case study

There is two different case studies and their plan of action all you need to do is respond back to both students because these are discussion board. like 1 and 1/2 paragraphs for each study

The client who I chose to do a mini nutritional assessment on is an 84-year-old male Caucasian male with a late stage of dementia. He is my grandfather and lives in my house with my family and I. He has been living with us for at least five years up to this point. This person is not at risk for malnutrition and is not malnourished. The MNA shows that he is actually in a normal range for his nutritional status. As you can see from the form attached, he is pretty much all within good ranges for each concept in regards to his nutrition. He has no pressure ulcers, he can feed himself, and with him living her with us we are constantly taking care of him and making sure he is getting enough of the needed nutrients and is safe and moving around frequently. He is in good spirits, just needs a little extra help sometimes.

Care Plan: Short-term Goals

  1. First short term goal would be to limit his sugar intake in the mornings. He has been seen consuming too much coffee cake/desserts/pie in the morning with his coffee while reading the paper.
  2. He is often uninterested in drinking water, so I think it would help him if he were to incorporate more glasses of water in his day/diet.

Care Plan: Long-term Goal

  1. One long-term goal that would be crucial for this person would be what will his future nutrition going to look like? Right now, with him being here constantly around a family member, he is getting his medications on time with water and food, he is getting at least 3 square meals a day, and he is getting good healthy meals during the day with snacks intermittently. At some point, he will require the need for professional help either in an assisted living center or a nursing home. It is a concern that he will not be given the proper amount of attention or adequate nutrition when in a place like that. So, a long-term goal for him in regards to his nutrition, would be to make sure that if he ever changes locations, he is monitored and helped very frequently in this area.

Education 

For right now, this patient does not need to be educated on how to feed himself and on how to eat/chew/swallow. He is sufficient in that area. He needs to be educated on why it is important to eat three meals a day and why it is important to drink enough water. The problem with him though is that with his dementia he forgets to do so, but if he has the help of our family he will continue to have adequate nutrition levels as he does now. Again, if he were to change locations, the staff would need to make sure he is being taken care of as we take care of him here. If this happens, I have no doubt he will meet these goals listed above and he will be able to successfully maintain optimum nutrition. He should be sure to stay away from beer, processed meats and cheeses, microwavable popcorn,  and white foods specifically since these foods are not good for dementia patients (Mole, 2018).

Follow-up Care

As stated earlier, right now this patient is not at nutritional risk. However, in a few weeks it would make sense to check again his levels and make sure he is still within proper range. When doing so, we can check to see if he is more hydrated, has clear urine, and this would help indicate that he has been drinking more water. Also, we can try to take away the coffee cakes in the morning to reduce the sugar intake. Giving him once slice and putting it away would be helpful and this could be a part of his education, as well as a part of the follow-up care. Lastly, follow-up care would involve checking with a professional to see if his nutrition is still normal if he switched locations. If he was still living with my family in a few weeks, we would check at his next doctor’s appointment to see if we are making sure we are doing a good job to keep his nutritional levels where they need to be.

The person that I interviewed is a 69 year old male. He is relatively active and does not show much if any signs of cognitive decline. His total MNA assessment score was 20, which puts him at risk for malnutrition. The main factors placing him at a risk for malnutrition are a moderate decrease in food intake leading to a loss of 4.5 lbs in the past 3 months. The patient does not have adequate intake of legumes or vegetables in his diet either. 

Short Term Goals

Increase his intake of legumes, fruits and vegetables to at least 2 servings per day. Especially his intake of vegetables as he has expressed that he does not eat very much vegetables at all.

Increase his overall food intake including well rounded, nutritious meals.

Long Term Goal

Gain back the 4.5 pounds that were lost due to decreases in food intake over the next 3 months.

Education

Research has showed a direct link between the intake of fruits and vegetables to a reduced risk of mortality among older adults (Nicklett & Kadell, 2013). The patient should increase his intake of green, leafy vegetables as this will give him vitamin K which promotes blood clotting and reduce bone fragility. Increasing the patients intake of legumes will also be helpful to supply him with good energy for his daily activities as they are filled with carbohydrates. Increasing his legume intake will also provide him with his daily fiber which will help with digestion. The patient should continue being active as this will keep his mind sharp and promote healthy cognitive function. 

Follow Up Care

In 3 months, revisit the patient to see if he has accomplished his long term goal in gaining back the 4.5 pounds that he had lost from decreased food intake. Also, assess his diet and ensure that he is taking at least 2 servings of fruits and vegetables per day. 

Module 7 Case study Analysis

  • Explain the following related to this case study:  Anemia and the different kinds of anemia (i.e., micro and macrocytic). 
  • Why a patient would need a splenectomy after a diagnosis of ITP.

 Case Study:

A 14-year-old female is brought to the urgent care by her mother, who states that the girl has had an abnormal number of bruises and “funny looking red splotches” on her legs. These bruises were first noticed about 2 weeks ago and are not related to trauma. PMH not remarkable and she takes no medications. The mother does state the girl is recovering from a “bad case of mono” and was on bedrest at home for the past 3 weeks. The girl noticed that her gums were slightly bleeding when she brushed her teeth that morning.

Labs at urgent care demonstrated normal hgb and hct with normal WBC differential. Platelet count of 100,000/mm3 was the only abnormal finding. The staff also noticed that the venipuncture site oozed for a few minutes after pressure was released. The doctor at urgent care referred the patient and her mother to the ED for a complete work-up of the low platelet count, including a peripheral blood smear for suspected immune thrombocytopenia purpura.

Nursing

 

At least 250 words with at least 1 scholarly article within the past 5 years.  APA format, no plagiarism.

 Define clinical significance, and explain the difference between clinical and statistical significance.

How can you use clinical significance to support positive outcomes in your future practice change project?

Benchmark – Part A: Population Health Research and PICOT Statement

In this course, you will be complete a 2-part assignment in which you conduct research about a population of focus, develop a PICOT statement, and write a Literature Review. The PICOT statement and Literature Review you write in this course can be used for your evidence-based practice project in the next course so be sure to select an issue you want to continue working on in your next course.

PICOT (Population/Problem, Intervention, Comparison, Outcome, and Time to achieve the outcome) is a method that helps clarify the qualities needed to create a good question out of a practice issue or problem affecting the population of focus. Additionally, the information derived from a good PICOT makes it easier to perform a literature search in order to find translational research sources that can be used to address the clinical problem.

Use a national, state or local population health care database to research indicators of disparity. Choose a mortality/morbidity indicator to identify a clinical problem or issue that you want to explore pertaining to a population of focus. Use this indicator to begin to formulate a PICOT and conduct research on the population.

Write a 750-1,000-word paper that analyzes your research and focuses on the population you have chosen. Describe the population’s demographics and health concerns, and explain how nursing science, health determinants, and epidemiologic, genomic, and genetic data may impact population health management for the selected population. Provide an overview of a potential solution for solving the health issue related to your population and the intended PICOT statement. Describe how the solution incorporates health policies and goals that support health care equity for the population of focus.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

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.

Benchmark Information

This benchmark assignment assesses the following programmatic competencies:

MS Nursing: Public Health

MS Nursing: Education

MS Nursing: Acute Care Nurse Practitioner

MS Nursing: Family Nurse Practitioner

MS Nursing: Health Care Quality and Patient Safety

4.1: Synthesize nursing science, determinants of health, and epidemiologic, genomic, and genetic data in the management of population health.

RUBRIC

Due Date: 09-Dec-2020 

Reply to my peers

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

Peer 1

Once an elderly individual becomes abused, they end up in a pattern of abuse. According to Levin et al., (2020), an elderly individual is mostly likely subject to abuse from a family member, and the abuse also comes from a caregiver or trusted individual. The abuse can be psychological, financial, physical, sexual, exploitation, neglect and self-neglect. Because these elderly individuals that require assistance due to physical or cognitive issues, they often with a family member, this makes it difficult for the elderly abused to get out of the situation. This abuse can be considered intentional, unintentional, or related to lack of knowledge. Miller (2018, p. 166) also indicated that the caregiver can become overwhelmed, or suffer from their own cognitive and physical issues making the neglect or abuse complicated. Elderly abuse is also perceived by differently cultures differently, for example the Chinese culture can consider raising your voice, or being disrespectful as abuse. Physical abuse to this vulnerable population is preventable and needs to be rectified. The second is emotional or psychological. This form of abuse can be hidden easier, but it causes the individua to become isolated leading to depression. According to the National Council on Aging, 5 million elderly are abused each year with only 1 in 14 cases being reported.  

There are ways to limit elderly abuse. Families that are taking care of an elderly person should seek outside time, or time for themselves, this helps prevent caregiver strain and fatigue. Elderly individuals can also be educated at checkup appointments about abuse and the many forms it can entail. As practitioner’s we should evaluate our patients regularly, even asking he caregiver to step outof the room to discuss their emotional state and identify any signs of possible abuse. We should also empower healthcare givers to attend group meetings to form relationships with other caregivers. 

Jaimee 

Levin, M. K., Reingold, D., & Solomon, J. (2020). Elder Abuse Shelter Programs: From Model to Movement. Generations, 44(1), 74–80. 

Miller, C. A. (2018). Nursing for Wellness in Older Adults. [South University]. Retrieved from https://digitalbookshelf.southuniversity.edu/#/books/9781975100735/ 

Peer 2

Elder abuse has been shined a spotlight on and has become more evident to the public. Two types of elder abuse that are very crucial to discuss are chemically subduing the elderly patients and physically abusing the elderly patients with assault and battery. Even though the light is on this topic, it may be difficult to intervene even though it may be easily spotted. if the elderly patient is being chemically subdued in the nursing home, it can become difficult to notice the signs since the elderly patient may be sleeping when the family members arrive, or may be afraid to say something because the patient believes they will receive some sort of punishment. When physically abusing the patient, the signs are easy to identify however the employee may say the patient just fell and hurt themselves. It is easily believable especially if the older patient suffers from dementia and has become restless and anxious.

These two are the most crucial because these two are mentally, physically, and emotionally exhausting to the patients that must endure it. These patients may become depressed, scared, traumatized, and have a hard time trusting anyone else. As nurses, it goes against our code when purposely inflicting damage to someone that is under our care. It is our responsibility to go beyond and provide the utmost care possible to everyone. The most important is prevention however we cannot prevent another employee causing harm however what we may do is be able to detect and know the early signs. Some signs are oversleeping, unexplained bruises, scarring, burns, sprains, so many signs so it is our duty to stay educated on this topic to help all our patients (Team, 2020).

Team, T. N. H. A. C. (2020, January 8). Physical Elder Abuse – Signs of Physical Elderly Abuse. Nursing Home Abuse Center. https://www.nursinghomeabusecenter.com/elder-abuse/types/physical-abuse/

2 theories

 The two theories that i have selected are :  Roy Adaption Model of Nursing and Interpersonal relations in Nursing 

 This week, reflect up your personal nursing philosophy as it has evolved over the course of your RN-BSN program at WCU. Identify specific theorists you feel you most identify with. How does your personal nursing philosophy, and the work you completed in your program support evidence of meeting the following?

Essential IX: Baccalaureate Generalist Nursing Practice

· Outcome #18: Develop an awareness of patients as well as healthcare professionals’ spiritual beliefs and values and how those beliefs and values impact health care.

Review your past academic work, evaluate your effectiveness at meeting this program essential, and ponder the impact that this proficiency will have on your future.

Identify how you met the essential by referring to the assignment(s) specifically in your response. Additionally, reflect upon and make connections between your academic experience and real-world applications. 

Recommended: Refer back to work you completed for NURS 500 Theoretical Foundations of Nursing Practice and LDR 432 Principles of Leadership for Healthcare Organizations, as well as other courses to gather academic examples and evidence of having met this essential.

Your reflection should be 1-1 1/2 page and in APA Style. Include at least 1 Reference 

Policy Brief – 3 pages

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

  1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.
  2. Create a problem statement.
  3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.
  4. Discuss the impact on the health care delivery system.

Include three peer-reviewed sources and two other sources to support the policy brief.

APA Format

No copying

No plagiarism

Pediatrics

 

Please respond to these discussion points using appropriate grammar and punctuation.

#1) Name two expected outcomes to promote optimal infant growth and developmental needs.  

#2) Pick two typical developmental milestones in the toddler and discuss them.

#3)What are a couple of ways that the nurse can promote the health of the preschooler and family?

#4)  Make a list of nursing diagnoses and expected outcomes for the following clients:

  • A mother brings her son to a clinic for a checkup. She tells the nurse that she is concerned because her 4-year-old son is having trouble with his speech and is repeating words and syllables in his sentences.
  • Parents of a 3-year-old girl bring her to their pediatrician for a visit. They tell the nurse that they are concerned because their daughter will only allow her father to take care of her and wants to be near him all the time.

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APA Format