for family; this will help create a distraction from the stress the family is going through, and the bond of the family will be strengthened since the family also seems to be somehow everyone seems to be lonely and there seems to be lack of communication between them. Having some family time together will help create a good bond between them and communicate amongst themselves when there is a problem.

References

Staider B. (2017, Dec 22nd). Cold Medication to Avoid While taking Zoloft. Cold Medications To Avoid While Taking Zoloft (walrus.com)

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