Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%

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Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5 kg
  2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
  3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
  5. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

 

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Evaluate the implications of the effects of contemporary health policy on providers and consumers.

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1. Evaluate the implications of the effects of contemporary health policy on providers and consumers.

2.Assess the legislative and policy-making strategies specific to scope of practice and nursing roles that influence health care services and practice.

Choose a health care treatment option that is controversial and maybe costly. Describe the positive and negative benefits from the treatment, evidence of effectiveness, and the potential harm of a different treatment option. What strategies would you use to advocate for a legislative change in your state to influence insurance coverage for this treatment.

  1. Choose a controversial health care treatment option. Describe the treatment.
  2. Describe the social and legal controversy associated with your controversial treatment.
  3. Describe the evidence that supports the effectiveness of the controversial treatment.
  4. Describe the evidence that does not support the effectiveness of the controversial treatment.
  5. Compare and contrast the positive and negative benefits or harm of the controversial treatment.
  6. Compare and contrast positive and negative aspects of available traditional treatments.
  7. Compare and contrast the costs of the controversial treatment with the costs associated with traditional treatments
  8. Describe the required process for legislative change to occur in your state.
  9. Describe a strategies that you would you use at the local and state level to advocate for a legislative change in your state that would influence insurance coverage for this treatment.
  10. Provide an estimated timeline for your legislative change to occur. Use the steps describe in required process for legislative change for your state.

Note:

  • This is a fact-based Assignment that will not include your opinion.
  • This will require research and support for what is written.
  • The Assignment should be in your words after reading the scholarly and fact-based publications and have proper citations. There should be no quotations. The professor wants to hear your voice as a masters trained nurse.
  • The paper should have a minimum of seven citations and some of these should be case law or applicable statutes.

Journal Readings

Please retrieve and read the following journal articles

American Nurses Association. (2015). Health care reform. Retrieved from http://www.nursingworld.org/healthcarereform

Arnold, H. D. (2013). The Affordable Care Act and international recruitment and migration of nursing professionals. Indiana Journal of Global Legal Studies, 20(2), 1373–1391. doi:10.2979/indjglolegstu.20.2.1373

Buerhaus, P. I., DesRoches, C., Applebaum, S., Hess, R. Norman, L. D., & Donelan, K. (2012). Are nurses ready for health care reform? A decade of survey research. Nursing Economic$, 30(6), 318–330.

Fox, J. B., & Shaw, F. E. (2015). Clinical preventive services: Coverage and the Affordable Care Act. American Journal of Public Health, 105(1), e7-e10. doi:10.2105/AJPH.2014.302289

 

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According to Rodriguez, Ferreira, Mishima & et al. (2016), group dynamics is a form of communication, interaction and collective relationship that provides learning and education for group interest.

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Groups

According to Rodriguez, Ferreira, Mishima & et al. (2016), group dynamics is a form of communication, interaction and collective relationship that provides learning and education for group interest. Group interacts, exchange opinions and communicates to accomplish better outcomes. Group dynamics are essential for leadership and management of any healthcare organization.

Group belongings: The group I am currently involved in my organization is the unit based council. It is an open group committee for the psychiatric department. Although the purpose is to collaborate with staff for our department improvement, it is open to employees and management for the development and growth of patient care. It uses evidence-based practice to improve nursing practice. It empowers employees to provide excellent care for a better outcome. It focuses on things that influence nursing standard, quality improvement, patient safety and care. It gives nurses shared decision-making skills and encourages nurse to take shares governance, voice, and ownership of patient care to make change possible for better patient outcomes. We meet twice a month to discuss any issues or solution to problems in the department, and it is a paid or clock-in education in-service.

Group formation stages: the five stages of group development are forming, storming, and norming, performing and adjourning. The forming stage of group development involves group orientation, guidance, and direction. This stage includes the gathering of strangers to form common goals, impression and seeking ways to known and understand each other. The storming stage evaluates prospective leaders among the group, rules are created, and individual members struggle for power or authority in the group. Norming is group unity showing interpersonal relationships. Here, members gather, contribute, maintain and tries to solve group problems. In performing stage, subgroups are created, and group morale is high, and the members are working together for group goals. The final step of group development is adjourning. It involves rewarding members for their contributions.

Group role and leadership strategies: during the formation of unit-based council and meeting involve anxiety, vision, and communication. Leadership strategies involve commitment, delegation and open-minded in carrying out group mission.

In conclusion, group communications are needed to assess and advance group mission adequately. In healthcare, nursing leadership is necessary to inspire members and contribute to group success.

 

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Healthy People Initiative

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Healthy People Initiative

1313 unread replies.2020 replies.

This week’s graded discussion topic relates to the following Course Outcomes (COs).

  • CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities. (PO 1)
  • CO3 Utilize effective communication when performing a health assessment. (PO 3)

The topic this week asks you to apply what you have learned to the following case study.

As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After conducting her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She attends class a total of 15 hours per week, plus she must be present for 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. She lives 1 hour from campus and commutes each day. Using Healthy People 2020 (Links to an external site.)Links to an external site. and your text as a guide, answer the following questions.

  1. What additional information would you like to gather from Maria?
  2. What are Maria’s real and potential health risks?
  3. Why is Maria’s culture important when obtaining the health assessment?
  4. Pick one of Maria’s health risks. What would be one reasonable short-term goal for this risk?
  5. What nursing interventions would you incorporate into Maria’s plan of care to assist her with meeting your chosen goal? Please provide rationale for your selections.
  6. Class,

    As we begin this week starting to talk about Healthy People 2020, I am looking forward to your input and answers to the questions with the scenario and Maria. As you are reviewing the Healthy People 2020 new topic areas, in this week’s lesson, what are your thoughts on them? Do any of these topics apply to your current workplace setting? Can you share an example of the scenario or a workplace example, and would these new areas benefit you in your practice?
 

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People typically think of filling prescriptions and counseling patients in a retail setting.

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Informative Speech Outline

Specific Purpose: At the end of my speech, the audience will be able to describe what consultant pharmacists are, some jobs they perform, and some advantages of utilizing consultant pharmacists in senior care facilities.

Central Idea: Consultant pharmacists are important because they aid in the improvement of senior care and quality of life for institutionalized seniors.

INTRODUCTION

  1. When you think of a pharmacist, what comes to mind?
  2. People typically think of filling prescriptions and counseling patients in a retail setting.
  3. I will speak about the consultant pharmacist today, which wikipedia.com defines as a “specialized pharmacist who focuses on reviewing and managing the medication regimens of patients, particularly those in institutional settings such as nursing homes.”
  4. According to ascp.com, “There are 5.5 million seniors with long-term disabilities in the United States. This figure is expected to increase to 10 million by the year 2020, and to 20 million by 2040.”
  5. Consultant pharmacists are important because they aid in the improvement of senior care and quality of life for individuals living in institutions like nursing homes.

Transition: To understand the importance of consultant pharmacists you must further understand what they are.

BODY

  • These are some of the characteristics of consultant pharmacists.
    • Completed pharmacy school
    • Medication therapy experts
    • Have specific knowledge of geriatric care
    • Typically work for, or own their own firm or practice
  • There are many jobs these pharmacists perform, but these are a few of great importance.
    • Check that prescribed medications are appropriate for older patients.
    • Double check that certain medications are safe to use together.
    • Adjust drug regimens or possibly medication types to prevent or reduce adverse side effects because about 28% of hospitalizations of seniors are due to adverse drug effects, according to ascp.com
    • Possibly adjust medication dosages or brands to save patient money.

Transition: Now that you understand the type of people that work as consultants, you will see how they perform many jobs to help patients.

Transition: These results I have just presented are very important, we will probably all agree.

CONCLUSION

  1. ascp.com states that “There are more than 1.6 million nursing home beds in the United States; this represents an increase of over 25% since 1980.”
  2. Since there is an increase of this magnitude, the significance of the consultant pharmacist is growing as well.
  3. Senior citizens are important to all of us here, so the work of consultants is of the utmost importance because we want the elderly to be well taken care of.
  4. Thank you very much for your attention.

Works Cited

American Society of Consultant Pharmacists. Fact Sheet. 26 February 2004.

Wikipedia. Consultant Pharmacist.25 January 2006.

Medscape Pharmacists. Promotion of a Safe Medication Environment.

© 2001 Medscape Portals, Inc.

 

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Smoking causes lung cancer.

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Forum Objective: Prepare students for the Week 3 speech assignments

You do not have to record your Week 3 speech. Recording your speech is totally optional. Instead, you have the option of just posting your Powerpoint or a recorded narration of your Powerpoint. It is up to you. Just remember, however, to place your speech in the speaker notes.

If you want to know which citation style to use with your major, consult The APUS Library Style Guide for Majors.

Read the Week 3 Overview to learn more about how to make a speech.

For your Initial post:

Post an outline of your Week 3 speech. You can attach your Power Point to your forum post or you can simply type out your Power Point speech structure like the example below. It is up to you. Take a look at this Power Point speech template Here is an example of a Power Point speech:

Structure of a Power Point Speech

Slide 1: Title Slide with your name

Slide 2: Put your main idea (thesis) with all three reasons. Smoking causes lung cancer, throat cancer and stomach cancer.

Slide 3: Smoking causes throat cancer. (3 bullets tops) Write what you want to say in the speaker notes.

Slide 4: Smoking causes lung cancer. (3 bullets tops)

Slide 5: Smoking causes stomach cancer (3 bullets tops)

Slide 6: Conclusion

Slide 7: Sources

“I am a nursing major. In the future, I want to practice nursing. Topics that I am interested in pursuing include obesity and weight management, death with dignity as well as palliative care. In my speech, I will explore how to control obesity and weight management. As a nursing major, it will be possible for me to interact with people of all ages and discuss with them the need to eat healthily. In my position paper, I will explore the benefits associated with death with dignity. It is important to note that death with dignity is beneficial as it allows the deceased die with dignity, it as well helps to conserve resources as well as reducing emotional trauma in the terminally ill patient. In the analysis paper, I will focus on the influence that training has on the delivery of services for palliative care patients.

 

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Are Sartre and Smullyan right that it is impossible for anything that is self-conscious not to have free will?

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Using the prompts below, choose one and write an essay (approximately 1000 words). Read the grading rubric BEFORE writing so that you are sure to address all four elements of the grading rubric. Your essay MUST be submitted in one of the following formats (.doc, .docx, .rtf, .pdf). Failure to do so will count as a NON-SUBMISSION. This also means that you cannot type the essay directly into ecampus. YOU MUST SAVE YOUR ESSAY IN ONE OF THOSE FORMATS AND ATTACH IT TO THE LINK ABOVE (Where the word “Essay” is underlined above.) If you do not know what this means or how to save your work as one of those files, see me or email me immediately. Not knowing how will not be an excuse to allow late work. The essay will go through software that will test for plagiarism. Be sure that when you write your essay you do not use material from other sources without citing them. Doing so is cheating and grounds for a 0. I will select two topics and you must write a 1000 word essay on one of those two topics.I am providing you with the topics from Module 2 so that you can prepare for the topics as you study each chapter.Your essays will be graded according to the rubric presented in “Writing a Philosophy Paper.”

Write your essay as if you are writing to a friend who missed class on the day this was discussed. There is no bibliography or works cited page required. You may write in first person or even write the essay as if it were a letter to your “friend” from class.

The essay should be double spaced and in a readable font (10pt. and 12pt. are best)

PROMPTS:

  1. Are Sartre and Smullyan right that it is impossible for anything that is self-conscious not to have free will? Explain and evaluate your position.
  2. Is it reasonable to believe something when you do not have sufficient evidence? Explain and evaluate your position.

Essay: At the end of the semester, I will give you a choice of two topics on which you must write a brief essay (approximately 1000 words). The point of this paper will be to focus on one particular argument or theory. The goal is not to do research (looking up stuff in the library) but to focus your thoughts on one argument or one position and dig deep. Your grade on this paper will be primarily based on the clarity of your writing, the command of the material and the “depth” of your explanations. (Which side of the issue you are on is completely irrelevant). In fact, I will give you the grading rubric I will use to assess your essays. You should use this rubric as a guide to develop your outline. The topics will come from the list of possible essay topics found in each module. I will choose the topics that you will write on, but you should study these possible topics throughout the semester so you will be prepared to write your essay when the assignment is given.

 

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What is the work hardening program?

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1. What is the work hardening program? Which objectives it should fulfil to improve employee’s capacity to complete a specific task safely? (5 Points)

2. What are the main risk factors for falls in retail operations? How they can be prevented. (minimum 300 words – 6 Points)

3. State and explain personal and environmental factors that affect physical work (minimum 300 words- 6 Points)

4.Summarize the important points you learned in this class and how you will incorporate them in your daily routine.(minimum 300 words- 3 Points)

 

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Demonstrate understanding of the main themes/ controversies presented in the articles

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The purpose of this assignment is to enable students to reflect on and critically evaluate social work practice in a variety of settings, and address issues of diversity with regard to social work practice. These readings are found on Blackboard. In your Reaction Essay, you should read the
assigned articles carefully and:
Demonstrate understanding of the main themes/ controversies presented in the articles
Make connections between ideas presented by the authors/ arguments
Explore your feelings about the ideas and arguments made by the authors
Show evidence of original thought and critical thinking about the topic
Utilize correct APA format, including paraphrasing and citing sources correctly
It is expected that students will present information in such a manner that it is clear each
assigned reading has been read and that true, professional reflection has occurred. Superficial
Reaction Essays – those for which the Instructor cannot easily ascertain that reading has occurred
– will not receive credit. In addition, reaction essays should not be “book reports”, and should
not be a cut-and-paste regurgitation of the material. Well-written reaction essays should reflect
critical thinking/ discourse about the content/issues/themes presented by the authors.
Format requirements for Reaction Essays:
*Your essay must be double-spaced and typed in 12-pt font.
*The following information should be typed in as a “HEADER” in the upper right-hand corner:
First & Last Name
Reaction Essay #__ (date)
*You must use 6th edition APA format to cite CORRECTLY within the text of your paragraphs.
*NO “DIRECT QUOTES” ARE ALLOWED! You must paraphrase and cite your sources in
correct 6th edition APA format. [Note: Do NOT plagiarize any material in your paper. Any
plagiarism will result in a “0” for this assignment!
*You do NOT need to attach a “References” page because the readings/videos have been
provided to you.
*Your essay should be 1 full page (minimum) to 2 pages (maximum).
[SOCW 145]/
Spring, 2019

  • 18 –
    *You must use paragraphs, complete sentences, correct spelling, and punctuation as well as
    express your original ideas clearly.
    The rubric used to grade this assignment will be found under the “Rubrics” tab on Blackboard.
    Be sure to look over this rubric before turning your essays in. Students will receive a copy of
    this completed rubric, as well as written feedback on your essay.
 

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