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APA  FORMAT

2. CITE ALL REFERENCES 

3. PLEASE COMPLETE ALL QUESTIONS. Late assignments will not be accepted!!!

Case Study: Urinary Tract Infection

 You are working in an extended care facility when M.Z.’s daughter brings her mother in for a week’s stay while she goes on a planned vacation. M.Z. is an 89-year-old widow with a 4-day history of non- localized abdominal pain, incontinence, new-onset mental confusion, and loose stools. Her most current vital signs are 118/60, 88, 18, 98.4° F (37.4° C). The medical director ordered a post void catheterization, which yielded 100mL of cloudy urine that had a strong odor, and several lab tests on admission. Urine culture and sensitivity results are pending; the other results are shown in the chart.

Chart View Laboratory Test Results:

Complete metabolic panel: Within normal limits except for the following results:

 BUN 25mg/dL Sodium 131mEq/L

 Potassium 3.2mEq/L

White blood cell count 11,000/mm3

Urinalysis Appearance Cloudy Odor Foul

 pH 6.9

 Protein Negative

 Nitrites Positive

 Crystals Negative

WBCs 6 per low-power field

 RBCs 3

1. What condition do the lab reports point toward?

1. Which assessment findings are typical of an older adult with the condition in Question 1?
2. Considering her history and laboratory results, what other condition is a possibility?

4.The medical director makes rounds and writes orders to start an IV of D5 ½NS at 75mL/hr. and insert a Foley catheter to gravity drainage. Because M.Z. is unable to take oral medications, the medical director orders ciprofloxacin (Cipro) 400mg q12h IV piggyback (IVPB). Are the type of fluid and rate appropriate for M.Z.’s age and condition? Explain.

1. While the IVPB ciprofloxacin is being administered, which adverse effects might occur?

1. You enter the room to start the IV infusion and insert the Foley catheter and find that the nursing assistive personnel (NAP) has taken M.Z. to the bathroom for a bowel movement. M.Z. asks you to help her, and, as you open the door, you observe her wiping herself from back to front. What do you need to do at this time?

1. Because M.Z. has been having diarrhea, what special instructions should you give the NAP assigned to give basic care to M.Z.?

Case Study Progress:

 The next day, you are the nurse assigned to M.Z.’s care. You notice that the NAP emptying the gravity drain is not wearing personal protection devices. You also observe that the drainage port of the drainage bag was contaminated during the process because the NAP allowed it to touch the floor.

1. What issues need to be considered in protecting M.Z.’s safety? Describe your actions in working with the nursing assistant.

1. As you assess M.Z., you notice that her catheter tubing is not secured. Why does the tubing need to be secured, and where is the correct place for the catheter tubing?

1. What changes, if any, will be made to the antibiotic therapy?

You will write a case study review which includes your critique. This will be worth 30 points total. Create a detailed case study review in an essay APA format and include as your final page a reference list in APA format. Your review should be double-spaced, 2 pages minimum (not including reference list), with correct grammar and spelling. 

The purpose of this summative assignment is to reflect upon the new knowledge you have obtained from this course and apply it to your chosen case study while developing your critical thinking and critique skills. Be sure to consider all information from the course content – discussion board exercises, videos and any additional readings. Revisit readings from your Gilmore text. Put thought into how well you think the case study conducted their assessment, and how you would augment or improve it. Utilizing your knowledge from our course around assessing community needs, provide a detailed description and critique of your case study. Be sure to review your case study carefully to look for any gaps or areas with which improvements could be made, and justify your thinking. Reference additional scholarly resources to reinforce your justification. Be sure to cite your work appropriately.

Provide a brief (1 – 2 paragraph) description of the population and the health concern or issue being addressed. Explain how your chosen case study did, or did not, do in the area of describing the community, justifying the need for conducting the assessment, etc. Describe how your case study did with (or if they omitted) considering learning styles and theories as well as models to promote health education. Describe how your case study assessed groups and/or individuals (if applicable) and if they considered any factors that impact health education. Using your knowledge around each weekly module, discuss three suggestions for improving your case study. You may present an alternative approach or additional steps that you believe would improve the quality of your case study. Consider these prompts as you complete your critique:

• How did the case study identify the issue and explain the importance of the specific topic within the community?
• Did the case study paint a detailed picture of the population?
• Does it include a detailed description including information on demographics, barriers and challenges?
• Does it justify the need to conduct a needs assessment?
• Does it identify and describe community resources and explain why the resources are or are not effective?
• Does it explain any process for collecting data?

Remember to discuss recommendations. As you have done previously in our discussion boards and weekly modules, apply your critical critiquing skills to suggest what improvements are needed. Finish your essay with a summative paragraph which includes your final thoughts around how your suggested improvements would enhance this case study to meet the needs, or “fill in the gaps” and provide assistance to the community or population represented. 

Finally, include in APA format, a list of references. This should include a minimum of 2 references which are scholarly sources of information no previously referenced in the course. You may use any of the resources that were referred to throughout our weekly modules. You may also include your text as a resource in addition to your 2 references.

Prepare for your ethical and cultural inquiry. Consider how culture can impact healthcare decisions and outcomes. Read the following article from the Western Journal of Medicine: 

Galanti G. A. (2000). An introduction to cultural differences. The Western Journal of Medicine, 172(5), 335–336. doi:10.1136/ewjm.172.5.335

Discuss the following:

1. Do you agree with the writer’s premise that treating patients with respect is not enough, and it is necessary to learn about the specific customs of other cultures in order to provide quality health care? Explain your reasoning and provide examples.

2. Do you think there is a danger in stereotyping when discussing cultural norms? Explain and provide examples.

3. Which cultures and customs are you most familiar with?

4. Does culture play a significant role in the healthcare issue that you are researching? Explain.

Write a Letter for Graduation to yourself if you were graduating from nursing school.

 a. Your assignment is to write a letter to yourself on your graduation day. 

b. Consider the following questions as you compose your letter. 

i. How do you hope you have changed in terms of knowledge and skills, and personally? 

ii. What would you like to remind yourself about your inspiration for choosing this career? 

iii. You will be preparing to take the NCLEX exam and to start your first job as a baccalaureate-prepared nurse. Are there any words of encouragement that you would like to tell your future self? 

iv. Are there any words of caution you want to tell yourself—pitfalls to avoid? 

v. What kind of nurse do you hope you have become? What further growth and change do you envision for yourself?  

ALSO, Include an inspiration page.

One page that you create that represents your inspiration for becoming a nurse. It may be a picture, a collage, a series of quotes, and so forth. Choose words and images that are meaningful to you. This should be a picture that you can post somewhere, perhaps where you study, in order to motivate yourself as you move forward on your journey to become a nurse. 

Less than 10 % similarity

References APA

This is another student post to which i have to react adding some extra information related this post. 

short answers.

As nurses, we need to elaborate a care plan every time we receive a patient or have a particular situation that requires medical intervention. On a patient that is planning on hurt himself the first step will be to correctly diagnose the condition. Usually, patients who are at risk for self-harm are suffering of depression, anxiety and other secondary conditions such as bipolar disorder etc. 

The outcome will be that the patient will remain free from any self-harm during the time that patient remains in the hospital. It is also important to involve the patient in the plan of care, like encouraging him to talk about his feelings, any suicidal ideation and thoughts. In addition, the patient will verbalize different solutions or ideas to cope with the current situation. 

Some of the interventions will be not to leave the patient alone as a first step and stablish a one to one supervision or a backeract order in some states of USA like Florida. Always explaining to patient every step of the intervention and removing every object that the patient can use to harm himself such as curtains, needles, and cords. The second step will be to schedule a consultation with a psychiatric physician. It is important to evaluate every step of the interventions to make sure that patient can be discharge home safely.

(Nursing Care Plan and Diagnosis for Risk for Self Harm Related to | Suicide Depression Nanda Nursing Interventions and Outcomes, 2013).

References

Benzodiazepine Toxicity. (n.d.). Retrieved July 29, 2016, from 

http://emedicine.medscape.com/article/813255-overview

Lithium toxicity: MedlinePlus Medical Encyclopedia. (n.d.). Retrieved July 29, 2016, from 

https://medlineplus.gov/ency/article/002667.html

Nursing Care Plan and Diagnosis for Risk for Self Harm Related to | Suicide Depression Nanda 

Nursing Interventions and Outcomes. (2013). Retrieved July 29, 2016, from http://www.registerednursern.com/nursing-care-plan-and-diagnosis-for-risk-for-self-harm-related-to-suicide-depression-nanda-nursing-interventions-and-outcomes/

Valproate Toxicity. (n.d.). Retrieved July 29, 2016, from 

http://emedicine.medscape.com/article/819315-overview

Varcarolis, E. M. (2013). Essentials of psychiatric mental health nursing. S.l.: Saunders.

***Please use the NEW APA 7th Edition. Please reference this guide when completing assignment.***

***USE the ATTACHED PDF document to complete this assignment***

1) Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. 

2)Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population.

Healthcare organizations continually seek to optimize healthcare performance. For years, this approach was a three-pronged one known as the Triple Aim, with efforts focused on improved population health, enhanced patient experience, and lower healthcare costs.

More recently, this approach has evolved to a Quadruple Aim by including a focus on improving the work life of healthcare providers. Each of these measures are impacted by decisions made at the organizational level, and organizations have increasingly turned to EBP to inform and justify these decisions.

To Prepare:

• Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
• Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
• Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.

To Complete:

Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:

• Patient experience
• Population health
• Costs
• Work life of healthcare providers

By Day 7 of Week 1

Submit your analysis.

 The paper needs to be in APA 7 format, well cited, has at least three reference and plagiarism free.

Principles of Evidence-Based Practice and its Implementation

Evidence-Based Practice (EBP) is an essential concept in healthcare settings as it entails the use of quality and resent evidence while making the most accurate decision regarding patient care and needs. Incorporation of evidence-based preparation when giving patient care involves a range of abilities that will help the nurse in locating the appropriate resources after research. Furthermore, nurses must understand the information used in deducing, recording, and evaluating the repercussions of different interventions on a patient treatment plan. As a result, this essay will highlight the principles of evidence-based research and how they are implemented in advanced nursing practice.

Evidence-based Practice is founded on two principles. According to (Islas et al., 2018), the first principle states that recognition of scientific evidence can result at times insufficient to guide decision-making that can be of great importance. Nurses need to gather relevant evidence before settling on their final decision. Thus, the principle requires nurses to take into account evidence from multiple sources instead of basing their final decisions solely on their judgment. Therefore, nurse practitioners should rely on findings from empirical studies, facts, and figures gathered from the organization, the professional practitioners, and judgment from stakeholders involved in the study and are known trustable.

Consequently, the second principle suggests that within the available sources of evidence, hierarchies exist. According to (Vere & Gibson, 2020), the hierarchies available within the sources allows nurses to employ a top-down approach in deciding the best evidence to be used. Following the hierarchies make nurse practitioners first to consider the recent well-conducted systematic reviews. They then move to the next level of evidence when the previous level fails to yield a solution for their query. (Vere & Gibson, 2020) It is believed that the postulate of the hierarchies in EBP rank will show the variety of studies based on their strengths of research methods. Thus, different hierarchies exist for a variety of questions making it possible for nurses to make decisions based on the appropriate outcome that can provide simultaneously the best results.

While EBP is considered as the best practice that guarantees patients the best health outcome, most hospitals encounter many challenges that come along with the same. Therefore, its effective implementation is necessary. In advanced nursing practice understanding the data behind the evidence (Stavor et al., 2017) postulates that understanding the data will help in considering whether the available data is satisfactory in supporting the implementation of a new practice, or additional data is required for efficiency.

Furthermore, there is a need to consider the available resources at their disposal. Advanced nurse practitioners need to modify evidence-based Practice to fit the resources available to them since the availability of resources varies in different organizations (Thompson-Brenner et al., 2018). Besides, implementation of the philosophies of EBP, nurses must develop goals based on the outcomes of patients and not on the process itself. Implementation of the principles is dependent on the nurse’s preferences since their partialities play a vital role in the success of the implementation process.

In summary, Evidence-Based Practice is the application of updated proof in arriving at the best decision for better patient outcomes in terms of care delivery. EBP is based on the principle that states that scientific evidence is insufficient in the decision-making process and that hierarchies are present within the sources of evidence provided. Hence, the successful implementation is dependent on a better understanding of the presented data that was able to be collected, considering this way all the available resources, while the development of goals is based on the patient’s needs, and considering the preferences of the nurse practitioner.

References

‌

Islas, O., Arribas, A., & Gutiérrez, F. (2018). The contribution of Alvin Toffler to the theoretical and conceptual imaginary of communication. https://doi.org/10.4185/rlcs-2018-1274en

Stavor, D. C., Zedreck-Gonzalez, J., & Hoffmann, R. L. (2017). Improving the Use of Evidence-Based Practice and Research Utilization Through the Identification of Barriers to Implementation in a Critical Access Hospital. JONA: The Journal of Nursing Administration, 47(1), 56–61. https://doi.org/10.1097/nna.0000000000000437 (Links to an external site.)

Thompson-Brenner, H., Brooks, G. E., Boswell, J. F., Espel-Huynh, H., Dore, R., Franklin, D. R., Gonçalves, A., Smith, M., Ortiz, S., Ice, S., Barlow, D. H., & Lowe, M. R. (2018). Evidence-based implementation practices applied to the intensive treatment of eating disorders: Summary of research and illustration of principles using a case example. Clinical Psychology: Science and Practice, 25(1), e12221. https://doi.org/10.1111/cpsp.1222

Vere, J., & Gibson, B. (2020). Variation amongst hierarchies of evidence. Journal of Evaluation in Clinical Practice. https://doi.org/10.1111/jep.13404

Topic question:

Would a public health approach to child abuse/neglect decrease rates of mental health issues in minors living in the United States?

PLEASE follow the template that’s attached below. 

For you third essay, you will need to use research concepts and methods. You will have freedom of choice for your topic. You will need to argue for or against something in the nursing or medical field. Do we need better mental health care for patients? Do we need better post-natal care for mothers? Do we need different types of restraint for hostile patients? Is there a current issue in the medical field when it comes to patient care that nurses could resolve? These are just some examples to get you thinking about your topic. This paper will need to be at least 900 words, and you will have to use at least three sources to back up your argument. 

Requirements:

• APA formatting
  • cover page
  • abstract
  • Times New Roman, 12 point font
  • double spacing
  • reference page with at least three sources in APA formatting
• at least 900 words
• original work, NO PLAGIARISM
• subject to late work policy
• submit through Canvas, no emails or Google drive shares

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