Assignment- Eating Disorders

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Assignment- Eating Disorders

In a 3-page paper, written in APA format using proper spelling/grammar, research the topic of eating disorders and address the following:

    1. Compare and contrast anorexia nervosa and bulimia nervosa.
    2. Who is more likely to suffer from anorexia nervosa and bulimia nervosa? Why?
    3. What are the causes contributing to anorexia nervosa?
    4. What are the consequences of eating disorders?
    5. How can one diagnose eating disorders?
    6. What are the treatment and support options for a person who has eating disorders?

Be sure to include APA citations for any resources you used as references.

Rasmussen’s Library and Learning Services team has developed a variety of Guides to help support students’ academic endeavors. For this assignment, the Writing Guide and APA Guide may both be helpful. Also consider submitting each assignment to the online Writing Lab for feedback on your draft prior to submitting it for grading. You will find links to these Guides as well as other writing resources and services on the Resources tab. Assignment- Eating Disorders

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Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Jstudent_exampleproblem_101504

Module 04 Assignment – Portrayal of Families and Relationships

1.
As societal-norms evolve, a variety of popular entertainment media (books, movies, TV shows, etc.) feature stories of characters who are a part of traditional and non-traditional family or relationship structures. Examples include but are not limited to: traditional families, cohabitation, single-parent households, blended families, same-sex couples, and grandparents as the primary care-givers for their grandchildren.
In a 3-page paper, written in APA format using proper spelling/grammar, address the following:
1. Describe a book, movie, or TV show that you are familiar with which features characters in families or personal relationships.
2. Select at least two families/relationships from your chosen story and explain the relationship characteristics and dynamics between individuals.
3. Apply terminology presented within the module when analyzing the relationships. Be sure to include APA citations for any resources you used as references.
Rasmussen’s Library and Learning Services team has developed a variety of Guides to help support students’ academic endeavors. For this assignment, the Writing Guide and APA Guide may both be helpful. Also consider submitting each assignment to the online Writing Lab for feedback on your draft prior to submitting it for grading. You will find links to these Guides as well as other writing resources and services on the Resources tab.
Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates.
Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:
Jstudent_exampleproblem_101504. Assignment- Eating Disorders

 

 

 

 

Interprofessional Organizational And Systems Leadership

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Interprofessional Organizational And Systems Leadership

NICOLE POST

The national healthcare stressor that I selected for analysis is the Covid-19 Pandemic and the additional stress it adds to the supply chain and the well-being of healthcare workers. The current state of healthcare has been severely impacted by the pandemic.  As the coronavirus pandemic spreads worldwide, the effect on global healthcare systems has been immense. One of the key challenges in managing this public health crisis has been the production and distribution of medical supplies to healthcare providers. (Iyengar et al, 2020). My hospital has been greatly affected. We are short on supplies every day that I come to work. It makes it difficult to do the tasks that I need to complete and has a negative impact on patient care.

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            The supply shortage is one of the reasons that healthcare providers are struggling with their mental health. The rapid spread of the disease created challenges for healthcare systems and forced healthcare workers to struggle with stressors, including shortages of personal protective equipment, mortality and morbidity associated with COVID-19, fear of bringing the virus home to family members, and the reality of losing colleagues to the disease. Evidence from previous outbreaks, along with early evidence from the COVID-19 pandemic, suggests that these events have significant short- and long-term effects on the mental health of healthcare workers. (Hall, H, 2020) In my ER alone, we have had several staff members resign stating lack of supplies or the impact that Covid has had on their mental health as the main reason for leaving.

 

My Health system has responded to these stressors by offering overtime and hiring agency nurses to fill in while we acquire permanent staff to train and by ordering more supplies than needed when they are needed so that we have a backstock to pull from when the supply chain gets backlogged. These solutions are working at this time, although we continue to be short staffed and running out of supplies each day. The Hospital is trying to make the best of the situation the pandemic has brought forth, but we continue to lose nurses and available supplies regularly.

 

With change such as a pandemic, new technology or innovation there are implications, some foreseeable and some that come to light after the unveiling of the new process or product. Some impacts that are most notable are clinical, managerial, and policy implications. (Sweeney, J, 2017) The pandemic has brought to light the need for change in the healthcare field and I believe that nurses are embracing this by choosing career change, leadership roles and speaking out for their rights.  Interprofessional Organizational And Systems Leadership

 

References:

 

Hall, Heather MBA, MA, MPAS, PA-C The effect of the COVID-19 pandemic on healthcare

workers’ mental health, Journal of the American Academy of Physician Assistants: July    2020 – Volume 33 – Issue 7 – p 45-48

doi: 10.1097/01.JAA.0000669772.78848.8c

Iyengar, K. P., Vaisha, R., & Bahl, S. (2020). Impact of the Coronavirus Pandemic on the Supply Chain in Healthcare. https://doi.org/https://doi.org/10.12968/bjhc.2020.0047

 

Sweeney, J. (Feb, 2017). Healthcare Informatics. Online Journal of Nursing Informatics (OJNI), 21( 1), Available at http://www.himss.org/ojni

 

 

COURTNEY POST

 

The national Healthcare issue I chose was burnout/understaffing among nurses. It is probably common knowledge to everyone that has a family member/girlfriend/boyfriend in the medical field that is in nursing understands the draining duties of the job. Obviously, with COVID-19 it took this issue to a whole new level. There is ample evidence that adequate nurse staffing is associated with positive patient outcomes, including lower mortality, fewer complications, higher patient satisfaction, shorter hospital stays and fewer readmissions, as well as better outcomes for nurses, such as less burnout (Lasater et al., 2020). Burnout is at an all-time high causing huge staffing problems among hospitals in the country. Burnout is a significant problem among US nurses who leave their job or consider leaving their job. Health systems should focus on implementing known strategies to alleviate burnout, including adequate nurse staffing and limiting the number of hours worked per shift (Shah et al., 2021).

Burnout/understaffing will impact and has impacted our work setting by increasing the stress of the needs of a nurse in our day-to-day duties on the job. We are always understaffed and “flexed” each shift. Our rations are not safe and sometimes we don’t even have a patient care technician when we are staffed 5:1 with our patients. The nurse-patient ratio is a direct determinate of the effects of psychological, mental, emotional health and nurse productivity in the workplace which also determines the patients’ overall health (Gutsan et al., 2018). This also causes conflicts with the nurses and patients because the patients get upset when nurses don’t get to them fast enough which causes tension because the patient and nurse. When a unit or hospital is understaffed due to people being sick or calling in because they don’t want to be there causes an increased amount of stress and anxiety on the people that are there.  Interprofessional Organizational And Systems Leadership

The Healthcare system that I am involved with has tried some things to help with these problems. Including seminars on reflection and restoration to help with burnout and coping upon nurses with 1-2 years of experience. This will help a lot of people including me. Also, the hospital has initiated incentive pay among Registered Nurses for overtime duty. These things have helped but still the lack of staffing is one of the most draining problems to deal with. I personally feel as if more can be done. We need medical professionals, especially in these times. We need medical professionals to feel accepted and appreciated. So, much more work needs to be done but things are started to change slowly but surely.

References

Gutsan, E., Patton, J., Willis, W. K., & PH, C. D. (2018). Burnout syndrome and nurse-to-patient ratio in the workplace.

Lasater KB, Aiken LH, Sloane DM, French R, Martin B, Reneau K, et al. (2020). Chronic hospital nurse understaffing meets COVID-19: an observational study. BMJ Qual Saf bmjqs-2020-011512. DOI: 10.1136/bmjqs-2020-011512.

Shah, M. K., Gandrakota, N., Cimiotti, J. P., Ghose, N., Moore, M., & Ali, M. K. (2021). Prevalence of and factors associated with nurse burnout in the US. JAMA network open, 4(2), e2036469-e2036469. Interprofessional Organizational And Systems Leadership

 

 

Nursing homework help

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MIGUEL POST

Prescription opiate abuse is an epidemic in America; our population suffers from the results of over thirty years of mismanagement of prescription pain medications among providers and manufacturers as well as lack of information regarding the potential for substance abuse that these medicines have (Sofer, 2019). For this discussion, the focus will be on the efforts taken by the Centers for Medicare and Medicaid Services (CMS) and its evidence-based approach to deal with this issue.

Acknowledging that substance abuse disorder is a disease was the first step that allowed funding allocation to this matter (Sofer, 2019). The CMS decided to take a multi-level approach to address the opioid crisis, with strategies involving all the major stakeholders. First, it disseminated the Centers for Disease Control and Prevention guidelines to prescribe narcotics among primary care providers safely. It also promoted the enforcement of prescription medication databases that allowed doctors and pharmacies to communicate more efficiently and reduce the potential for interaction and over medication. Lastly, to improve the current data that shows that only 20% of people with a substance abuse problem receive treatment, it expanded coverage for substance abuse treatment for Medicare and Medicaid beneficiaries (CMS, 2020).

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While certainly there is a long road ahead of us to tackle the opioid epidemic, there is great potential in the measures taken by the CMS so far. According to Boller (2017), to improve patient safety, there should be a focus on interprofessional collaboration, patient-focused care, evidence-based practice, and an emphasis on quality and informatics. I believe that the measures taken by the CMS will set a reliable base for these goals to be met and ultimately improve patient outcomes.  Nursing homework help

References

Boller, J. (2017). Nurse educators: Leading healthcare to the quadruple aim sweet spot. Journal of Nursing Education, 56(12), 707-708. doi:10.3928/01484834-20171120-01

Centers for Medicare and Medicaid Services. (2020). CMS Roadmap strategy to fight the opioid crisis. Retrieved from  https://www.cms.gov/About-CMS/Agency-Information/Emergency/Downloads/Opioid-epidemic-roadmap.pdf

Sofer, D. (2019). Americaʼs Problem with Opioid Abuse Takes Its Toll on Nursing, Too. AJN, American Journal of Nursing, 119(4), 17–18. https://doi.org/10.1097/01.NAJ.0000554541.95395.53

CHLOE

 

I reviewed the website of the American Association of Nurse Practitioners (AANP). The AANP is a professional nursing organization for nurse practitioners of all specialties. The main goal of this organization is to advance quality healthcare: with education, practice, leadership, advocacy, and research. (AANP, 2019).

This health organization’s work is grounded in EBP, evident in its purpose and position. The AANP teaches and encourages nurse practitioners to use evidence-based practice as a crucial tool for delivering high-quality patient care and promoting patient outcomes. (USAHS, 2020).

While searching through the website, I found EBP located in several areas. There are articles referring to the importance of evidence-based practice, and it shares research findings of success using evidence-based practice interventions. Also, the website offers multiple EBP resources, such as Foundations of evidence-based practice in healthcare. It is a free, online course that teaches current trends and strategies to overcome barriers in the individual’s current practice settings. It teaches the importance of EBP in improving healthcare quality and patient outcomes. (Melnyk, 2018).

The information I discovered did not change my perception of the organization; it only enhanced it. I would have assumed an organization like this would contain a solid grounding of EBP. However, I was intrigued to discover how immensely rooted it is in EBP, from nurse practitioners’ listed standard of practice to resources to positions. Also, in my opinion, if it were based solely on the website, it would be easy to conclude that the AANP offers more as an organization than the ANA. Nursing homework help

Resources

AANP. (2019, September). The american association of nurse practitioners is now 100,000 members strong. Retrieved from https://www.aanp.org/news-feed/the-american-association-of-nurse-practitioners-aanp-is-now-100-000-strong#:~:text=AANP’s%20mission%20is%20to%20empower,what%20guides%20us%20every%20day.

Melnyk, B. (2018, October). Why choose evidence based practice? Retrieved from https://www.aanp.org/news-feed/why-choose-evidence-based-practice.

USAHS. (2020, August). The role of evidence-based practice in nursing. Retrieved from https://www.usa.edu/blog/evidence-based-practice/.

Delivering Culturally and/or Socially Sensitive Care

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Delivering Culturally and/or Socially Sensitive Care

Source of Evidence (SOE)

 

 

Present, to identify the best example of you “delivering culturally and/or socially sensitive care.” By a psychiatric NP or Psychiatric. The American Nurses Credentialing Center (ANCC) defines culturally and/or socially sensitive care as the following:

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“Communication with patients can be improved and patient care enhanced if healthcare providers can bridge the divide between the culture of medicine and the beliefs and practices that make up patients’ value systems. These may be based on ethnic heritage, nationality of family origin, age, religion, sexual orientation, disability, or socioeconomic status. Every healthcare encounter provides and opportunity to have a positive effect on patient health. Healthcare providers can maximize this potential by learning more about patient’s cultures” Delivering Culturally and/or Socially Sensitive Care

 

The full breakdown of the SOE and its key elements, what we must describe within the narrative, and provide evidence thereof, can be found here:

 

 

 

Evidence-based Practice (EBP) in Nursing

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Evidence-based Practice (EBP) in Nursing

Response posts: include at least 2 scholarly sources of evidence, cited within the body of your discussion responses  & at the end of your posting, at least 2 references

 

 

EBP Utilization:

Adoption and implementation of evidence-based practice (EBP) in nursing and other healthcare disciplines is acknowledged as critical to maintaining optimal patient outcomes and quality of care (Kim et al., 2016). Nurses are on the front lines of health care, and Evidence-based practice provides them with a unique chance to improve patient care and outcomes. The direct patient-care nurse is an important link in implementing evidence-based improvements in clinical practice (Crabtree et al., 2016). According to Kim and colleagues (2016), although EBP is regarded as the gold standard in nursing practice, its actual implementation has been inconsistent due to challenges such as nursing workload, a lack of organizational support, a lack of EBP knowledge and abilities, and negative attitudes about EBP.

Hospitals and healthcare organizations are increasingly relying on their websites as the nation becomes more computerized. It is critical for all healthcare institutions to have a website centered on EBP because it is frequently the primary means of disseminating information to the public. The healthcare organization website that I will discuss is The National Alliance on Mental Illness (NAMI). NAMI is the leading community mental health organization in the United States, dedicated to improving the lives of the millions of Americans impacted by mental illness (National Alliance on Mental Illness, n.d.) Evidence-based Practice (EBP) in Nursing

Grounding of EBP:

NAMI has long advocated for people with mental illnesses to receive evidence-based treatment and has fought against practices that continue to stigmatize mental diseases. This website is built on evidence-based practice, which may be found under the advocacy, education, and research sections of the NAMI website. NAMI supports and promotes nurses to continue their education, as well as nurses who perform research, through peer-led programs that provide free education, skill training, and support. One of the many examples of incorporating EBP on the website is seen in the education section of Conversion therapy. Conversion therapy is a controversial treatment that aims to change a person’s sexual orientation or gender identity. The NAMI website shares that all major medical organizations oppose it since it is not an evidence-based treatment and in fact, data shows that conversion therapy is dangerous, particularly for LGBTQ youth (National Alliance on Mental Illness, n.d.).

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Perception of Healthcare Organization:

The information that I have learned about this healthcare organization has not affected my opinion of this organization’s website. I utilize the NAMI website for research projects at school and at work, and I will continue to use it in the future. As a psychiatric nurse, I currently utilize this website to print educational handouts for my patients to assist them in better comprehending and managing their mental illness and the mental health medications they are prescribed by the Psychiatrist.

It is critical for nurses and students to incorporate EBP into their daily lives in order to provide better care for their patients and conduct significant research. Nurses must only conduct research on websites that focus on the most recent EBP strategies, and it is critical for nurses who are directly caring for patients to adopt and implement EBP as it is critical to maintaining optimal patient outcomes and best practice care.

References

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving Patient Care Through Nursing Engagement in Evidence-Based Practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. https://doi.org/10.1111/wvn.12126

Kim, S. C., Stichler, J. F., Ecoff, L., Brown, C. E., Gallo, A., & Davidson, J. E. (2016). Predictors of Evidence-Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants. Worldviews on Evidence-Based Nursing, 13(5), 340–348. https://doi.org/10.1111/wvn.12171

NAMI: National Alliance on Mental Illness. (n.d.). Nami.Org. Retrieved February 27, 2022, from https://www.nami.org/Home. Evidence-based Practice (EBP) in Nursing

 

Nutritional Principle In Nursing

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Nutritional Principle In Nursing

For this discussion you will review “Living well with HIV/AIDS – A manual on nutritional care and support for people living with HIV/AIDS” http://www.fao.org/docrep/005/y4168e/y4168e00.HTM

Then respond to the following:

1. What are three diet therapy considerations that must be made for people living with HIV/AIDS?

2. Why is it important for them to adhere to these dietary requirements?

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3. What may happen if they don’t?

4. What two strategies can you use to facilitate adherence?

Please make an initial post by midweek, and respond to at least two other student’s posts with substantial details that demonstrate an understanding of the concepts and critical thinking. Remember that your posts must exhibit appropriate writing mechanics including using proper language, cordiality, and proper grammar and punctuation. If you refer to any outside sources or reference materials, be sure to provide proper attribution and/or citation. Nutritional Principle In Nursing

Nutrition and Disease Assignment

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Nutrition and Disease Assignment

Top of Form

Nutrition plays a vital role in a person’s overall health and well-being. Not getting enough of the recommended nutrients over the long-term can lead to malnutrition which often results in disease and illness.

 

In a 3-page paper, written in APA format using proper spelling/grammar, address the following:

    1. Define malnutrition and identify a specific disease that can result from it.
    2. Perform library research about the selected disease, and explain its physiological effects on a person’s body.
    3. Describe the relationship between specific foods/nutrients and the disease. Use the questions below to guide your response. Nutrition and Disease Assignment
    4. Does research indicate that a lack of specific foods/nutrients increase a person’s chance of contracting the disease?
    5. Are there specific foods/nutrients that should be avoided by an individual afflicted with the disease?
    6. How do specific foods/nutrients work physiologically within the body to help combat the disease?
    7. Evaluate nutritional recommendations to help combat the disease.
    8. Cite at least 3 credible references and present the resources in APA format on the References page.

 

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For information about the impact of diseases on body systems and assessing the credibility of resources, consult the resources below.

    1. How do I know if a source is credible?
    2.  I need to find information about a disease and the body system it impacts.

 

Submit your completed assignment to the drop box below. Please check the Course Calendar for specific due dates.

 

Save your assignment as a Microsoft Word document. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below. Nutrition and Disease Assignment

 

 

 

Top of Form

 

Bottom of Form

 

 

Scenario Analysis Paper

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Scenario Analysis Paper

What priority problem(s) did you identify for Julia Morales and Lucy Grey?
What teaching measures and what other members of the health care team should be included in the home health nurse visit for Julia Morales and Lucy Grey?
What potential barriers might Julia Morales and Lucy Grey encounter that would hinder active participation in Julia’s care?
What appropriate assessments were made to help you decide what interventions Julia Morales and Lucy Grey needed?
What appropriate strategies could be implemented to empower Julia Morales and Lucy Grey in the management of Julia’s care?
What potential problems does Julia Morales face if the symptoms of her disease progression are not recognized and if actions are not initiated in a timely manner?
What is the role of the home health/hospice interprofessional team, and what is the importance of teamwork and collaboration in the case of Julia Morales and Lucy Grey?
What potential environmental/safety hazards need to be assessed in the home care setting?
Concluding Questions

Reflecting on Julia Morales and Lucy Grey’s case, were there any actions you would do differently?
How would you apply the knowledge and skills that you obtained in the case of Julia Morales and Lucy Grey to an actual patient care situation? Scenario Analysis Paper

Instructor’s Overview:

Julia Morales and Lucy Grey Part 1

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Scenario Overview

Patient: Julia Morales

Diagnosis: Lung cancer, stage 4

This scenario is part of the Julia Morales and Lucy Grey Unfolding Case. The scenario can be used as a standalone scenario or as part 1 of the case.

The Unfolding Case

Julia Morales, age 65, and Lucy Grey, age 73, are partners who have been together for more than 25 years. They are retired and have spent the past several years traveling together. Julia has lung cancer, which has been treated with chemotherapy and radiation, and now she wishes to stop treatment. Lucy is supportive and feels she will be able to care for Julia in their home. Lucy’s past medical history includes a knee replacement. Their support system includes Julia’s son, Neil.

The simulation scenarios begin with the home health nurse evaluating Julia after she has decided to stop treatment for her lung cancer. Her partner Lucy wishes to care for her in their home. In the second scenario, the end of Julia’s life is near and she is surrounded by her loved ones and the hospice nurses. Julia dies during this scenario. The learners are introduced to supportive measures for both the patient and the family during this process. The final scenario concentrates on Lucy and the difficulties she has adjusting to her new life after Julia is gone. The objectives focus on the students’ assessment of Lucy’s grieving process, how well she is coping, and the physical changes that she has experienced over the past few months.

Brief Summary of Present Scenario

This scenario involves a visit by the home health agency nurse. The students are expected to do a physical and functional assessment of Julia and her nursing care needs. Julia inquires about hospice services, but her son Neil urges her to try one more round of chemotherapy. Lucy is supportive of Julia’s decision and tries to comfort Neil. The students should assess Lucy’s caregiver preparedness, and articulate what hospice care means for the patient and family. The assessment tools recommended for this scenario include the Katz Index of Independence in Activities of Daily Living (ADL), and Informal Caregivers of Older Adults at Home: Let’s PREPARE!

Learning Objectives

Upon completion of the scenario, the student should be able to:

  • Provide care for the terminally ill older adult and her family in the home setting
  • Perform physical and functional assessments of the older adult, using standardized tools, to include:
    • Katz Index of Independence in Activities of Daily Living (ADL)
  • Assess caregiver preparedness using the Informal Caregivers of Older Adults at Home: Let’s PREPARE! assessment tool
  • Identify purpose of hospice care and services provided
  • Explain advance directives and durable power of attorney
  • Relate the importance of providing individualized care unique to each individual and family

Patient Case Introduction to Students

Time: 1400

Report from home health agency manager:

Julia Morales is a 65-year-old woman who has stage 4 lung cancer. She has been treated with chemotherapy and radiation but now wishes to forgo further treatment. She is living together with her partner, Lucy Grey, age 73. They have been together for more than 25 years. Julia and Lucy both want Julia to spend her remaining days in their home, and Lucy wishes to care for Julia. The oncologist nurse practitioner has asked the home health agency to do a home visit to assess client needs for comfort, safety, and other support. Julia has questions about hospice care and what that comprises, especially related to pain treatment. Lucy and Julia’s son, Neil, will also be present at the visit. Please make sure to assess Lucy’s preparedness to care for Julia. I think she has some questions related to the caregiver role. Scenario Analysis Paper

Patient Details

Patient data: Female – Age 65 years. Weight 56 kg (123 lbs). Height: 163 cm (64 inches)

Allergies: No known allergies

Past Medical History: Adenocarcinoma of the lung, diagnosed 4 years ago, treated with radiation and chemotherapy.

History of Present Illness: Julia was seen in her oncologist’s office yesterday. Julia, Lucy, Dr. Davis and the nurse practitioner (Laura Johnson) discussed at length Julia’s decision to stop chemotherapy, which at this point would have no documented benefit for Julia. Laura, the nurse practitioner, recommended a home health agency referral to assess and to support family’s needs.

Social History: Retired from work at a local nursery/garden center. Lives with partner Lucy. Son Neil, age 42, lives 20 miles away. Private insurance.

Primary Medical Diagnosis: Adenocarcinoma of the lung, stage 4.

Surgeries/Procedures & Dates: Hysterectomy at age 44.

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Provider’s Orders

  • Home health agency visit
  • Diet as tolerated
  • Oxygen per nasal cannula at 2 liters per minute as needed for comfort
  • Medication:
  • Docusate 100 mg: 1-2 capsules PO daily as needed for constipation
  • Morphine sulphate, controlled release, 100 mg PO every 6 hours as needed for pain

Nursing Diagnoses

  • Chronic Pain related to metastatic lung cancer
  • Readiness for Emancipated Decision Making related to end-of-life care

Overview of Proposed Correct Treatment

  • Introduce self and explain purpose of visit
  • Wash hands
  • Identify patient
  • Address Neil’s concerns, using therapeutic communication
  • Educate on available family support
  • Explain purpose of hospice
  • Obtain vital signs
  • Assess pain
  • Begin general assessment
  • Assess patient using Katz Index of Independence in Activities of Daily Living (ADL)
  • Assess caregiver preparedness using Informal Caregivers of Older Adults at Home: Let’s PREPARE!
  • Assess patient concerns
  • Provide patient education regarding role of hospice
  • Explain advance directives
  • Explain durable power of attorney
  • Provide patient education about:
    • Pain management
    • Medication
    • Medical equipment, including use of portable oxygen
    • Community resources

Case Considerations

During this scenario, the nurse should assess Julia’s functioning and Lucy’s ability to care for her in their home. It is important to look at the individual aging patterns by using standardized assessment tools, because this will help to ensure a comprehensive approach to the assessments. In this case, The Katz Index of Independence in Activities of Daily Living (ADL) should be included in the initial assessment, as well as analysis of the prefilled SPICES: An Overall Assessment Tool for Older Adults for an evaluation of Julia’s current condition. The nurse should assess the family’s understanding of expectations for hospice care and Julia’s dying at home. It is also important to assess Julia’s caregiver preparedness to be able to develop an individual plan of hospice care. The assessment tool: Informal Caregivers of Older Adults at Home: Let’s PREPARE! should be used for that purpose. The Modified Caregiver Strain Index may also be used for assessing the family’s preparedness for their loved one to enter hospice care.

Julia has extensive needs for physical and emotional care, which will certainly increase with time because her condition is bound to deteriorate. The nurse should use knowledge of hospice care to enlist the aid of others on the team as appropriate. It is important to ensure that Julia and her family are aware of each team member’s role, as well as whom to call and where to get the equipment and support needed.  A plan of comfort and pain relief should also be made with the family on this first visit. Support should be given to the family and education provided about medication, activities, and hospice care to give Julia and Lucy a complete understanding of the possibilities and limitations of home care.

Hospice care and end-of-life care in general are important roles for nurses. A nurse should be skilled in helping families cope with death, even if the patient is not in hospice. It is important for nurses to acknowledge their own feelings and be comfortable in dealing with the deaths of patients.

The nurse should assess Julia’s and Lucy’s level of understanding of what will likely happen as Julia faces death. The nurse will need to prioritize actions based on listening closely to the patient’s and family’s priorities, and meeting needs as they arise. Education on advance directives, durable power of attorney, available support resources, and family support are also important elements of this visit. Scenario Analysis Paper

Absurd Arguments Assignment

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Absurd Arguments Assignment

Creating an Argument assignment, you’ll construct an  absurd argument. An absurd argument isn’t meant to be particularly  serious, and there isn’t necessarily a right or wrong side or answer.  This week’s discussion question and dialogue with your classmates and  faculty member will help you become familiar with what an absurd  argument is and which topics work well for that argument.

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Select 1 of the following absurd questions for this discussion. Locate an article or blog that discusses your question.

  • Is Marvel or DC the best franchise?
  • Is it better to work to live or live to work?
  • Is American football or soccer better?
  • Should pizza be classified as a sandwich or a pie?
  • Are movies or music better?
  • Is it more important to be wealthy or happy?
  • Provide your own creative debatable idea.

 

Using the article or blog that corresponds to your selected absurd question, respond to the following in a minimum of 175 words:

  • Which article or blog did you select?
  • How would you quickly summarize the author’s argument?
  • What did you find compelling about the argument?
  • What weaknesses did you spot in the argument?
  • How might you write a more persuasive argument on this topic?

Include a reference list at the end of your post that credits the piece you read. Absurd Arguments Assignment

Scenario Overview Patient: Millie Larsen

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Scenario Overview Patient: Millie Larsen

  1. What findings indicate the cause(s) of Millie Larsen’s confusion? How do these findings do so?
  2. What potential problems can you identify for Millie Larsen?
  3. What communication techniques could be used to improve Millie Larsen’s situation?
  4. For the following Safety/Quality Improvement measures, what nursing actions should be taken during Millie Larsen’s case?
  5. Why was it important to include Dina, Millie Larsen’s daughter, as a member of the health care team?

Concluding Questions

  • Reflecting on Millie Larsen’s case, were there any actions you would do differently?
  • How would you apply the knowledge and skills that you obtained in Millie Larsen’s case to an actual patient care situation?

Diagnosis: Urinary tract infection

This scenario is part of the Millie Larsen Unfolding Case. The scenario can be used as a standalone scenario or as part 1 of the case.

The Unfolding Case

Millie Larsen is an 84-year-old Caucasian female who lives alone in a small home. Her husband Harold passed away a year ago and she has a cat, Snuggles, who is very important to her. Millie has one daughter, Dina Olsen, who is 50 years old, lives nearby, and is Millie’s major support system. Millie’s current medical problems include hypertension, glaucoma, osteoarthritis of the knee, stress incontinence, osteoporosis, and hypercholesterolemia.

The scenarios take place over 3 days when Millie is in the hospital with a diagnosis of urinary tract infection and dehydration. Her presentation is atypical, and she is confused. The scenarios depict varied situations Millie encounters during her brief hospital stay. The objectives focus on assessment; appropriate use of assessment tools such as the SPICES: An Overall Assessment Tool for Older Adults, a fall risk assessment tool, and Confusion Assessment Method (CAM); communication skills; conflict between Millie and her daughter on living arrangements; functional assessment; discharge teaching; and making appropriate referrals. Scenario Overview Patient: Millie Larsen

Brief Summary of Present Scenario

The scenario is set at 7 p.m., and Millie is in the emergency department. She was brought in with confusion by her daughter Dina three hours ago. As the scenario unfolds, it will become clear that due to her confusion, Millie has not been taking her medications properly in the days prior to admission and, as a result, her blood pressure is very elevated. Millie’s daughter Dina is at the bedside and is quite concerned about the confusion and elevated blood pressure. The students receive a report from the emergency room triage nurse and are expected to perform a general assessment as well as use the Confusion Assessment Method (CAM) and Morse Fall Scale tools. Objectives for this scenario include the identification and use of appropriate assessment tools for older adults, recognition of an elevated blood pressure, and notification of the physician, using SBAR format.

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Learning Objectives

Upon completion of the scenario, the student should be able to:

  • Perform a head-to-toe physical assessment and focused assessment of the patient’s mental status
  • Assess the patient’s individual aging pattern and functional status using standardized assessment tools, including:
  • Confusion Assessment Method (CAM)
  • Morse Fall Scale
  • Identify critical assessment findings, including elevated blood pressure and confusion
  • Identify the need to communicate with other members of the health care team using SBAR format
  • Report pertinent assessment findings and relate which findings are commonly found in the older adult patient
  • Recognize geriatric syndrome(s) present in simulation, including:
  • Urinary incontinence
  • Confusion

Patient Case Introduction to Students

Time: 1900

Report from emergency room triage nurse:

Millie Larsen is an 84-year-old female who lives alone in a small home. She arrived with her daughter, Dina, three hours ago. Her daughter noticed that Millie wasn’t making sense or acting normally during a visit earlier today. She was seen by Dr. Lund an hour ago. He suspects urinary tract infection and has written preliminary orders. An IV has been started and labs have been drawn. They just came back. I haven’t had a chance to look at them. Her antibiotic also just arrived from the pharmacy and needs to be given. I completed a SPICES assessment, which indicated problems with incontinence and confusion. The result is in the health record. The confusion needs to be further assessed, and her fall risk should also be assessed. Can you please do that?

Patient Details

Patient Data: female- Age: 84 years. Weight: 68 kg (150 lbs). Height: 155 cm (61 in).

Allergies: No known

Past Medical History: Glaucoma, hypertension, osteoarthritis, stress incontinence, hypercholesterolemia.

History of Present Illness: Millie’s daughter became concerned when she stopped over to check on her and found her still in her bathrobe at 3 p.m. The house was very unkempt, and Millie couldn’t remember her daughter’s name.

Social History: Not recorded.

Primary Medical Diagnosis: Dehydration, suspected urinary tract infection.

Surgeries/Procedures & Dates: Cholecystectomy at age 30. Scenario Overview Patient: Millie Larsen

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Provider’s Orders

  • Bedrest, bathroom privileges with assistance
  • Regular, low fat diet
  • Vital signs and SpO2 every 2 hours
  • I & O
  • Notify physician if systolic BP > 150 or < 100; temperature > 38°C, Urine output < 60 mL in 2 hours
  • Ciprofloxacin 400 mg IV every 12 hours for 24 hours, then Ciprofloxacin 500 mg PO every 12 hours for 10 days.
  • Acetaminophen 650 mg PO every 4–6 hours as needed
  • IV fluids D5 0.45 NaCl + 20 mEq KCl at 60 mL/hr
  • CBC with diff., BMP, urine analysis, urine culture

Nursing Diagnoses

  • Risk for Falls related to age > 65 years, diminished mental status, and antihypertensive medications
  • Impaired urinary elimination related to degenerative changes in pelvic muscles and urinary tract infection
  • Risk for Imbalanced Fluid Volume related to decreased oral intake of fluids, possible misuse of diuretic medications and IV fluid administration
  • Acute Confusion related to fluid volume deficit and urinary tract infection

Overview of Proposed Correct Treatment

  • Wash hands
  • Introduce self
  • Identify patient
  • Obtain vital signs
  • Identify elevated blood pressure
  • Auscultate heart and lungs
  • Assess pain
  • Assess IV site, fluid and rate
  • Evaluate lab data
  • Identify abnormal urine analysis and electrolytes
  • Begin assessments:
  • Head-to-toe
  • CAM assessment
  • Fall risk assessment
  • Focus on communication with Dina to gain necessary information for the CAM
  • Educate Dina about relationship between UTI and delirium
  • Identify geriatric syndromes, including confusion and incontinence
  • Consider safety precautions
  • Call provider and give report using SBAR
  • Assess ability to take oral medications
  • Administer medications

Case Considerations

Millie exhibits an atypical presentation (delirium) for a urinary tract infection that is common in the older adult population. In addition, she has other coexisting chronic conditions, including hypertension, and due to her confusion she has not been taking her medications correctly. As a result her blood pressure is highly elevated.

It is important that the nurse understands the research underlying the concept of atypical or unique presentations in older adults, how they may differ from the general adult population, and the complexity of care required by several coexisting conditions.

The focus of the assessment in this scenario is on evaluating Millie’s current condition, including assessing her confusion. Using standardized evidence-based tools for the assessments allows for a systematic approach to the patient. In this case the Confusion Assessment Method (CAM) will help to quickly and precisely identify the presence of delirium. To ensure safety, Millie’s risk of falling also needs to be assessed. Although she is living independently under normal circumstances, the acute change in her status can greatly increase her risk of falling.

The nurse should also recognize other abnormalities, including the highly elevated blood pressure and abnormal lab findings to include the urine analysis, and communicate the findings clearly and promptly to the provider. The use of the standardized SBAR format will assist with communication of clinically relevant information.

During assessments the nurse should communicate therapeutically with the daughter, Dina, as the primary source of information. It is important to focus attention on the differences between Millie’s presentation at the hospital and her normal baseline. The nurse should explain the relationship between urinary tract infection and delirium to Dina. Under normal circumstances, Millie is well-functioning, and seeing her so confused can be an upsetting experience. Scenario Overview Patient: Millie Larsen