respond

Restatement of PICO question

In the intensive care unit, how does creating management awareness and decreasing workload compared to other methods contribute to determining burnout levels?

Information Needed to Create Cost-benefit Analysis

When creating a cost-benefit analysis, the researcher needs to have options, which to weigh against and make an informed decision. The idea is to determine the benefits and disadvantages of each choice to identify the one that has the best outcomes. The process involves considering decisions objectively including assessment of advantages, investment costs, and the disadvantages. In the current project, the researcher attempts to compare how creating management awareness and decreasing work overload determines the burnout levels.

The researcher will identify the benefits of creating management awareness, an aspect that allows nurse leadership to understand how managing employees should function. Some of the benefits of the creation of management awareness include better communication, improved agility, and quicker problem-solving, among others. These benefits interlink with understanding nurses better to determine their burnout levels. Disadvantages of the same include time-consuming require intensive management involvement, and increased supervision, which might harbor productivity.

The other option to evaluate is decreasing work overload. Increased exposure to work overload is proved to contribute to burnout. When work is overwhelming, there is a high probability that nurses will tend to overwork, tire, and lack of time to recreate. Does decreasing workload have cost implications? Yes, at first, the hospital might want to employ new staff to cover for work for absent or resting nurses. However, nurses will have increased productivity and reduced medication errors as well as improve work-life balance. There are multiple benefits of decreasing work overload compared to its disadvantages.

 Social media platforms have been proven to be effective at promoting secondary prevention measures and changing behavior through education. 

If you are a community health nurse who is creating health promotion strategies that can be used for patients experiencing cardiovascular disease what specific prevention activity would you create? 

Must be in APA 

Must include at least one peer reviewed nursing journal article 

must be at least 300 words not including the reference 

Please answer the 3  questions and please provide rationale

case study, references, and in APA 6th ed format.

DERMATOLOGY CASE STUDY

Chief complaint:  “ My right great toe has been hurting for about 2 months and now it’s itchy, swollen and yellow. I can’t wear closed shoes and I was fine until I started going to the gym”.

HPI: E.D a 38 -year-old Caucasian female presents to the clinic with complaint of pain, itching, inflammation, and “yellow” right great toe. She noticed that the toe was moderately itching after she took a shower at the gym. She did not pay much attention. About two weeks after the itching became intense and she applied Benadryl cream with only some relief.  She continued going to the gym and noticed that the itching got worse and her toe nail started to change color. She also indicated that the toe got swollen, painful and turned completely yellow 2 weeks ago. She applied lotrimin  AF cream and it did not help relief her symptoms. She has not tried other remedies. Denies associated symptoms of fever and chills. 

PMH:

Diabetes Mellitus, type 2.

Surgeries: None

Allergies: Augmentin

Medication: Metformin 500mg PO BID.

Vaccination History:  Immunization is up to date and she received her flu shot this year.

Social history:

College graduate married and no children. She drinks 1 glass of red wine every night with dinner. She is a former smoker and quit 6 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis. mother alive and has history of atopic dermatitis, HTN.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: Regular rhythm.

Skin: Right great toe swollen, itchy, painful and discolored.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 130/70 T 98.0, P 88 R 22, non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS: No Crackles. Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. 1+ pitting edema ankle bilaterally.

ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.

MUSCULOSKELETAL: Slow gait but steady. No Kyphosis.

SKIN: Right great toe with yellow-brown discoloration in the proximal nail plate. Marked periungual inflammation. + dryness. No pus. No neuro deficit.

PSYCH: Normal affect. Cooperative.

Labs: Hgb 13.2, Hct 38%, K+ 4.2, Na+138, Cholesterol 225, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

A:

Primary Diagnosis: Proximal subungual onychomycosis

Differential Diagnosis:  Irritant Contact Dermatitis, Lichen Planus, Nail Psoriasis

Special Lab: Fungal culture confirms fungal infection.

Please see below:

      Now that you have identified the treatment for onychomycosis and labs for baseline and follow up therapy. please address the following:

1. Specify when to refer the patient after therapy and why? Provide rationale.
2. According to the recommended guidelines, what are the non-pharmacological approaches to Onychomycosis?
3. Provide patient education. Keep in mind the past medical history of this patient.

Minimums of 300 words  with at least 2 peers review reference in apa style.

What is the difference between diabetic ketoacidosis and hyperosmolar nonketotic syndrome? How do the treatment options differ as well as have similarities? What are the associated conditions that would cause either of the conditions?