All posts by : chebby

1)  Write down sample nursing diagnoses, interventions, and expected outcomes for the following client:

Elaina, 27 years old, visits a prenatal clinic to confirm a positive pregnancy test. Elaina tells the nurse that she is not married and has no support system. She also states that she is making minimum wage at a restaurant with no health insurance and cannot afford prenatal care. She intends to keep the baby and would rather not tell her partner because “they don’t have that kind of a relationship.” Elaina asks the nurse “If I take good care of myself, why do I need prenatal care?”

#2) Explain how the fetus is affected by tobacco use during pregnancy.  Keeping in mind the 2020 National Health Goals, what are some things you can do as a nurse to promote these goals and carry your ideas out into the community.

#3) You are asked to perform an assessment of a pregnant  woman and her family. Prior to the assessment, devise a list of interview questions to use to assess the woman’s readiness for parenthood and current health status as well as her goals for the pregnancy.

#4) For each of the following QSEN competencies write a list of nursing interventions for promoting fetal and maternal health related to each competency:

         Patient centered care

        Teamwork and collaboration

         Evidence-based practice

        Quality improvement

         Safety

         Informatics.

#5)  List the four major hormones produced in early pregnancy.  Describe what each one does.

Search entries 

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care.
When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines”
Critical thinking activities
1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?
3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.

Why is understanding the health care system at the local level important to consider when planning an EBP implementation? Conduct research and solicit anecdotal evidence from your course preceptor that you will take into consideration for your own change project.

Capstone Project Change Proposal Presentation 

Review  the feedback on the change proposal professional presentation and make  required adjustments to the presentation. Present your evidence-based  intervention and change proposal to an interprofessional audience of  leaders and stakeholders. Be prepared to answer questions and accept  feedback.

After presenting your capstone project change proposal,  write a 250-350 word summary of the presentation. Include a description  of the changes that were suggested by your preceptor before your  presentation and how you incorporated that feedback. Describe how this  interprofessional collaboration improved the effectiveness of your  presentation. Include a description of the feedback and questions from  your audience after your presentation, and how this experience will  affect your professional practice in the future.

While APA style  is not required for the body of this assignment, solid academic writing  is expected, and documentation of sources should be presented using APA  formatting guidelines, which can be found in the APA Style Guide,  located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

TOPIC IS :

 DRUG ADDICTION 

NARCAN USE 

DRUG REHAB

1. Create an infographic teaching tool for the community educational project. View these links on how to create infographics: 
   • https://www.visme.co/make-infographics/
   • http://blog.hubspot.com/blog/tabid/6307/bid/34223/5-Infographics-to-Teach-You-How-to-Easily-Create-Infographics-in-PowerPoint-TEMPLATES.aspx
   • http://blog.hubspot.com/marketing/free-ppt-infographic-templates-designs-ht

Submit  an 8 X 11.5 color (one page Word or pdf. document) infographic teaching  tool for your chosen community. Please also submit a reference page in  APA format with at least two references you used as sources for the  information on the infographic.

100 words–Opioid crisis newsletter magazine THIS IS NOT AN ESSAY—-USE THE attached template as an example 

In New York state describe the effects of the opioid crisis on children. Include statistics data with your reasoning. 

300 words—Determine the ways in which the opioid crisis affects these children. Include the short- and long-term effects on society.

300 words—Describe how the crisis impacts children nationally. Compare this to the global opioid crisis.

300 words—Analyze the global consequences of the opioid crisis on children.

100 Connect the information learned to Anytown, and discuss the ways public health officials can help reduce the opioid crisis.

cite your resources both in text and with a reference list.

reply1

The impact of evidence-based practice (EBP) in health care cannot be overemphasized. It is has been endorsed in research and practice as a method that obtains the highest level of care for patients, reduces the cost of health care, reduces medical errors and injuries, and encourages individual and professional advancement for nurses and other health professionals because it encourages research and educational progression. Consequently, the Institute of Medicine (IOM) recognizes the fact that achieving a safe and quality-driven healthcare system in the United States by the year 2020 would require that 90% of clinical decisions must be supported by accurate, timely, and up-to-date clinical information, that will reflect the best evidence in clinical practice literature (Institute of Medicine, 2009). This is the concept of evidence-based practice.

However, according to HealthyPeople.gov, the United States is very far away at reaching this goal, at approximately 15%. Research has identified a number of individual and organizational obstacles limiting nursing practice from achieving this goal (e. g. Mahmoud and Abdelrasol, 2019; Solomons and Spross, 2011). These obstacles include inadequate time to read literature, intense workload, shortage of staff qualified in EBP, and shortage of nursing faculties to inculcate the knowledge of EBP in nurses. The shortage in the supply of nursing faculties is one significant barrier that is holding nursing practice from achieving the EBP goal. Nurses need to be trained in EBP, but the numbers of nursing instructors or faculties are limited due to inadequate remuneration. To address this obstacle, more nurses should be encouraged to seek educational advancements to the level of a PhD and their salaries must be reviewed upward.

In addition to shortages in nursing faculties, shortage of the number of staff qualified in EBP is another barrier that might be holding nursing practice from achieving the EBP goal of 90% evidence-based practice by 2020. When there are no adequate nursing faculties to instill the knowledge of EBP in nurses, and when there is lack of funds for motivated nurses to pursue advance degrees, then it will be difficult to achieve the EBP goal, To address this obstacle, more funding should be made available for well motivated nurses in the form of loans, grants, scholarships, fellowships.

                                                                                       References

Institute of Medicine. (2009). Roundtable on Evidence-Based Medicine. Available from: https://www.ncbi.nlm.nih.gov/books/NBK52847/

Matmoud, M. H., & Abdelrasol, M. (2019). Obstacles in Employing Evidence-Based Practice by Nurses in their Clinical Settings: A Descriptive Study. Frontiers of Nursing, 6(2); pp. 123-133.

Solomons, N. M., & Spross, J. A. (2011). Evidence-Based Practice Barriers and Facilitators from a Continuous Quality Improvement Perspective: An Integrative Review. Journal of Nursing Management, 19: 109-120

reply2

By using evidence-based practice (EBP), nurses are providing safe, quality patient care. Although all health care professionals would prefer using the latest, updated EBP for their practice, understanding and staying up-to-date on all the emerging EBP is impossible. According to Whitney (2018), nurses play a primary role in transforming how the health care system works for the community. Nurses need to take the time out of their work schedule and personal time to stay updated on the EBP which applies to their practice. This requires a lot of time and energy from the nurse and not all nurses have ample time to look into new research and EBP for their own scope of practice. Another issue for EBP practice to reach 90% is that the working environment is already fast paced for all nursing and changes that need to be made need to help the nurse stay efficient while providing safe patient care. If these changes are not fully understood by the administration implementing these changes, then the staffing runs into issues trying to adapt to the new changes based off EBP. The changes need to happen in proper steps so that the organization and the staff working directly for the organization are able to make the transition smooth and reliable for themselves and their patients.

References

Whitney, S. (2018). The future of nursing in an evolving health care system. In GCU’s (Eds.), Trends in health care: A nursing perspective. Retrieved from: https://lc.gcumedia.com/nrs440vn/trends-in-health-care-a-nursing-perspective/v1.1/#/home

 Instructions

Develop Essay Evaluation Title: 

Instructions

Develop: Essay

Evaluation Title: Analyze and Infer

Watch: Hold On (Negro Spiritual)

As you watch and listen to the video, consider the following:

• The unit 5 learning map material discusses a number of key musical elements. Which can you identify?
• Of the musical genres discussed in the learning map material, which does this piece belong to? Can you explain why you feel as you do?
• The learning map material says the work of the humanities involves “looking at the impact and meaning the work of art has upon the human experience.”
  • As you listen to the song, compare and contrast the impact and meaning of it for you with those that originally sang it in the 19th century.
  • How does the meaning of this song differ for you versus those that originally sang it? Alternately, how is its meaning the same?

• “Hold On” (Negro Spiritual): https://www.youtube.com/watch?list=RDTfvLZjofEXA&v=TfvLZjofEXA&feature=emb_rel_end05:38

• After listening to the video, please write a response composed of two parts. In the first part, identify key musical elements you can detect in the song, and then explain what genre you feel it belongs to. In the second part, provide a substantive analysis of the similarities and differences between the culture this song was originally a reflection of to the world that you now live in. In your response, please refer to specific aspects of the song. You may also draw from personal experience as well as from stories you have heard from your family members or others in your community.

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

 1-Which level of measurement would you prefer to utilize for quantitative research? Defend your answer. 

2-APA style

3- 3 paragraphs of 3 sentences each

4- 2 references not older than 2015

Part I

• Write a prescription! 
  • Pretend you are a physician writing a prescription for a patient.  The patient is a 21 year old  male who had a  just root canal. He is experiencing pain which will not go away with over the counter medications. Do your research and prescribe him a medication which will help with pain as well as help him to sleep. Please use the sample prescription in the text as a guide. Place in a word document and submit. 

Part II

Answer the questions below in a brief paragraph.

1. You review a prescription and find that you cannot determine whether the medication is Trileptal (an antiseizure medication) or Tylenol 3 (a narcotic pain reliever). What would the difference mean to the patient if the wrong drug were given? What should you do in this situation?

2. If most patients do not understand Latin, why do you think physicians write the signature in Latin?