DQ1

How has the patient’s control over his own health care changed?

DQ2

What part does negotiation play in patient education?

Read chapters 9, 12, and 13.

URL:http://gcumedia.com/digital-resources/jonesandbartlett/2010/effective-patient-education_-a-guide-to-increased-adherence_ebook_4e.php

Watch: Communicating with Aged-Care Residents (28:18)

Effective communication with elderly people living in residential care is key to the delivery of high-quality treatment that not only meets the physical needs of patients, but also their mental, emotional, social, and spiritual needs. This program examines the basic elements of communication and how they can be adapted to older people who are living with hearing, vision, speech, and cognitive losses. The video also looks at effective communication methods for those from culturally diverse backgrounds. Viewable/printable educational resources are available online. A part of the series Aged Care.

URL:https://lopes.idm.oclc.org/login?url=http://digital.films.com.lopes.idm.oclc.org/PortalPlaylists.aspx?aid=12129&xtid=40256

For these questions, please read the following case study and then respond to the questions noted below.

Ms. BD is a 33-year-old G2P1 African-American female who presents to your clinic today complaining of unusual fatigue, nausea, and vomiting for the last five days. She has a medical history of chronic hypertension (HTN) that was diagnosed shortly after her first pregnancy two years ago and GERD. MS. BD’s blood pressure is controlled on Lisinopril-Hydrochlorothiazide 20/12.5mg by mouth twice a day, and GERD controlled on Bismuth Subsalicylate 262mg by mouth every 6 hours as needed. During the interview, you learn that she is single, sexually active, has one partner and that her menses is ten days late. She performed a home pregnancy the three days after missing her menstrual cycle, and the results were inconclusive. She states she feels terrible and needs relief. She has no other medical problems, symptoms, or concerns.

Assessment: Physical examination is unremarkable. BP128/68, HR is 74, Urine human chorionic gonadotropin (HCG) positive, beta HCG sent, potassium 4.2, blood
urea nitrogen (BUN) 14, creatinine is 0.6, Alanine aminotransferase (ALT) 29, White blood cells (WBCs) 6.5, hemoglobin (Hgb) 12.8, hematocrit (Hct) 39, and platelets 330,000.

1. List the additional questions you would need to ask this patient. Explain.
2. What is the safety profile of Lisinopril-hydrochlorothiazide and bismuth subsalicylate in pregnant women? What are the possible complications to the pregnant woman and her fetus?
3. What is the importance of assessing laboratory values when prescribing medications? How might the laboratory values, in this case, impact your treatment plan?
4. Would you make any changes to Ms. BD’s blood pressure and GERD medications? Explain. If yes, what would you prescribe? Discuss the medications safety in pregnancy, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.
5. How does ethnopharmacology apply to this patient if she were NOT pregnant? Explain.
6. What health maintenance or preventive education do you provide in this client case based on your choice of medications/treatment?
7. Would you treat this patient or refer her? Explain. If you refer, where would you refer this patient?

New health care innovations offer the advanced registered nurse an opportunity to apply emerging technologies in practice to improve quality and patient outcomes. For this assignment, research an emerging health care technology that you think has the potential to overcome current or emerging barriers to care.

Write a 500-word brief that provides an overview of the technology, its purpose, and how it would function in a health care setting, including any ethical or legal issues that would accompany the incorporation of the technology. Discuss how this technology could improve access to care and promote patient safety and quality.

Refer to the Topic 6 materials for samples and resources to help you construct your brief.

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.

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.

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.

This is a case study that was split in 2 part, first I had to find the primary and diferencial diagnosis and now with the same data I have to work with the lab result. 

CASE STUDY: 

Male    20 y/o    Self employee landscaping   Marihuana ocassional user. Heterosexual choices with no regular single  partner. He loves parties and Practice Soccer regularly.   

Ricardo does not speak English so he comes to see you with his sister. She says that he has a very sore throat and feels very tired. On closer questioning, you find out that the sore throat started approximately 24 hours ago. He has pain on swallowing, and he does not have a cough. He has not taken any tablets for pain. On examination, Ricardo’s temperature is 38 degrees centigrade and he has tender enlarged anterior cervical lymph nodes on the left side. He has an enlarged red left tonsil partially covered in white exudate. The right tonsil is also red but not so enlarged. He is breathing and swallowing normally throughout the consultation. 

You do not have any access to Ricardo’s past medical history as he has just registered with your practice and he previously lived in Brazil. Ricardo’s sister says that Ricardo has not had serious medical conditions before and has never been allergic to antibiotics. 

PART 1: What are the provisional primary and differential diagnoses ( ANSWER:  primary: tonsilitis; differencial: mononucleosis, or strep throat) 

PART 2: Then you have the labs results   ( LAB IS ATTACHED)

What factors increase the possibility that the infection is bacterial in origin keeping in mind Hx and this lab results? 

 Posting should be a minimum of one short paragraph and a maximum of two paragraphs.  Word totals for each post should be in the 50-150 words range.   Include a reference, link, or citation when appropriate. APA 6th edition format for references as well as in-text citations is expected, but are not mandatory.

PART 1 RESPONSE IS ATTACHED 

 Respond + summary 

In our ever-changing healthcare industry today, it is fundamental for leaders have the skills to manage and adapt to change. This week we discuss the importance of leading change as a project manager. Leaders need to be experienced in theory and implementation of change in order to succeed. After reading Mitchell’s article on the importance of selecting a change theory, I gained a better understanding of the importance of following a theory and what change theory will work best in executing my proposed project plan. My framework of choice to guide me has been Lewin’s Change Theory, as I find it simple enough to follow, yet effective.

According to Lewin, there are three important steps to follow when planning and implementing change. The three steps are: the unfreezing process, the movement stage, and the refreezing process. The unfreezing process involves the impulse for change by the leader, stating why change is needed, and deciding to make the change. The movement stage requires an actual change of thoughts and actions to be made. Lastly, the refreezing process is attained once the change is established successfully (Woten & Karakashian, 2018).

I believe Lewin’s Theory of change will be a useful framework to guide organizational change in Chamberlain Hospital’s Emergency Department. I will use this framework by following the three simple steps. During the unfreezing process I will point out to the emergency department staff the need to see more patients in order to decrease the LWBS rate and patient satisfaction scores. I will do so by showing the statistics of current LWBS rates versus the benchmark to the staff. During the movement stage, staff members will choose to be mentally proactive and willing to follow the plan and implementation of increasing nursing staff in order to make improvements. Lastly, over 3-6 months, I will monitor and be involved in this phase until the change is fully accepted by staff. I look forward to hearing what theories everyone else chose. Thank you.