All posts by : chebby

Read Chapter 11

1. Why is the subject of workplace health and safety of concern to nurses? 

How are these concepts related to patient safety and patient outcomes? 

2. What action is suggested when you are faced with an angry or hostile coworker?

3. Why is substance misuse among nurses a serious concern? What is the most appropriate way to handle a suspicion that a coworker may be involved in serious substance misuse?

4. What is the most common physical injury experienced by LPNs and nursing assistants? How can a nurse manager help staff avoid physical injury at work? 

5. Describe several examples of sexual harassment in the workplace. Discuss methods of dealing with these instances.

6. Review the policies and procedures on the following safety issues in your current clinical rotation. Compare with other students in the class. What are the similarities and differences? What might this mean in terms of workplace safety? 

• Latex allergies

• Needlestick injuries

• Violence 

3. Go to the ANA website and explore the sections on workplace and patient safety under the heading “Professional Nursing Practice.” 

Which concepts discussed in these sections are particularly important to the beginning RN? Why? 

4. Interview one of the staff nurses on your unit. Explore his or her feelings and concerns related to the following topics. Based on the comments, develop strategies to address the concerns.

• Substance abuse among nurses

• Emergency preparation 

• Quality of work life within the organization 

 Compare two leadership theories. Provide an overview of each and discuss the strengths and weakness in relation to nursing practice. 

Thank you for sharing information on the micro and meso levels how they are involved with the current problem of shortage of healthcare providers that you are experiencing at your workplace. I appreciate you mentioning how the ultimate benefit of system approach is the three systems working together. Systems thinking has gained traction as a positive mechanism to change. 

Within your health system(Seasons Hospice), what views of systems change do you encounter?

I need to answer this question in 2 paragraphs and use at least 2 sources no later than 5 years.

Note: I work in Seasons Hospice  

you need to make a 3 paragraphs conclusion from the experience you made with the interview you have made with the med-surg nurse, was it easy to get the interview or was it  insterested, was it worthy?

CASE STUDY 2

A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity.

• Based on the scenarios provided:
  • reflect on the material       presented throughout this course.
  • What necessary information       would need to be obtained about the patient through health assessments       and diagnostic tests?
  • Consider how you would       respond as an advanced practice nurse. Review evidence-based practice       guidelines and ethical considerations applicable to the scenarios you       selected.

Write a detailed one-page narrative (not a formal paper) explaining the health assessment information required for a diagnosis of your selected patient (include the scenario number). Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your response using at least three different references from current evidence-based literature.

This assignment has new comments and instructions from the professor and it requires for the comments to be incorporated into the project. You can also see the professor’s comments in the attached 10 Strategic Points.

Areas Needing corrections are as follows: It must be updated in the 10 Strategic Points and in the main project ATTACHED.

1. Interventions

a. This has to be for Diabetes. Currently, it is not the right methodology

b. The intervention is what will be done for each patient which should be based on educating the patients on lifestyle changes. It should be like this: –

i. Diet Teaching Education- what type of education will be used for teaching the patients. Where are you going to get the materials from? You must explain the Therapy in full. This must be rearranged in the project.

2. Lifestyle Changes Education must be addressed as follows: –

a. Discuss Medication Nutrition Education Therapy in full

b. Discuss Medication Adherence Education in full

c. It must specify Disease Education on Diabetes

d. It must indicate who is doing it e.g. RN, Nurse Practitioner etc.? How are they doing it? How long is it going to take or for long?

3. You must indicate what the expected result is going to be. 

4. How do you plan to measure Medication Adherence and the tools that will be used to measure it.

5. The Problem Statement must now change based on these new listed additions. It must start with “It is not known the extent to which………………

6. SAMPLE:

a. Explain why you are picking the specific number of patient population

b. Use population of adults 18 and above. Don’t limit to 45 and older.

7. Inclusion Criteria

a. Adult 18 – above with Type 2 Diabetes

b. It should state who identified it in the home health setting such Physicians since they are the ones that refer patients to the home health care for non-compliant or non-adherent to medication

8. Exclusion Criteria

a. It should state that you will exclude patients with cognitive impairment

9. Data Collection and Data Analysis

a. You must adjust both of them by using an existing method of Data Collection-please, do not make up your own

Please make corrections in all the chapters including 1, 2 and 3.

APPENDIX A is the 10 Strategic Points

PLEASE DO NOT INCLUDE THE CRITERION TABLES.

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.  

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

RUBRIC

Attempt Start Date: 05-Oct-2020 at 12:00:00 AM

Due Date: 11-Oct-2020 at 11:59:59 PM

 3 page essay reproducing your understanding and capability to apply the readings to your critical thinking. 12 point font, double spaced with standard margins. Follow APA and reference page. 

Please see the attached Case study.

All Case studies /assignments must be done in APA format with a separate sheet for references. 

Managing care in a Culturally Considerate manner

CASE STUDY 2

Patient Profile
F.M. is a 68-year-old white man who comes to the emergency department (ED) in the early afternoon with a 2-day history of severe chest pain. The pain started on wakening the previous day. The pain increased during the night, but his wife could not convince him to go to the hospital. He comes to the ED today because the pain is severe and no longer relieved by rest.

Subjective Data

• Describes recurring chest pain for the past 6 months that was relieved by rest; the pain is a feeling of heaviness in chest with no radiating pain to arm or jaw or accompanying complaints of nausea or dizziness
• Recently the chest pain has become severe and is no longer relieved by rest; is now complaining of being slightly nauseated
• His father died of a heart attack at age 62
• Denies alcohol or drug use
• Smokes one pack of cigarettes per day
• Describes his lifestyle as sedentary

Objective Data

Physical Examination

• Blood pressure 180/96, pulse 98, temperature 99.8° F, respirations 20
• Height 5’11”, weight 210 lbs, BMI 29.3 kg/m2
• Alert and oriented to person, place, and time
• Skin diaphoretic and clammy
• Heart rhythm regular, no murmurs or extra heart sounds
• Lungs are clear to auscultation

Diagnostic Studies

• Hemoglobin 14 g/dL
• Chemistry panel is normal
• Cardiac markers – pending
• Electrocardiogram showing changes that correlate with non-ST-segment-elevation myocardial infarction (NSTEMI)

Collaborative Care

• 9% NaCl infusing into IV catheter at 75 mL/hr
• Nitroglycerin and morphine given with relief of pain

1. What are F.M.’s modifiable risk factors for coronary artery disease (CAD)? What are his non-modifiable risk factors?
2. What is the difference between chronic stable angina pain and pain associated with myocardial infarction?
3. What are diagnostic studies indicated for F.M.?
4. F.M. is diagnosed as having a myocardial infarction (MI).
5. What is the priority nursing care for F.M.?
6. What other interventions do you anticipate for F.M. at this time?

Gastrointestinal & Endocrine

42 year old, African American Female patient with a chief complaint of neck swelling that has progressively gotten worse over a period of a year.  She also confirms that she has loss weight without any changes to her diet.  Patient is tachycardic with a pulse of 102, anxious but no acute distress.

What other subjective data would you obtain?

 Subjectively we know the patient has complaints of neck swelling, weight loss, and difficulty swallowing.  Additional questions should be asked to gather additional information to aid in reaching a proper diagnosis for this patient.  Initial questions should be general such as any changes in bowel habits, how they feel in hot or cold weather and any changes in energy.  The most common thyroid diseases are Hypothyroid and Hyperthyroid.  These two diseases manifest with opposite symptoms.

What other objective findings would you look for?

 With the documented weight loss, tachycardia and anxiety.  Additional questions and testing should be geared towards Hyperthyroidism.  Key objective assessment findings for Hyperthyroidism include tachycardia, palpitations, weight loss, elevated T4 and T3, decreased TSH and diaphoresis.  When you have hyperthyroidism, your body is producing excessive amounts of the thyroid hormones T3 and T4. Since these hormones regulate your metabolism (how your body processes and uses energy), having too high a level will cause symptoms related to a high metabolism (Milas, 2019).

What diagnostic exams do you want to order?

 Diagnostic testing includes blood tests, iodine uptake scan and thyroid scan.  Blood tests are preformed to measure the levels of thyroid hormones. T4 and T3, must be high to diagnosis a patient with hyperthyroidism.  Thyroid stimulation hormone (TSH) is also measured and is low in hyperthyroidism.  The iodine uptake scan is used to measure the thyroid function by determining how much iodine is taken up by the thyroid gland.  Normal values are up to 25% in a 24-hour period.  If the percentage is above 35% in 24 hours the abnormal results could indicate hyperthyroidism, hashimoto’s or goiter.  Hyperthyroidism speeds up some of your body’s processes.  Thyroid scan is typically done at the same time as the iodine uptake test.  Thyroid scans use the emissions of gamma rays from radioactive iodine to obtain a picture of the thyroid (UCLA Health, n.d.).

Name 3 differential diagnoses based on this patient presenting symptoms? Give rationales for each differential diagnosis.

 Hyperthyroidism is an excessive concentration of thyroid hormones in tissues.  The most common causes of excessive production of thyroid hormones are Graves’ disease, toxic multinodular goiter, and toxic adenoma.  Graves’ disease is an autoimmune process in which antibodies stimulate the TSH receptor leading to overproduction of thyroid hormones.  With Graves’ symptoms include anxiety, moist skin, weight loss, enlarged thyroid gland, bulging eyes and palpitations.

References

Milas, K. (2019). Hyperthyroidism Symptoms. Retrieved November 20, 2020, from https://www.endocrineweb.com/conditions/hyperthyroidism/hyperthyroidism-symptoms (Links to an external site.)

UCLA Health. (n.d.). Radioactive Iodine Uptake Test. Retrieved November 20, 2020, from https://www.uclahealth.org/endocrine-center/radioactive-iodine-uptake-test