Summarizing Nursing Scholarly Article

Find and read a nursing scholarly article that relates to your clinical practice and is found in a peer-reviewed journal. Follow the instructions for the format in course textbook and write a 1-page summary.

The weekly article summary assignment starts from Module 1 through Module 6. Each summary is due in the following module. For example, Article Summary 1 must be submitted by 11:59 PM ET Sunday in Module 2, and Article Summary 6 must be submitted by 11:59 PM ET Sunday in Module 7.

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Submission Instructions:

• Must be a research article. Write a 1-page summary using an outline of the steps of the research process stated in the course textbook. Discuss the study type, purpose, and research question(s).
• The summary is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
• The summary should be formatted per current APA and 1 page in length, excluding the title page and references page. No abstract needed.
• Incorporate a minimum of 2 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
• Complete and submit the assignment by 11:59 PM ET Sunday.
• Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor Summarizing Nursing Scholarly Article

NURS 6512: Advanced Health Assessment and Diagnostic Reasoning – Discussion Diversity and Health Assessments discussion essay examples 

Diversity and Health Assessments

Case #1: “I came for my annual physical exam, but do not want to be a burden to my daughter.” History of Present Illness (HPI): At-risk 86-year-old Asian male – who is physically and financially dependent on his daughter, a single mother who has little time or money for her father’s health needs. According to Dains, Baumann, and Scheibel (2016), an assessment begins with the patient stating their primary concern or reason for the visit. In the case of the 86-year-old Asian male, he is in for his annual physical exam but clearly states that he concerned about burdening his daughter. The patient requires a complete physical exam on this visit, but would also benefit from a comprehensive geriatric assessment (CGA) based on his age but also because of is comment. Functional and social vulnerabilities are challenges characteristic of older populations (Ramani, Furmedge, & Reddy, 2014). Discussion Diversity and Health Assessments discussion essay examples .

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The socioeconomic factor related to this patient is his dependency on his daughter for financial stability. The patient’s daughter is a single mother who does not have money to spend on her father’s health needs. The patient is 86 years old and physically dependent on his daughter, so is unable to contribute to the household both financially or physically. It is unclear if the daughter able to support for her father beyond his health needs. According to Yan, Chan, and Tiwari (2015), Asian cultures prescribe to adult children caring for their elderly parents providing financial support and showing them obedience Discussion Diversity and Health Assessments discussion essay examples . This is based on a Confucian teaching which, according to more recent studies, is being interpreted differently by younger generations who feel that it is dependent on their own circumstances (Yan, Chan, & Tiwari, 2015).

Subjective data obtained from the assessment identified a weight loss of 25 pounds over the past year, multiple bruises on the patient’s upper arms and back, and a history of two falls within the last 6 months. Objective data identified that the patient was hypertensive, even though taking medication for hypertension, and multiple bruises in different stages of healing on his upper arms and back. The patient also has arcus senilus bilaterally, which is common for this age population and does not require intervention. The bruises, weight loss, and hypertension need to be addressed. Discussion Diversity and Health Assessments discussion essay examples .

Sensitive Issues

The patient’s assessment is affected by cultural beliefs and behaviors and the relationship with the family should be explored (Ball, Dains, Flynn, Solomon, & Stewart, 2015). Ball et al. (2015) also indicate that older patients who are physically impaired are at higher risk for elder abuse. A conversation regarding the bruises is a sensitive subject particularly because Asian populations are hesitant to report elder abuse as it is considered a family matter (Yan, Chan, & Tiwari, 2015). According to Yan, Chan, and Tiwari (2015), discussing the potential elder abuse with a third party is considered shameful in Asian culture because the behavior may be seen as a reflection of poor parenting. Addressing the hypertension should include assessing if the patient is taking his medication, which may identify if the daughter is purchasing the medication or not Discussion Diversity and Health Assessments discussion essay examples . This is a sensitive issue because the patient does not want to burden his daughter and may not want to indicate that his daughter is neglecting his needs.

Older adults require health care that goes beyond medical management and includes evaluation of issues such as physical, financial, and environmental aspects that impact their health (Ramani, Furmedge, & Reddy, 2014). Identifying problems with the patient’s social support can aid in obtaining resources for the patient and choices can be made regarding outcomes most important to the patient and his daughter (Ramani, Furmedge, & Reddy, 2014). Lastly, the patient is functionally impaired and may qualify for state or local benefits depending on his income (Ramani, Furmedge, & Reddy, 2014) and since he is being supported by his daughter, this may alleviate the burden on her and improve his access to medications and care that he requires. Discussion Diversity and Health Assessments discussion essay examples .

Targeted Questions

• How do you take your medications each day?
• What do you normally eat and drink each day?
• Are you able to get around okay at home?
• Do you feel safe at home?
• Would you like help with things at home such as bathing, dressing, and mobility?
• Do you often feel sad or depressed?
• Discussion Diversity and Health Assessments discussion essay examples

References

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.

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.

Ramani, L., Furmedge, D. S., & Reddy, S. H. (2014). Comprehensive geriatric assessment. British Journal of Hospital Medicine (London, England: 2005), 75(8), C122-C125.

Yan, E., Chan, K., & Tiwari, A. (2015). A Systematic Review of Prevalence and Risk Factors for Elder Abuse in Asia. Trauma, Violence & Abuse, 16(2), 199-219 21p. doi:10.1177/152483801455503

 

 

NURS 6512: Advanced Health Assessment

Diversity and Health Assessment

     Cultural competence is the gradually developed capacity of nurses and healthcare providers to provide safe and quality healthcare to clients of different background (Duan-Ying, 2016). Cultural competence involves recognizing one’s own culture, values, and biases, and using effective patient-centered communication skills (Ball et al., 2015). To be culturally competent, the practitioner must be able to respond to the cultural diversity of her or his patients and adapt to the unique needs of patients from the cultural and spiritual background different from her or his own (Ball et al., 2015). For this forum, the cultural health assessment of MR, the 23-year-old Native American male will be discussed.

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Case 3: Culturally Competent Health Assessment of the 23-year-old Native American Male

MR, a 23-year-old Native American presents with complain of anxiety, history of smoking “pot,” alcoholism, a family history of diabetes, hypertension, and alcoholism. He is afraid of the adverse outcomes of his lifestyle choices. He is not currently on prescription medication and denies drug use. He needs some prescriptions to help him with his anxiety.

According to Espey at al. (2013), “American Indians in the United have long endured a legacy of injustice and discrimination with multiple negative manifestations, including alarming health disparities and inadequate healthcare.” Patterns of mortality among Native Americans are strongly influenced by the high incidence of diabetes, smoking prevalence, problem drinking, and social determinants (Epsey et al., 2013). For many young Native Indian Americans like MR, the problem of poor health, smoking, and alcohol abuse can be explained by poverty, unemployment, and lack of education. Sarche & Spicer (2008) state that more than one-quarter of American Indian and Alaskan Native is living in poverty, a rate that is more than double of that of the general population. The discrepancy in education and employment is also found and overall, there are fewer individuals within the American Indian and Alaska community who possess a high school diploma or GED (71% versus 80%) or a bachelor degree (11% versus 24.4%) (Sarche & Spicer, 2008). The social determinants of health including poor-socioeconomic status, poor education, low income as well as unhealthy lifestyle and poor access to healthcare services play a major role in MR’s anxiety, alcohol use, and “pot” smoking Discussion Diversity and Health Assessments discussion essay examples . MR health seeking behavior is related to his spiritual beliefs that he might not “get into heaven” if he continues to have an unhealthy lifestyle. This attitude is an excellent initiative towards a healthier lifestyle.

                           Addressing critical issues when interacting with the patient

According to scenario 3, MR has multiple health risks. He has a family history of hypertension, diabetes, and alcoholism. He is a current “pot” smoker, alcohol drinker, and a very anxious young man looking for prescriptions against anxiety. Anxiety is one the withdrawal symptoms and therefore, MR may have drug addiction issue. This patient may need a psychiatric consult for better assessment of his drug addiction status. He is also at risk for cardiovascular diseases and lung cancer related to “pot” smoking, hypertension and diabetes-related to family history and alcoholism. Discussion Diversity and Health Assessments discussion essay examples

Targeted Questions

1-    How are you doing today? How can I help you with your visit?

2-    You stated that you have been smoking “pot.” How long have you been smoking?

3-    What do you think is the cause of your anxiety?

4-    You stated that drinking alcohol can help cope with your anxiety. How many drinks do you have in one day?

5-    Have you ever felt you should cut down on your drinking? (CAGE questionnaire)

6-    Have people annoyed you by criticizing your drinking? (CAGE questionnaire) Discussion Diversity and Health Assessments discussion essay examples

7-    Have you felt bad or guilty about drinking?  (CAGE questionnaire) (Addiction & Recovery, 2018).

8-    Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover? (CAGE questionnaire)

9-    Do you have insurance coverage? Do you have concerns about how to cover your medical expenses?

10-    Before coming to this health center did you seek help from a family member, spiritual leader or a friend? Did they listen to you or provide any support?                                                                                                                                                                                                                                   Reference

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., Stewart, R. W. (2015). Seidel’s Guide to          

          Physical Examination. (8^th E.). Elsevier, Mosby. St. Louis, Missouri.

Addiction and Recovery (2018). CAGE Questionnaire. Addiction Self-Assessment.

Retrieved from https://addictionsandrecovery.org/addiction-self-test.htm

Duan-Ying, C. (2016). A Concept Analysis of Cultural Competence. International Journal of

         Nursing Sciences. Volume 3, Isuue3, pages 268-273.

https://doi.org/101016/j.ijnss.2016.08.00 Retrieved from

https://www.sciencedirect.com/science/article/pii/S2352013216300795

Espey, D. K., Jim, M. A., 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 Public Health Association.

Doi: 10.2105/AJPH.2013.3017.98 Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4035872/ Discussion Diversity and Health Assessments discussion essay examples

 

Sarche, M., Spicer, P. (2008). Poverty and Health Disparities for American Indian and Alaska

Native Children: Current Knowledge and Future Prospect. American Indian and Alaska

            Native Programs. Doi: 10.1196/annals.1425.017. Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2567901/pdf/nihms58363.pdf Discussion Diversity and Health Assessments discussion essay examples

 

Mrs. J. history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

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Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD. Mrs. J. history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

Subjective Data

Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is \”running away.\”
Reports that she is exhausted and cannot eat or drink by herself.
Objective Data

Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention

The following medications administered through drug therapy control her symptoms:

IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.\’s situation. Include the following:

Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients\’ transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale. Mrs. J. history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.\’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Mrs. J. history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD)

Please follow the rubric to answer everything required in the Lumbar Puncture Procedure Recommendation for Newborns paper.

• VERY IMPORTANT: Critique of each research study:

The critique of each of the research studies (total of 2 studies to be located using Cochrane, cinahl or pubmed please) should include: purpose of the study, study design, description of study sample, results of study, description of how results relevant to the recommended revision.

Assessment of an Advanced Practice Procedure

The purpose of this assignment is for the student to identify and review a procedure that NNPs (and/or neonatologists) perform in their NICU where they work as an RN and suggest improvements to the procedure based on the most current evidence for practice (i.e. research studies).

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Steps in the process:

1. Identify a procedure of interest Lumbar Puncture
2. Identify the existing policy for the procedure that is used by NNPs and neonatologists in the student’s NICU. My current policy does not use any type of pain medication like lidocaine when performing a Lumbar puncture on infant and only gives sucrose (sugar water with pacifier dips).
3. Explore the medical literature to identify ways that the procedure could be improved/updated (with the result of improved patient care/safety). Lumbar Puncture Procedure Recommendation for Newborns

I need literature that is no more than 5 years old the oldest it can be in 2015. The one specific recommendation I want to change in my policy is for lidocaine or analgesia for pain during the lumbar procedure

4. Make ONE SPECIFIC recommendation for policy change for the procedure with support from the current medical literature (two research studies published within the past 5 years that BOTH support the student’s recommendation). An example of a research study is a randomized controlled trial. Do not use None of the following are research studies: quality improvement reports, clinical guidelines/bundles, reports of evidence-based practice projects, meta-analyses. A major part of your grade for this assignment is your ability to identify current research, critique the research, and make an informed recommendation about the need for procedure revision. Because you are being evaluated, you may not ask your instructor to preview your research studies for appropriateness. If you are unclear on what constitutes a research study, refer back to your research text book from N5366. Lumbar Puncture Procedure Recommendation for Newborns

 

 

Lumbar Puncture Procedure Recommendation for Newborns Assignment Rubric

	Points possible	Points earned
Procedure ·         Brief description of procedure (a few sentences, not a list of the steps of the procedure) ·         Rationale for choosing procedure ·         Identify the providers’ current source for the selected procedure (unit-based policy or published guideline with reference) [NOTE: Do not include the actual procedure or steps in the procedure in this paper.]	20
Recommendation for Revision ·         Identify the (one) revision being recommended with rationale. ·         Critique of each research study: The critique of each of the research studies (total of 2 studies) should include: purpose of the study, study design, description of study sample, results of study, description of how results relevant to the recommended revision. Lumbar Puncture Procedure Recommendation for Newborns NOTE: BOTH studies must support the ONE revision being recommended.	50
Conclusion Summarize with a paragraph which includes the recommended revision with rationale and support from the two research studies critiqued in prior section.	20
Format  NOTE: This section is not percentage correct, but instead, reflects points deducted for each error. Title page from N5204 course used. Paper in 12 pt Times New Roman font throughout Use the headings in this rubric for the paper: Procedure, Recommendation for Revision, Conclusion Paper in  7th edition APA format including title page, headings citations, and reference list Sources cited properly. Lumbar Puncture Procedure Recommendation for Newborns Paper free of errors. Writing organized, clear, and free of grammatical and spelling errors. Paper 3-4 pages in length excluding title page and reference list (pages in excess of 4 will not be evaluated toward grade).	10
Total Lumbar Puncture Procedure Recommendation for Newborns	100