Pulmonary Case Study

CH is a sixty-three-year-old man who has had emphysema problems for many years. History: He smoked for twenty years before quitting.

The nurse meets CH for the first time. In performing a physical assessment, the healthcare provider would expect CH to have a “barrel” configuration to the chest. What is the underlying pathological process that contributed to the “barrel” chest configuration?

Lab values were drawn during the last physician visit; would you expect arterial gases to be normal or abnormal? Identify the pathological process involved in your response. CH and other patients with emphysema are at risk for what complications because of the pathologic process of their disease?

APA format

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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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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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The research article to be critiqued is: https://journals.lww.com/journaloftraumanursing/Fu…

Please use the following guide for the research critique. The paper needs to be APA format.

QUALITIATIVE RESEARCH CRITIQUE GUIDE

1. Is the research tradition for the qualitative study identified? If none was identified, can one be inferred? If more than one was identified, is this justifiable or does it suggest “method slurring”?

2. Does the study purpose match the study design? Was the best possible design (or research tradition) used to address the study purpose? Is the research question congruent with a qualitative approach and with the specific research tradition?

3. Is the design appropriate, given the research question? Does the design lend itself to a through, in-depth, intensive examination of the phenomenon of interest?

4. Does the report describe an explicit theoretical or conceptual framework for the study? If not, does the absence of a framework detract from the significance of the research or its conceptual integration?

5. Given the nature of the data, was the data analysis approach appropriate for the research design?

6. Is the category scheme described? If so, does the scheme appear logical and complete? Does there seem to be unnecessary overlap or redundancy in the categories? Were manual methods used to index and organize the data, or was a computer program used?

7. Did the report adequately describe the process by which the actual analysis was preformed? Did the report indicate whose approach to data analysis was used (e.g., Glaserian or Straussian, in grounded theory studies)?

8. What major themes or processes emerged? If excerpts from the data are provided, do the themes appear to capture the meaning of the narratives?

9. What evidence did the report provide that the analysis is accurate and replicable? Were data displayed in a manner that allows you to verify the researcher’s conclusions?

10. Did the analysis yield a meaningful and insightful picture of the phenomenon under study? Did the report give you a clear picture of the social or emotional world of study participants?

11. Which specific techniques (if any) did the researcher use to enhance the trustworthiness and integrity of the inquiry? Where these strategies used judiciously and to good effect? Given the efforts to enhance data quality, what can you conclude about the study’s validity/integrity/rigor/trustworthiness? Does the report adequately address the transferability of the findings?12. Did the report discuss any study limitations and their possible effects on the credibility of the results or on interpretations of the data? Were results interpreted in light of findings from other studies? Did the researchers discuss the study’s implications for clinical practice or future research?

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