NRNP 6540 Climate Change
Climate Change
The selected patient is Emily, a 71-year-old African American female who enjoys gardening and spends time outdoors in the midday sun. Emily showed signs of heat exhaustion during a home examination, such as feeling dizzy, flushed, and having a fever of 101°F. Additionally, she claimed to have used Roundup, a chemical pesticide that contains glyphosate, which may be harmful if breathed or absorbed via the skin. A complete set of vital signs, an examination of the patient’s level of hydration, skin turgor, mental alertness, and urine color would all be part of my evaluation. I would also ask her how she handles pesticides, how much water she drinks, and how she dresses for gardening safety (Shaban et al., 2024).
Emily would learn how to avoid getting sick from the heat and how to limit her exposure to pesticides. I would tell her to stay inside from 10 AM to 4 PM, wear protection clothes, a wide-brimmed hat, and sunscreen when she goes outside. People who are learning about hydration need to be educated to drink water before, during, and after gardening, even if they are not thirsty (Khayat et al., 2022). Emily should be told to limit how much Roundup she uses, carefully read and follow the directions on the package, wear gloves and long sleeves, and think about non-toxic options like vinegar-based weed killers or pulling weeds by hand to lower her exposure to dangerous chemicals.
Emily would be evaluated using the Heat Exhaustion Checklist, the Mini Nutritional Assessment (MNA) to check her water and nutrition levels, and environmental health screening questions to find out if she may have been exposed to any toxins. Follow-up tests should be given to Emily to make sure she knows how to stay healthy and how to incorporate her new behaviors into her daily life. It is good for her health and the health of the earth to tell her to garden in the morning or evening when it is cooler and to use eco-friendly planting methods (Idris et al., 2024). This plan backs climate-smart care measures that keep older people who are vulnerable safe.
References
Idris, M. A., Markham, C., Mena, K. D., & Perkison, W. B. (2024). Examining Management and Employees’ Perceptions of Occupational Heat Exposure and the Effectiveness of a Heat Stress Prevention Intervention on Safety and Well-Being among Natural Gas Construction Workers: A Qualitative Field-Based Study. International Journal of Environmental Research and Public Health, 21(9), 1255. https://doi.org/10.3390/ijerph21091255
Khayat, M. E., Halwani, D. A., Hneiny, L., Alameddine, I., Haidar, M. A., & Habib, R. R. (2022). Impacts of climate change and heat stress on farmworkers’ health: A scoping review. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.782811
Shaban, M., Amer, F. G. M., & Shaban, M. M. (2024). The impact of a sustainable nursing prevention program on heat strain among agricultural elderly workers in the context of climate change. Geriatric Nursing, 58, 215–224. https://doi.org/10.1016/j.gerinurse.2024.05.021
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Climate Change
EVALUATION PLAN
Environment is one of four traditional concepts in nursing: nurse, patient, health, and environment. All nurses practice in one or more places that we can call an environment. Patients live, work, learn, play, and worship in various environments. Nurses are to assist in creating healthy environments in which individuals, families, groups, and communities can thrive (American Nurses Association, 2020). As you read Unit II, p. 24-27, think about some of the environmental toxins that an older adult patient may be exposed to.
Choose one case for discussion with your classmates. Refer to the readings to inform your discussion and recommendations for education of the patient and family.
Resources
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
Learning Resources
Required Readings
- Kennedy-Malone, L., & Groenke-Duffy, E. (2023). Musculoskeletal disorders. In Advanced practice nursing in the care of older adults (3rd ed., pp. 367-400). F.A. Davis.
- Kennedy-Malone, L., & Groenke-Duffy, E. (2023). Central and peripheral nervous system disorders. In Advanced practice nursing in the care of older adults (3rd ed., pp. 401-436). F.A. Davis.
- Kennedy-Malone, L., & Groenke-Duffy, E. (2023). Appendix B: Laboratory values in the older adult. In Advanced practice nursing in the care of older adults (3rd ed., pp. 581-582). F.A. Davis.
Note: See the labs that are relevant to this week’s topics.
- Hammond, L., & Moseley, K. (2019). Medication and fall safety for older adults
- Links to an external site.. Nursing Made Incredibly Easy!, 17(3), 16–19. https://doi.org/10.1097/01.Nme.0000554604.14103.50
- U.S. Preventive Services Task Force. (2018). Clinical Summary: Falls prevention in community-dwelling older adults: Interventions
- Links to an external site.. https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/falls-prevention-in-older-adults-interventions
Required Media
- Goldberg, C. (2018e). Musculo-skeletal examination
- Links to an external site.. In C. Goldberg, Practical guide to clinical medicine. Regents of the University of California. https://meded.ucsd.edu/clinicalmed/joints.htm
Recommended Media
- Engage-IL (Producer). (2017h). Driving safety of the older adult
- Links to an external site. [Video]. https://engageil.com/modules/driving-safety-of-the-older-adult
Note: View the Driving Safely of the Older Adult video module available in this free course.
- Engage-IL (Producer). (2017v). Preventing falls among community-dwelling older adults
- Links to an external site. [Video]. https://engageil.com/modules/preventing-falls-among-community-dwelling-older-adults
Note: View the Preventing Falls Among Community-Dwelling Older Adults video module available in this free course.
Case 1:
Albert is a 69-year-old Caucasian male with mild asthma, arthritis of his knees, and controlled HTN. His medications include HCTZ 12.5 mg daily, and Airsupra (albuterol 90 mcg/budesonide 80 mcg) Inhalation prn, and extra strength Tylenol as needed every 4 hours for knee pain. He also uses Voltaren gel on his knees if he walks outside to relieve knee pain.
Since he retired, Albert has an interest in painting, which he gave up when he was working. He has an easel in his small bedroom and paints with oils and uses turpentine to clean the brushes. He notices he has been wheezing more than usual.
What advice would you offer to Albert regarding his wheezing and his painting? What education would you offer?
Albert should not use the oil paints and paint thinner in a small room, but if possible can paint outside or in a well-ventilated room. If a hobby includes paint and paint thinners (or refurnishing furniture), for example, an individual would be placed at a similar risk to those who are exposed occupationally.
Another option is for him to switch to acrylic or watercolor paints which are much less toxic. He needs education on the toxic qualities / VOCs of oil paints and paint thinners and how they can affect his lungs.
Case 2:
Emily is a 71-year-old AA female who is retired and loves to garden in her backyard. She often goes outside after lunch (usually at noon) to water her garden and weed, and she mentions she uses Roundup for the ‘pesky weeks’ that just keep coming back. You see her as a home assessment, and notice she is flushed, dizzy, and has not worn a hat. Her temperature is 101. F.
What would your assessment include? How would you educate her on sun exposure, pesticide use, and the symptoms of heat exhaustion?
Home gardeners can be exposed to pesticides that can have serious side effects. Emily is also having symptoms of heat exhaustion and dehydration from being in the sun without a hat in the midday sun. Your first intervention is to cool her down, with cold water, washcloths, and have her sit in a cool room. She needs her vital signs taken every 5-6 minutes to ensure her temp, and BP are normalized. After she drinks a glass or two of water, see if she can void, and what color it is – if dark have her drink more.
Your education for Emily will include how to avoid heat exhaustion, gardening in the evening rather than midday, and avoiding pesticide exposure.
By Day 3
Post an explanation of your evaluation & education plan for the patient in the case study you chose and explain what assessment you might use for the patient.
Read a selection of your colleagues’ responses.
By Day 6
Respond to at least two of your colleagues on two different days in one or more of the following ways:
- Recommend additional strategies for mitigating environmental harms for the case you chose.
- Explain other health promotion considerations for patients in this population or with related issues.
Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Reply button to complete your initial post. Remember, once you click on Post Reply, you cannot delete or edit your own posts and you cannot post anonymously. Please check your post carefully before clicking on Post Reply!