NURS 340 Week 8 Case Study: Environmental Health Assignment

NURS 340 Week 8 Case Study: Environmental Health Assignment

Review the following case study and complete the questions that follow. Submit your completed document to Blackboard using the assignment link.

As a nurse practicing within a family practice, you are interviewing a 55-year-old woman who is an executive assistant at a local law firm, where she has worked for 9 years. She has a 7-year history of respiratory illness, which occurs several times throughout the year, not seemingly connected to the changes in season. She does not use tobacco products in any form. During your questions regarding her home and work environments, she reports that she enjoys working adjacent to the courthouse in a building over 100 years old because it is such a contrast to her brand-new home on a local golf course. When describing the health of her coworkers, she indicates, “We all share illnesses, which seem to affect everyone else during the year; we just seem to be sicker more often!”

• What information is pertinent to your client’s case?
• How would you assess your client’s risk?
• What would be an exposure pathway for your client?

Your document should be 1-2 pages in length, in APA format, typed in Times New Roman with 12-point font, double-spaced with 1” margins, and include at least two citations using references less than five years old.

Environmental Health

Some buildings are polluted from contaminants that come from the outside due to the fact that buildings have broken or inefficient ventilation systems; consequently, combustion byproducts from motor vehicles enter the building’s environment. In addition, biological contaminants such as pollen, fungus, and mold are stagnant in air conditioning ducts; therefore, these collect on ceilings, walls, carpets and other upholstery. What is more, offices with a high density of occupants are disposed to spread airborne diseases from one person to another; especially in old building where the air conditioning does not efficiently recirculate air. Appliances such as microwaves and computer monitors produce electromagnetic radiation. These buildings would need an inspection from professionals with the collection and culturing of air samples. Additionally, the buildings need an evaluation of the air movement and daily temperatures as well as a measurement of carbon dioxide (Magnavita, 2015).

In this case, the patient needs a detailed health assessment and then an evaluation of the coworkers to define what is producing these acute illnesses. However, it could be easy to link the healthcare issue to the exposure of an old, or “sick” building. Indeed, this is a public health issue; and the approach to solve it should be by performing changes that remove those hazards that make individuals sick (Miskulin, Benes, & Miskulin, 2014). This patient needs to be assessed medically and occupationally; the patient should have blood work to exclude other conditions that may be making them sick. The patient needs specific testing, in case of acerbations of any of the symptoms, while at the same time finding out the ubiquitousness if the same type of symptoms are occurring to the patient’s coworkers. After all, if the patient does not have a distinguishable health issue the condition is consistent with Sick Building Syndrome (SBS) (Lu et al., 2018). This patient, and coworkers, needs to be approached to confirm that no recognizable disease is existing, by acquiring a medical history that is carefully generated and documented.

Most of the patients with SBS have mucous membrane irritations of the eyes, nose and mouth; this is a condition that is triggered by allergens of nonspecific origin. Therefore, the patient and co-workers should be assessed to find out if they describe the same level of irritation. The patient also has asthma like symptoms; however, she has nonexistence of physiologic abnormalities of the lungs which would allow to conclude that symptoms are produced by pollutants (Borchers, Chang, & Eric Gershwin, 2017). Additionally, this is a public building therefore, is important evaluate those individual that are not permanent occupants to determine if they experience any discomfort when they are at the building. Consequently, data should be collected to determine severity of the conditions in those individuals that work at the building and those that are transients there. NURS 340 Week 8 Case Study: Environmental Health Assignment

Sick building syndrome includes several broad symptoms that occurs to the occupiers of old buildings. Consequently, occupants of this buildings experiences acute health issues that could be related to the numbers of hours spent in the building. Indeed, there is not a specific illness that is identified; however, occupants of the building present the same condition respiratory problems such as cough, shortness of breath, extrinsic allergic alveoli, legionnaire’s disease, asthma and permanent flu-like symptoms (Borchers et al., 2017). In cases where there are strong pollutants inside the building, a system that removes them should be installed to vent pollutants to the outside. In addition, there is the need to investigate what kind of maintenance is being provided to the heating and air-conditioning system.

This building needs improvements, however, renovations should not be a hazard to health of all individuals in the community; perhaps a partial evacuation of the building during renovation. Indeed, the best alternative is to move the occupants out of the building during remodeling. Obviously, this is a health and environmental issue; even though this an old building sometimes offices are maintained in a manner that is unreliable with the structure and operating procedures (Miskulin et al., 2014). Poor quality indoor air could be also related to occupants’activities; therefore, they should be made aware of how to maintain a good indoor air quality. After all, this patient must be removed from this building and recovering will take a while because she has been working there for seven years. NURS 340 Week 8 Case Study: Environmental Health Assignment

Overall, this is a case in which interrelated environmental factors are making the occupants of a public building sick. Just about everyone could be affected by a sick building; however, not everyone is at risk. Indeed, those that are employed in routine jobs are the ones that are exposed for more hours to the pollutants and contaminants of the building. In this case there is a need of an action plan; for example, identifying issues that are relevant to everyone, check symptoms of the occupants of the building. If there is not a specific medical problem, a public health nurse could work in an investigation with a detailed assessment of the situation. The important thing is to reassure, to be motivated in participating in the situation where actions could be taken to alleviate the problem. NURS 340 Week 8 Case Study: Environmental Health Assignment

References

Borchers, A. T., Chang, C., & Eric Gershwin, M. (2017). Mold and human health: A reality check. Clinical Reviews in Allergy and Immunology, 52(3), 305-322.

Lu, C., Tsai, M., Muo, C., Kuo, Y., Sung, F., & Wu, C. (2018). Personal, psychosocial, and environmental factors related to sick building syndrome in official employees of Taiwan. International Journal of Environmental Research and Public Health, 15(1), 7.

Magnavita, N. (2015). Work-related symptoms in indoor environments: A puzzling problem for the occupational physician. International Archives of Occupational and Environmental Health, 88(2), 185-196.

Miskulin, I., Benes, M., & Miskulin, M. (2014). Is there connection between the exposure to various physical factors of the working environment and the occurrence of sick building syndrome? Acta Medica Saliniana, 43(1), 26-31.

ADDITIONAL INSTRUCTIONS FOR THE CLASS

Discussion Questions (DQ)

• Initial responses to the DQ should address all components of the questions asked, include a minimum of one scholarly source, and be at least 250 words.
• Successful responses are substantive (i.e., add something new to the discussion, engage others in the discussion, well-developed idea) and include at least one scholarly source.
• One or two sentence responses, simple statements of agreement or “good post,” and responses that are off-topic will not count as substantive. Substantive responses should be at least 150 words.
• I encourage you to incorporate the readings from the week (as applicable) into your responses.

Weekly Participation

• Your initial responses to the mandatory DQ do not count toward participation and are graded separately.
• In addition to the DQ responses, you must post at least one reply to peers (or me) on three separate days, for a total of three replies.
• Participation posts do not require a scholarly source/citation (unless you cite someone else’s work).
• Part of your weekly participation includes viewing the weekly announcement and attesting to watching it in the comments. These announcements are made to ensure you understand everything that is due during the week.

APA Format and Writing Quality

• Familiarize yourself with APA format and practice using it correctly. It is used for most writing assignments for your degree. Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for APA paper templates, citation examples, tips, etc. Points will be deducted for poor use of APA format or absence of APA format (if required).
• Cite all sources of information! When in doubt, cite the source. Paraphrasing also requires a citation.
• I highly recommend using the APA Publication Manual, 6th edition.

Use of Direct Quotes

• I discourage overutilization of direct quotes in DQs and assignments at the Masters’ level and deduct points accordingly.
• As Masters’ level students, it is important that you be able to critically analyze and interpret information from journal articles and other resources. Simply restating someone else’s words does not demonstrate an understanding of the content or critical analysis of the content.
• It is best to paraphrase content and cite your source.

LopesWrite Policy

• For assignments that need to be submitted to LopesWrite, please be sure you have received your report and Similarity Index (SI) percentage BEFORE you do a “final submit” to me.
• Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.
• Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?
• Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

• The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.
• Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.
• If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.
• I do not accept assignments that are two or more weeks late unless we have worked out an extension.
• As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

• Communication is so very important. There are multiple ways to communicate with me: 
  • Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.
  • Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.