Video Transcript:

KARI (on phone): This is Kari the nurse from the Emergency Department. I’m calling to give you a transfer report on Ms. Janet Lieberman. Janet is a 36-year-old woman who came because she felt weak and dizzy. She has a history of Crohn’s disease with intermittent gastritis and six months ago she had surgery and an ileostomy. Traces of serosanguineous effluent were present in her ostomy bag upon arrival. Her Blood type is A-. She is typed and cross-matched for two units of packed RBCs, so please administer as soon as they are available. She started on Infliximab IV six months ago and the last dose was given seven weeks ago. Her vital signs were temperature 98.8, pulse 114, respiration 22, blood pressure 100/60, and oxygen saturation 95%. Her hemoglobin is seven milligrams per deciliter and her hematocrit is 21%. She has an IV of 0.9% sodium chloride 1000- milliliters infusing at 150-milliliters per hour, and has 700-milliliters remaining in the bag. We started an IV while she was in ED. Her skin has been pale, warm, and dry to the touch. She voided 500-milliliters at 1500 in the ED. A hemoccult of her stool was sent to the lab. Esther: Were the coagulation tests within normal range? KARI: Yes, her pro time is 12.2, her PT is 21 seconds, and her INR is 0.7. Esther: Okay, thanks for the report. KARI: You’re welcome. I’ll bring her up to your unit in a few minutes. Esther: Thanks. KARI: Hi Esther, this is Janet Lieberman. Esther: Hi Ms. Lieberman, my name’s Esther. I’ll be taking care of you this evening. KARI: I gave you a transfer report a couple minutes ago. Ms. Lieberman needs the two units of packed RBCs as soon as possible. Esther: Okay. Ms. Lieberman, I need to take a quick look at your ostomy bag. MS. LIEBERMAN: Sure, okay. Esther: Thank you. Do you have any family here? MS. LIEBERMAN: No, I came alone to the emergency room today, but I have a sister who’s on her way to the hospital. KARI: Do you have any questions before I leave? Esther: No, thanks for the report. I can take it from here. KARI: I am going back to the Emergency Department now. Esther’s going to be taking care of you. I hope you feel better soon. MS. LIEBERMAN: Thanks so much for taking such good care of me. Esther: Ms. Lieberman, I need to ask you some questions. MS. LIEBERMAN: Okay, what else do you need to know? Esther: I need to review your abdominal status. Are you having abdominal pain? MS. LIEBERMAN: Oh yes, it’s very sore and crampy. Esther: On a scale of 0 to 10, with 0 being no pain, and 10 being unbearable, how do you rate your pain now? MS. LIEBERMAN: I would say a 6. Esther: When did the pain begin? MS. LIEBERMAN: Uh, after I got up this morning. Esther: Can I ask you where the pain is? MS. LIEBERMAN: Yes, it’s here in the top of my stomach. Esther: Okay, Have you noticed anything that brings on the pain or makes it worse? MS. LIEBERMAN: I’m pretty sure stress makes it worse. Esther: Okay. MS. LIEBERMAN: When I get stressed I don’t eat healthy foods and then I get headaches and take Ibuprofen. Esther: Okay, when you’re feeling a little bit better I’d like to review some ways to manage your stress. For now, I need to take a listen to your bowel sounds. MS. LIEBERMAN: Sure, Okay

Video Transcript:

KARI (on phone): This is Kari the nurse from the Emergency Department. I’m calling to give you a transfer report on Ms. Janet Lieberman. Janet is a 36-year-old woman who came because she felt weak and dizzy. She has a history of Crohn’s disease with intermittent gastritis and six months ago she had surgery and an ileostomy. Traces of serosanguineous effluent were present in her ostomy bag upon arrival. Her Blood type is A-. She is typed and cross-matched for two units of packed RBCs, so please administer as soon as they are available. She started on Infliximab IV six months ago and the last dose was given seven weeks ago. Her vital signs were temperature 98.8, pulse 114, respiration 22, blood pressure 100/60, and oxygen saturation 95%. Her hemoglobin is seven milligrams per deciliter and her hematocrit is 21%. She has an IV of 0.9% sodium chloride 1000- milliliters infusing at 150-milliliters per hour, and has 700-milliliters remaining in the bag. We started an IV while she was in ED. Her skin has been pale, warm, and dry to the touch. She voided 500-milliliters at 1500 in the ED. A hemoccult of her stool was sent to the lab. Esther: Were the coagulation tests within normal range? KARI: Yes, her pro time is 12.2, her PT is 21 seconds, and her INR is 0.7. Esther: Okay, thanks for the report. KARI: You’re welcome. I’ll bring her up to your unit in a few minutes. Esther: Thanks. KARI: Hi Esther, this is Janet Lieberman. Esther: Hi Ms. Lieberman, my name’s Esther. I’ll be taking care of you this evening. KARI: I gave you a transfer report a couple minutes ago. Ms. Lieberman needs the two units of packed RBCs as soon as possible. Esther: Okay. Ms. Lieberman, I need to take a quick look at your ostomy bag. MS. LIEBERMAN: Sure, okay. Esther: Thank you. Do you have any family here? MS. LIEBERMAN: No, I came alone to the emergency room today, but I have a sister who’s on her way to the hospital. KARI: Do you have any questions before I leave? Esther: No, thanks for the report. I can take it from here. KARI: I am going back to the Emergency Department now. Esther’s going to be taking care of you. I hope you feel better soon. MS. LIEBERMAN: Thanks so much for taking such good care of me. Esther: Ms. Lieberman, I need to ask you some questions. MS. LIEBERMAN: Okay, what else do you need to know? Esther: I need to review your abdominal status. Are you having abdominal pain? MS. LIEBERMAN: Oh yes, it’s very sore and crampy. Esther: On a scale of 0 to 10, with 0 being no pain, and 10 being unbearable, how do you rate your pain now? MS. LIEBERMAN: I would say a 6. Esther: When did the pain begin? MS. LIEBERMAN: Uh, after I got up this morning. Esther: Can I ask you where the pain is? MS. LIEBERMAN: Yes, it’s here in the top of my stomach. Esther: Okay, Have you noticed anything that brings on the pain or makes it worse? MS. LIEBERMAN: I’m pretty sure stress makes it worse. Esther: Okay. MS. LIEBERMAN: When I get stressed I don’t eat healthy foods and then I get headaches and take Ibuprofen. Esther: Okay, when you’re feeling a little bit better I’d like to review some ways to manage your stress. For now, I need to take a listen to your bowel sounds. MS. LIEBERMAN: Sure, Okay

Examine changes introduced to reform or restructure the U.S. health care delivery system. In a 1,000-1,250 word paper, discuss action taken for reform and restructuring and the role of the nurse within this changing environment.

Include the following:

1. Outline a current or emerging health care law or federal regulation introduced to reform or restructure some aspect of the health care delivery system. Describe the effect of this on nursing practice and the nurse’s role and responsibility.
2. Discuss how quality measures and pay for performance affect patient outcomes. Explain how these affect nursing practice and describe the expectations and responsibilities of the nursing role in these situations.
3. Discuss professional nursing leadership and management roles that have arisen and how they are important in responding to emerging trends and in the promotion of patient safety and quality care in diverse health care settings.
4. Research emerging trends. Predict two ways in which the practice of nursing and nursing roles will grow or transform within the next five years to respond to upcoming trends or predicted issues in health care.

You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.  

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

RUBRIC

Attempt Start Date: 05-Oct-2020 at 12:00:00 AM

Due Date: 11-Oct-2020 at 11:59:59 PM

Discussion Prompt #1

• What methods can nurses use to actively influence health policies and legislation?

Discussion Prompt #2

• Discuss the controversy regarding childhood immunization and the potential affect on community health.

1page each 

references should not be older than 2015

1) Minimum 8  full pages (Follow the 3 x 3 rule: minimum three paragraphs per page)

              Part 1: Minimum 7 pages

              Part 2: minimum 1 page

Submit 1 document per part

2)¨******APA norms, please use headers

          All paragraphs must be narrative and cited in the text- each paragraphs

          Bulleted responses are not accepted

          Dont write in the first person 

          Dont copy and pase the questions.

          Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph

         Submit 1 document per part

3)****************************** It will be verified by Turnitin (Identify the percentage of exact match of writing with any other resource on the internet and academic sources, including universities and data banks) 

********************************It will be verified by SafeAssign (Identify the percentage of similarity of writing with any other resource on the internet and academic sources, including universities and data banks)

4) Minimum 5 references per part not older than 5 years

5) Identify your answer with the numbers, according to the question.

Example:

Q 1. Nursing is XXXXX

Q 2. Health is XXXX

6) You must name the files according to the part you are answering: 

Example:

Part 1.doc 

Part 2.doc 

__________________________________________________________________________________

Part 1: Tuberculosis

 Write a paper in which you apply the concepts of epidemiology and nursing research to a communicable disease. 

Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment (This pages must be in the references).

Tuberculosis

1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). 

   a. Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.

2.. Describe the social determinants of health and explain how those factors contribute to the development of this disease.

3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. 

     a. Are there any special considerations or notifications for the community, schools, or general population?

4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.

5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.

6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

Part 2: 

Issue: Infection Control and Prevention 

Topics: Cleaning and disinfection; Standards precaution and Cross-contamination

Place:  University Plaza Nursing and Rehabilitation center

Review your strategic plan (check File 1) to implement the change proposal, the objectives, the outcomes, and listed resources (Check File 2). 

1. Develop a process to evaluate the intervention if it were implemented. Write a summary of the evaluation plan that will be used to evaluate your intervention.