Why are these interventions appropriate to this situation?

Please read each case study and answer the questions. Your answer should be 50-100 words, no more than that.1. Vista Hills is a small, low-income community within a major metropolitan area. In home visits to several older clients, the population health nurse assigned to the area discovers that they have not been able to keep medical appointments or get prescrip- tions filled due to lack of available transportation. There is a bus that traverses the area, but it only has stops on major thorough- fares, and most older residents have difficulty walking from their homes to the bus stops. In the past, the community had access to a Dial-a-Ride service that provided door-to-door transportation for elderly residents for 50 cents a ride (one-way). This service was discontinued several years ago because of escalating costs.The city in which the community is located has some funds for transportation services for elderly clients, but they have not een allocated to this community because older residents com- prise only 11% of the overall population. Some residents use taxi services to meet their transportation needs, but find this very expensive given their limited incomes.a) What are some of the determinants of health operating in this situation?b) What population health nursing interventions might be needed to address this community health problem? Why are these interventions appropriate to this situation?c) Give examples of some specific activities the population health nurse might carry out in relation to each intervention.2. Janice Wu, a community health nurse, is visiting a new client in a nursing home in an inner-city area in Los Angeles. As she en- ters the nursing home, she notices that several of the residents are doing calisthenics in the yard. Some of the residents are sit- ting on the sidelines and appear quite short of breath. When Janice checks to make sure they are all right, they tell her that they usually have a hard time breathing when they exercise on smoggy days like today. The residents say that they usually try to continue their exercises because it is one of the few activities hat get them out of the building. They also enjoy the social as- pects of the exercise sessions. Many of them state that they have always been active and want to maintain their strength and mo- bility as long as possible. They express fears of being bedridden and unable to care for themselves.After Janice is sure that all of the residents will be all right, she goes on to see her client. When she enters the building, she notices that it is quite hot inside, even though all the windows and doors are open. Although it is only 10 a.m., it promises to be one of L.A.’s scorching summer days. After seeing her cli- ent, Janice talks to the director about the heat in the building. The director tells her that the building is always hot and that the air conditioning has never worked properly. The last time the service people came to fix the air-conditioning unit, they said it could not be repaired and would have to be replaced. The nursing home is run by a large national corporation, and the director says she has been told they will have to wait until the next budget year (October) before money will be available for a new air conditioner. Fortunately, the heating system is separate, so there will be heat when the colder weather starts. The director says that staff members have been particularly careful about maintaining hydration in the residents during the hot weather, but many of the residents seem fatigued and listless with the heat.a) hat hazards are present in the natural, built, and social environments in this situation? What health effects, if any, are these hazards causing?b) What levels of intervention are warranted in this situation? What might Janice do to intervene?3. You have been appointed to the mayor’s task force on health care in the midsize community in which you work as a population health nurse. The assessment of population health and economic status conducted by the task force in- dicates that most of the population’s health care needs are adequately met at all levels of health care. The exception to this, however, is the population of the migrant farm camp at the edge of town.This group consists primarily of male Mexican workers who have entered the United States on legal work visas. Very few of the workers have brought their families with them. Most of this population receives no health care except for treatment in the emergency room of the community hospital. Usually, this care is provided for work-related injuries or serious illness. Members of this group receive no health promotion or preventive care and do not seek care for minor illnesses because of their inability to pay.Because most of these people are in the United States legally, they would be eligible for county medical assistance (CMA); however, very few have applied for this program because of lan- guage barriers, lack of transportation to the social services of- fice, and inability to afford to take the time off work to submit an application. Even if they did receive assistance, they would be unlikely to find a regular health care provider who has a contract with the county to provide services under CMA reim- bursement. Only one community clinic and one independent nurse practitioner, in addition to the community hospital, have county contracts. Local physicians receive adequate income from private paying clients and those with private health insur- ance. Because of the extended time between provision of ser- vices and receipt of reimbursement, these physicians no longer accept county assistance clients.The rest of the population is well off when compared with average state and national incomes. With the exception of the migrant workers, most residents are employed by three large in- dustries and receive salaries that are quite adequate to meet the cost of living. Because of the industry present in the community, the local tax base is more than adequate. The community does not budget any public funds for health care as the majority of the population is adequately served by private providers. There is no local health department, but the county offers public health services in a town 50 miles away.a) What factors are influencing the health status of the migrant group?b) How would you finance health care for this population group?c) Would fee-for-service care or managed care arrangements be more appropriate for providing care to the migrant population? Why?4. Alfinia Michaels is a 45-year-old single parent of two children, a boy of 8 years and a girl of 5. She has recently been diagnosed with breast cancer and is scheduled to have a lumpectomy and reconstruction of her right breast in 2 weeks. Ms. Michaels is divorced and is responsible for the care of her 79-year-old fa- ther who has mild Alzheimer’s disease. Her father is still capa- ble of caring for himself during the day while she works, but cannot be left alone overnight and cannot care for the children. Ms. Michaels has one sister who lives approximately 150 miles away. She states that she and her sister have always been close. Ms. Michaels’s former husband lives in the same community. He provides child support and health insurance for the chil- dren and takes them every other weekend. Ms. Michaels does not have health insurance because she works two part-time jobs, neither of which includes benefits. She tells the population health nurse she doesn’t have any idea how she will pay for her surgery and the chemotherapy that will follow. She is worried about care of her father and her children during her hospitalization and afterward.a) What biological, psychological, environmental, sociocultural, behavioral, and health system factors are influencing this situation?b) Is this a crisis situation? If so, what type of crisis would this be?c) What nursing interventions might the population health nurse employ with this family?d) How might the nurse evaluate the effectiveness of nursing intervention?e) How might your interventions be different if you find that many families in the population are experiencing similar problems?