All posts by : chebby

Mrs. Smith was a 73-year-old widow who lived alone with no significant social support. She had been suffering from emphysema for several years and had had frequent hospitalizations for respiratory problems. On the last hospital admission, her pneumonia quickly progressed to organ failure. Death appeared to be imminent, and she went in and out of consciousness, alone in her hospital room. The medical-surgical nursing staff and the nurse manager focused on making Mrs. Smith’s end-of-life period as comfortable as possible. Upon consultation with the vice president for nursing, the nurse manager and the unit staff nurses decided against moving Mrs. Smith to the palliative care unit, although considered more economical, because of the need to protect and nurture her because she was already experiencing signs and symptoms of the dying process. Nurses were prompted by an article they read on human caring as the “language of nursing practice” (Turkel, Ray, & Kornblatt, 2012) in their weekly caring practice meetings.

The nurse manager reorganized patient assignments. She felt that the newly assigned clinical nurse leader who was working between both the medical and surgical units could provide direct nurse caring and coordination at the point of care (Sherman, 2012). Over the next few hours, the clinical nurse leader and a staff member who had volunteered her assistance provided personal care for Mrs. Smith. The clinical nurse leader asked the nurse manager whether there was a possibility that Mrs. Smith had any close friends who could “be there” for her in her final moments. One friend was discovered and came to say goodbye to Mrs. Smith. With help from her team, the clinical nurse leader turned, bathed, and suctioned Mrs. Smith. She spoke quietly, prayed, and sang hymns softly in Mrs. Smith’s room, creating a peaceful environment that expressed compassion and a deep sense of caring for her. The nurse manager and nursing unit staff were calmed and their “hearts awakened” by the personal caring that the clinical nurse leader and the volunteer nurse provided. Mrs. Smith died with caring persons at her bedside, and all members of the unit staff felt comforted that she had not died alone.

Davidson, Ray, and Turkel (2011) note that caring is complex, and caring science includes the art of practice, “an aesthetic which illuminates the beauty of the dynamic nurse-patient relationship, that makes possible authentic spiritual-ethical choices for transformation—healing, health, well-being, and a peaceful death” (p. xxiv). As the clinical nurse leader and the nursing staff in this situation engaged in caring practice that focused on the well-being of the patient, they simultaneously created a caring-healing environment that contributed to the well-being of the whole—the emotional atmosphere of the unit, the ability of the clinical nurse leader and staff nurses to practice caringly and competently, and the quality of care the staff were able to provide to other patients. The bureaucratic nature of the hospital included leadership and management systems that conferred power, authority, and control to the nurse manager, the clinical nurse leader, and the nursing staff in partnership with the vice president for nursing. The actions of the nursing administration, clinical nurse leader, and staff reflected values and beliefs, attitudes, and behaviors about the nursing care they would provide, how they would use technology, and how they would deal with human relationships. The ethical and spiritual choice making of the whole staff and the way they communicated their values both reflected and created a caring community in the workplace culture of the hospital unit.

Critical thinking activities

Based on this case study, consider the following questions.

1. What caring behaviors prompted the nurse manager to assign the clinical nurse leader to engage in direct caring for Mrs. Smith? Describe the clinical nurse leader role established by the American Association of Colleges of Nursing in 2004.
2. What issues (ethical, spiritual, legal, social-cultural, economic, and physical) from the structure of the theory of bureaucratic caring influenced this situation? Discuss end-of-life issues in relation to the theory.
3. How did the nurse manager balance these issues? What considerations went into her decision making? Discuss the role and the value of the clinical nurse leader on nursing units. What is the difference between the nurse manager and the clinical nurse leader in terms of caring practice in complex hospital care settings? How does a clinical nurse leader fit into the theory of bureaucratic caring for implementation of a caring practice?
4. What interrelationships are evident between persons in this environment—that is, how were the vice president for nursing, nurse manager, clinical nurse leader, staff, and patient connected in this situation? Compare and contrast the traditional nursing process with Turkel, Ray, and Kornblatt’s (2012) language of caring practice within the theory of bureaucratic caring 

• Describe a beneficial use for bacteria of the microbiome in treating disease. These answers can vary and may be experimental. Use some outside library resources like CINAHL Plus with Full Text or NCBI.gov to find these unique viral applications. Entries should include an overview of the viral application and the benefit to patient health or society.
• Also include any complications with this strategy preventing its immediate application.

Please be sure to validate your opinions and ideas with citations and references in APA format.

This should be between 300-500 words

See attachments below this assignment has a template 

Week 5

This week discussion involves a 37-year-old European female seen in the clinic for frequent and watery bowel movements for three days.  The patient has no prior medical history besides an appendectomy at the age of 14. Blood pressure is elevated, and she denies taking any home medications.  There can be many causes that leads up to loose stools.  Your diet, medications, chronic conditions, etc. Loose stools often occur after eating but can also happen at other points in the day. When loose stools occur consecutively on multiple occasions throughout a day, this is described as diarrhea.

This female appears normal and overall healthy.  Sometimes, the body can have problems digesting certain types of sugars, such as  alcohol and lactose (Rhodes, 2021). The subjective data that I would obtain will be: Prior to the three days, how often do you have bowel movements? What form did the bowel movements appear, for example, hard, soft, formed or loose? What did you eat differently this week than normal? Did you take any over the counter medications? If so, what did you take?

            The objective findings that I would look for is already displayed in assessment such as good skin turgor, active bowel sounds, moist mucus membranes, no cyanosis, etc. The diagnosis test that I would order will be a KUB, A kidney, ureter, and bladder (KUB) X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal (GI) system.  A stool sample will be collected to test for bacterium or parasite.

Furthermore, the diagnosis that the patient can possibly have is irritable bowel syndrome (IBS), ulcerative colitis or food poisoning. IBS occurs when a properly functioning immune system attacks foreign organisms, such as viruses and bacteria, to protect the body. The cause is unknown. To rule out IBS, combination of endoscopy or colonoscopy, and imaging studies, such as contrast radiography, magnetic resonance imaging (MRI), or computed tomography (CT) will be used (CDC, 2014).

 Chronic causes of colitis include inflammatory bowel diseases like ulcerative colitis and Crohn’s disease.  Ulcerative colitis (UC) is a chronic condition causing inflammation in the colon and rectum. People with UC often experience loose stools and diarrhea. Other symptoms of UC include abdominal pain, frequent bowel movements, fatigue, appetite and weight loss. While ulcerative colitis is not caused by the foods you eat, you may find that once you have the disease, particular foods can aggravate the symptoms. It’s important to maintain a healthy and soothing diet that helps reduce your symptoms, replace lost nutrients, and promote healing (CDC, 2014). Loose stools can also be caused by diets high in alcohol rich and spicy foods, coffee and magnesium.

Food poisoning invades the body with Viruses, bacteria or parasites can cause inflammation in the stomach and intestines. This can cause loose stools and diarrhea, along with other symptoms including abdominal pain, vomiting, and nausea (Kornbluth, 2010). When someone is assessed with frequent diarrhea, we tend to draw labs and evaluate their electrolytes to ensure nothing is abnormal. If hospitalized, fluids will be administered. Broad spectrum antibiotics will be started, and blood cultures will be obtained.   

References:

   Kornbluth A, Sachar DB; Practice Parameters Committee of the American College of Gastroenterology. Ulcerative colitis practice guidelines in adults: American College Of Gastroenterology, Practice Parameters Committee. Am J Gastroenterol. 2010 Mar;105(3):501-23. http://gi.org/guideline/ulcerative-colitis-in-adults/external icon

            Rhoads, J., & Wiggins Petersen, S. (2021). Advanced Health Assessment and Diagnostic Reasoning. Burlington, MA: Jones and Bartlett Learning. ISBN: 9781284105377

The Facts About Inflammatory Bowel Diseases. New York, NY: Crohn’s and Colitis Foundation of America; center for disease control ( CDC)  2014 .http://www.crohnscolitisfoundation.org/assets/pdfs/updatedibdfactbook.pdf pdf icon[PDF-2.32MB]external icon.

 APA Style less than 10 % similarity

You are a school nurse in a middle school when Jamal comes to the nurse’s office requesting medication for a headache. You notice that his eyes are red, and it appears as if he has been crying. You ask if he is hurt, but he denies it. The phone rings in the office, and a teacher tells you that a female student has approached her concerned about Jamal. The teacher tells you that Jamal sent her a text message saying that he flunked his biology examination and wished he was dead.

1. If Jamal shared with you a suicide plan that includes harming himself with a weapon, what would be your first nursing intervention? Why? (Explain your answer).

Everything needed to know is in the word document.

Vital Signs
1. You are a nurse caring for a 58-year-old ironworker who has been admitted to your unit with acute hypertension. He became extremely symptomatic at work and was brought to your emergency department (ED) via ambulance. After receiving a report from the ED nurse, he is brought to your unit asymptomatic (other than his BP of 178/106) and seems in good spirits. After completing his admission paperwork, he settles in and awaits his health care provider. Four hours later, you answer his call light and he reports headache (rated 6 on a 0-to-10 scale) and dizziness. 
a. Outline the pertinent information within this case study.
b. How often would you expect to measure the patient’s vital signs based on his history?
c. What would be your first intervention upon his reporting increased symptoms? Include rationale.
d. What is the patient’s pulse pressure?
e. Describe risk factors that could be contributing to your patient’s hypertension.
2. As a nurse in a critical care unit, your newest admission is a 24-year-old victim of a motor vehicle accident (MVA). Report from the OR nurse indicates that the patient has several surgically repaired fractures, a closed head injury, and elevated temperature. Additionally, he has IV fluid running postoperatively and dressing changes scheduled every shift. The patient is intermittently alert and disoriented, with his pain adequately controlled by IV analgesics. 
a. Outline the pertinent information within this case study.
b. What factors could be causing the patient’s elevated body temperature?
c. Why is determining the fever’s cause important?
d. Indicate areas that are important to monitor in a patient with elevated body temperature.
e. Describe cause-specific interventions useful in treating the patient’s elevated body temperature.

PLEASE, answer each question in order and separately. PLEASE,  this is the bibliography( Chapter 29-30).
1.Potter, P.A., &Perry, A. G. (2017). Fundamentals of Nursing: Concepts, Process, and Practice (9th ed.). St. Louis: MO:  Mosby. ISBN: 9780323327404

little on the background of Wal-Mart and one of the Person in a leadership position Latrice Watkins!!! I need a picture of maybe the original wal-mart, Sam Walton and the person I’m speaking about included in the powerpoints. It can only be about 3 or 3 and a half minutes long . !!!!!! I also need some short flashcards about the presentation.

Instructions
Although controversial art is not a topic exclusive to the 20th and 21st centuries, the distribution of information regarding controversial art has increased with the proliferation of media. Choose an example of a controversial work of art from the 20th or 21st centuries from any discipline of the humanities (music, literature, sculpture, film, television, etc.). Then, address the following:

• Identify the work and the medium.
• Based on your example, to what extent does this work of controversial art make a social contribution?
• What aesthetic value does the work have? How does it reflect the human condition? How does it relate to your life?
• Has this work ever been censored? If so, explain the circumstances.
• Are governments ever justified in censoring art? Why or why not?
• Examine some of the influences of this work of art.
• Argue whether or not this work should be considered art. Explain why using terms learned in this course.
• Include an accompanying statement from the artist(s) and a statement from a critic to support your points.

Writing Requirements (APA format)

• Length: 1.5-2 pages (not including title page or references page)
• 1-inch margins
• Double spaced
• 12-point Times New Roman font
• Title page
• References page (minimum of 1 scholarly source and 1 primary source)

Grading
This activity will be graded based on the W7 Essay Grading Rubric.

Course Outcomes (CO): 2, 4, 6

In Melnyk & Fineout-Overholt (2019) textbook Box 23.1 on page 682, select one of the Fifteen Ethical Principles of the Universal Declaration on Bioethics and Human Rights.

State the principle and describe the importance of the selected principle to ethical research. In addition, describe how a researcher would ensure that this principle would be protected for human subjects in a research study.

Expectations

Initial Post:

• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA format from within the last 5 years