Case studies
Complete the following:African-American case study #2Appalachian case study #1Version:1.0 StartHTML:000000480 EndHTML:000083756 StartFragment:000001175 EndFragment:000083724 StartSelection:000001632 EndSelection:000083724 SourceURL:https://classroom.aspen.edu/d2l/common/assets/pdfjs/1.0.0.30/web/viewer.html?file=%2Fcontent%2Fenforced%2F43768-N512-KK8-08-20-19-Sect2%2FCaseStudies.pdf%3Fd2lSessionVal%3DFeuJBWYKC5d0CfstmT4x6NuRM%26ou%3D43768&lang=en-us&container=d2l-fileviewer-rendered-pdf&fullscreen=d2l-fileviewer-rendered-pdf-dialog&height=1186 PDF.js viewerFRICAN AMERICAN CASE STUDY #2Mr. and Mrs. Evans are an African American couple who retired from the schoolsystem last year. Both are 65 years of age and reside on 20 acres ofland in a large ruralcommunity approximately 5 miles from a Superfund site and 20 miles from twochemical plants. Their household consists oftheir two daughters, Anna, aged 40 years,and Dorothy, aged 42 years; their grandchildren, aged 25, 20, 19, and 18; and their 2-year-old great-grandson. Anna and Dorothy and their children all attended theuniversity.Mr. Evans’s mother and three of hisnieces and nephews live next door. Mr.Evans’s mother has brothers, sisters, other sons and daughters, grandchildren, andgreat-grandchildren who live across the road on 10 acres of land. Other immediate andextended family live on the 80 acres adjacentto Mr. Evans’s mother. All members ofthe Evans family own the land on which they live.Mrs. Evans has siblings and extended family living on 70 acres of land adjacentto Mr. Evans’s family, who live across the road. Mr. and Mrs. Evans also have familyliving in Chicago, Detroit, New York, San Francisco, and Houston. Once a year, thefamilies come together for a reunion. Every other month, local family members cometogether for a social hour. The family believes instrict discipline withlots of love. It iscommon to see adult members of the familydiscipline the younger children, regardlessof who the parents are.Mr. Evans has hypertension and diabetes. Mrs. Evans has hypertension. Bothare on medication. Their daughter Dorothy isbipolar and is on medication. Within thelast 5 years, Mr. Evans has had several relatives diagnosed with lung cancer and coloncancer. One of his maternal uncles died lastyear from lung cancer. Mrs. Evans hasindicated on her driver’s license that she is an organ donor.Sources of income for Mr. and Mrs. Evans are their pensions from the schoolsystem and Social Security. Dorothy receives SSI because she is unable to work anylonger. Mr. Evans and his brothers must assume responsibility for their mother’smedical bills and medication. Although she has Medicare parts A and B, many of herexpenses are not covered.Mr. and Mrs. Evans, all members of their household, and all other extendedfamily in the community attend a large Baptist church in the city. Several familymembers, including Mr. and Mrs. Evans, singin the choir, are members of the usherboard, teach Bible classes,and do community ministry.Study Questions1.Describe the organizational structure of this family and identify strengths andlimitations of thisfamily structure.2.Describe and give examples of what you believe to be the family’s values abouteducation.3. Discuss this family’sviews about child rearing.4. Discuss the role that spirituality plays in this family.5.Identify two religious or spiritual practices in which members of the Evansfamily may engage for treating hypertension, diabetes, and mental illness.6.Identify and discuss culturalviews that Dorothy and her parents may have aboutmental illness and medication.7.To what extent are members of the Evans family at risk for illnesses associatedwith environmental hazards?8.Susan has decided to become an organ donor. Describe how you think the Evansfamily will respond to her decision.9. Discuss views that African Americans have about advanced directives.10. Name two dietary health risks for African Americans.11.Identify five characteristics to considerwhen assessing the skin of AfricanAmericans.12. Describe two taboo views that African Americans may have about pregnancy.AMISH CASE STUDYElmer and Mary Miller, both 35 years old, live with their five children in the mainhouse on the family farmstead in one of the largest Amish settlements in Indiana.Aaron and Annie Schlabach, aged 68 and 70, live in the attached grandparents’cottage. Mary is the youngest of their eight children, and when she married, she andElmer moved into the grandparents’ cottagewith the intention that Elmer would takeover the farm when Aaron wanted to retire.Eight years ago, they traded living space.Now, Aaron continues to help withthe farm work, despite increasing pain in his hip, which the doctor advises should bereplaced. Most of Mary’s and Elmer’s siblings live in the area, though not in the samechurch district or settlement. Two of Elmer’s brothers and their families recentlymoved to Tennessee, where farms are less expensive and where they are helping tostart a new church district.Mary and Elmer’s fifth child, Melvin,was born 6 weeks prematurely and is 1month old. Sarah, aged 13, Martin, aged12, and Wayne, aged 8, attend the Amishelementary school located 1 mile from their home. Lucille, aged 4, is staying withMary’s sister and her family for a week because baby Melvin has been havingrespiratory problems and their physician toldthe family he will need to be hospitalizedif he does not get better within 2 days.At the doctor’s office, Mary suggestedto one nurse, who often talks with Maryabout “Amish ways,” that Menno Martin, anAmish man who “gives treatments,” maybe able to help. He uses “warm hands” totreat people and isespecially good withbabies because he can feel what is wrong. The nurse noticed that Mary carefully placedthe baby on a pillow as she prepared to leave.Elmer and Mary do not carry any health insurance and are concerned aboutpaying the doctor and hospital bills associated with this complicated pregnancy. Inaddition, they have an appointment for Wayneto be seen at Riley Children’s Hospital,3 hours away at the University Medical Center in Indianapolis, for a recurring cystlocated behind his left ear. Plans are beingmade for a driver to take Mary, Elmer,Wayne, Aaron, Annie, and two of Mary’s sisters to Indianapolisfor the appointment.Because it is on the way, they plan to stop inFort Wayne to see an Amish healer whogives nutritional advice and does “treatments.” Aaron, Annie, and Elmer have beenthere before, and the other women are considering having treatments, too. ManyAmish and non-Amish go there and tell othershow much better they feel after thetreatments.They know their medical expenses seem minor in comparison to the familywho last week lost their barn in a fireand to the young couple whose 10-year-old childhad brain surgery after a fall from the hayloft. Elmer gave money to help with theexpenses of the child and will go to the barn raising to help rebuild the barn. Mary’ssisters will help to cook for the barn raising, but Mary will not help this time becauseof the need to care for her newborn.The state health department is concerned about the low immunization rates inthe Amish communities. One community-health nurse, who works in the area whereElmer and Mary live, has volunteered to talkwith Elmer, who is on the Amish schoolboard. The nurse wants to learn how the healthdepartment can work more closely withthe Amish and also learn more about whatthe people know about immunizations. Thecounty health commissioner thinks this is a waste of time and that what they need to dois let the Amish know that they are creatinga health hazard by neglecting or refusingto have their children immunized.Study Questions1.Develop three open-ended questions orstatements to guide you in yourunderstanding of Mary and Elmer and whathealth and caring meanto them and tothe Amish culture.2. List four or five areas of perinatalcare that you would want to discuss with Mary.3. Why do you think Mary placed the babyon a pillow as she was leaving the doctor’soffice?4. If you were the nurse to whom Mrs. Miller confided her interest in taking the babyto the folk healer, what would you do to learn more about their simultaneous use offolk and professional health services?5. List three items to discuss with the Millers to prepare them for their consultation atthe medical center.6. If you were preparing the reference for consultation, what would you mention aboutthe Millers that would help to promote culturally congruent care at the medicalcenter?7. Imagine yourself participating in a meeting with stateand local health departmentofficials and several local physicians and nurses to develop a plan to increase theimmunization rates in thecounties with large Amishpopulations. What would yousuggest as ways to accomplish this goal?8.Discuss two reasons why many Old Order Amish choose not to carry healthinsurance.9.Name three health problems with geneticlinks that are prevalent in some Amishcommunities.10.How might health-care providers use theAmish values of the three-generationalfamily and their visiting patterns in promoting health in the Amish community?11. List three Amish values to consider in prenatal education classes.12.Develop a nutritional guide for Amish women who are interested in losing weight.Consider Amish values, daily lifestyle, and food production and preparationpatterns.13. List three ways in which Amish express caring.APPALACHIAN CASE STUDY #1William Kapp, aged 55 years, and his wife, Gloria, aged 37, have recently moved from anisolated rural area of northern Appalachiato Denver, Colorado, because of Gloria’sfailing health. Mrs. Kapp has had pulmonary tuberculosis for several years. They decidedto move to New Mexico because they heard that the climate was better for Mrs. Kapp’spulmonary condition. For an unknown reason, they stayed in Denver, where Williamobtained employment making machine parts.The Kapp’s oldest daughter, Ruth, aged 20, Ruth’s husband, Roy, aged 24, andtheir daughter, Rebecca, aged 17 months, moved with them so Ruth could help care forher ailing mother. After 2 months, Roy returned to northern Appalachia because he wasunable to find work in Denver. Ruth is 3 months’ pregnant.Because Mrs. Kapp has been feeling “more poorly” in the last few days, she hascome to the clinic and is accompanied by her husband, William, her daughter Ruth, andher granddaughter, Rebecca. On admission, Gloria is expectorating greenish sputum,which her husband estimates to be about a teacupful each day. Gloria is 5 ft 5 in. tall andweighs 92 pounds. Her temperature is 101.4°F,her pulse is regular at 96 beats perminute, and her respirations are 30 per minuteand labored. Her skin is dry and scaly withpoor turgor.While the physician is examining Mrs. Kapp, the nurse is taking additionalhistorical and demographic data from Mr. Kapp and Ruth. The nurse finds that Ruth hashad no prenatal care and that her first child, Rebecca, was delivered at home with theassistance of a neighbor. Rebecca is pale andsuffers from frequent bouts of diarrhea andcolicky symptoms. Mr. Kapp declines to offer information regarding his health status andstates that he takes care of himself.This is the first time Mrs. Kapp has seen a health-care provider since theirrelocation. Mr. Kapp has been treating his wifewith a blood tonic he makes from soakingnails in water; a poultice he makes from turpentine and lard,which he applies to her chesteach morning; and a cough medicine he makes from rock candy, whiskey, and honey,which he has her take a tablespoon of fourtimes a day. He feels this has been morebeneficial than the prescription medication given to them before they relocated.The child, Rebecca, has been taking acup of ginseng tea for her colickysymptoms each night and a cup of red bark tea each morning for her diarrhea.Ruth’s only complaint is the “sick headache” she gets three to four times a week.She takes ginseng tea and Epsom salts for the headache.Mrs. Kapp is discharged with prescriptions for isoniazid, rifampin, and anantibiotic and with instructions to return in1 week for follow-up based on the results ofblood tests, chest radiograph, and sputum cultures.She is also told to return to the clinicor emergency department if her symptomsworsen before then. The nurse gives Ruthdirections for making appointments with the prenatal clinic for herself and the pediatricwell-child clinic for Rebecca.Study Questions1.Describe the migration patterns ofAppalachians over the last 50 years.2.Discuss issues related to autonomyin the workforce for Appalachians.More InformationLess InformationCloseEnter the password to open this PDF file.OKCancelFile name:-File size:-Title:-Author:-Subject:-Keywords:-Creation Date:-Modification Date:-Creator:-PDF Producer:-PDF Version:-Page Count:-Close@media print { #printContainer div { page-break-after: always; page-break-inside: avoid; } } #mozPrintCallback-shim { position: fixed; top: 0; left: 0; height: 100%; width: 100%; z-index: 9999999; display: block; text-align: center; background-color: rgba(0, 0, 0, 0.5); } #mozPrintCallback-shim[hidden] { display: none; } @media print { #mozPrintCallback-shim { display: none; } } #mozPrintCallback-shim .mozPrintCallback-dialog-box { display: inline-block; margin: -50px auto 0; position: relative; top: 45%; left: 0; min-width: 220px; max-width: 400px; padding: 9px; border: 1px solid hsla(0, 0%, 0%, .5); border-radius: 2px; box-shadow: 0 1px 4px rgba(0, 0, 0, 0.3); background-color: #474747; color: hsl(0, 0%, 85%); font-size: 16px; line-height: 20px; } #mozPrintCallback-shim .progress-row { clear: both; padding: 1em 0; } #mozPrintCallback-shim progress { width: 100%; } #mozPrintCallback-shim .relative-progress { clear: both; float: right; } #mozPrintCallback-shim .progress-actions { clear: both; } Preparing document for printing… 0%
