case study week 8

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BACKGROUND

This week, we examine a 31-year-old male who presents to the office with a chief complaint of insomnia.

 

SUBJECTIVE

Patient is a 31-year-old male. He states that his insomnia has gotten progressively worse over the past 6 months. Per the patient, he has never been a “great sleeper” but is now having difficulty both falling asleep and staying asleep at night. The problem began approximately 6 months ago after the sudden loss of his fiancé. The patient states this is affecting his ability to perform his job, which is a forklift operator at a local chemical company. The patient states he has used diphenhydramine in the past to sleep but does not like the way it makes him feel the morning after. He states he has fallen asleep on the job due to lack of sleep from the night before. The patient’s medical record from his previous physician states that he has a history of opiate abuse, which began after he broke his ankle in a skiing accident and was prescribed hydrocodone/apap (acetaminophen) for acute pain management. The patient has not received a prescription for an opiate analgesic in 4 years. The patient states recently he has been using alcohol to help him fall asleep, approximately four beers prior to bed.

 

MENTAL STATUS EXAM

The patient is alert and oriented to person, place, time, event. He makes good eye contact and is dressed appropriately for time of year. He denies auditory/visual hallucinations. Judgement, insight, and reality contact are all intact. Patient denies suicidal/homicidal ideation, and is future oriented.

 

Decision Point One

Select what you should do:

 

Zolpidem: 10 mg daily at bedtime

 

T\razodone 50 mg po at bedtime

 

Hydroxyzine: 50 mg daily at bedtime

 

Examine  Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

· Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient.

Decision #1 (1 page)

· Which decision did you select?

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

· Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.

· What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).

· Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Conclusion (1 page)

· Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature.

 

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Journal Entry

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Discussion: Building a Health History

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Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.

 

With the information presented in Chapter 1 of Ball et al. in mind, consider the following:

  • By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
  • How would your communication and interview techniques for building a health history differ with each patient?
  • How might you target your questions for building a health history based on the patient’s social determinants of health?
  • What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
  • Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
  • Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
  • Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
  • Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

Analyze communication techniques used to obtain patients’ health histories based upon social determinants of health

Analyze health-related risk

Apply concepts, theories, and principles related to patient interviewing, diagnostic reasoning, and recording patient information

This is case assignment for this week’s Discussion listed below :

38-year-old Native American pregnant female living on a reservation

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implementing EBP

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Overview

Imagine you are on a team at your workplace and have identified a new best practice to implement.  In this assignment, you will describe the steps of implementing this new practice.  This will require you to do some research of your own about how change comes about in your workplace.  You will need to check your policies and procedures and may need to talk with a supervisor with experience in this area.  You will need to support your thoughts on why you think a change needs to occur.  This should be done by using the literature.

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Number of Pages/Words

Unless otherwise specified all papers should have a minimum of 600 words (approximately 2.5 pages) excluding the title and reference pages.

REQUIRED

CHAPTER 19 AND 20

NIGHTINGALE article attached

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Discussion post: Identifying and Interpreting Descriptive Statistics

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Examine the survey results downloadable from the link below. Choose one of the items, determine the descriptive statistic that is reported, and indicate what it means. For example, “What is the highest level of education of this group?” (Please do not repeat the same topic as your classmates.)

Hypothetical Results from Survey

I need one full page with two references to support the evidence.

Use the scholarly articles that are less than 5 years published to support the evidence and another one  from the book we are using in the class.

Thank you.

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Assignment Week # 3: Developing Organizational Policies and Practices

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Assignment: Developing Organizational Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

 

To Prepare:

· Review the national healthcare issue/stressor you examined in your Assignment for Module 1. (See attached document- WK2Assg_Lopez Cordova-A. ) and review the analysis of the healthcare issue/stressor you selected.

· Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.

 

The Assignment – Instructions (4 pages):

 

Developing Organizational Policies and Practices

 

Add a section to the paper you submitted in Module 1. (See attached document- WK2Assg_Lopez Cordova-A. Add the 4 pages to this document)

The new section should address the following:

 

1. Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.

2. Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.

3. Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.

4. Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.

5. Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations.

 

 

**At least 5 references**

 

Assignment: Developing Organizational

Policies and Practices

 

Competing needs arise within any organization as employees seek to meet their targets

and leaders seek to meet company goals. As a leader, successful management of

these goals requires establishing priorities and allocating resources accordingly.

 

Within a

healthcare setting, the needs of the workforce, resources, and patients are

often in conflict. Mandatory overtime, implementation of staffing ratios, use of

unlicensed assisting personnel, and employer reductions of education benefits are

examples of pract

ices that might lead to conflicting needs in practice.

 

Leaders can contribute to both the problem and the solution through policies, action,

and inaction. In this Assignment, you will further develop the white paper you began

work on in Module 1 by address

ing competing needs within your organization.

 

 

To Prepare:

 

·

 

Review the national healthcare issue/stressor you examined in your Assignment

for Module

1.

 

(See

 

attached document

–

 

WK2Assg_Lope

z

 

Cordova

–

A.

)

 

and

 

review the analysis of the healthcare issue/stressor you selected.

 

·

 

Identify and review two evidence

–

ba

sed scholarly resources that focus on

proposed policies/practices to apply to your selected healthcare issue/stressor.

 

 

The Assignment

–

 

Instructions

(4

 

pages):

 

 

Developing Organizational Policies and Practices

 

 

Add a section to the paper you submitted in Module 1.

 

(See

 

attached document

–

 

WK2Assg_Lope

z

 

Cordova

–

A.

Add the 4 pages to this document)

 

 

The new section should address the following:

 

 

1.

 

Identify and describe at least two competing needs impacting your selected

healthcare issue/stressor.

 

2.

 

Descr

ibe a relevant policy or practice in your organization that may influence

your selected healthcare issue/stressor.

 

3.

 

Critique the policy for ethical

considerations and

 

explain the policy’s strengths

and challenges in promoting ethics.

 

4.

 

Recommend one or more

policy or practice changes designed to balance the

competing needs of resources, workers, and patients, while addressing any

ethical shortcomings of the existing policies. Be specific and provide examples.

 

5.

 

Cite evidence that informs the healthcare issue/st

ressor and/or the

policies and

 

provide two scholarly resources in support of your policy or practice

recommendations.

 

 

 

**

A

t least 5 references

**

 

 

Assignment: Developing Organizational

Policies and Practices

Competing needs arise within any organization as employees seek to meet their targets

and leaders seek to meet company goals. As a leader, successful management of

these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are

often in conflict. Mandatory overtime, implementation of staffing ratios, use of

unlicensed assisting personnel, and employer reductions of education benefits are

examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action,

and inaction. In this Assignment, you will further develop the white paper you began

work on in Module 1 by addressing competing needs within your organization.

 

To Prepare:

 Review the national healthcare issue/stressor you examined in your Assignment

for Module 1. (See attached document- WK2Assg_Lopez Cordova-A. ) and

review the analysis of the healthcare issue/stressor you selected.

 Identify and review two evidence-based scholarly resources that focus on

proposed policies/practices to apply to your selected healthcare issue/stressor.

 

The Assignment – Instructions (4 pages):

 

Developing Organizational Policies and Practices

 

Add a section to the paper you submitted in Module 1. (See attached document-

WK2Assg_Lopez Cordova-A. Add the 4 pages to this document)

The new section should address the following:

 

1. Identify and describe at least two competing needs impacting your selected

healthcare issue/stressor.

2. Describe a relevant policy or practice in your organization that may influence

your selected healthcare issue/stressor.

3. Critique the policy for ethical considerations and explain the policy’s strengths

and challenges in promoting ethics.

4. Recommend one or more policy or practice changes designed to balance the

competing needs of resources, workers, and patients, while addressing any

ethical shortcomings of the existing policies. Be specific and provide examples.

5. Cite evidence that informs the healthcare issue/stressor and/or the policies and

provide two scholarly resources in support of your policy or practice

recommendations.

 

 

**At least 5 references**

 

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Discussion question 6

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Older adults (OA) are at risk for potential hazards of hospitalization, these include: immobility, delirium, medication side effects, malnutrition, pressure ulcers, procedures, peri- and postoperative periods, and hospital-acquired infections and more. Discuss in detail three potential hazards for this population while in the hospital and identify potential prevention strategies for each hazard.

Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length.

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Women’s Health Brochure

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Module 01 Written Assignment – Women’s Health Brochure

Module 01 Content

Competency

Identify multidimensional nursing care strategies for clients with reproductive system disorders.

Scenario

You work in a gynecological office, and your office has been asked to participate in a women’s health fair. The focus of the fair is health promotion. Preventative screening for female reproductive disorders is vital to identify and treat rapidly to produce the best patient outcomes. Preventative screening includes mammogram and Pap smear and should be performed based on recommended age and associated risk factors. To promote preventative screening, your office will be creating brochures to distribute at the health fair.

Instructions

Design a women’s health brochure by choosing one of the female reproductive disorders covered in this module. In the brochure, include the following:

  • Overview of the disease including disease process, signs and symptoms, and risk factors
  • Preventative screening
  • Diagnostics tests
  • Treatment
  • Multidimensional nursing care interventions
  • Resources

    For assistance completing this assignment, refer to the FAQ: How do I create a brochure?

    Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.

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The evolution of nursing informatics

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As an advanced registered nurse leader, you have an opportunity effect change through the practice of nursing health informatics. Informatics has evolved over time to become what it is today. Using the resources provided in this assignment, prepare a 12-15 PowerPoint presentation. Create speaker notes of 100-250 words for each slide. Include an additional slide for the title and references. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the study materials for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and another at the end for References.

 

Include the following in your presentation:

 

Define nursing informatics.

Provide a brief history of the field of nursing informatics. Discuss how the specialty has evolved.

Discuss how nursing informatics affects nursing leadership, clinical practice, administration, education, and research.

Explain how organizational policy on health information systems can be affected or impacted by government regulation.

Discuss nurse-led innovation as it relates to the advances in informatics and how informatics innovation can be used to improve the quality of patient care.

Provide an example of the role of the nurse in transforming health care data into knowledge that can improve patient care using nursing informatics practice.

You are required to cite three to five sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

 

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

 

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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ethno etiologies

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Many cultures have ethno-etiologies that provide explanations for illness that are not based in science. From a biomedical perspective, the non-scientific medical treatments provided in these cultures have a low likelihood of success. Despite this, people tend to believe that the treatments are working.

  • Why do you think people tend to be satisfied with the effectiveness of the treatments they receive that are based on the ethno-etiologies?
  • In transcultural nursing practice, why would it be important for nurses to understand such ethno-etiologies when nurses interact with patients of different cultures?

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