Respond  on two different days who selected different types of anemia than you, in the following ways:

Share insights on how the anemia you selected is similar to or different from the one your colleague selected.

Discuss how genetic, gender, ethnic, age, and behavioral factors impact the diagnosis and prescription of treatment for anemic patients.

                                          Main Post

                                           Anemia

Anemia is an insufficient amount of red blood cells that carry vital oxygen to the tissues. There are different types of anemia with unique pathological processes. This post will explore the pathophysiology of iron deficiency and folate deficiency anemia, including the impact of behavior on these disorders.

Iron deficiency anemia is like it sounds. The body has a deficiency of iron and cannot produce enough hemoglobin to oxygenate the tissues properly. The heme molecules that constitute hemoglobin need iron as it attracts oxygen to attach to the red blood cell (erythrocyte). When it is not available, hematopoiesis (red blood cell formation) cannot occur. The body has some reserves of iron, but it does not last because hematopoiesis happens throughout life. Red blood cells die or are lost through bleeding and need replacement. The causes of iron deficiency include inadequate dietary intake, chronic blood loss, and metabolic disorders via insufficient delivery or absorption. In all types of anemia, patients present with classic symptoms of weakness, fatigue, dyspnea, and paleness (Hammer & McPhee, 2019). Obtaining a serum ferritin level is the best way to measure iron deficiency as the iron binds to ferritin. Treatment includes increasing dietary intake of iron or giving supplemental iron after ruling out a chronic bleed (most often the gastrointestinal tract). If there is bleeding, this needs correction to resolve the anemia.

Folate deficiency anemia is an insufficient amount of folic acid. Folic acid is necessary for RNA and DNA synthesis in erythrocytes (Huether & McCance, 2017). Folate deficiency occurs more often in alcoholics or malnourished individuals. Symptoms that can present with this type of anemia include watery diarrhea, stomatitis, burning mouth syndrome, and ulcers in the mouth to name a few. Treatment requires an oral supplement of folic acid until blood levels rise to adequate levels. Although different in their pathology, both types of anemia effect hematopoiesis, and this is critical for oxygen delivery to the tissues.

Behavior

Adequate dietary intake of iron and folate can reduce these types of anemia. However, as mentioned above, with iron deficiency anemia, it is essential to determine the cause because it could be from bleeding. Odewole et al. (2013) conducted a study of folate deficiency anemia after the mandatory enrichment of folic acid into cereal grains in the United States. The researchers found only two individuals out of over 1500 surveyed, suggesting that this type of anemia is nearly nonexistent in the United States. (Odewole et al., 2013). 

References

Hammer, G. D., & McPhee, S. J. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed.). New York, NY: McGraw-Hill Education.

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Odewole, O. A., Williamson, R. S., Zakai, N. A., Berry, R. J., Judd, S. E., Qi, Y., … Oakley Jr., G. P. (2013). Near-elimination of folate-deficiency anemia by mandatory folic acid fortification in older US adults: Reasons for Geographic and Racial Differences in Stroke study 2003-2007. The American Journal of Clinical Nutrition, 98(4), 1042–1047. Retrieved from https://doi-org.ezp.waldenulibrary.org/10.3945/ajcn.113.059683 

I need 100 words for each question without any plagiarism and individual reference for each. 

Unit 2

Q2

Select a nursing model or theory described in your textbook. What are the key concepts and components of the example you selected, and how are they defined? Create an example describing the application to an area of nursing practice.

Unit 3

Q1

Compare and contrast a minimum of two middle range theories and discuss potential applications in your specific area of nursing practice.

Q2

Conduct a literature search in the Cumulative Index of Nursing and Allied Health Literature (CINAHL) using the terms middle range theory, mid-range theory, and nursing. Select one of the articles where the development of the middle range theory is the major focus of the paper. Share the article citation and describe how the theory was developed.

Unit 4

Q2

Consider yourself in a role in which you are accountable for allocation of scarce health care resources for a given situation. Discuss how ethical principles, virtues, and values affect your decision making. Describe your process for ethical decision making. How might a resolution cause conflicts between personal values and beliefs and the perspective of the community or organization?

Unit 5

Q1

Learning theories have implications for advanced practice nurses outside the classroom. Share an example describing the application of learning theory or theories to develop a program targeting change to a specific organizational issue, patient lifestyle, or specific unhealthy behaviors.

Q2

Health behavior change theories suggest behavior change as a “process,” not an “event.” How can you put this into action for developing an intervention for practice or research? Discuss how you would apply this in planning your DNP project.

Unit 6

Q1

Discuss “Envisioning Recovery” as an overarching framework for practice development and focus for all health care treatment.

Q2

How can the knowledge of economic theory be utilized by advanced practice nurses? How can economic theory be applied in analysis of interventions?

Unit 7

Q1

How can the DNP-prepared nurse apply the concepts of a complex adaptive system to individual patient care? Provide examples.

Q2

Research change theories in scholarly literature and on the Internet. Develop a scenario and describe application of a change theory from the perspective of an advanced practice nurse leader.

To be one of the best organizations the mission statement and values set forth by that organization must show respect and overall care for the employees representing such. Organizations like ones we work for have a duty to provide the highest of quality care for patients while maintaining safety. In order to perform at these levels it starts with great communication methods.  As many know communication is a crucial element at the forefront of all successful businesses.  At times the downfalls of organizations stem from unhealthy communication lines. Many organizations lack healthy work environments due to communication breakdown (Laureate Education, 2018). Individuals must know how to communicate thoroughly and effectively. 

 A healthy working environment is essential to overall staff and patient satisfaction. When staffs are being treated fairly and under the right conditions results are felt through patient satisfaction surveys and such.  Within organizations the culture is created with an attempt to amplify the healing and health of the populations serviced (Marshall  & Broome, 2017). When there are broken lines of communication, disruptive behaviors and such it causes a great deal on incivility amongst staff.  According to Marshall & Broome (2017), incivility can be classified as behaviors of low intensity which is displayed as being impolite, or rude placing strains on the working environment (p.76).  After taking the workplace assessment this week, my organization was determined to be an unhealthy environment. My work place would be classified as uncivil with this score based on such determining factors such as the lines of communication amongst each other, the fact staff feel over worked with patient acuity and workloads, and the issues with retention of staff.

                An incident in my workplace where I was a key witness of incivility was with a nurse leader and nurse manager. She was very demeaning with every word she spoke. She was not that took well to constructive criticism, but would greatly give out with much pleasure. There was a difficult patient on our unit for a lengthy time. He was very rude to all staff, very manipulative, and demanding. As much as we all kept trying to keep the moral from drowning because of his behaviors, this one particular day I must say the patient won. The nurse leader received a phone call from this patient which was discharged a day before. The patient was calling regarding medications he thought he had left and was informed the medication was not with us but was with him at discharge. The patient began to become frustrated with the nurse leader. While this conversation took place, the nurse manager overheard this interaction. She instructed the nurse leader to hang up the phone and tell the patient we did not have anything that belongs to him. The nurse leader was trying to diffuse the situation with the patient, and be very courteous and diligent. The nurse manager was still in front of the nurse leader and instructing her to hang up the phone on the patient. Again the nurse leader is trying her best to ease off the phone, but clearly it was not fast enough for the nurse manager. The manager then hangs up the phone on the patient in mid-sentence. She then in the middle of the nurses’ station scolded the nurse leader about her conversation and her actions of insubordination towards her requests to hang up the phone. Staff all around was very shocked at this interaction and quickly shifted away. Now although this was not towards me, I felt every bit of sympathy for my fellow leader. She felt belittled, incompetent, and disrespected. This was no way a leader above us should act nor treat staff as such. The nurse leader did walk away and had a moment where she broke down and cried to me. I felt helpless at that moment, but I could not allow this behavior manager or not. I later talked to the manager and expressed my concerns regarding her actions. She did mention her frustrations, and that she did get carried away. Her frustrations grew from the patient overall and the difficult times he caused on our unit. The manager did express her feelings of sorrow towards her staff and fellow leader.

                The issue was resolved for the moment, but overall we did lose a great leader because the nurse transferred to another unit. I will say although the issue was addressed, it should have never happened and this is not something I can ever condone. In this profession of nursing we are looked upon as the most “trusted and caring professions” (Clark, Olender, Cardoni, & Kenski, 2011).  With this being said nothing short of those actions would make me feel comfort with a nurse like this and these behaviors. It is never ok to allow workplace violence and knowing that I was a voice for a peer allowed me to feel comfortable as a nurse leader and advocate for not only patient but my fellow staff.

References

Clark, C. M., Olender, L., Cardoni, C., & Kenski, D. (2011). Fostering civility in nursing education and practice: Nurse leader perspectives. Journal of Nursing Administration, 41(7/8), 324–330. doi:10.1097/NNA.0b013e31822509c4

Laureate Education (Producer). (2018). Diagnosis: Communication Breakdown [Video file]. Baltimore, MD: Author.

Marshall, E., & Broome, M. (2017). Transformational leadership in nursing: From expert clinician to influential leader (2nd ed.). New York, NY: Springer.

Teaching Experience

1. Purpose: To document and evaluate teaching skills necessary to provide teaching to an individual client with a demonstrated need. With the completion of this assignment the student will be able to achieve the following objectives.

1. Demonstrate ability to thoroughly assess the learning styles of an individual or family using given developmental or cultural models.
2. Demonstrate ability to anticipate learning needs based on developmental or cultural assessments.
3. Identify and utilize teaching/learning principles to facilitate achievement of learning goals and outcomes.
4. Select and prioritize learning strategies based on the developmental or cultural assessment to achieve learning goals and outcomes.
5. Support rationales for teaching plan using teaching and learning theories from required readings with references

2. Nursing Competencies:

1. Assessing and identifying developmental, cultural, and socioeconomic factors affecting a client.
2. Providing evidence-based health information and teaching based on developmental, cultural, and socioeconomic factors affecting a client or family
3. Integrating teaching/learning activities into client interactions based on developmental, cultural, and socioeconomic factors affecting a client or family.
4. Incorporating health promotion and teaching into the plan of care based on developmental, cultural, and socioeconomic factors affecting a family or client.

3. Plan: submitted to the clinical instructor during the teaching experience. Your clinical instructor must approve the topic.

1. Develop nursing diagnosis (NANDA)
2. Develop two (2) learning objectives
3. State methodology (teaching methods)
4. Provide and utilize teaching aids
5. State needed resources

4. This write-up should be 2 pages to follow the Teaching Experience Rubric.

Teaching Experience

1. Purpose: To document and evaluate teaching skills necessary to provide teaching to an individual client with a demonstrated need. With the completion of this assignment the student will be able to achieve the following objectives.

1. Demonstrate ability to thoroughly assess the learning styles of an individual or family using given developmental or cultural models.
2. Demonstrate ability to anticipate learning needs based on developmental or cultural assessments.
3. Identify and utilize teaching/learning principles to facilitate achievement of learning goals and outcomes.
4. Select and prioritize learning strategies based on the developmental or cultural assessment to achieve learning goals and outcomes.
5. Support rationales for teaching plan using teaching and learning theories from required readings with references

2. Nursing Competencies:

1. Assessing and identifying developmental, cultural, and socioeconomic factors affecting a client.
2. Providing evidence-based health information and teaching based on developmental, cultural, and socioeconomic factors affecting a client or family
3. Integrating teaching/learning activities into client interactions based on developmental, cultural, and socioeconomic factors affecting a client or family.
4. Incorporating health promotion and teaching into the plan of care based on developmental, cultural, and socioeconomic factors affecting a family or client.

3. Plan: submitted to the clinical instructor during the teaching experience. Your clinical instructor must approve the topic.

1. Develop nursing diagnosis (NANDA)
2. Develop two (2) learning objectives
3. State methodology (teaching methods)
4. Provide and utilize teaching aids
5. State needed resources

4. This write-up should be 2 pages to follow the Teaching Experience Rubric.