Scenario:

As a community health nurse, you are working in an outpatient clinic in a community that serves mainly elderly clients.

This year, you noted that 85 percent of the visits resulting in hospitalization resulted from bronchitis, asthma, pneumonia, and influenza as compared to last year. At that time; the visits weredue to colds, sore throats, influenza, bronchitis, and pneumonia, in order of frequency.

Maria Perez, a 73-year-old Cuban American woman has been referred for community health nursing services following her discharge from the hospital. She smokes two packs of cigarettes per day. She was recently hospitalized as a result of a severe shortness of breath due to an asthma attack. The primary care provider prescribed respiratory treatments using Albuterol via jet nebulizer every 4-6 hours as needed. Mrs. Perez lives alone and has three cats to take care of.

1. Read the scenario above and answer the following questions:
   • What are the biophysical, psychological, physical environmental, sociocultural, behavioral, and health system factors influencing Mrs. Perez’s health?
   • Describe at least three primary, secondary, and tertiary prevention strategies that would be appropriate in resolving Mrs. Perez’s health problems. Why would they be appropriate?
   • What activities related to health promotion and disease prevention would you plan for the late fall?
   • How would you evaluate your nursing interventions? What criteria would you use to evaluate care?