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Discussion Questions 1

The COVID-19 pandemic has changed many ways we normally communicate with the interprofessional team and patients.

Using the South University Online Library or the Internet, read more about this statement. Based on your investigation and understanding, answer the following questions:

·  How has communication with patients changed? Provide examples.

·  What are you doing to better communicate with patients?

·  How has communication among the interprofessional team changed?

·  What affect has this had on patient outcomes?

·  What needs to happen to make communication better?

As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the  University Online Library. Below are guides that are located in the library and can be accessed and downloaded via the  University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

Write a 5 page research paper about brain injuries and what are the methods of Rehabilitation After Them.

Include reference within the last 5 years

APA style

Assignment:

Essay: Answer each prompt using at least 400 words.

• Is social class really an invisible difference or are there ways that people often deduce other’s social class origins? What can be the effect of this in job interviews, work-related social situations, etc.?
• In your own success in achieving a college education, consider the following four factors:
  • a) your parent’s attitude toward education,
  • b) your parent’s financial resources,
  • c) the quality of your elementary and secondary schools, and
  • d) your own hard work and determination.

First, rank these factors in terms of importance.  Then, choose any three combinations of two factors listed in question 1 (for example, school quality and student work ethic) and explain why they are likely to be correlated.

• Using the Religious Diversity Checklist, conduct an audit of an organization to which you have belonged. Once you answer the questions, analyze the answers and generalize from them to offer the organization advice on its treatment of religion in the workplace. How would you rate the organization on its performance on a scale of 1 to 10 (with 10 being excellent)?
• Watch the videos listed below and write a reaction on how you would help understand the communication of a new foreign worker at your company (The Widget Company):
  • https://www.youtube.com/watch?v=kujUs_6qeUI
  • https://www.youtube.com/watch?v=YMyofREc5Jk

Assignment Expectations:

• Length:
  • 1600-1750 words (5-7 pages); answers must thoroughly address the questions in a clear, concise manner
• Structure:
  • Include a title page and reference page in APA style
• References:
  • Reference any outside content. Include the appropriate APA style in-text citations and references for all resources utilized to answer the questions

Research a patient safety database and provide two additional scholarly references. Feel free to use your text to identify resources and begin your search.

Compose a three (3) page double-spaced paper in APA format that includes the content areas listed below:

Identification of how this database has the potential to increase patient outcomes.

Discussion of how this product or technology will improve data security, improve analytics and benefit health consumers in such a way that minimizes clinical error.

Analysis of the challenges and opportunities to fully automate this product to share with multiple health systems.

What technical and social barriers must be considered in order to provide effective training and use for providers?

Based on what you have learned in the course, how would you evaluate the efficiency and overall benefit of this database system? What needs to be improved?

Ashley AdamsPosted Date:November 30, 2020 11:25 AMStatus:Published

The patient in this scenario is displaying the clinical manifestations of rhabdomyolysis, which is the breakdown of muscle from various causes which leads to the shift of intracellular components into vascular and extracellular compartments(McCance & Huether, 2018). Clinical signs include pain, weakness, and tea-colored urine (myoglobinuria) along with elevated serum K+ and creatine kinase (CK) levels (Hocagil et al., 2019). While the roommate in the scenario does not know how long the patient was in the unresponsive state, lack of oxygen and energy to the muscle tissue in a dependent state can rapidly lead to ischemia and necrosis (Hocagil et al., 2019). 

At the cellular level, anoxia leads to the cessation of aerobic metabolism and reduced generation of ATP, ultimately causing the failure of the NA+-K+ pump (McCance & Huether, 2018). Na+ accumulates in the ICF while K+ accumulates in the ECF, causing the cell to swell and damaging the cell membrane, while increased calcium in the ICF leads to further cell damage (McCance & Huether, 2018). If oxygenation is not restored quickly, cell death will occur (McCance & Huether, 2018).

The patient is presenting with the symptoms of hyperkalemia, marked by the elevated serum K+ levels and EKG abnormalities. Common EKG alterations in hyperkalemia are prolonged PR intervals, wide QRS complexes, and ST segment depression (Roberts, 2020). Left uncorrected, severe dysrhythmias may occur up to and including ventricular fibrillation and cardiac arrest (McCance & Huether, 2018). 

While much more specific research is needed, early studies are pointing to a correlation between genetics and substance abuse or addiction disorders (Hancock et al., 2018). Several replicable genomic variables have been identified among individuals with various addictive disorders that could lead to early and targeted prevention measures (Hancock et al., 2018).  

In this scenario, different patient demographics could lead to different causes of rhabdomyolysis. In addition to tissue ischemia, rhabdomyolisis can result from the ingestion of certain drugs and toxins, trauma such as a crush injury, physical overexertion, infections, and metabolic imbalances (McCance & Huether, 2018). 

References

Hancock, D. B., Markunas, C. A., Bierut, L. J., & Johnson, E. O. (2018). Human genetics of addiction: New insights and future directions. Current Psychiatry Reports, 20(2). https://doi.org/10.1007/s11920-018-0873-3

Hocagil, H., İzci, F., Hocagil, A., Tatli, M., Sözen, S., & Akkaya hocagil, T. (2019). Detection of rhabdomyolysis in patients admitted to emergency department due to drug overdose as a suicide attempt: A propective original clinical study. Turkiye Klinikleri Journal of Medical Sciences, 39(3), 237–244. https://doi.org/10.5336/medsci.2018-64073

McCance, K. L., & Huether, S. E. (2018). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). Mosby.

Roberts, D. M. (2020). Metabolic complications of poisoning. Medicine, 48(3), 169–172. https://doi.org/10.1016/j.mpmed.2019.12.005

Sara AndrewsPosted Date:November 30, 2020 6:27 PMStatus:Published

         At first glance, the necrosis discovered in the patient’s greater trochanteric area and forearm could be attributed to his unconscious state and prolonged pressure to bony prominences with resulting rhabdomyolysis.  However, the case scenario does not indicate the amount of time the patient was lying unconscious on the floor.  Opioid overdose is suspected given the patient regained consciousness after administration of the opiate receptor antagonist naloxone (Schiller &Goyal, 2020). Within 3-5 minutes, opioid overdose results in hypoxia and death (Schiller & Goyal, 2020), therefore increasing the probability that necrosis was present prior to the overdose ( as a result of tissue damage related to drug abuse) and not the result of  an extended period of unconsciousness, rhabdomyolysis, or pressure on bony prominences.  

         Musculoskeletal and vascular injury are the most common complications of toxicity related to opioid abuse (Delaney, Stanley & Bolster, 2020); specifically, necrotizing fasciitis related to soft tissue injury from needle puncture to the vessel wall or infection (Delaney, Stanley & Bolster, 2020).  Further, studies show that opioid abuse results in damage to microvasculature structures resulting in decreased blood flow and ischemic death to tissues and bone (Wu, Song, Ni, & Dai, 2015).

         Hyperkalemia is defined as potassium levels greater than 5.0 (McCance & Heuther, 2019).  The patient in the case scenario presented to the ED with a serum potassium level of 6.5.  Hyperkalemia is common in trauma since tissue damage caused by ischemic muscle cells release intracellular potassium to extracellular space (Wu, Song, Ni, & Dai, 2015).  When extracellular potassium ratios exceed intracellular, the cell membrane becomes depolarized, “excitable” and “irritable”, manifested by tall T-waves and longer PR intervals on the ECG (McCance & Huether, 2019). 

         The crux of the problem and solution lies in the disease of addiction itself.  Amid rising opioid use and overdose-related deaths, genetics, specifically D2 (dopamine) receptors is shown to have a significant role in 23-54% of opioid use disorders (Crist, Reiner, & Berrettini, 2019). Genome studies using brain tissue from the prefrontal cortex have revealed specific shared genetic loci linked to illicit drug addiction (Hancock, Markunas, Bierut, & Johnson, 2018). These studies provide valuable data and promise for developing effective treatments against the opioid epidemic and its heavy burden on the fabric of our social and healthcare systems.

Reference

Crist, R. C., Reiner, B. C., & Berrettini, W. H. (2019). A review of opioid addiction
         genetics. Current Opinion in Psychology, 27, 31–35. https://doi-
         org.ezp.waldenulibrary.org/10.1016/j.copsyc.2018.07.014

Delaney, F. T., Stanley, E., & Bolster, F. (2020). Retrieved November 30, 2020, from https://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/detail/detail?vid=4

Genes matter in addiction. (2008, June). Retrieved November 30, 2020, from https://www.apa.org/monitor/2008/06/genes-addict

Hancock, D., Markunas, C., Bierut, L., & Johnson, E. (2018, March 5). Human Genetics of Addiction: New Insights and Future Directions. Retrieved November 30, 2020, from https://www.ncbi.nlm.nih.gov/pubmed/29504045

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in
         adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier

2 resources for each of the discussion

 Goal:

Identify the process for decision making regarding technology. Discuss nursing role in identifying appropriate technology for practice.

Your paper should include the following:

1. One technology application used in health care to facilitate decision making.
2. The application’s impact on quality of decision making.
3. The process for selecting and implementing the application.
4. The costs associated with the application.
5. Nurses’ role(s) in selecting and evaluating the application.

Your assignment will be graded according to the grading rubric.

Final Essay/Paper RubricCriteriaRatingsPoints

Identification of Main Issues/Problems

10 points
Distinguished

Identify and demonstrate a sophisticated understanding of the issues/problems.

8 points
Excellent

Identifies and demonstrate an accomplished understanding of most of issues/problems.

6 points
Fair

Identifies and demonstrate an acceptable understanding of most of issues/problems.

4 points
Poor

Identifies and demonstrate an unacceptable understanding of most of issues/problems.

10 points

Analysis and Evaluation of Issues/Problems

10 points
Distinguished

Presents an insightful, thorough analysis and evaluation of issues/problems.

8 points
Excellent

Presents a thorough analysis and evaluation of most of the issues/problems.

6 points
Fair

Presents a superficial or incomplete analysis and evaluation of issues/problems.

4 points
Poor

Presents unacceptable analysis and evaluation of issues/problems.

10 points

Demonstrates a Conceptual Understanding

10 points
Distinguished

Provides a thorough, competent and interpretive responses to all issues/problems, and shows a high level of conceptual understanding.

8 points
Excellent

Provides a competent and interpretive responses to all issues/problems, and shows a moderate level of conceptual understanding.

6 points
Fair

Provides a competent responses to all issues/problems, but lacks interpretation and a moderate level of conceptual understanding.

4 points
Poor

Provides an unacceptable response to all issues/problems, and lacks interpretation and a moderate level of conceptual understanding.

10 points

Use of Citations to Course Readings and Additional Research/Literature

10 points
Distinguished

Effectively uses the literature and other resources to inform their work. Exceptional use of citations and extended referencing.

8 points
Excellent

Effectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.

6 points
Fair

Ineffectively uses the literature and other resources to inform their work. Moderate use of citations and extended referencing.

4 points
Poor

Ineffectively uses the literature and other resources to inform their work. An unacceptable use of citations and extended referencing.

10 points

Writing Mechanics and APA Formatting Guidelines

10 points
Distinguished

Demonstrate a high level of clarity, precision, and attention to detail. APA style is correct and writing is free of grammar and spelling errors.

8 points
Excellent

Demonstrate a high level of clarity. APA style and writing mechanics need more precision and attention to detail.

6 points
Fair

Demonstrate a moderate level of clarity. APA style and writing mechanics need more precision and attention to detail.

4 points
Poor

Demonstrates issues in writing and communicating clearly. APA style and writing mechanics need serious attention.

10 points

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

• Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
• Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
• Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

• Briefly and generally explain the policy or regulation you selected.
• Address the impact of the policy or regulation you selected on system implementation.
• Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
• Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

Scenario:
• Your 79, year old female patient suffered a stroke 6 months ago. She is cared for in her sister’s home. The patient is dependent for position changes. She is unable to communicate the need to be turned. She must be fed at all meals. She has a stage II pressure injury on her sacral area.

Questions:
• Develop a teaching plan for the family to ensure that the patient’s needs are met

scenario 2

Directions: Musculoskeletal
• A 72, year old man lived a fairly sedentary lifestyle as an accountant. Now that he is retired, he recognizes the need to be active to maintain his health as long as possible. He is concerned, however, that it is too late for him to start exercising because he has never engaged in such activities.

 APA STYLE AT LEAST 3 REFERENCES AND CITATIONS. 

NOTE: “Im studying nursing”

1. What are three questions you should ask yourself when you begin your job search?

2. What are the most common mistakes people make in preparing their résumés? 

3. What should you know about your prospective employer before the job interview?

4. What should the interviewee try to achieve during a job interview? What should you look for? What red flags should you watch for? 

5. What can you do in advance to prepare for the changes during the first year of employment? 

6. Create your own SWOT analysis. How would you respond to your personal strengths and weaknesses if you were a prospective employer? How can you enhance your strengths and improve in areas of weakness? 

7. Draw a career path for yourself, beginning with the present year and extending to the age of retirement. Be sure to include any “twists and turns” of the path you expect to experience along the way and any barriers you expect to encounter. How will you handle these experiences? 

8. Do an online nationwide search for information about current job prospects in nursing.Compare opportunities in various regions of the country. Why do you think these opportunities are the same or different? 

9. Develop a list of questions that you should ask a potential employer. What “homework” will you need to do to prepare for an interview? 

According to the Association of State and Territorial Health Officials (ASTHO), the four core components of knowledge management are:

• Governance: The leadership that commits to an organizational structure that is capable of managing the knowledge.
• Content: The quantity and quality of the data and information that is managed.
• Processes: The standards and guidelines that will be used to collect, manage, and disseminate information.
• Technology: The system supporting the other three components.

Tasks:

CHI and Knowledge Management

In Week 2, we discussed EHRs as they relate to knowledge management. This week, we take a look at the consumer perspective of PHR, Social Networking, Home Telemedicine, and Smart Phone Technology. Using the South University Online Library or the Internet, research EHR. Based on your research and understanding, answer the following questions:

• Identify and describe the stakeholders involved in collecting and stakeholders involved with contributing to data collection in the Personal Health Record systems and other consumer informatics tools such as smartphone applications.
• Examine the role of knowledge management components in consumer informatics.
• Justify the importance of health literacy for patient empowerment in consumer informatics.

Submission Details:

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

To support your work, use your course and text readings, South University Online Library and also use outside sources. As in all assignments, cite your sources in your work and provide references for the citations in APA format.