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Mrs. Demetilla Hernandez is a 63-year-old Cuban woman who seeks consultation at the Liberty health-maintenance organization (HMO) clinic because of weakness, lethargy, and fatigue that she has experienced for the last 2 months. A week ago, while cooking dinner at her daughter, Mariana’s house, she momentarily lost her balance and slipped on the kitchen floor. Although Mrs. Hernandez sustained only a mild bruise on her leg, her daughter insisted on taking her to the clinic for a check-up because of her persistent symptoms.

Mrs. Hernandez, widowed 4 years ago when her husband died of a heart attack, lives with Mariana, aged 40. Mariana is divorced and has three children: Luis, age 15; Carolina, age 10; and Sofia, age 7. Since moving into Mariana’s house, Mrs. Hernandez has been managing the household while Mariana is at work. Mrs. Hernandez prepares the family’s meals, attends to the children when they come home from school, and performs light housekeeping chores. Mariana is employed full-time as a supervisor at the local telephone company. The family, originally from Cuba, has been living in Miami for 12 years. Carolina and Sofia were born in Miami, but Luis came from Cuba with his parents when he was 3 years old. Mrs. Hernandez, who does not speak English, converses with her daughter and grandchildren in Spanish. Although the children and their mother occasionally speak English among themselves, the family’s language at home is Spanish.

At the Liberty HMO clinic, Mrs. Hernandez was diagnosed with essential hypertension and non–insulin-dependent diabetes mellitus. The physician prescribed an oral hypoglycemic drug and advised Mrs. Hernandez to exercise daily and to limit her food intake to 1500 calories a day. Mrs. Hernandez was concerned because she usually prepares traditional Cuban meals at home and was not sure whether she could tolerate being on a diet. Besides, she explained to Mariana, she thought the dishes she prepares are very “healthy.” Proof of that, she stated, is that her three grandchildren are plump and nice-looking. Mrs. Hernandez told her daughter that, instead of buying the prescribed medicine, perhaps she should go to the botanica and obtain some herbs that would help lower her blood sugar.

1. What are the typical Cuban communication patterns you need to be aware of in dealing with Mrs. Hernandez?
2. How would you assist Mrs. Hernandez in developing a plan for a 1500-calorie diet and regular exercise?
3. Would you encourage Mrs. Hernandez to go to the botanica to purchase some herbs? How would you approach her desire to use herbs instead of the prescribed oral hypoglycemic agent?
4. Discuss some common folk practices that Cuban families may use to maintain health or cure common ailments.

 post should be at least 500 words, formatted, and cited in current APA style with support from at least 2 academic sources. 

Current research indicates that communication breakdown among health care professionals is a leading causes of medical errors and patient harm (PSQH, 2017). Choose one patient from the scenario assigned to your group for discussion. Describe a potential error that could occur due to communication breakdown. Discuss evidence based strategies to avoid such errors. Include at least 2 evidenced-based strategies. 

Instructions:

• Please post your initial response by Midnight on Day 3 of the week.
• Comment on the post of one classmate by Midnight on Day 5 of the week. 
• Respond to a peer who responded on your initial post by Midnight of Day 7. 

Submission Instructions:

• Read the materials and discussion guided question/prompt.
• Click in “Type Your Response”  to write or paste your answer. Longer answers may be easier to write and spell check in a word processing programs (i.e Word, Wordpad, Notes) first.
• When you have finished entering your answer click on the “Submit” button.
• Respond to one classmate’s post. Under that peer’s post, click “reply” to write or paste your response. 
• Check back frequently for new additions.
• Respond to a classmate who responded on your initial post. 
• EVERY post/response MUST be supported with TWO references from recent Professional Journals (less than 5 years – 2020-2025) and a minimum of 250 words.

Grading Rubric 

Your assignment will be graded according to the grading rubric.

 . Topic: Air Pollution and Its Impact on Respiratory Health

Decision to Use This Environmental Concern:I have chosen air pollution as my topic because it is a significant environmental issue that affects both urban and rural populations, contributing to respiratory diseases such as asthma, bronchitis, and lung cancer. According to Healthy People 2030, reducing exposure to air pollutants is essential for improving public health outcomes. This topic interests me because nurses play a key role in educating patients about reducing exposure to air pollution and advocating for healthier environments.

Nature of the Environmental Concern and the Population Affected:Air pollution, caused by emissions from vehicles, industrial processes, and wildfires, releases harmful particles and chemicals into the atmosphere. It affects vulnerable populations such as children, older adults, and individuals with pre-existing respiratory conditions.

Why This Environmental Concern is Good or Bad for Society:Air pollution is harmful to society as it increases healthcare costs, reduces quality of life, and contributes to climate change. It disproportionately impacts low-income communities, creating health disparities.

Impact on Nursing Practice:Nurses play a crucial role in educating patients on minimizing exposure to pollutants and advocating for clean air initiatives. They also monitor and manage respiratory symptoms in patients affected by poor air quality.

 Reports hard stools, straining, and discomfort but denies  

 G6T2P1A2L2, LMP 08/19/2024, EDD: 05/26/2025, who presents today, 1/27/25,