Soap Note “Hypertension”

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Turn it in Score must be less than 50% or will not be accepted for credit, must be your own work and in your own words. You can resubmit, Final submission will be accepted if less than 50%. Copy paste from websites or textbooks will not be accepted or tolerated. Please see College Handbook with reference to Academic Misconduct Statement.

Example:

PATIENT INFORMATION

Name: Mr. W.S.

Age: 65-year-old

Sex: Male

Source: Patient

Allergies: None

Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime

PMH: Hypercholesterolemia

Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.

Surgical History: Appendectomy 47 years ago.

Family History: Father- died 81 does not report information

Mother-alive, 88 years old, Diabetes Mellitus, HTN

Daughter-alive, 34 years old, healthy

Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.

SUBJECTIVE:

Chief complain: “headaches” that started two weeks ago

Symptom analysis/HPI:

The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness.He states that he has been under stress in his workplace for the last month.

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Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.

ROS:

CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures.  Soap Note “Hypertension”

HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.

Respiratory:Patient denies shortness of breath, cough or hemoptysis.

Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal

dyspnea.

Gastrointestinal:Denies abdominal pain or discomfort.Denies flatulence, nausea, vomiting or

diarrhea.

Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.

MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.

Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.

Objective Data

CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10.

General appearance: The patient is alert and oriented x 3. No acute distress noted.NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.

HEENT:Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race.

Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses.

Cardiovascular:S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec.

Respiratory:No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation.

Gastrointestinal:No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no reboundno distention or organomegaly noted on palpation

Musculoskeletal:No pain to palpation. Active and passive ROM within normal limits, no stiffness.

Integumentary:intact, no lesions or rashes, no cyanosis or jaundice.

Assessment

Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed.

Differential diagnosis:

Ø Renal artery stenosis(ICD10 I70.1)

Ø Chronic kidney disease(ICD10 I12.9)

Ø Hyperthyroidism (ICD10 E05.90)

Plan

Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease.

These basic laboratory tests are:

· CMP

· Complete blood count

· Lipid profile

· Thyroid-stimulating hormone

· Urinalysis

· Electrocardiogram

Ø Pharmacological treatment:

The treatment of choice in this case would be:

Thiazide-like diuretic and/or a CCB

· Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily.

 

Ø Non-Pharmacologic treatment:

· Weight loss

· Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat

· Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults

· Enhanced intake of dietary potassium

· Regular physical activity (Aerobic): 90–150 min/wk

· Tobacco cessation

· Measures to release stress and effective coping mechanisms.

Education

· Provide with nutrition/dietary information.

· Daily blood pressure monitoring at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP

· Instruction about medication intake compliance.

· Education of possible complications such as stroke, heart attack, and other problems.

· Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all

Follow-ups/Referrals

· Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn.

· No referrals needed at this time.

References

Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017 (25th ed.). Print (The 5-Minute Consult Series).

Codina Leik, M. T. (2014). Family Nurse Practitioner Certification Intensive Review (2nd ed.). ISBN 978-0-8261-3424-0 Soap Note “Hypertension”

Discussion: Using Emotional Intelligence And Appreciative Inquiry To Promote Quality

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Discussion: Using Emotional Intelligence And Appreciative Inquiry To Promote Quality

Question 1 A patient has been prescribed a Scheduled 5 drug, an example of this drug is

Question 2 A nurse has just completed a medication history on a newly admitted patient. In order to complete medication reconciliation for this patient the nurse will

Question 3 A physician has ordered subcutaneous injections of morphine, a narcotic, every 4 hours as needed for pain for a motor vehicle accident victim. The nurse is aware that there is a high abuse potential for this drug and that it is categorized as a

Question 4 A nurse works in a private hospital and needs to administer some narcotic drugs to one of her patients. Which of the following should the nurse consider when administering narcotics to patients in a hospital setting?

Question 5 Drugs have a valid medical use but a high potential for abuse, both psychological and physiologic. In an emergency, a Schedule 2 drug may be prescribed by telephone if a written prescription cannot be provided at the time. However, a written prescription must be provided within 72 hours with the words authorization for emergency dispensing written on the prescription. These prescriptions cannot be refilled. A new prescription must be written each time. Examples include certain amphetamines and barbiturates. This is scheduled drug Discussion: Using Emotional Intelligence And Appreciative Inquiry To Promote Quality

Question 6 A nurse receives an order to administer a critically ill patient two drugs immediately (stat). The nurse begins the process by

Question 7 A nurse working for a drug company is involved in phase III drug evaluation studies. Which of the following might the nurse be responsible for during this stage of drug development?

Question 8 Federal legislation dictates a lengthy and rigorous process of testing for new drugs. What is the primary purpose of this testing process?

Question 9 These drugs have a potential for abuse, but the potential is lower than for drugs on Schedule 2. These drugs contain a combination of controlled and noncontrolled substances. Use of these drugs can cause a moderate to low physiologic dependence and a higher psychological dependence. A verbal order can be given to the pharmacy and the prescription can be refilled up to five times within 6 months. Examples include certain narcotics (codeine) and nonbarbiturate sedatives. This is scheduled drug

Question 10 Which of the following patients should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

Question 11 Drugs have a high potential for abuse. There is no routine therapeutic use for these drugs and they are not available for regular use.They may be obtained for “investigational use only” by applying to  the U.S. Drug Enforcement Agency. Examples include heroin and LSD. Which scheduled drug is this?

Question 12 A patient has taken an overdose of a vitamin/mineral supplement containing magnesium. The nurse will be sure to assess

Question 13 A nurse practitioner understands when prescribing a medication that there are certain questions to address. Check all that apply.

Question 14 A nurse is caring for a 46-year-old patient of Chinese origin who has bipolar disorder. The physician has prescribed lithium carbonate (Eskalith) to treat the disorder. The nurse is aware that the lithium dose will likely be given in a

Question 15 The nurse practitioner orders Amoxicillin 250 mg/5 ml tid for 10 days? The nurse practitioner would expect the pharmacist to fill the prescription bottle with how many ml?

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Question 16 A patient will begin three new medications as part of her treatment plan. The nurse practitioner understands that proper disposal of medications is key when the nurse practitioner states

Question 17 A nurse is providing a patient with a list of drugs as a part of the patient’s plan of care. Which of the following drug nomenclatures should the nurse use to list the drugs?

Question 18 A nurse is providing care for a 71-year-old woman who was sponsored to emigrate from Mexico to the United States 6 months ago. Earlier this week, the woman slipped while getting off a bus and fractured  her hip. How should the woman’s nurse best exemplify cultural competence in the care of this patient?

Discussion: Using Emotional Intelligence And Appreciative Inquiry To Promote Quality

 

Question 19 Which of the following serves to protect the public by ensuring the purity of a drug and its contents?

Question 20 A nurse is admitting a Mexican woman to the hospital who cannot speak or understand English. The patient is alone, and there is no interpreter available. When trying to communicate with the patient the nurse will

Question 21 A patient comes to primary clinic for strep throat. A throat swab culture is sent to lab. What information is required for the nurse practitioner to disclose on lab transmittal?

Question 22 A Native American man who lives a traditional lifestyle is scheduled to have heart surgery. The tribal chief has requested that the tribe’s medicine man perform a ritual before the patient goes to surgery. The nurse’s response to this request should be

Question 23 A patient with seasonal allergies is exasperated by her recent nasal congestion and has expressed her desire to treat it by using pseudoephedrine. The nurse should inform the patient that

Question 24 A 46-year-old white American has been prescribed a drug that binds to acid glycoproteins. The nurse understands that white Americans usually receive

Question 25 A nurse is a member of a research team that is exploring unique differences in responses to drugs that each individual possesses, based on genetic make-up.  Discussion: Using Emotional Intelligence And Appreciative Inquiry To Promote Quality

 

 

Case Studies Of Community Health Topics

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CASE STUDIES

 

CASE # 1 About: History of Public Health and Public and Community Health Nursing

Michael works as a home health nurse in his suburban community. He visits 7-10 clients each day. On today’s visitations, Michael will provide care for four clients who are recovering from hip replacement surgery and three clients who are recovering from heart surgery, and he will provide intravenous (IV) antibiotics for a man with an infected wound.

 

Among this list of clients, Michael visits Mrs. T., an 87-year-old white woman who lives alone and is recovering from triple bypass surgery that she underwent a month ago. Michael’s goals are to check on her recovery progress, reload her medications in her weekly medication container, and administer an influenza vaccine.

 

Upon entering Mrs. T.’s small house, Michael finds the house in disarray: clothes are scattered about, dirty dishes with crusted food line the kitchen counters, and no lights are on. Michael finds Mrs. T. lying in bed watching television. Mrs. T. complains to Michael of feeling too tired to do anything; she eats only what is already prepared (e.g., frozen dinners or snack foods like potato chips) because cooking requires too much effort. She spends most of her days lying in bed and has not bathed in a week.

 

Michael helps Mrs. T. out of bed and assists her with a bath. After the bath, Michael fixes Mrs. T. a quick lunch and refills her medication box while she eats. Michael encourages Mrs. T. to start getting some exercise by doing the household chores so that her heart can get stronger. “The stronger your heart is, the more energy you will have,” Michael tells Mrs. T. Michael also enlists several services for Mrs. T.: A home health aide will come to the house three times a week to help Mrs. T. bathe, and Meals-on-Wheels will bring her breakfast and lunch. Finally, Nurse Michael administers the influenza vaccine.

 

During Nurse Michael’s visit the following week, Mrs. T. is showing improvement. She tells Michael, “I just love that little girl who comes to help me; she is just so sweet. And the Meals-on-Wheels program is a blessing, I now have more energy to keep this place clean the way I like it.” Case Studies Of Community Health Topics

Questions

  1. What challenges did Nurse Michael face in his first visit with Mrs. T. that public health nurses (PHNs) in the late 1800s also faced?

 

 

  1. From your knowledge about the history of public health, compare an example of care displayed by nursing leaders of the past versus the current activities of Nurse Michael. For example, how was Nurse Michael’s nursing care similar to what Mary Breckinridge provided in the Frontier Nursing Service (FNS)?

 

 

  1. How do the types of illnesses of Nurse Michael’s clients differ from the types of illnesses that were experienced by clients of PHNs in the early 1900s?

 

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CASE STUDY # 2 ABOUT CULTURAL DIVERSITY IN THE COMMUNITY

 

Nurse Betty is teaching a health-promotion class to a group of Hispanic migrant workers. Nurse Betty is white, and this is her first time interacting with people of Hispanic culture. Nurse Betty speaks a little Spanish, but not enough to teach the whole class in Spanish. Most of the migrant workers speak only Spanish. Nurse Betty understands that she needs to provide culturally competent care to make her health-promotion class most effective but is not sure where to start.

Questions

  1. What is the first step that Nurse Betty should take to prepare for her health-promotion class?

 

 

  1. What are the language barriers, specific risk factors, and traditional healing practices that Nurse Betty must be aware of if she is to successfully interact with the group of Hispanic workers?

 

 

  1. How can Nurse Betty involve the community to improve the effectiveness of her health-promotion class?

 

 

CASE # 3: ABOUT ENVIROMMENTAL HEALTH

John J. is a school nurse at Jackson Elementary School, which was built in 1960. Nurse John has noticed that many students from Ms. Zee’s second grade class have come to the clinic complaining about coughing, sneezing, runny nose, and watery eyes. Nurse John has also observed that Steven Tea, the only asthmatic student in Ms. Zee’s class, has had more asthma attacks this year than he did last year. Because the rest of the school is not experiencing the same respiratory problems, Nurse John is concerned that something in Ms. Zee’s classroom is causing students to feel ill.

 

Nurse John decides to visit Ms. Zee’s classroom. Upon entering the classroom, one of the few located in the school’s basement, John is struck by the powerful musty smell that inhabits the room. While talking to Ms. Zee, John learns that the classroom has “smelled bad for years,” and that students from previous years have complained about respiratory problems. Nurse John notes that Ms. Zee has stuffed a blanket at the base of the classroom’s small rectangular window near the ceiling because the window does not close completely.

 

John suspects that Ms. Zee’s classroom walls are contaminated with mold. Upon further research, Nurse John learns that if water gets between the exterior and the interior of a building’s wall, mold can grow in the moist environment. This situation can occur as the result of construction defects in the building (e.g., leaky windows). Nurse John also learns that people who are exposed to extensive mold growth may experience allergic reactions, such as hay fever-like allergy symptoms, and that people who already have a chronic respiratory disease, such as asthma, may experience difficulty breathing when exposed to mold. Nurse John is concerned about the possible mold contamination effect on his asthmatic student, Steven.

Questions

  1. Identify the agent, host, and environment in this case study, and describe how they interacted to bring about the occurrence of disease.

 

  1. Is the mold contamination in Ms. Zee’s room a point-source pollutant or a non–point-source pollutant?

 

  1. What can Nurse John do to learn more about indoor air quality (IAQ) and about what to do in case of mold?

 

  1. What are some possible interventions that Nurse John could apply to address the mold contamination in Ms. Zee’s room?

 

 

CASE # 4: ABOUT INFECTIOUS DISEASE PREVENTION AND CONTROL

 

Hilary S. is a nurse health inspector at the county health department. Nurse Hilary visits businesses in the community that have the potential to spread infectious diseases to large and/or vulnerable populations. Today, Nurse Hilary will visit the We Love Kids daycare center and a nearby seafood restaurant.

 

The daycare center cares for children ages 1 month to 6 years. To enroll a child in daycare, parents must show proof that the child is up-to-date on all age-appropriate immunizations or must show proof of medical or religious exemption. Nurse Hilary finds the records in the office area and confirms that all children have received the necessary immunizations. She observes that employees use gloves when changing diapers, cleaning a baby’s spit-up, and tending to a scratched knee from a playground accident. Employees also wash their hands after each of these events, before and after giving a baby his bottle, and before entering the 1- to 6-month-old room after leaving the 2- to 3-year-old room. Nurse Hilary also notices a flyer posted in the employee break room that informs staff of the upcoming mandatory in-service that will be held to discuss the importance of checking bottles, especially those that contain breast milk, for the correct name before feeding a child.

 

The seafood restaurant is a chain restaurant that has become less popular over the past couple of years. Many customers have complained about the quality of the food. Recently, 20 cases of severe diarrhea were reported to the health department by people who had just eaten at the restaurant. Nurse Hilary observes the cooks in the kitchen. The refrigerator and the freezer are kept at appropriate temperatures for storing food. Food is stored in airtight, plastic containers. Nurse Hilary watches as the cook who is preparing the chicken for broiling is also in charge of prepping the plates that are going out to the customers. Upon cutting into a piece of chicken about to go out to the dining room, Nurse Hilary notes that the center looks pink and undercooked. Pieces of wilted lettuce are scattered on the countertops. During her 2-hour visit, the main chef washes his hands twice, although he leaves the kitchen four times for a smoking break.

Questions

  1. How is the daycare center providing infectious disease control?

 

  1. Describe the outbreak of diarrhea.
  2. Endemic
  3. Epidemic
  4. Pandemic

 

  1. Which of the five keys to safer food does the restaurant not follow?

 

 

CASE # 5: ABOUT FAMILY HEALTH RISK

The M. family consists of Mr. M. (Harry), Mrs. M. (Shirley), 18-year-old Annie, 15-year-old Michelle, 13-year-old Sean, and 7-year-old Bobby. Harry is the pastor of Faith Baptist Church, where he has served for the past 15 years. Shirley is a housemother and is the primary caretaker for the children.

 

For the past year, Shirley has felt tired and “rundown.” At her annual physical, Shirley describes her symptoms to her physician. After several tests, Shirley is diagnosed with stomach cancer. Shirley starts to cry and says, “How will I tell my family?”

 

Shirley’s primary physician refers the family to Trisha F., a mental health nurse specialist. Nurse Trisha calls the household and speaks to Shirley. Nurse Trisha tells Shirley that she was referred by the physician, and she can help Shirley cope with the diagnosis. Shirley confides in Trisha that it has been 2 weeks since she received the diagnosis, but she has yet to tell her husband and children. Shirley asks Trisha if she can help her tell her family and explain what it all means. Nurse Trisha makes an appointment to go to the M. household and facilitate the family meeting.

Questions

  1. Use the five interacting variables (physiological, psychological, sociocultural, developmental, and spiritual) of the Neuman Systems Model to assess the family’s ability to adapt to this life event. Think of one question Nurse Trisha can ask the family regarding each variable. Case Studies Of Community Health Topics
  1. Is this life event a normative event or a nonnormative event?
  1. Which phase of the home visit has Nurse Trisha reached (initiation phase, previsit phase, in-home phase, termination phase, or postvisit phase)?

 

CASE # 6: ABOUT CHILD AND ADOLESCENT HEALTH

 

Glenda R. is a parish nurse for Holy Cross Catholic Church. The church’s youth group teacher has overheard several of the 13- and 14-year-old teenagers talking about dating and sexual behaviors. The youth group teacher invites the parish nurse to speak to the group about sex and abstinence. Nurse Glenda sends letters to the parents describing when she will speak to the group about these topics and what will be discussed. Parents who would like their child to attend this class are asked to fill out the permission form.

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On the night of the class, 18 of the 20 youth group members arrive for the class with their consent forms in hand. The room is set up with chairs in a circle and a computer with projector next to Nurse Glenda’s chair. Using pictures on the computer, Nurse Glenda illustrates the basic anatomy of the reproductive system and discusses what should be expected during puberty. Most of the class time is then spent discussing reasons for abstinence, how to know when you are ready for sex, and how to say no if you are not.

Questions

  1. Which teaching intervention designed to gather questions and feedback about the lesson would be most effective for this age group?
  2. A confidential question box passed around for students to submit any questions they have about sex. Each student is asked to write something on a piece of paper, even if it is not a question or a comment, and to place it inside the box. Nurse Glenda reviews the papers and answers questions at the end of the class.
  3. An open forum where students raise their hands and ask questions. Nurse Glenda responds appropriately.
  4. A survey completed at the end of the class that students give to Nurse Glenda as they leave.

 

  1. After the class has been given, Nurse Glenda talks to the parents and the church’s religious education teacher. Nurse Glenda believes that she can do more with this age group and would like to offer her services to them. She suggests that an evening of preventive screenings should be offered. What should Nurse Glenda screen for in this group of teenagers?

 

  1. How can Nurse Glenda use interactive health communication (IHC) to reinforce the lesson?

 

 

CASE # 7: ABOUT POVERTY AND HOMELESSNESS

 

The community of Finnytown has identified the need for a shelter to serve homeless women and children. Finnytown currently has a homeless shelter for men. Women and children can obtain health care services there but are not allowed to stay overnight. The Finnytown health care task force performed a community assessment that revealed that a higher number of homeless men than women reside in Finnytown, but the percentage of homeless women is steadily increasing. Results further showed that more women with children than men are living in poverty. The task force speculated that many women who are living in poverty are being overlooked and thus are becoming women without homes.

 

The task force and the community of Finnytown decide to open a homeless shelter for women and children. The new shelter will primarily serve women with children who are homeless or in poverty. Georgia B. is the community health nurse who is a member of the task force team. Nurse Georgia and other health care professionals are charged with planning health care services for women with children to be provided at the new homeless shelter.

Questions

  1. What common health problems should Nurse Georgia and the task force be aware of when planning health services to be provided at the new shelter?

 

  1. What effects of poverty on the health of children should Nurse Georgia and the task force be aware of when planning appropriate services?

 

  1. After the shelter opens, Nurse Georgia becomes one of the nurses who works in the clinic. What strategies are important for Nurse Georgia to implement when working with this population?

 

 

 

CASE # 8: ABOUT THE NURSE LEADER IN THE COMMUNITY

 

Ann T. is the state school nurse consultant. Nurse Ann provides guidance for school nurses across the state and organizes policy development for school nursing. Many of Nurse Ann’s hours are spent communicating by phone, face-to-face, or by e-mail with nurses and families who have questions regarding health services in the schools.

 

Terry L. contacts Nurse Ann. This is Terry’s first year as a school nurse, and she is working in a rural high school. She is worried about delegating medication administration to unlicensed personnel. “What exactly can be delegated, to whom, and how should I document it?” asks Nurse Terry. Case Studies Of Community Health Topics

 

Nurse Ann explains to Terry that some state laws specify who may delegate tasks, and the State Board of Nursing gives advice on which nursing tasks can be delegated. Nurse Ann tells Terry where on the Internet she can find these laws along with advisory opinions, and she e-mails copies to Terry. Nurse Ann shows Terry how to use the delegation decision tree and discusses some of Nurse Terry’s more challenging delegation issues. Nurse Terry must then use the materials to decide what she is comfortable delegating. Nurse Ann also gives Nurse Terry some sample training materials and documentation forms that other nurses in the state are currently using.

Questions

  1. Which type of consultation model did Nurse Ann use? Explain your answer.

 

  1. What can Nurse Ann do to reduce for other school nurses the confusion that surrounds delegation in school nursing?

 

  1. What should Nurse Ann do to communicate effectively with the nurses and families whom she encounters?

 

 

 

CASE # 9: ABOUT FORENSIC NURSING IN THE COMMUNITY

 

Amanda J. is a forensic nurse who has been trained as a sexual assault nurse examiner (SANE). Amanda works part-time in the emergency room, where she occasionally examines victims of rape and sexual assault. Amanda also works part-time as a consultant for a local domestic-violence shelter for women and children. Every year Nurse Amanda helps to organize a Walk to Prevent Domestic Violence in her community. Proceeds raised from the walk go toward the domestic-violence shelter. Nurse Amanda provides literature about domestic violence at the walk as well as at other organizations in town.

Questions

  1. Which levels of prevention does Nurse Amanda address in her practice?
  2. Primary only
  3. Secondary only
  4. Tertiary only
  5. Two of the above
  6. All of the above
  7. None of the above

 

  1. What are the most common types of trace evidence of victims of violence, including those who are raped?

 

  1. The concepts in forensic nursing theory include, but are not confined to, safety, injury, presence, perceptivity, victimization, and justice. How might Nurse Amanda address these concepts in her nursing practice? Case Studies Of Community Health Topics

 

 

Focused Exam: Cough Assignment

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Review this week’s Learning Resources and consider the insights they provide related to ears, nose, and throat.

  • Review the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation within the Shadow Health platform. Review the examples also provided.
  • Review the DCE (Shadow Health) Documentation Template for Focused Exam: Cough found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
  • Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Focused Exam: Cough Assignment
  • Review the Week 5 Focused Exam: Cough Rubric provided in the Assignment submission area for details on completing tReview the Shadow Health Resources provided in this week’s Learning Resources specifically the tutorial to guide you through the documentation and interpretation within the Shadow Health platform. Review the examples also provided.
    Review the DCE (Shadow Health) Documentation Template for Focused Exam: Cough found in this week’s Learning Resources and use this template to complete your Documentation Notes for this DCE Assignment.
    Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

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Episodic/Focused SOAP Note Exemplar

Focused SOAP Note for a patient with chest pain

S.
CC: “Chest pain”

HPI: The patient is a 65 year old AA male who developed sudden onset of chest pain, which began early this morning.  The pain is described as “crushing” and is rated nine out of 10 in terms of intensity. The pain is located in the middle of the chest and is accompanied by shortness of breath. The patient reports feeling nauseous. The patient tried an antacid with minimal relief of his symptoms.

PMH: Positive history of GERD and hypertension is controlled

FH: Mother died at 78 of breast cancer; Father at 75 of CVA.  No history of premature cardiovascular disease in first degree relatives.

SH : Negative for tobacco abuse, currently or previously; consumes moderate alcohol; married for 39 years

ROS
General–Negative for fevers, chills, fatigue
Cardiovascular–Negative for orthopnea, PND, positive for intermittent lower extremity edema
Gastrointestinal–Positive for nausea without vomiting; negative for diarrhea, abdominal pain
Pulmonary–Positive for intermittent dyspnea on exertion, negative for cough or hemoptysis

O.

VS: BP 186/102; P 94; R 22; T 97.8; 02 96% Wt 235lbs; Ht 70”

 

General–Pt appears diaphoretic and anxious

Cardiovascular–PMI is in the 5th inter-costal space at the mid clavicular line. A grade 2/6 systolic decrescendo murmur is heard best at the

second right inter-costal space which radiates to the neck.

A third heard sound is heard at the apex. No fourth heart sound or rub are heard. No cyanosis, clubbing, noted, positive for bilateral 2+ LE edema is noted.

Gastrointestinal–The abdomen is symmetrical without distention; bowel

sounds are normal in quality and intensity in all areas; a

bruit is heard in the right para-umbilical area. No masses or

splenomegaly are noted. Positive for mid-epigastric tenderness with deep palpation.

Pulmonary— Lungs are clear to auscultation and percussion bilaterally

 

Diagnostic results: EKG, CXR, CK-MB (support with evidenced and guidelines)

 

A.

Differential Diagnosis:

1) Myocardial Infarction (provide supportive documentation with evidence based guidelines).

2) Angina (provide supportive documentation with evidence based guidelines).

3) Costochondritis (provide supportive documentation with evidence based guidelines).

 

Primary Diagnosis/Presumptive Diagnosis: Myocardial Infarction

 

 

 

 

 

  1. This section is not required for the assignments in this course (NURS 6512) but will be required for future courses. Focused Exam: Cough Assignment

 

Pharmacotherapy For Cardiovascular Disorders

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Pharmacotherapy For Cardiovascular Disorders

Consider the following case study:

Patient AO has a history of obesity and has recently gained 9 pounds. The patient has been diagnosed with hypertension and hyperlipidemia. Drugs currently prescribed include the following: Pharmacotherapy For Cardiovascular Disorders

· Atenolol 12.5 mg daily

· Doxazosin 8 mg daily

· Hydralazine 10 mg qid

· Sertraline 25 mg daily

· Simvastatin 80 mg daily

To prepare:

  • Review      this week’s media presentation on hypertension and hyperlipidemia, as well      as Chapters 19 and 20 of the Arcangelo and Peterson text.
  • Select      one one the following factors: genetics, gender, ethnicity, age, or      behavior factors.
  • Reflect      on how the factor you selected might influence the patient’s      pharmacokinetic and pharmacodynamic processes. Pharmacotherapy For Cardiovascular Disorders
  • Consider      how changes in the pharmacokinetic and pharmacodynamic processes might      impact the patient’s recommended drug therapy.
  • Think      about how you might improve the patient’s drug therapy plan based on the      pharmacokinetic and pharmacodynamic changes. Reflect on whether you would      modify the current drug treatment or provide an alternative treatment      option for the patient.

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With these thoughts in mind:

Post an explanation of how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study. Then, describe how changes in the processes might impact the patient’s recommended drug therapy. Finally, explain how you might improve the patient’s drug therapy plan.

– This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2012 and up)

– Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

4. Mayoclinic.com

Required Readings

**Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

  • Chapter 19, “Hypertension”      (pp. 257-272)
    This chapter examines the relationships between the cardiovascular,      nervous, and renal systems. It then describes diagnostic criteria for      hypertension patients, drugs used to treat hypertension and possible      adverse reactions, monitoring patient response, and patient education.
  • Chapter 20, “Hyperlipidemia”      (pp. 275-286) Pharmacotherapy For Cardiovascular Disorders
    This chapter explores causes of hyperlipidemia, treatments for      hyperlipidemia patients, and methods for monitoring patient response. It      also reviews strategies for risk assessment and patient education.
  • Chapter 21, “Chronic Stable      Angina” (pp. 289-303)
    This chapter begins by exploring factors that contribute to chronic stable      angina, types of drugs used in treatment, and diagnostic criteria for      initiating drug therapy. It also examines methods for monitoring patient      response to treatment and educating patients on self-care.
  • Chapter 22, “Heart Failure”      (pp. 305-322)
    This chapter examines the process of prescribing drugs to treat heart      failure and explores effects of prescribed drugs, proper dosages, and      possible adverse reactions.
  • Chapter 50, “Pharmacotherapy      for Venous Thromboembolism Prevention and Treatment, Stroke Prevention in      Atrial Fibrillation, and Thromboembolism Prevention with Mechanical Heart      Valves” (pp. 863-886)

This chapter covers drug therapy options for three disorders requiring anticoagulants: venous thromboembolism, atrial fibrillation, and ischemic stroke. It also explains the process of initiating and managing drug therapy for patients with these disorders.

**Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

Required Media

Laureate Education, Inc. (Executive Producer). (2012). Hypertension and hyperlipidemia. Baltimore, MD: Author.

This media presentation outlines hypertension and hyperlipidemia including contributing factors, evaluation, treatment, and implications. Pharmacotherapy For Cardiovascular Disorders

Week 5 Patient’s Spiritual Needs: Case Analysis

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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following:      Should the physician allow Mike to continue making decisions that seem to      him to be irrational and harmful to James, or would that mean a disrespect      of a patient’s autonomy? Explain your rationale.
  2. In 400-450 words, respond to the following: How      ought the Christian think about sickness and health? How should a      Christian think about medical intervention? What should Mike as a      Christian do? How should he reason about trusting God and treating James      in relation to what is truly honoring the principles of beneficence and      nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How      would a spiritual needs assessment help the physician assist Mike      determine appropriate interventions for James and for his family or others      involved in his care?

Remember to support your responses with the topic study materials.

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. You are required to submit this assignment to LopesWrite.

Rubric:

1. Decisions that need to be made by the physician and the father are analyzed from both perspectives with a deep understanding of the complexity of the principle of autonomy. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%

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2. Decisions that need to be made by the physician and the father are analyzed with deep understanding of the complexity of the Christian perspective, as well as with the principles of beneficence and nonmaleficence. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 20%

3. How a spiritual needs assessment would help the physician assist the father determine appropriate interventions for his son, his family, or others involved in the care of his son is clearly analyzed with a deep understanding of the connection between a spiritual needs assessment and providing appropriate interventions. Analysis is supported by the case study, topic study materials, or Topic 3 assignment responses. 30%

4. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%

5. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%

6. Writer is clearly in command of standard, written, academic English. 5%

7. All format elements are correct. 5%

8. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5% Week 5 Patient’s Spiritual Needs: Case Analysis

 

There are three different parts to this paper:

· Part one deals with Mike’s decision-making capabilities. 

· Part two deals with how to think issues related to sickness and health.

· Part three deals with a spiritual assessment.

Read “Doing a Culturally Sensitive Spiritual Assessment: Recognizing Spiritual Themes and Using the HOPE Questions,” by Anandarajah, from AMA Journal of Ethics(2005).

https://journalofethics.ama-assn.org/article/doing-culturally-sensitive-spiritual-assessment-recognizing-spiritual-themes-and-using-hope/2005-05

Read “End of Life and Sanctity of Life,” by Reichman, from American Medical Association Journal of Ethics, formerly Virtual Mentor (2005).

http://journalofethics.ama-assn.org/2005/05/ccas2-0505.html Week 5 Patient’s Spiritual Needs: Case Analysis

Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs)

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Discuss the differences and similarities between Managed Care Organizations (MCOs) vs. Accountable Care Organizations (ACOs). Given the current health care environment, provide a solid speculation to how MCOs and ACOs may transform to meet the needs of its consumers. Be sure to support your thoughts and analysis with scholarly sources.

*Will also need to respond to 3 classmate’s post, will send that after you turn in assignment.

Student Sumetria

The differences and similarities between Managed Care Organizations (MCO) and Accountable Care Organizations (ACO) will be explained below.

The MCO is a group of medical providers and facilities that provide care to its members at a reduced cost. Many MCO’s require the patient to have a primary care provider. The ACO is a group of medical providers and medical facilities that work together to provider collaborative care to its members. The ACO doesn’t require the member to have a primary care provider.    The providers work together voluntarily to provider care as a medical team for the patient. The different specialties work with each other to treat the patient with continuity of care. The information is shared so that all the providers that are treating the patient are aware of the medications, tests, hospital visits, and treatment the patient has currently and the past treatments. The providers that are part of the MCO’s don’t work as a team to provider collaborative care to the patients. They don’t strive to work together to treat the patient with the team approach like providers in the ACO’s strive for. The MCO groups can share information if it is requested. The focus is not continuity of care.  Some providers send their notes to the referring provider as a courtesy.  The ACO’s are still changing to become better.  The MCO’s and ACO’s may transform and merge into one entity to meet the needs of consumers. They both are similar enough to the point where I think they can be combined with the best interest of the consumer in mind. I believe that we can take the best features from both of them. Considering the current health care environment , continuity of care is important. This is the best way to treat the patient with the best possible outcome. Having the providers work together as a team avoids having the patient take medications that interact, repeating the same tests, and other wasteful or harmful medical practice. This approach can also reduce the cost of medical care. The cost of medical care is constantly increasing and I think this is a way to reduce the cost of medical care. This will help control wasteful spending.

 

“Managed Care.” MedlinePlus, U.S. National Library of Medicine, 25 Sept. 2017, medlineplus.gov/managedcare.html.

 

“What Is an ACO? Definitive Guide: Accountable Care Organizations.” Health Catalyst, Health Catalyst, 24 Oct. 2017, www.healthcatalyst.com/what-is-an-ACO-definitive-guide-accountable-care-organizations.

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Student 2 Kpanbu

Health care spending is the biggest drive for formulating the different kinds of payment systems in healthcare. Health care insurance enrollees may obtain care from various Managed Care Organizations (MCOs) or Accountable Care Organizations (ACOs). Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs)

Managed Care Organizations (MCOs): is a group of people working together to manage the cost of health care.  MCOs work along with medical facilities and health care providers to render support to MCO patients. MCOs only pays for the care provided and its plan is not as flexible as ACOs. MCOs give incentives to physicians like the ACOs. There are four types of MCOs: Health Maintenance Organization (HMO), Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO), and Point-of-Service Plan (POS).  According to (Andrews, 2014), HMOs only pay within network health care and insurers need a referral to seek care from a specialist or else the services provider will not be covered. For PPOs, care is covered both in and out of the network, however; the patient pays a higher premium for out of network care.  In EPO, care is not covered outside of the network, nevertheless; patients do not require referral to get seen by a specialist.  In POS, plan varies between HMOs and PPOs, and insurers may seek out of network care but with a higher cost-sharing rate. PPO and HMO both have Medicare options.

Accountable Care Organizations (ACOs): is a number of individuals that consist of health care providers and health care settings, collectively working together to accomplish the goal of improving optimum quality of health care. This network of people may include physicians, surgeons, pharmacists, doctors, nurses, healthcare assistants, caregivers, lab specialists, psychiatrists, mental health professionals, rehabilitation workers, other healthcare specialties and hospitals. This group of people collaboratively work together to coordinate patient care to obtain maximum care for clients and the group “accepts joint responsibility for health care spending and quality for a defined population of patients” (Song, 2014).  According to Song (2014), the three key characteristics of the ACO are: “joint accountability,” accountability for both quality of care and health care spending, and the ACO is responsible for the care of a population of people.” In the ACO plan patients have more freedom to choose the type of care within a restricted time period.  ACO provides a variety of payment structures and incentives to health care providers and hospitals primarily focusing on quality of care and financial risks to hospitals and physicians. ACO reward health care providers for the quality of care provided to patients, while eliminating irrelevant spending. ACOs do not focus on profit, but the quality of care while MCOs focus on profit.

References:

Andrews, M. (2014). What’s the best health plan for you? HMO, PPO, EPO or POS? Retrieved from https://www.washingtonpost.com/national/health-science/whats-the-best-health-plan-for-you-hmo-ppo-epo-or-pos/2014/08/25/772f96a8-27c1-11e4-958c-268a320a60ce_story.html?utm_term=.51bd23ba540e

Humana. (n.d.). HMO vs. PPO: Which one is right for you? Retrieved from https://www.humana.com/all-products/understanding-insurance/hmo-vs-ppo

Song, Z. (2014). Accountable Care Organizations in the U.S. Health Care System. J Clin Outcomes Manag. 2014 Aug 1; 21(8): 364–371.

 

 

 

Student 3 Talisha

 

An MCO is a type of health care system that links health insurance with care delivery for a defined population. An MCO delivers health care through a network of providers, determines the prices for services, coordinates care, and manages appropriate use of health care services. According to the National Accountable Care Organization Summit (n.d.), ACOs are provider collaborations that support the integration of groups of physicians, hospitals, and other providers in different ways around the opportunity to receive additional payments by achieving continually advancing patient-focused quality targets and demonstrating real reductions in overall spending growth for their defined patient population. According to Shortell, Casalino, and Fisher (2010), there are at least five different types of practice arrangements that could serve as ACOs: the integrated or organized delivery system, multispecialty group practices, physician-hospital organizations, independent practice associations, and “virtual” physician organizations. The Accountable Care Model (ACO), the health care providers develop and drive the models’ respective agendas (McWilliams et al., 2016).

Given the similarities seen between MCOs and ACOs it is clear that MCOs have a more monopoly set up on their delivery method of care; while ACOs allows for free movement outside or within their integrated networks. Centers for Medicare and Medicaid Services (2015) states that participation in ACO is voluntary. This implies that the patient consumers have the freedom to select the Primary Care Physician of their choice, the hospitals they want and their favorable specialist. Given the current healthcare environment over time MCOs and ACOs can evolve into more organized networks of practices that will actively engage in practice redesign, quality improvement initiatives, and implementation of much more innovate technologies moving forward, for example one of their noteworthy success has been the implementation of electronic health records. The Electronic Health Records (EHRs) are now giving doctors and physicians real time secure access to patients records to better assist them across both MCO and ACO networks alike, saving time, money and creating more vital time providing much needed focused patient care.

Reference

Centers for Medicare and Medicaid Services. (2015). Accountable care organizations (ACO). (n.d.). Retrieved from http://www. cms. gov/Medicare/Medicare-Fee-for-Service-Payment/ACO/index. html.

National Accountable Care Organization Summit. (n.d.). What is an ACO? Retrieved from http://www.acosummit.com/past2011/overview.html

Shortell, S. M., Casalino, L. P. & Fisher. E. S. (2010). How the Center for Medicare and Medicaid Innovation Should Test Accountable Care Organizations. Health Affairs, 29 (7), 1293-1298. Managed Care Organizations (MCOs) Vs. Accountable Care Organizations (ACOs)

 

 

 

 

Diversity And Health Assessments

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Diversity And Health Assessments

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.

Case 1

JC, an at-risk 86-year-old Asian male is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. He has a hx of hypertension (HTN), gastroesophageal reflux disease (GERD), b12 deficiency, and chronic prostatitis. He currently takes Lisinopril 10mg QD, Prilosec 20mg QD, B12 injections monthly, and Cipro 100mg QD. He comes to you for an annual exam and states “I came for my annual physical exam, but do not want to be a burden to my daughter.” Diversity And Health Assessments

Case 2

TJ, a 32-year-old pregnant lesbian, is being seen for an annual physical exam and has been having vaginal discharge. Her pregnancy has been without complication thus far. She has been receiving prenatal care from an obstetrician. She received sperm from a local sperm bank. She is currently taking prenatal vitamins and takes Tylenol over the counter for aches and pains on occasion. She a strong family history of diabetes. Gravida 1; Para 0; Abortions 0.

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Case 3

MR, a 23-year-old Native American male comes in to see you because he has been having anxiety and wants something to help him. He has been smoking “pot” and says he drinks to help him too. He tells you he is afraid that he will not get into Heaven if he continues in this lifestyle. He is not taking any prescriptions medications and denies drug use. He has a positive family history of diabetes, hypertension, and alcoholism.

To prepare:

· Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.

· Select one of the three case studies. Reflect on the provided patient information.

· Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient you selected.

· Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

· Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?

Post

Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you selected. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.

This work should have Introduction and conclusion

– This work should have at 3 to 5current references (Year 2013 and up)

– Use at least 2 references from class Learning Resources Diversity And Health Assessments

The following Resources are not acceptable:

1. Wikipedia

2. Cdc.gov- nonhealthcare professionals section

3. Webmd.com

CLASS LEARNING RESOURCES

**Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

  • Chapter 1, “The History and      Interviewing Process” (pp. 1-20)

This chapter highlights history and interviewing processes. The authors explore a variety of communication techniques, professionalism, and functional assessment concepts when developing relationships with patients.

  • Chapter 2, “Cultural      Competency” (pp. 21–29)

This chapter highlights the importance of cultural awareness when conducting health assessments. The authors explore the impact of culture on health beliefs and practices.

**Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care (5th ed.). St. Louis, MO: Elsevier Mosby.

  • Chapter 2, “Evidenced- Based Health Screening”      (pp. 6-9)

**Melton, C., Graff, C., Holmes, G., Brown, L., & Bailey, J. (2014). Health literacy and asthma management among African-American adults: An interpretative phenomenological analysis. Journal of Asthma, 51(7), 703–713. doi: 10.3109/02770903.2014.906605

Retrieved from the Walden Library Databases.

The authors of this study discuss the relationship between health literacy and health outcomes in African American patients with asthma.

**Centers for Disease Control and Prevention (2015). Cultural competence. Retrieved from https://npin.cdc.gov/pages/cultural-competence

This website discusses cultural competence as defined by the Center for Disease Control and Prevention (CDC). Understanding the difference between cultural competence, awareness, and sensitivity can be obtained on this website. 

**United States Department of Human & Health Services. Office of Minority Health. (2016). A physician’s practical guide to culturally competent care. Retrieved from https://cccm.thinkculturalhealth.hhs.gov/

From the Office of Minority Health, the Website offers CME and CEU credit and equips health care professionals with awareness, knowledge, and skills to better treat the increasingly diverse U.S. population they serve.

**Espey, D., Jim, M., Cobb, N., Bartholomew, M., Becker, T., Haverkamp, D., & Plescia, M. (2014). Leading causes of death and all-cause mortality in American Indians and Alaska Natives. American Journal of Public Health, 104(S3), S303-S311.

The authors of this article present patterns and trends in all-cause mortality and leading cause of death in American Indians and Alaskan Natives.

**Wannasirikul, P., Termsirikulchai, L., Sujirarat, D., Benjakul, S., Tanasugarn, C. (2016). Health literacy, medication adherence, and blood pressure level among hypertension older adults treated at primary health care centers. Southeast Asian J Trop Med Public Health., 47(1):109-20.

The authors of this study explore the causal relationships between health literacy, individual characteristics, literacy, culture and society, cognitive ability, medication adherence, and the blood pressure levels of hypertensive older adults receiving health care services at Primary Health Care Centers. Diversity And Health Assessments

Assignment: Position Paper On Health Policy

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Assignment: Position Paper On Health Policy

Now that you have analyzed many different aspects of health care policy, you are better able to form a comprehensive evidence-based opinion on its effectiveness. The policy you chose to focus on, like all policy, as you now well know, is a conglomeration of many different facets. Each of those facets is integral to the policy’s success, efficiency, and value. Assignment: Position Paper On Health Policy

As a nursing professional and advocate for change, having an all-inclusive understanding of health care policy is extremely important. Nurses have a tremendous amount of untapped power to make positive changes. Your knowledge of policy is just a first step. With this new process of breaking down and analyzing each of the pieces of health care policy, you have added another tool to your toolkit.

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To complete this Assignment, consider all of your findings from the Discussion in Week 1 and the Assignments in Weeks 2 and 3. Analyze your research on the policy, including costs, quality, and/or safety issues.

Address the following:

  1. Introduce the topic by drawing from your previous work. Introduce the policy by providing an overview of the suggested or implemented policy: background of the topic, including main elements of the policy, costs, and quality/safety. Assert your main thesis statement.
  2. Offer an evidence-based, informed opinion in support of the suggested or implemented policy. Describe at least two major contributions that this policy makes to health care, nursing, or health outcomes. Provide support with at least three sources of evidence.
  3. Discuss at least one opposing opinion to the suggested or implemented policy. Provide evidence and/or data to support the counterargument.
  4. Present a final position on the policy. Support the final defensible argument with current literature.
  5. Conclusion:
    A. Restate your argument.
    B. Provide a plan of action, but do not introduce new information. In total, your paper will be 4–5 pages in length, not including the title page or reference page. Assignment: Position Paper On Health Policy

Shadow Health Focused Exams

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  • Complete the ShadowHealth© Focused Exams – Special Populations: Chest Pain, Cough and Abdominal Pain assignments

After you have achieved at least 80% on the assignment(s) download, save and upload your LabPass document to the dropbox.

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Professional Development

  • Write a 500-word APA reflection essay of your experience with the Shadow Health virtual assignment(s). At least two scholarly sources in addition to your textbook should be utilized. Answers to the following questions may be included in your reflective essay:
    • What went well in your assessment?
    • What did not go so well? What will you change for your next assessment?
    • What findings did you uncover?
    • What questions yielded the most information? Why do you think these were effective?
    • What diagnostic tests would you order based on your findings?
    • What differential diagnoses are you currently considering?
    • What patient teaching were you able to complete? What additional patient teaching is needed?
    • Would you prescribe any medications at this point? Why or why not? If so, what?
    • How did your assessment demonstrate sound critical thinking and clinical decision making? Shadow Health Focused Exams