Nursing Care Plan

Posted: February 08, 2016


Public Health Nursing




One of the greatest achievements in the health-care field for over 30 years now is the emergence of a nurse as an active initiator and co-coordinator of community health care. Stanhope and Lancaster (2012) define community as a collection of individuals in a well-defined geographical area who have shared culture, values and norms. Sines (2005) adds that the individuals are placed in a social structure that is dependent on the relationship that the community is built over a period. Today, nurses are designated the role to design nursing care plans that transform a community towards improved health and maximum independence. They are regarded by Sines (2005) as the leaders of change to the system in a community that support health. Their role ranges from disease, disability, and injury prevention and also health promotion. A nursing care plan involves the assessment, diagnosis, planning, intervention and evaluation of a particular community health problem. The article examines the need for a community public health nurses crucial roles in ensuring there is a consistent improvement in the health conditions of people in Kendall community by designing a proper nursing care plan. The problems of concern affecting the community are diabetes. Asthma, and overweight, obesity and physical activity   

Community Assessment

Kendall community is an example of an unincorporated community located in Miami-Dade County in the southeastern part of the state of Florida. The community is found 10 miles south-west of Miami. The population of the community is 75,371 citizens as per the 2010 US Census. Hispanics make up the largest race totaling up to 63.7% of the total population. Other races found in the community are the whites at 28.4%, blacks at 4.4% and Asian at 3% of the total population.

Overweight, obesity and physical activity

Nearly two-thirds of Miami-Dade County adults are obese or overweight. The Black, African American and the Hispanics are the races primarily affected. The percentage of the obese adult in the community is 26.0% compared to 24.1% of the state, overweight adults 38.9% compared to 38.0% of the state and lastly the adults who are overweight or obese are 64.9% compared to 62.1% in the state. In the case of the physical activity and nutrition among the adults are 63.7% of adults who are inactive compared to 34.5% of the states, 35.4% of those who are sedentary while for the state is 25.4%, 24.3% of adults who consume three or more serving of vegetables per day compare to the 29.1%. Those who met moderate physical activity recommendations were 29.2% compared to the 34.6%. For those who met vigorous physical activity, recommendations were 23.7% compared to 26.0% of the states population.


Diabetes has been reported to be the fifth deadliest disease in the United States. In Kendall community. The disease affects approximately 208,700 people and the largest group affected are adults age 40 years and above, the group of persons living below the federal poverty line, Hispanics and the Black race. 2,847 adults were admitted to hospital as a result of diabetes Miami-Dade County 181, 425 people were reported to have diabetes, the mortality rates in 2008 from diabetes reported complications. The total cost that was incurred for the admission was $139 million catering for service that were offered in the hospital.


Asthma regarded as a life-threatening respiratory disease affecting the quality of life of people living in the Unite States. In Kendall community, asthma prevalence is quite high affecting an estimated 71, 600 children and 286300. 4.9% of the middle school student and 17.1% of high school students have reported being attacked by the disease. However, the rates of adults being admitted as a result of asthma per 100,000 adults rose in 2008 after 7.7 percent fall in 2007. Those admitted to hospital with the principle diagnosis of asthma were 3,229 costing $90,898,051 for the services offered by the hospital. The average per admission was $28,510  and this excluded personal convenience items and associated professional fee.

Community Nursing Diagnosis

Overweight, obesity and physical activity

There are health problems that are related to physical activities and weight in the community. The community has the prevalent case of overweight and obesity caused by energy imbalance that is due to eating too many calories and doing little to no physical activity. In all the cases in the assessment, the results are slightly higher than the states' results.


The patient with overweight and obese are highly susceptible to Type 2 diabetes compared to those with normal healthy body weight.  The patients who are suffering from central obesity, belly fat and abdominal obesity are also at risk of developing Type 2 obesity. As per the results of the assessment, Kendall community is seen to have reported highest mortality rate with the comparison to the State of Florida.


Exposure to second and third-hand smoke, indoor mold, pet danger as a result of animals with fur or feathers, cockroaches, dust mites, combustion by-products such as car fumes and fuel burning appliance fumes, strong odors such as aerosols and talcum powder, outdoor allergens are regard as the factor that increased the frequency and severity of asthma attacks.

Planning and Interventions

Overweight, obese and physical activity

The effects of the surrounding environment are crucial the health and physical activity. The community, homes and workplaces have the ability to influence significantly personal health. Therefore, it is important for the community to make it easy for people to engage in physical activities and eat a healthy diet. The favorable climatically conditions contribute substantially to the better health. Also, the community can improve the health standard by providing shady, aesthetic and safe modes of transportation


Actions taken to control the blood glucose levels in the per-diabetics assist delay or prevent Type 2 diabetes from developing. Also, moderately improving in weight, maintaining low levels of fat, having a high fiber diet, and carrying out regulate physical activity are some of the aspects recommended activities used to prevent pre-diabetes and Type 2 diabetes. Also, the environments that favour these healthy food practices and the physical activities help in addressing the health concern.


To reduce asthma cases in the community there some aspects that must be considered. They include continuous monitoring of the lung function for the assessment and treatment, ensuring the environmental control measures are implemented so as to reduce triggers, providing there is comprehensive pharmacological therapy and creating awareness of the causes and the results in the efficient management of asthma. As per the meteorological patterns of the South Florida and the topography, the harmful air emissions is naturally removed from the community environment.

Research proves that the quality of air in Miami-Dade County falls within the “Good” range of the Environmental Protection Agency. However, during the days when the quality of air falls below the health standards, it poses threat to the portion of the populations which are highly sensitive to air pollution. They include the elderly and very young people and those suffering from respiratory diseases. Therefore, more artificial methods can be sued to ensure that the pollution level of the air is maintained at the less threatening state.

The community should address the social challenge as a whole instead of an isolated part. The act will result in raising the quality of life of the people. The community has to identify the linkage between the peoples' and need and look into how best the people can be educated, avail needed services efficiently, and ensure the services are availed comprehensively depending on the individual and neighbour requirements.


Access to healthier food and selections of healthier food choices such as eating less processed foods and eating more locally produced fresh food options reduced the risk of developing obesity and other health conditions. Also. The environmental benefit was observed as a result of consumption of more locally made food by reducing the energy need to develop and move food. Reduction in the use of cars, and shifting to use of biking anf=d walking brought a positive impact not only to the health of the individuals but also the environment. The health of the people was increased due to the rise in the physical activity, avoiding emission that affected the respiratory systems and reduced traffic related injuries. Also, there was the reduction in the noise and improved interaction with natural surrounding the decrease in the stress level hence, thus promote the overall well-being of the community.


A community health plan avails information that people can consider when coming up with effective interventions. It's an important tool in identifying issues of greatest concern, and hence resources can be committed in those areas. This will result in the greatest possible impact on the community health status.


Sines, D. (2005). Community health care nursing (3rd ed.). Oxford, UK: Blackwell Pub.

Stanhope, M. (2012). Cram101 textbook outlines to accompany Foundations of nursing in the community: Community-oriented practice, Marcia Stanhope, Jeanette Lancaster, 2nd edition. Place of publication not identified: Content Technologies.


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