In this assignment, you will review the interactive Upper Respiratory Case Study patient scenario and analyze the data to determine the health status of the patient. You will need a minimum of two evidence-based practice articles to include clinical practice guidelines, as well as the course textbook.

• Use the NU641 Upper Respiratory Case Study Questions (Word) document to complete the case study assignment.
• Follow the requirements posted in the rubric.
• This case study should be three to five pages, excluding title and references pages.

All papers must conform to the most recent APA standards.

RUBRIC:

Clinical Case Study Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Clinical Case Study Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsContent of Clinical Case StudyThe writer demonstrates a well-articulated understanding of the case study subject matter in a clear, complex, and informative manner. The case study content and theories are well developed and linked to the course content, assignment requirements, and practical experience. The case study includes relevant material that fulfills all objectives of the assignment.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

all instruction requirements noted

30 pointsThe writer demonstrates an understanding of the subject matter, and the components of the case study are accurately represented with evidence-based practice, ethics, theory, and/or role content. Course materials and scholarly resources are present to support required concepts. The paper includes relevant material that fulfills all objectives of the case study.

Cites two references.

Most instruction requirements are noted.

26 pointsThe writer demonstrates a moderate understanding of the subject matter. as evidenced by components of the case study and use of evidence-based practice, theory, or role-development. Course content is present but missing depth and or development.

Cites one reference.

23 pointsAbsent application to evidence-based practice, theory, or role development.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Significant content of case study is vague, inaccurately portrayed, or missing.

No references cited.

Submits assignment late.

20 points30Analysis and Synthesis of Case Study Content and Meaning with Content Related to Preventative GuidelinesThrough critical analysis, the submitted case study provides an accurate, clear, concise, and complete summary of the scenario.

Information from scholarly resources is synthesized, providing new information or insight related to the context of the assignment by providing both supportive and alternative information or viewpoints

Includes all major and minor relevant risk factors based on standard preventative guidelines for age and gender and treatment/follow-up plans.

all instruction requirements noted.

30 pointsCase study is complete, providing evidence of further synthesis of course content via scholarly resources.

Information is synthesized to help fulfill the case study requirements. The content supports at least one viewpoint.

Submission provides clarification of the assignment by correctly answering all posed questions within the instructions.

Includes all major risk factors and most minor relevant risk factors based on standard preventative guidelines for age and gender (i.e.’ to two minor risk factors are missing and/or one incorrect treatment plan).

Most instruction requirements are noted.

26 pointsLacks clarification or new information. Scholarly reference supports the content without adding any new information or insight. Case study content may be confusing or unclear, and the summary may be incomplete.

Risk factors are partially complete (i.e., missing one to two major risk factors or three to four minor risk factors, or two incorrect treatment plans).

Missing some instruction requirements.

23 pointsSubmission is primarily a summation of the assignment without further synthesis of course content or analysis of the scenario.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Multiple risk factors missing (e.g., three major risk or five to six minor risk factors or three incorrect treatment plans, or four or more major risk factors or seven or more minor risk factors or four or more incorrect treatment plans).

Scholarly reference(s) are incorrect or inappropriate for the topic case.

Missing several instruction requirements.

Submits assignment late.

20 points30Application of Knowledge To Clinical Aspect of Patient EncounterThe summary of the case study provides validated information via scholarly resources that offer a multidisciplinary approach to the scenario provided.

The student’s application in practice is accurate and plausible, and additional scholarly resources supporting the application are provided.

all questions posed within the assignment are answered correctly in a well-developed manner, applying knowledge with citations for validation.

Includes all relevant subjective and objective data; diagnostic testing; routine care to be provided; patient education; anticipatory guidance; review of previous diagnostics; and follow-up of acute concern and chronic health issues, etc.—based on assignment instructions.

all instruction requirements noted.

30 pointsA summary of the study, findings, and knowledge gained from the assignment is presented.

Student indicates how the information will be used within their professional practice.

all questions posed by the study are answered correctly.

Includes most of the routine content (subjective and objective data; diagnostic testing; routine care to be provided; education; anticipatory guidance; review of previous diagnostics; and follow-up) (is missing two minor details or one major detail).

Most instruction requirements are noted.

26 pointsComponents of the case study are summarized with minimal application to evidence-based practice, theory, or role development, thus presenting a more superficial analysis of content between the assignment and the broader course content. Synthesis of course content is present but missing depth and or development.

Student’s explanation of how the information will be used within their professional practice is vague or incomplete.

One of the questions posed is not answered and/or one of the questions is answered incorrectly.

Includes some of the routine content (subjective and objective data; diagnostic testing; routine care to be provided; education; anticipatory guidance; review of previous diagnostics; and follow-up) (is missing three minor details or two major details).

Cited one reference.

Missing some instruction requirements.

23 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Content of case study is inaccurately portrayed or missing.

Student’s explanation of how the information will be used within their professional practice is not feasible or appropriate, or student fails to explain how the information will be used within their personal practice.

Omits routine content (subjective and objective data; diagnostic testing; routine care to be provided; education; anticipatory guidance; review of previous diagnostics; and follow-up) (is missing four to five minor details or three major details or six or more minor details or four or more major details.

Two or more questions are not answered and/or are answered incorrectly.

No references cited.

Missing several instruction requirements.

Submits post late.

20 points30OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise, with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed, with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used.

No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors, or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

2 points5Total Points100 

Assignment Description

Cultural Group Exploration Assignment (in-text citation and APA format 7th edition) Required.

Understanding the impact of culture on the health beliefs / practices of a client is an important component of assessing, planning, implementing and evaluating comprehensive nursing care. To provide culturally competent care is a worthy goal. Insensitivity to a client’s culture may render interventions fruitless.

Purpose: The PURPOSE of this assignment is to develop in the learner an awareness of the health beliefs / practices of a culture different from their own.

Guidelines: Download the Cultural Exploration Guidelines before you start the activity and refer to it as you work. Submit completed table along with reference page to your faculty mentor through the Submissions tab and then post it in your group discussion.

 Cultural Exploration Table and Rubric is attached below

  In a well-developed paragraph (300–350 words) to each peer integrating atleast 2 an evidence-based resource, APA format. Respectfully agree and disagree with the responses and explain your reasoning by including your rationales in your explanation.

Response 1

 The purpose of this post is to discuss diagnosis of RR case study. After reviewing the present complaint and past medical history of RR, this writer suspects that the patient has pneumonia. This writer suspects that either of the following S. pneumoniae, H. influenzae, S. aureus, or gram-negative bacteria was the cause of the infection (Woo, Terri Moser, Robinson & Marylou. 2020). This is because RR has symptoms of fever, chills, green sputum (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR has complaints of pain in the right mid-back with deep breathing and coughing (Woo, Terri Moser, Robinson & Marylou. 2020). Additionally, RR had rales during the auscultation of the lungs in the right lower-posterior lung field (Woo, Terri Moser, Robinson & Marylou. 2020). As a result, ordering a lung ultrasound is beneficial to solidify the diagnosis of pneumonia (Long et al., 2017).

Pneumonia is an infection of one or both lungs (Zambare & Thalkari. 2019). The cause of pneumonia is from either bacteria, viruses, or fungi (Zambare & Thalkari. 2019). As a healthcare provider assessing for the cause of pneumonia in patient RR is crucial because pneumonia can be life-threatening (Zambare & Thalkari. 2019). The goal of treatment is to return to the respiratory status before having pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020). This writer would assess the last use of antibiotics to ensure no antibiotics in the past 3 months, and the patient was previously healthly with no cardiopulmonary disease (Woo, Terri Moser, Robinson & Marylou. 2020).The first choice antibiotic this writer would recommend to treat RR with is an advanced-generation macrolide, such as azithromycin or clarithromycin (Woo, Terri Moser, Robinson & Marylou. 2020). Erythromycin would mostly likely be used to treat RR pneumonia because it is the least expensive of the macrolides (Woo, Terri Moser, Robinson & Marylou. 2020). If RR is allergic to macrolide, then this writer would use doxycycline for treatment (Woo, Terri Moser, Robinson & Marylou. 2020). The patient should respond to treatment within 48 to 72 hours, unless the patient illness is not improving (Woo, Terri Moser, Robinson & Marylou. 2020). Due to RR not having any comorbidities fluoroquinolone ushc as moxifloxacin, gemifloxacin, or levofloxacin is not needed for treating pneumonia (Woo, Terri Moser, Robinson & Marylou. 2020).

Erythromycin is the medication used to treatment RR pneumonia. The mechanism of action for macrolide such as erythromycin is to suppresses protein synthesis at the level of the 50S bacterial ribosome (Vallerand & Sanoski. 2016). The therapeutic effect of erythromycin is bacteriostatic action against susceptible bacteria  (Vallerand & Sanoski. 2016). Educating and counseling the patient about the medication is essential for the patient to understand the treatment, expected adverse effects, drug interactions, and length of treatment (Woo, Terri Moser, Robinson & Marylou. 2020). Some of the adverse effects of erythromycin are nausea, vomiting, abdominal pain, and cramping  (Vallerand & Sanoski. 2016). Moreover, RR should be informed to take the medication as prescribed and until finished even if feeling better  (Vallerand & Sanoski. 2016). Patient will be educated that the response to treatment will assist in determining the pathogen (Woo, Terri Moser, Robinson & Marylou. 2020). This writer will discuss lifestyle modifications such as hydration, smoking cessation and rest (Woo, Terri Moser, Robinson & Marylou. 2020). A discussion of worsening symptoms of pneumonia with RR will occur (Woo, Terri Moser, Robinson & Marylou. 2020). Lastly, this writer will inform RR to contact this writer or seek urgent medical care for worsening symptoms (Woo, Terri Moser, Robinson & Marylou. 2020).

Response 2

 The purpose of this discussion is to assess and treat patient RR from the case study provided. RR could have several causes of these symptoms. The test I would focus on due to her health history and symptoms would be for pneumonia, however I would like to rule out Tuberculosis (TB)as well. Mycobacteria is responsible for TB and is defined as an atypical bacterium and are more difficult to treat than other forms of bacteria (Woo & Robinson, 2020). The most common bacteria that causes bacterial pneumonia in America is called Streptococcus pneumoniae (CDC, 2020). Bacterial pneumonia presents with all the symptoms RR lists: fever, productive green sputum, cough that causes pain, difficulty breathing, and rales. Smoking will exacerbate these symptoms. The rule out on TB would be because of her living conditions, patients who are in homeless shelters are at higher risks for being susceptible to TB (Brown, 2019).
The antibiotic used for bacterial community acquired pneumonia is most commonly a combination of azithromycin and ceftriaxone (Woo & Robinson, 2020). Because this condition has not yet been treated starting with the most generally used antibiotics would be recommended. If these medications do not work and the bacteria appears to be resistant other antibiotics can be initiated.
Azithromycin is known as a bacteriostatic or bactericidal antibiotic when given in higher doses (Woo & Robinson, 2020). This is a broad spectrum antibiotic that gram-negative and gram-negative bacteria are susceptible to. Ceftriaxone is a third generation cephalosporin medication that is recommended for broader indications and is more effective against gram-negative bacteria (Woo & Robinson, 2020).
The mechanism of action for azithromycin is that it binds to 50S ribosomal subunit of the causative bacteria and intercepts the detachment of peptidyl tRNA from the ribosomes. The bacteria are dependent on the RNA for protein synthesis therefore, without it the bacteria cannot synthesize (Medscape, 2020). Ceftriaxone works less successfully against gram-positive microorganisms, however, is a better choice for a cephalosporin for resistant organisms. This antibiotic inhibits the production of peptidoglycan which is the bacteria’s enzyme that builds its cell wall. This creates the bacteria lyse (Medscape, 2020).
Studies have concluded that the use of these two medications in a combination therapy has resulted in quicker recovery, less residual symptoms, and a decrease in sepsis occurrence and should be given to high risk patients (Caballero et al., 2011). Given RR’s health history and current living conditions I would conclude that she falls into the high risk population for pneumonia complications. I would also recommend that RR gets plenty of rest and fluid, educate on the benefits of smoking cessation (and offer a nicotine gum prescription), to take the full course of medication even if symptoms resolve, and to come back if any symptoms persist or worsen.

RUBRIC

 Peer Response Post. Offers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Teaching Plan Sickle Cell Anemia 10 Year Old- due 4 hours from now – Apply if only you can meet the deadline 

You  only need to work on number 3. Because the other things are objectives  that you must meet in the writing. Basically what you are doing its teaching a child  of 10 years about sickle cell anemia and you need to use what number 3  is asking you to do

you must follow grading rubric

Give quality work and I will work with you always in my 3 classes which have just began

Check the attachment for the assignment 

 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  

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

1. Evidence-based solution
2. Nursing intervention
3. Patient care
4. Health care agency
5. 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. 

 Disease: Hemorrhoids 

Patient care decisions should be supported by timely clinical information, reflecting the best evidence possible (Institute of Medicine 2013). Present and future professional nurses must be able to use informatics and technology to facilitate critical decision-making for optimal patient outcomes (Massachusetts Department of Higher Education Nursing Initiative 2016). Nursing clinical informatics competencies involve the collection and use of patient data for analysis and dissemination. Nursing informatics with computer science was established to create innovative ways to provide quality care to our patients. Evidence based practice is a cornerstone to making NI better for the future. Without EBP there would be no such thing. 

What I see for the future is that technology would be expanding at a faster rate. There would be less hands on and more robotics. What I mean by this is that robots would be administering meds at the bedside, documenting task, and even doing patient consults. I believe that this would be in the near future to come because it would cut the need for nursing staff in half and it would be cost effective for the company. The only thing that would be the downfall to this is that robots do not pose interpersonal skills so patient questions would go unanswered and in would block the communication to building a rapport. We have already advanced to telemedicine which in some cases can be beneficial to the patient being seen by the physician. 

Another thing that would probably be good for the up and coming future would be if we could use the pyxis like we use Alexa and Siri. If we could give them voice commands where it could dispense patient medications that are due just by giving the first and last name of the patient would cut down on the time spent pulling meds. Instead of your taking 30mins to 1 hour pulling meds could just take about 15 to 20 mins. Modern technology is advancing so much that some of us cannot not keep up with the new demands of the workplace. In nursing we are always learning new things and we must continue to learn as we advance in our careers in order to be successful. New media offer new possibilities in teaching and learning. However, the appropriation of new knowledge and skills in dealing with technology, especially for older adults, is a critical challenge. This needs to be considered against the background of the digital divide. Which describes, among other things, the lack of information on the ability of older adults to use technology among those who have access to ICTs and new media in healthcare. In conclusion informatics will be changing for the better.

Reference 

Institute of Medicine. (2013). Core measurement needs for better care, better health, and lower costs: Counting what counts, workshop summary. Washington, DC: National Academies Press. doi:10.17226/18333 

Massachusetts Department of Higher Education Nursing Initiative. (2016). Massachusetts nursing of the future nursing core competencies. Retrieved from https://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016.pdf (Links to an external site.) 

Reply 2

The origin of health informatics began in the 1950s when computers were introduced into healthcare. Computers allowed new technology to expand the fields of medicine and nursing education (Nelson, 2014, p. 596). Today, health informatics takes the information technology that exists and applies it to systems in place already, creating a more innovative vision for healthcare. This can be accomplished by reviewing the current trends, as well as offering tools for predicting the future. Health professionals and informatics specialists can then prepare their leadership roles in planning effective future healthcare information systems (Nelson, 2014, p. 612).  

Our textbook further explains these changes by dividing the scope of change into three levels. The first level of change makes the process in use more efficient without changing the process or goal. An example of this would be for health care to completely move from paper documentation to an electronic way of inputting patient information. As I have discussed in other posts, this can be achieved by providing organizations that rely on pen and ink with the resources they need to provide all their cases electronic devices for accessing the plan of care for patients and medication administration records. Having patients check in to doctor’s offices with an iPad versus a clipboard and paper is another way the first level of change can occur. Second level changes involve changing how a specific outcome is achieved (Nelson, 2014, p. 614). An example of this today is the rise of telehealth medicine. Allowing patients more access to therapies and physicians through the phone offers more accessibility to those quarantining or social-distancing due to COVID-19. Telehealth medicine allows clinics the opportunity to limit the number of clients that are in a room to minimize risks for other patients and healthcare workers. Another example would be the initiation of apps for accessing health information and scheduling appointments. Phone applications can be downloaded and used at the discretion of patients 24/7 rather than patients calling the doctor for test results, medication refills, appointment scheduling, and taking printouts of visit summaries. The third level of change alters the process and refocuses the goal at the societal and institutional level (Nelson, 2014, p. 614). Phones have had the ability to track location since cell towers were installed. This past summer, location tracking has taken on a new role in the life of coronavirus. Digital contact tracing has become popular with governments of various countries to identify infected individuals and tracing people they have been in contact with. The process uses Bluetooth technology that logs when devices are near another device associated with an infected user for a prolonged period (Frith & Saker, 2020). Changing how phone tracking is used to benefit the community and allowing health agencies to monitor those who should be social-distancing due to a positive COVID-19 virus. The use of technology in this way  shows how a third level change can reflect the changes happening in our society. However, some oppose digital contact tracing because of HIPAA and surveillance concerns. My hope for the future of informatics is to successfully find the balance between technology and patient-centered care. Taking into consideration what nurses need to do their jobs most efficiently, improving patient care to be most accessible, and seamlessly integrate technology into the community to improve health in our neighborhoods is my vision of the future of health informatics.  

References 

Frith, J., & Saker, M. (2020). It Is All About Location: Smartphones and Tracking the Spread of COVID-19. Sage Journals. https://doi.org/10.1177/2056305120948257 (Links to an external site.) 

Nelson, R., & Staggers, N. (2014). Health Informatics: An Interprofessional Approach (2nd ed.). Mosby. 

Edited by Wood, Carmen on Oct 7 at 12:46pm

All replies must be constructive and use literature where possible.

Your assignment will be graded according to the grading rubric.

250 words for each reply

 ATI RN Fundamentals Proctored Focus Can an RN delegate to the LPN to provide tracheostomy care to a client with pneumonia? A nurse on a med-surg unit has received change-of-shift report & will care for 4 clients. Which of the following client’s needs may the nurse assign to a assistive personnel (AP)? A nurse is delegating the ambulation of a client who had knee arthroplasty 5 days ago to an AP. Which of the following information should the nurse share with the AP? Select All. An RN is making assignments for client care to a LPN at the beginning of the shift. Which of the following assignments should the LPN question? A nurse is preparing an in-service program about delegation. Which of the following elements should she identify when presenting the 5 rights of delegation? Select all. A nurse manager of a med-surg unit is assigning care responsibilities for the oncoming shift. A client is awaiting transfer back to the unit from the PACU following thoracic surgery. To which staff member should the nurse assign to this client? A nurse observes an AP reprimanding a client for not using the urinal properly. The AP tells him she will put a diaper on him if he does not use the urinal more carefully next time. Which of the following torts is the AP committing? An adult client who is competent tells the nurse that he is thinking about leaving the hospital against medical advice. The nurse believes that this is not in the client’s best interest, so she administers a PRN sedative med that the client has not requested along w/his usual meds. Which of the following tort has the nurse committed? A client who will undergo neurosurgery the following week tells the nurse in the surgeon’s office that he will prepare his advance directives before he goes to the hospital. Which of the following statements by the client indicates to the nurse that he understands advance directives? A client is about to undergo an elective surgical procedure. Which of the following actions are appropriate for the nurse who is providing pre-op care regarding informed consent? Select all. A nurse has noticed several occasions in the past week when another nurse on the unit seemed drowsy & unable to focus on the issue at hand. Today, she found the nurse asleep in a chair in the break room when she was not on break. Which of the following actions should the nurse take? A nurse is preparing info for a change-of-shift report. Which of the following info should the nurse include in the report? A nurse enters a client’s room & finds him sitting in his chair. He states, “I fell in the shower, but I got myself back up & into my chair.” How should the nurse document this in the client’s chart? A nursing instructor is reviewing documentation w/a group of nursing students. Which of the following legal guidelines should they follow when documenting a client’s record? Select all that apply The skin barrier covering a client’s intestinal fistula keeps falling off when she stands up to ambulate. The nurse has reapplied it twice during the shift, but it remains intact only when the client is supine in bed. The nurse telephoned the physical therapist about the difficulties containing the drainage from the fistula, so the therapist didn’t ambulate the client today. The client sat in a chair during lunch w/an absorbent pad over the fistula. The client ate all the food on her tray. The wound care nurse confirmed that she will see the client later today. The client states she feels frustrated at not having physical therapy, but the nurse thinks the client welcomed having a day to rest. Which of the following information should the nurse include in the change-of-shift report? Select all that apply. A nurse is receiving a provider’s prescription by telephone for morphine for a client who is reporting moderate to severe pain. Which of the following nursing actions are appropriate? Select all that apply A nurse is caring for an older adult client who lives alone & is to be discharged in 3 days. He states that it is difficult to prepare adequate nutritious meals at home for just 1 person. To which of the following members of the health care team should the nurse refer him? A goal for a client who has difficulty w/self-feeding due to rheumatoid arthritis is to use adaptive devices. The nurse caring for the client should initiate a referral w/which of the following members of the inter-professional care team? A client who is postop following a knee arthroplasty is concerned about the adverse effects of the medication he is receiving for pain management. Which of the following members of the inter-professional care team may assist the client in understanding the medication’s effects? Select all that apply. A client who has had a cerebrovascular accident has persistent problems w/dysphagia. The nurse caring for the client should initiate a referral w/which of the following members of the inter-professional care team? A nursing instructor is acquainting a group of nursing students w/the roles of the various members of the health care team they will encounter on a medical-surgical unit. When she gives examples of the types of tasks CNAs may perform, which of the following client activities should she include? Select all. A nurse in a provider’s office is preparing to assess a young adult male client’s musculoskeletal system as part of a comprehensive physical examination. Which of the following findings should the nurse expect? Select all. A nurse is evaluating a client’s neurosensory system. To evaluate stereo-gnosis, she would ask the client to close his eyes & identify which of the following items? A nurse is assessing a client who reports pain when the nurse evaluates the internal rotation of her right shoulder. Which of the following activities is this problem likely to affect? A nurse is preforming a neurosensory examination for a client. Which of the following tests should the nurse preform to test the client’s balance? Select all. A nurse is collecting data from an older adult client as part of a neurosensory examination. Which of the following findings should the nurse expect as changes associated w/aging? Select all. A nurse is providing discharge instructions to a client who has a prescription for the use of oxygen in his home. Which of the following should the nurse teach the client about using oxygen safely in his home? Select all. A nurse educator is conducting a parenting class for new parents. Which of the following statements made by a participant indicates a need for further clarification & instruction? A home health nurse is discussing the dangers of carbon monoxide poisoning w/a client. Which of the following information should the nurse include in her counseling? A nurse educator is presenting a module on basic first aid for newly licensed home health nurses. The nurse educator evaluates the teaching as effective when the newly licensed nurse states the client who has heat stroke will have which of the following? A home health nurse is discussing the dangers of food poisoning w/a client. Which of the following info should the nurse include in her counseling? Select all. A nurse is caring for a client diagnosed w/severe acute respiratory syndrome (SARS). The nurse is aware that health care professionals are required to report communicable & infectious diseases. Which of the following illustrate the rationale for reporting? Select all. A nurse is contributing to the plan of care for a client who is being admitted to the facility w/a suspected diagnosis of pertussis. Which of the following should the nurse include in the plan of care? Select all. A nurse is caring for a client who presents w/linear clusters of fluid-containing vesicles w/some crustings. Which of the following should the nurse suspect? A nurse is caring for a client who reports severe sore throat, pain when swallowing, & swollen lymph nodes. The client is experiencing which of the following stages of infection? A nurse educator is reviewing w/a newly hired nurse the difference in clinical manifestations of a localized vs. a systemic infection. The nurse indicates understanding when she states that which of the following are clinical manifestations of a systemic infection? Select all. A nurse is teaching a young adult client about health promotion & illness prevention. Which of the following statements by the client indicates an understanding of the teaching? A nursing instructor is explaining the various stages of the lifespan to a group of nursing students. The nurse should offer which of the following behaviors by a young adult as an example of appropriate psychosocial development? A nurse is counseling a young adult who describes having difficulty dealing w/several issues. Which of the following problems the client verbalized should the nurse identify as the priority for further assessment & intervention? A nurse is reviewing safety precautions w/a group of young adults at a community health fair. Which of the following recommendations should the nurse include specifically for this age group? Select all. A nurse is reviewing the CDC’s immunization recommendations w/a young adult client. Which of the following recommendations should the nurse include in this discussion? Select all. A nurse is caring for an 82-yr-old client in the ER who has an oral body temp of 38.3 C (101 F), a pulse rate of 114/min, & a RR of 22/min. He is restless & his skin is warm. Which of the following are appropriate nursing interventions for this client? Select all. A nurse is instructing an AP in caring for a client who has a low platelet count as a result of chemo. Which of the following is the nurse’s priority instruction for measuring vital signs for this client? A nurse is instructing a group of nursing students in measuring a client’s RR. Which of the following guidelines should the nurse include? Select all. A nurse who is admitting a client who has a fractured femur obtains a BP reading of 140/94 mmHg. The client denies any history of HTN. Which of the following actions should the nurse take next? A nurse is performing an admission assessment on a client. When measuring her vital signs, the nurse finds that her radial pulse rate 68/min & her simultaneous apical pulse rate is 84/min. What is the client’s pulse deficit? A nurse is caring for a client who will perform fecal occult blood testing at home. Which of the following info should the nurse include when explaining the procedure to the client? A nurse is talking w/a client who reports constipation. When the nurse discusses dietary changes that can help prevent constipation, which of the following foods should the nurse recommend? A nurse is caring for a client who has had diarrhea for the past 4 days. When assessing the client, the nurse should expect which of the following findings? Select all. A nurse is preparing to administer a cleansing enema to an adult client in preparation for a diagnostic procedure. Which of the following are appropriate steps for the nurse to take? Select all. While a nurse is administering a cleansing enema, the client reports abdominal cramping. Which of the following is the appropriate intervention? A nurse is caring for a client who has been sitting in a chair for 3 hrs. Which of the following problems is the client at risk for developing? A nurse is caring for a client who is on bed rest. Which of the following interventions should the nurse implement to maintain the patency of the client’s airway? A nurse is caring for a client who is postop. Which of the following nursing interventions reduce the risk of thrombus development? Select all. : A nurse is instructing a postop client about the sequential compression device the provider has prescribed. Which of the following statements should indicate to the nurse that the client understands the teaching? To promote the safe use of a cane for a client who is recovering from a minor musculoskeletal injury of the left lower extremity, which of the following instructions should the nurse provide? Select all that apply. A nurse is assessing the pain level of a client who has come to the ER reporting severe abd. pain. The nurse asks the client whether he has nausea & has been vomiting. The nurse is assessing which of the following? A nurse is assessing a client who is reporting severe pain despite analgesia. The nurse can best assess the intensity of the client’s pain by: A nurse is obtaining history from a client who has pain. The nurse’s guiding principle throughout this process should be that: A nurse is caring for a client who is receiving morphine via a PCA infusion device after abdominal surgery. Which of the following statements indicates that the client knows how to use the device? A nurse is monitoring a client who is receiving opioid analgesia for adv effects of the med. Which of the following effects should the nurse anticipate? Select all. A nurse is assessing a client who takes haloperidol (Haldol) for the tx of schizophrenia. Which of the following findings should the nurse document as extrapyramidal symptoms (EPS)? Select all. A nurse is providing teaching about managing anticholinergic effects for a client who has a new prescription for oxybutunin (Ditropan XL). Which of the following are appropriate to include in the teaching? Select all. A nurse is reviewing the reported meds of a client who was recently admitted. The meds include cimetidine (Tagamet) & imipramine hydrochloride (Tofranil). Knowing that cimetidine decreases the metabolism of imipramine hydrochloride, the nurse should identify that this combination is likely to result in which of the following effects? A nurse in an outpatient clinic is caring for a client who states she is trying to get pregnant. The client currently takes a Category D pregnancy risk med for the control of seizures. Which of the following statements by the nurse is appropriate? A nurse in an outpatient surgical center is admitting a client for a laparoscopic procedure. The client has a prescription for preoperative diazepam (Valium). Prior to administering the med, which of the following actions is the highest priority? A nurse is preparing to administer methylprednisolone acetate (Depo-Medrol) 10 mg by IV bolus. The amount available is 40 mg/mL. How many mL should the nurse administer? (round to nearest tenth) A nurse is preparing to administer lactated Ringer’s (LR) IV 100 mL over 15min. The nurse should set the infusion pump to deliver how many mL/hr? (round to nearest whole number) A nurse is preparing to administer 0.9% sodium chloride (0.9% NaCl) 250 mL IV to infuse over 30min. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV infusion to deliver how many gtt/min? (round to nearest whole number) A nurse is caring for a client who is at high risk for aspiration. Which of the following is an appropriate nursing intervention? A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following is the body’s priority energy reserve? A nurse is caring for a client who is on a low-residue diet. The nurse should expect to see which of the following foods on the client’s meal tray? A nurse is caring for a client who weighs 80 kg (176 lb) and is 1.6 m (5 ft 3 in) tall. Calculate her BMI & determine whether this client is obese based on her BMI. . A nurse in a senior center is counseling a group of older adults about their nutritional needs & considerations. Which of the following info should the nurse include? Select all. A nurse is caring for a client who is 1 day postop following a total knee arthroplasty. The client states his pain level is a 10 on a scale of 0-10. After reviewing the client’s medication administration record, which of the following medications should the nurse administer? A nurse is teaching a client about taking multiple oral meds at home to include time-release capsules, liquid meds, enteric-coated pills, & narcotics. Which of the following statements by the client indicates an understanding of the teaching? A nurse is teaching a client how to administer medication through a jejunostomy tube. Which of the following instructions should the nurse include in the teaching? A nurse educator is teaching a module on pharmacokinetics to a group of newly licensed nurses. Which of the following statements by a newly licensed nurse indicates an understanding of the 1st-pass effect? A nurse is teaching an adult client how to administer ear drops. Which of the following statements by the client indicates understanding of the proper technique? A nurse prepares to administer an injection of morphine (Duramorph) to a client who reports pain. Prior to administering, the nurse is called to another room to assist another client onto a bedpan. She asks a 2nd nurse to give the injection. Which of the following actions should the 2nd nurse take? A nurse is preparing to administer a med to a client. The med was scheduled for administration at 0900. Which of the following are acceptable administration times for this med? Select all. A nurse is working w/a newly hired nurse who is administering meds to clients. Which of the following actions by the newly hired nurse indicates an understanding of med error prevention? A nurse educator is teaching a module on safe med administration to newly hired nurses. Which of the following statements by the newly hired nurse indicate understanding of the nurse’s responsibility when implementing med therapy? Select all. A nurse is preparing to administer digoxin (Lanoxin) to a client who states, “I don’t want to take that med. I do not want one more pill.” Which of the following responses by the nurse is appropriate in this situation? A nurse is assessing a client who has an acute resp. infection that puts her at risk for hypoxemia. Which of the following findings are early indications that should alert the nurse that the client is developing hypoxemia? Select all. A nurse is caring for a client who is having difficulty breathing. The client is lying in bed & is already receiving oxygen therapy via nasal cannula. Which of the following interventions is the nurse’s priority? A nurse is preparing to preform endotracheal suctioning for a client. Which of the following are appropriate guidelines for the nurse to follow? Select all. A nurse is caring for a client who has a tracheostomy. Which of the following actions should the nurse take each time he provides tracheostomy care? Select all. A provider is discharging a client with a prescription from home oxygen therapy via nasal cannula. Client & family teaching by the nurse should include which of the following? Select all. A nurse is delivering an enteral feeding to a client who has an NG tube in place for intermittent feedings. When the nurse pours water into the syringe after the formula drains from the syringe, the client asks the nurse why the water is necessary. Which of the following is an appropriate response by the nurse? A nurse is preparing to instill an enteral feeding to a client who has an NG tube in place. Which of the following is the nurse’s highest assessment priority before performing this procedure? A nurse is caring for a client who is receiving continuous enteral feedings. Which of the following nursing interventions is the highest priority when the nurse suspects aspiration of the feeding? A nurse is caring for a client in a long-term care facility who is receiving enteral feedings via NG tube. Which of the following is an appropriate nursing action prior to administering the tube feeding? Select all that apply A nurse is preparing to insert an NG tube for a client who requires gastric decompression. Which of the following actions should the nurse perform prior to beginning the procedure? Select all. An adolescent who has diabetes mellitus is 2 days postop following an appendectomy. The client is tolerating a regular diet. He has ambulated successfully around the unit w/assistance. He requests pain meds Q 6-8 hr while reporting pain at a 2 on a scale of 1-10 after receiving the med. His incision is approximated & free of redness, w/scant serous drainage on the dressing. Which of the following risk factors for poor wound healing does this client have? Select all. A nurse is assessing a client who is 5 days post op following abd. surgery. The surgeon suspects an incisional wound infection & has prescribed antibiotic therapy for the nurse to initiate after collecting wound & blood specimens for culture & sensitivity. Which of the following assessment findings should the nurse expect? Select all. A nursing instructor is reviewing the wound healing process w/a group of nursing students. They should be able to identify which of the following alterations as a wound or injury that heals by secondary intention? Select all. A client who had abd. surgery 24 hr ago reports a pulling sensation & pain in his surgical incision. The nurse checks the client’s surgical wound & finds the wound separated w/viscera protruding. Which of the following interventions is appropriate? Select all. A nurse is caring for an older adult client who is at risk for developing pressure ulcers. Which of the following interventions should the nurse use to help maintain the integrity of the client’s skin? Select all. 

1)  Submit 1 document per part

Part 1: Complete the file “Template Soap Note”  taking into account the following information:

     Diagnosis:   (D64.9) Anemia, unspecied 

      Female

      39 Years

Part 2: Complete the file “Template Soap Note” taking into account the following information:

     Diagnosis:    (G44.51) Hemicrania continua 

      Female

      62 Years

Part 3: Complete the “Template Soap Note”  taking into account the following information:

        Diagnosis:    (E73.9) Lactose intolerance, unspecied 

         Male

         58 years

2)¨******APA norms, please use headers

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3) It will be verified by Turnitin and SafeAssign

4) Minimum 4 references per part not older than 5 years