History of Present Illness

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History of Present Illness

Max Wellington is a 59 y/o male with a history of diabetes mellitus type two on oral meds, frequent urinary tract infections and hypertension. He presents to the office today with c/o of dribbling, frequency hesitancy and also now some erectile dysfunction which is more apparent due to the fact that he is in a new relationship.

Chief Complaint

“I am up 4-5 times at night having to pee. I am dribbling urine and sometimes I do not make it to the bathroom in time. It is also sometimes hard to get going once I get to the bathroom. I recently met a very nice woman and we are in a relationship, but I am finding it increasingly difficult to be intimate with her. Being up all night going to the bathroom and then going to the bathroom on myself is ruining my love life!”

Past Surgical History

Appendectomy age 14

Medications

Metformin 500mg po BID, Toprol XL 50mg po daily, Terazosin 10mg po daily.

Allergies

Seasonal allergies i.e. leaves and pollen, worse in the spring. No known drug or food allergies.

Medical History

Hypertension (HTN), Diabetes Mellitus Type II, frequent Urinary Tract Infections

Family History

He is an only child. His mother is living at age 85 with HTN, HLD, CAD, DM II and his father is deceased at age 78 from an MI.

Social History

Divorced, in a new relationship with one female partner for the last 6mo. Has 2 adult children, one son and one daughter, both in good health. Denies heavy ETOH use, reports a glass of wine 1-2 times per week. Previous smoker, 1ppd for 20 years, quit in 2000. He is still working full time as a car salesman.

General

Denies recent fever, weight loss. Does admit to feeling fatigued because he is up so many times at night. Sitting comfortably in exam table, well nourished, in no acute distress.

Create a differential diagnosis list based on the information gathered about this case.

 

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What were the name and type of measurement method used to measure Caring Practices in the Roch, Dubois, and Clarke (2014) study?

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1. What were the name and type of measurement method used to measure Caring Practices in the Roch, Dubois, and Clarke (2014) study?

2. The data collected with the scale identified in Questions 1 were at what level of measurement? Provide a rationale for your answer.

3. What were the subscales included in the CNPISS used to measure RNs ’ perceptions of their Caring Practices? Do these subscales seem relevant? Document your answer.

4. Which subscale for Caring Practices had the lowest mean? What does this result indicate?

5. What were the dispersion results for the Relational Care subscale of the Caring Practices in Table 2 ? What do these results indicate?

6. Which subscale of Caring Practices has the lowest dispersion or variation of scores? Provide a rationale for your answer.

7. Which subscale of Caring Practices had the highest mean? What do these results indicate?

8. Was the most common arrhythmia in Question 7 related to LOS? Was this result statistically significant? Provide a rationale for your answer.

9. What study variables were independently predictive of the 50 premature ventricular contractions (PVCs) per hour in this study?

10. In Table 1 , what race is the mode for this sample? Should these study findings be generalized to American Indians with ACS? Provide a rationale for your answer.

 

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Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change.

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As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

  1. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
  2. Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.
  3. In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
  4. A minimum of three scholarly references are required for this assignment.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines.

 

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Positive Linear Versus Negative Linear Relationship

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Respond to 1 other discussion question with a minimum of 100 words

Introduction

It is imperative for medical professionals to make decisions based on evidence. For this to be possible, the expert ought to understand the procedures which will aid them in statistical analysis. The calculation and interpretation of data enable them to draw the appropriate and accurate results based on the evaluation of the findings. The linear analysis allows medical professionals to make assessments between two values.

Positive Linear Versus Negative Linear Relationship

The differences can be seen in; first, in a positive linear relationship, the values under comparison change together. For example, if one variable is high, the other one is equally as high. Besides, if one of the values is low the other becomes low as well. The most common correlation is evident in body weight, and blood pressure as the more the patient weighs, the higher their blood pressure tends to be. In a negative linear equation, if a value is high, the other one is usually low and vice-versa. The relationship can be seen in weight loss and calories consumption (Grove, Burns,& Gray, 2012). When a person is consuming a lot of calories their likelihood of weight loss usually is very low.

Second, in a positive linear relationship, the correlation values change in the same direction. For instance, if one goes up the other also goes up, for example, the relationship between stress and illness, when anxiety increases, illness also rises. In a negative linear equation, the correlation values change in the opposite directions as observed in the relationship between blood pressure and relaxation.

Conclusion

The linear relationships help medical professional to make analysis and treatment based on evidence. The professionals can also make predictions on outcomes based on the correlation values.

 

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Case Study Ethical Legal Dilemma Advanced Practice Nursing

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Case Study Ethical Legal Dilemma Advanced Practice Nursing

Demonstrate integrity through the application of relevant codes of conduct and social responsibility within one’s profession.

Please take a moment to watch this Assignment Introduction, or read the presentation transcript.

Instructions:

  • Create an ethical legal decision-making dilemma involving an advanced practice nurse in the field of education, informatics, administration, or a nurse practitioner. Apply relevant codes of conduct that apply to the practice of nursing and your chosen field.
  • Include one ethical principle and one law that could be violated and whether the violation would constitute a civil or criminal act based on facts.
  • Construct a decision that demonstrates integrity and that would prevent violation of the ethical principle and prevent the law from being violated.
  • Describe the legal principles and laws that apply to the ethical dilemma.
  • Support the legal issues with prior legal cases or state or federal statutes.
  • Analyze the differences between ethical and legal reasoning and apply an ethical-legal reasoning model in the case study to create a basis for a solution to the ethical-legal dilemma.
  • List three recommendations that will resolve advanced practice nurses’ moral distress in the dilemma you have presented.
  • Based on the issue you presented and the rules of the law, apply the laws to your case and come up with a conclusion.

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.

Description

In the Unit 2 topic 1 Discussion, you chose an ethical-legal dilemma that would cause the advanced practice nurse moral distress. You will write the introductory paragraphs for the Unit 4 Assignment.

You will continue working on the topic you have chosen and submit the paper using the most recent version of APA format. The paper should have a minimum of seven citations and some of these should be case law or applicable statutes. The Library has Westlaw Campus Research database where you can find case laws that relate to your topic. The APA Manual and the textbook have instructions on legal formatting.

4 pages not including tittle page or references.

Ethical Dilemma Discussed in Unit 2

As an advanced practice nurse in a clinical setting, there will be many instances in which contact with ethical-legal dilemmas will occur potentially causing a great deal of stress on personal morals (Pattison, 20015). As a practicing RN in the ICU, I have faced many obstacles pertaining to ethical-legal dilemmas. For instance, a 43 year old patient presented to the ICU with a case of T-cell lymphoma has been treated with multiple rounds of chemotherapy. Unfortunately, these rounds of chemotherapy led to her neutropenic count to drop and subsequently developed septic shock. As a result, her organs went into failure, necessitating total care including intubation. Following neurological assessments, tests, and overall presentation of the case, the prognosis was poor, and physicians agreed to diagnose the patient with cerebral death. In this case, the family was unwavering in their attempts to keep the patient ventilated and alive with total care as they were suffering from the first stage of grieving (Newman, 2014). As a result, this conjured a large degree of frustration to the staff nurses and clinicians working on the case. In this particular case, there are many variables that can be discussed regarding the legal implications of brain death and the process in physicians derive to the conclusion of brain death. Additionally, according to the hospital policy on ethical decision making every patient or the surrogate has the right of refusal of treatment/testing. As a future practicing clinician, this paper serves to embody the role of the advanced practice nurse to discuss the implications of brain death covering the legal aspects regarding the challenge of patient family refusal and what is beneficent for the patient and ethical-moral consideration (Joynt et al., 2015).

References

Joynt, G. M., Lipman, J., Hartog, C., Guidet, B., Paruk, F., Feldman, C., & … Sprung, C. L.

(2015). Communication: The Durban World Congress Ethics Round Table IV: Health care

professional end-of-life decision making. Journal of Critical Care, 30(1), 224-230.

doi:10.1016/j.jcrc.2014.10.011

Newman, L. (2014). Strategies for handling ethical problems in end of life care: obstacles and

possibilities. Nursing Ethics, 22(7), 778-789. doi:10.1177/0969733014547972

Pattison, N., O’Gara, G., & Wigmore, T. (2015). Negotiating transitions: involvement of critical

care outreach teams in end-of-life decision making. American Journal of Critical Care,

24(3), 232-240. doi:10.4037/ajcc2015715

 

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How would the use of the Roy Adaptation Model assist the nurse in planning the continuation of care for Sgt. Johns?

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Sgt. Eddie Johns leaned back against the chair in the outpatient orthopedic clinic. His head was killing him! He wasn’t sure which was worse, the “morning after” headache or not being able to sleep at night. At least when he had a few beers under his belt so he could catch a few hours of sleep. It had been like this since he was air evacuated back stateside from Afghanistan after the roadside bomb went off. He was thankful that he had only broken his leg in a couple of places and gotten a bad bump on the head. They called that traumatic brain injury but he didn’t know what that was and really didn’t believe them anyway. He was still thinking just fine. His friend Joe wasn’t so lucky! How was Joe going to learn to walk on those artificial legs? He was still in the hospital in Washington, DC. That was pretty far from his home. Eddie wished he could visit Joe. They had been in the same platoon for 9 months. But, Eddie was glad that he had been able to come back to his own home town for outpatient treatment. It took an hour to get here but at least he could see his girl almost every day. Sure he had moved back in with his mom but it was easier to have someone to help him get around and cook for him. It was a bummer that he couldn’t work right now. He guessed it didn’t matter much since he really didn’t have a job to go back to. He had been replaced at the plant. They said they would find something for him to do once he could get around more easily. Eddie sure hoped the doc would take the pins out of his leg today and give him a clearance to work. •How would the use of the Roy Adaptation Model assist the nurse in planning the continuation of care for Sgt. Johns? •Describe the influence of Roy’s Theory in guiding the nurse’s actions in promoting Sgt. Johns adjusted self-concept. •From the perspective of the Roy Adaptation Model, why is it important for the nurse to listen to Sgt. Johns’ “story” in his own words and not just base her interactions on information from the chart, fellow colleagues, or his family? •Based on Neuman System’s Model, identify at least 4 stressors from the case study. Create a plan of care based on Neuman Systems Model for Sgt. Johns. Your PowerPoint should include at least 1 outside reference and your book. The presentation should be 10 to 15 slides in length.

 

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A Family in Crisis

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A Family in Crisis

  1. Read the scenario below.
  2. Respond to the questions in full sentences. Be sure to use standard English grammar and spelling
    1. What biological, psychological, physical environmental, sociocultural, behavioral, and health system factors are influencing this situation?
    2. Is this a crisis situation? If so, what type of crisis would this be?
    3. What nursing interventions will you employ with this family?
    4. How might your interventions be different if you find that many families in the population are experiencing similar problem?

Scenario:

Juanita Brown is a 48-year-old African American single mother who live in a rural community with three children, a 13-year-old daughter, an 18-year-old son, and a 9 year-old step-daughter, and her 72-year-old mother who has been living with diabetes, hypertension, and is a breast cancer survivor who is unable to walk and function independently. Her 69 year-old father died of a heart attack 5 years ago.

Mrs. Brown has been a widow for the past two years. She has no other siblings. She has no marketable skills and has not been able to find a job within her community. She receives aid from the government through social security and does not have any health insurance for her, the three children, and for her mother.

She informs you, the community health nurse, that she feels depressed and does not want to live anymore.

 

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English Composition 101 Need By 1pm 06/26/2019

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English Composition 101 Need By 1pm 06/26/2019

Module 8 Graded Learning Activity #1

11 unread reply.11 reply.

Part 1:

Read “Making Appeals” in your Student’s Book of College English. It can be found on pages 320-322.

Watch the video below:

[youtube https://www.youtube.com/watch?v=9L_G82HH9Tg?feature=oembed&w=1200&h=675]

In 3-5 sentences, summarize what Ethos, Pathos, and Logos mean. In this summary, address the features associated with each appeal.

Your submission must use correct SPELLING, GRAMMAR, and PUNCTUATION!

The post English Composition 101 Need By 1pm 06/26/2019 appeared first on graduatepaperhelp.

 

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Was the nursing manager legally compliant with to protect patient information?

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In one particular case, a 13-year old patient was seen for trauma care by the UCCO Emergency Clinic. The patient’s parents make it clear to the staff that they are not willing to give consent to any procedure involving blood products or transfusion. The risks are explained to the parents. The patient arrived unconscious but shortly regains consciousness. After the parents leave the room, the patient tells the nurse that she is afraid of dying and would like any care, including blood procedures and products, to save her life. The nurse later finds out that the rejection by the parents was due to religious reasons. The nurse quickly discusses the case with fellow employees, one of which posts comments on her social media page using a clinic-owned computer. The nursing director give a verbal warning to all involved nurses and staff.

Using your research, address the following points in a minimum of 3-page report:

•Was the nursing manager legally compliant with to protect patient information? Explain the legal risks and support with federal legislations and professional expectations, such as HIPAA and professional codes of ethics.

•What bearing does the age and religious requests have on the patient’s case? Are there medical and ethical laws that supersede the parent’s requests?

•What is the role and importance of communication among UCCO facilities, particularly in reference to compliance and ethical standards?

•What are the ethical and professional factors of using social media?

•Were the reactions to the patient’s case illegal, or just unethical? How does this align with UCCO’s mission, values, and strategic action plans? How does it compare to your own personal beliefs and values?

 

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