Explain how health care reform has helped shift the focus from a disease-oriented health care system to one of wellness and prevention. Discuss ways in which health care will continue this trend and explain the role of nursing in supporting and facilitating this shift.
DUE DATE: THURSDAY 26
Situation: Patient “CP” is an 18-year-old male who was admitted at 1900 today. His mother visited him at his college dormitory and was very concerned with his health; he seemed weak and had lost weight since she last saw him. She took him to see his primary care provider, and the provider admitted him and has ordered a tube feeding. I placed an 8-Fr, 42-inch feeding tube in his right nares about an hour ago, and x-ray just called and confirmed placement in the stomach. The pump is in his room. He is up to the bathroom prn; otherwise bed rest.
Background: CP was diagnosed with cystic fibrosis as a child and has had frequent hospitalizations previously. He reports fatigue and has recently lost 6 kg (13.2 lb) after he registered at the local college and moved to live in a dormitory. CP’s mom was here earlier, but she is a single parent and has two younger boys, so she had to go home.
Assessment: CP is awake and alert. His heart rate and rhythm are regular at 80–85/min. Breath sounds are fine with a respiratory rate at 18/min. His color is a bit pale. Blood pressure is 118/78 mm Hg. He reports no pain and states he’s not had much appetite the past few weeks. His belly is flat and nontender. Bowel sounds are normoactive.
Recommendation: CP is due for vital signs and assessment. The tube feeding just arrived, and you will need to start it on the pump. He needs 720 kilocalories over 8 hours overnight. His regular diet is high calorie, high fat, but he wasn’t too hungry this evening; just had a bit of his chocolate shake. You will need to give his pancreatic enzymes orally before you start the tube feeding. You should also assess his diet and reinforce patient education on nutrition.
REQUIREMENTS
Write a 6-10 page paper recommending treatment and care for patient regarding cystic fibrosis. Rubric will be attached. APA citations needed. At least 4 citations, only 1 being from an online source. Also include pathophysiology, nursing process, patient teaching, diagnostic tests, etc.
CASE STUDY # 2
CHEIF OF COMPLAIN: A 45-year-old female presents with a complaint of an itchy red rash on her arms and legs for about two weeks.
SUBJECTIVE:She has been going on a daily basis to the local YMCA with children for Summer camp.
OBJECTIVE:
VS: (T) 98.3°F; (RR) 18; (HR) 70, regular; (BP) 118/74
GENERAL: healthy-appearing female in no acute distress
HEENT: EYES: no injection, no increase in lacrimation or purulent drainage; EARS: normal TM: Normal
SKIN: CTA AP&L
NECK/ THOAT: mild edema with inflammation located on forearms, upper arms, and chest wall, thighs and knees; primary lesions are a macular papular rash with secondary linear excoriations on forearms and legs
Answer the following questions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.
Purpose
The purpose of this assignment is to provide the student an opportunity to reflect on the weekly concepts learned in the course.
Activity Learning Outcomes
Through this assignment, the student will demonstrate the ability to:
Requirements:
Reflection: write 1-2 paragraphs reflecting on your learning for the week. Guiding questions are provided or you may write about what you felt was most significant to you for the week.
Some possible areas to explore:
Minimum of 350 words with at least 2 peer review reference in 7th edition apa style
As a practice scholar, you are searching for evidence to translate into practice. In your review of evidence, you locate a quantitative descriptive research study as possible evidence to support a practice change. You notice the sample of this study includes 200 participants and is not normally distributed. Reflect upon this scenario to address the following.
Nurses are often portrayed in films and television. From Nurse Ratched in One Flew over the Cuckoo’s Nest, to Julia Baker in Julia, and Gaylord “Greg” Focker in Meet the Parents, nurses have been portrayed showing various traits. Some are positive, while others are less than caring. For each, the five elements of emotional intelligence, 1) self-awareness, 2) self-regulation, 3) motivation, 4) empathy, and 5) social skills, are expressed at different levels. Select a nurse archetype portrayed in films or on television and consider the following.
· What features of emotional intelligence does your selected nurse portray? What features are they lacking? Provide an example to support your rationale.
· If you were the nurse’s leader, how would use your change agent characteristics to support that individual’s growth? Provide specific examples using scenarios from the setting from which the nurse is portrayed.
· How does complexity theory or chaos theory influence the organization in which the nurse is portrayed? Provide specific examples to support your rationale.
Reading:
Hanrahan, K., Wagner, M., Matthews, G., Stewart, S., Dawson, C., Greiner, J., & Williamson, A. (2015). Sacred cow gone to pasture: A systematic evaluation and integration of evidence-based practice (Links to an external site.). Worldviews on Evidence-Based Nursing, 12(1), 3-11. https://doi.org/10.1111/wvn.12072 (Links to an external site.)
Kawar, L. N., Dunbar, G., & Scruth, E. A. (2017). Creating a credible and ethical curriculum vitae (Links to an external site.). Clinical Nurse Specialist: The Journal for Advanced Nursing Practice, 31(6), 298. https://doi.org/10.1097/NUR.0000000000000327 (Links to an external site.)
Marshall, E. S. & Broome, M.E. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). Springer Publishing Company.
· Chapter 1: Expert Clinician to Transformational Leader in a Complex Health Care Organization: Foundations
o Table 1.2 Examples of Situational and Constituent Interaction Theories for Leadership, Emotional Leadership,” p. 10
· Chapter 2: Understanding Contexts for Transformational Leadership: Complexity, Change, and Strategic Planning
o Theory of Complex Adaptive Systems, P. 40-41
o Nurse Leaders Within Complex Health Care Systems, P. 41-44
Instructions:
This is a Doctorate level paper. APA format (7th edition). At least 2 references (must be within 5 years)
Absolutely plagiarism free.
Read the following case study and submit a 1500 – 2000 word paper that addresses the case study and the questions at the end of the case study.
Mr. B. is an 83 year old male referred to home health services following a hospital admission for congestive heart failure. His payor source is Medicare (traditional). He lives alone and indicates he does not have sufficient financial resources to afford private-pay in home supportive care. His daughter, who lives in the neighboring county about 30 miles away, has offered her father to move in with her – he has refused and she is not “forcing the issue”. Mr. B. is also not open to discussing moving to an assisted living environment.
This is his third hospital admission for the same problem over the last 12 months and his second admission to a home health agency. He was discharged from the previous home health agency 6 weeks ago. Physician orders are for the home health agency to provide skilled nursing for assessment of his cardiac condition and to teach him about his care and medication regime. Physical therapy has been ordered to establish a home exercise program. Home health aide services have been ordered 3 times a week to assist Mr. B. with his personal care needs.
By the end of the third week of service, it is clear to the RN Case Manager that Mr. B. is not making progress to the established goals. She reports during case conference that he is not a good candidate for teaching because of intermittent confusion and forgetfulness. According to the nurse, no matter what she has tried to teach him and regardless of the aids she has used, Mr. B. continues to take is medication incorrectly. She states, “I know he needs services, but I am not sure that he is in the right environment. I am concerned about Mr. B. – I am not sure why his daughter won’t just step up and put her foot down.”
The physical therapist reports at case conference that the “client lacks motivation”. The home exercise program has been established with Mr. B.; however, he does not complete the exercises between therapy visits.
An improvement in his personal hygiene has been noted with the Home Health Aide (HHA) services. The HHA has also been successful in decluttering his living space. The HHA reports that she is concerned that he is not eating regular meals.
This situation offers an ethical challenge to the professional caregivers and to the agency for which they work.
Discuss how you would handle this ethical dilemma. Address the following questions as a part of your response:
By the due date assigned, write a 1-page paper addressing the sections below of the research proposal.
COMMUNITY: WHEELING COMMUNITY, ILLINOIS
AGREGATE: OBESE POPULATION
need two case studies
apa format
references must be less than 5 years
please provide proof of turnitin.com
no plagiarism
providing two templates you can use.
#1 Anxiety (differential diagnosis 1) Cardiac disease 2) Substance abuse 3) hyperthyroidism)
#2 Trichomoniasis (differential diagnosis 1) gonorrhea 2) chlamydia 3) vaginal cancer)
please provide 3 differential diagnosis as you will see what I’m referring to when you open my supporting files.
