All posts by : chebby

You have probably seen one or more of the many inspirational posters about decisions. A visual such as a forked road or a street sign is typically pictured, along with a quote designed to inspire.

Often decisions are not so easily inspired. Perhaps you discovered this when choosing a specialty within the MSN program. This decision is a critical part of your plan for success, and you no doubt want to get it right. This is yet another area where your network can help, as well as other sources of information that can help you make an informed choice.

To Prepare:

Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization.

By Day 3

Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member 

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.

I need a truthful person to work with through out my program.

Hi

I already completed my research paper for my advanced pathophisiology with the question below:

” What is the pathophysiologic difference between stable angina and unstable angina? “

Please make correction with grammar and sentences structure.  Thank you very much for your help!

Angina is a coronary artery disease that occurs when there is an imbalance between oxygen supply and demand in the myocardium (McCance & Huether, 2019). When supply is impaired and doesn’t meet demand, myocardial ischemia happens (McCance & Huether, 2019). There are two important concepts of accumulation of fatty streaks and endothelial dysfunction that explain the process of coronary artery disease (McCance & Huether, 2019). The coronary artery is made up of vascular smooth muscle and lined with vascular endothelium (McCance & Huether, 2019). 

With normal function, low-density lipoproteins (LDL) circulate throughout the arteries and deliver triacylglycerol fuel to tissues (McCance & Huether, 2019). However, when under abnormal circumstances, a certain percentage of LDLs are mutated by oxidative damage (McCance & Huether, 2019). Normally, macrophages ingest the oxidized LDL, and the body wants to get rid of waste. However, macrophages become engorged and become foam cells (McCance & Huether, 2019).  The foam cells become very big and accumulate and lodge in the layer of the vascular smooth muscle (McCance & Huether, 2019). When the foam cells accumulate, it displays the fatty steaks in the artery (McCance & Huether, 2019). The foam cells and lipid deposits will burst through the endothelial lining of the artery and cause a break in the artery. Besides the accumulation of fatty streaks, the dysfunctional endothelial cells have been damaged for many years and are result in the development of atherosclerosis (McCance & Huether, 2019). They cannot produce nitric oxide and cause the reduction of vasodilatation (McCance & Huether, 2019). As a result, the blood blow through the artery becomes restricted, oxygen supply to the distal tissues is diminished, and causing angina and heart attack.

Angina is a type of chest pain caused by reduced blood flow to the heart with a condition called myocardial ischemia and is a symptom of coronary artery disease (Mayo Clinic, 2020). Stable angina is not a heart attack and association with transient ischemia and no permanent damage and no infarction (American Heart Association, 2020). Patients usually feel uncomfortable pressure, fullness, squeezing, and pain at the center of the chest (American Heart Association, 2020). Stable angina is caused by fixed obstruction with a high cholesterol level (Huff, Boyd, & Jialal, 2020). Stable angina can be predictable, and patients are familiar with pain patterns, prompted by physical exertion such as exercise, emotional stress, cold temperatures, and having heavy meals (American Heart Association, 2020). Stable angina is not happened at rest, subsides with rest, and responds well to medications (American Heart Association, 2020).

On the other hand, unstable angina is unpredictable, even at rest, with unexpected chest pain (American Heart Association, 2020). It changes pain patterns, more severe, lasts longer and doesn’t respond well to medications (American Heart Association, 2020). As the coronary arteries are narrowed by fatty buildups, they can rupture, causing blood clots and blockage the flow of the heart muscle (American Heart Association, 2020). When having plaque ruptured, patients could have a heart attack and should be treated as a medical emergency (American Heart Association, 2020). 

Patients with angina is usually having ST-segment depression during attacks that display on the electrocardiograms (Ginghina, Ungureanu, Vladaia, Popescu, & Jurcut, (2009).). Providers can refer patients to have a stress test to perform during exercise (Mayo Clinic, 2020). Using an angiogram can also help detect obstruction and show the abnormal coronary (Mayo Clinic, 2020). The treatment of angina by relieving symptoms reduces the frequency of future anginas and reduces the risks of heart attacks. Patients can take nitroglycerin, long-lasting nitrates, antiplatelet drugs such as aspirin to relieve and prevent the symptoms (Mayo Clinic, 2020). They should also have lifestyle changes that include stop smoking, limit alcohol, keep a healthy weight, healthy diet, and regular exercise, but avoid exertion, avoid stress, and avoid large meals (Mayo Clinic, 2020). There are surgical procedures to restore normal blood flow, including a balloon or stent, coronary bypass, to wider the effective artery (Mayo Clinic, 2020). 

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following cases. 

CASE STUDY #2

CHEIF OF COMPLAIN: A 25-year-old Hispanic female, computer programmer presents to your clinic complaining of a 12-day history of a runny nose

SUBJECTIVE: States that her symptoms began about 12 days ago. She suffers from allergies; she gets a runny nose during the spring-time, pollen season. However, in the winter, her allergies are not a problem.

OBJECTIVE  DATA: 

VS: (BP) 115/75, (P) 89, (RR) 16, (T) 100.4°F (38°C), O2 sat 98% on room air

GENERAL: No signs of acute distress. Patient appears mildly fatigued. She is breathing through her mouth. Breathing easily. Voice has a nasal quality to it.

HEENT:Ear canals: normal; EYES: normal; NOSE: Bilateral erythema and edema of turbinates with significant yellow drainage on the right. Nares: Obstructed air passages

RESPIRATORY : CTA AP&L

NECK/THROAT: Posterior pharynx: mildly injected, scant postnasal drainage (PND), no exudate, tonsils 1+, no cobblestoning

HEART: Regular rate and rhythm, no murmur, S3, or S4

answer the following questions:

1. What other subjective data would you obtain?
2. What other objective findings would you look for?
3. What diagnostic exams do you want to order?
4. Name 3 differential diagnoses based on this patient presenting symptoms?
5. Give rationales for your each differential diagnosis.

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

• Differentiate the process of evaluating health information technology systems from other types of evaluation in health care. What specific strategies might you employ for an information system evaluation? What factors might you examine to judge the system’s effectiveness?
• Assess the main challenges of designing a successful information system evaluation.

Required Readings

Course Text: American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Author.
“Standard 6. Evaluation” (p. 78)
This standard outlines nursing competencies for evaluating informatics systems.

Nahm, E., Vaydia, V., Ho, D., Scharf, B., & Seagull, J. (2007). Outcomes assessment of clinical information system implementation: A practical guide. Nursing Outlook, 55(6), 282-288. e2.

The authors of this article use their background in informatics and scholarly research to provide an overview of system evaluations for frontline clinicians.

Rahimi, B., & Vimarlund, V. (2007). Methods to evaluate health information systems in healthcare settings: A literature review. Journal of Medical Systems, 31(5), 397- 432.

A detailed analysis of recent HIT literature reviews is presented in this article. Common facets of the evaluation process and end benefits of the overall HIT system are also synthesized.

Wyatt, J. (2010). Assessing and improving evidence based health informatics research. Studies in Health Technology and Informatics, 151, 435-445

The findings in this article provide HIT researchers with impacting factors and suggested criteria to help with the development of research questions, methods, and study designs.

Healthcare Information and Management Systems Society. (2019). Retrieved from https://www.himss.org

The Healthcare Information and Management Systems Society (HIMSS) organization is dedicated to providing global leadership in the use of information technology. Use their website to explore how HIMSS is transforming health care through research, collaboration, and professional developments.

Required Media

This week there is only one GHA exercise to complete.  This is because this one exercise may take you a substantial amount of time.  It is important that you start early in the week so that you can email me with any questions. While this exercise can take some time, if you complete it one step at a time you will get to the end!

Start by reading the chapter carefully and then working your way through the course materials that I have provided to you in this week’s Module. If you need help with how to allocate costs using excel, please click here.

This exercise represents a somewhat simplistic example of what health care finance people really do!  It is very similar to many projects that I did when I consulted to hospital Finance departments.

GHA 4

This week’s GHA is not in the eText.

You can access the template for GHA 4 by clicking here.

You can also access an example and explanation of how to complete GHA 4 here.

Please be sure that you upload the correct file when you submit your work!

Warning:  Pay close attention to where the assignment requires INDIRECT vs. DIRECT costs. Using the wrong costs is the most frequent error that students make in completing this assignment.

 Assignment Objectives:Print Assignment InfoAssessment and Care Plan with clinical focus on:
• Managing Patient Care
• Infection Prevention and Control
Care Plan on- Methicillin- Resistant Staphylococcus Aureus Patient
Document Medical TerminologyCompetencies You are Expected to Address in this Assignment:

• Quality and Safety Education for Nurses (QSEN):  Patient-Centered Care
• Quality and Safety Education for Nurses (QSEN):  Teamwork & Collaboration
• Quality and Safety Education for Nurses (QSEN):  Evidence-Based Practice
• Quality and Safety Education for Nurses (QSEN):  Quality Improvement
• Quality and Safety Education for Nurses (QSEN):  Safety
• Quality and Safety Education for Nurses (QSEN):  Informatics
• The NCLEX-RN® Client Needs:  Safe and Effective Care Environment: Management of Care
• The NCLEX-RN® Client Needs:  Safe and Effective Care Environment: Safety and Infection Control
• The NCLEX-RN® Client Needs:  Health Promotion and Maintenance
• The NCLEX-RN® Client Needs:  Psychosocial Integrity
• The NCLEX-RN® Client Needs:  Physiological Integrity: Basic Care and Comfort
• The NCLEX-RN® Client Needs:  Physiological Integrity: Pharmacological and Parenteral Therapies
• The NCLEX-RN® Client Needs:  Physiological Integrity: Reduction of Risk Potential
• The NCLEX-RN® Client Needs:  Physiological Integrity: Physiological Adaptation
• National Patient Safety Goals:  Identify Patients Correctly
• National Patient Safety Goals:  Improve Staff Communication
• National Patient Safety Goals:  Use Medicines Safely
• National Patient Safety Goals:  Use Alarms Safely
• National Patient Safety Goals:  Prevent Infection
• National Patient Safety Goals:  Identify Patient Safety Risks
• National Patient Safety Goals:  Prevent Mistakes in Surgery

Agenda comparation

Work #1:

Actual work where 2 students given their post on this:

Describe in 500 words discuss the scope of a cloud computing audit for your business.

Use at least three sources. Use the Research Databases available from the Danforth Library not Google. Include at least 3 quotes from your sources enclosed in quotation marks and cited in-line by reference to your reference list.  Example: “words you copied” (citation) These quotes should be one full sentence not altered or paraphrased. Cite your sources using APA format. Use the quotes in your paragaphs.  Stand alone quotes will not count toward the 3 required quotes.

Copying without attribution or the use of spinbot or other word substitution software will result in a grade of 0. 

Write in essay format not in bulleted, numbered or other list format. 

Reply to two classmates’ posting in a paragraph of at least five sentences by asking questions, reflecting on your own experience, challenging assumptions, pointing out something new you learned, offering suggestions. These peer responses are not ‘attaboys’.   

It is important that you use your own words, that you cite your sources, that you comply with the instructions regarding length of your post and that you reply to two classmates in a substantive way (not ‘nice post’ or the like).  Your goal is to help your colleagues write better. Do not use spinbot or other word replacement software. It usually results in nonsense and is not a good way to learn anything . I will not spend a lot of my time trying to decipher nonsense. Proof read your work or have it edited. Find something interesting and/or relevant to your work to write about.  

Please find the attachment.