Questions Of Values And Ethics Essay

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Questions Of Values And Ethics Essay

Answer questions 

APA style

2 Reference

cover page

1-which of the following behaviors may be (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical. Questions Of Values And Ethics Essay

A. Working in a clinic that performs abortions  

B. Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

  C. Respecting the health surrogate’s wishes regarding termination of life support of her friend   

D. Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient.

2-differentiate among the following: deontological theories, utilitarianism, and principlism.

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   3-what do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress. 

 4-What do they think about health-care professionals disclosing information to clients against family wishes? Questions Of Values And Ethics Essay

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do?  

 6.Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? 

  8-You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication? Questions Of Values And Ethics Essay

Role as an Advanced Practice Nurse

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Role as an Advanced Practice Nurse

Assignment # 1.

W10- Discussion:

Leadership Implications

“The greatest leader is not necessarily the one who does the greatest things. He is the one that gets the people to do the greatest things.” Role as an Advanced Practice Nurse

— Ronald Reagan
U.S. President (1981-1989)

Leadership is a critical role for advanced practice nurses. In order to be an effective leader, one must examine his or her role as an advanced practice nurse, and use his or her knowledge, and leadership skills to address issues related to his or her specialty area. There is a saying that one must know when to follow and when to lead. In order to be a good leader, you must also learn how to follow. As you transition from student to practicing NP, seek opportunities for mentorship to develop your leadership skills. Recognizing when to lead and when to follow is an interchangeable process that requires experience and preparation. The future for Americans in health care is unpredictable. This week it is important to focus on the complex and advanced leadership role that is needed to make effective change in a dynamic and demanding health care system.

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This week you will focus on the importance of leadership in advanced practice nursing. You will have an opportunity to examine how you can execute positive social change in your state for salient advanced practice nursing issues.

State Practice Agreements

Write 1 page

This week you will have an opportunity to evaluate state practice agreements in your state ( of TEXAS ) and examine issues related to NP practice. Role as an Advanced Practice Nurse

To prepare:

1. Review and Post a brief description of the REVIEW of practice agreements for NPs in your state of TEXAS.

2. dentify /name at least two physician collaboration issues in your state of Texas.

3. Explain what you think are the barriers to NPs practicing independently in your state mof TEXAS.

4. Finally, outline a plan for how you might address NP practice issues in your state.

5. Suggest additional actions you will  take.

6. Validate an idea with your own clinical experiences with the support of an additional literature search from a reputable source.

REFERENCES:
Required Readings

Buppert, C. (2015). The Employed Nurse Practitioner. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.). (323-336). Burlington, MA: Jones & Bartlett.

This chapter covers the rights of employed NPs, contract negotiation, interviewing, responsibilities of an NP employee, employer’s evaluation of the NP’s performance, malpractice insurance, and collaborative practice agreements.

Hatt, K. (2015). 5 Interview Pitfalls. Recruiters reveal how to respond to the most complicated questions. Advance Healthcare Network for NPs & PAs. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/student-and-new-grad-center/student-top-story/5-interview-pitfalls.aspx Role as an Advanced Practice Nurse

Thomas, A. C., Crabtree, M. K., Delaney, K. R., Dumas, M. A., Kleinpell, R., Logsdon, C.,…Nativio, D. G. (2012). Nurse Practitioner Core Competencies. Retrieved from http://c.ymcdn.com/sites/www.nonpf.org/resource/resmgr/competencies/npcorecompetenciesfinal2012.pd

Assignment #2

W11 – Discussion: Write 1 page. 

State Practice Agreements

Social Change Agents

Assignment #2

W 11 Discussion

STATE PRACTICE AGREEMENT

Social change Agents

“We’ve been called disruptive innovators,” Ford said. “And I think ‘disruptive innovators’ is great – we just need more of them.”

— Heidesch, T. (2008)

As NPs, we are obligated to promote our profession. A component of promoting the profession is proactively being engaged with our communities and identifying areas where change is needed. An example of this would be identifying a community issue, such as an increase in the rate of obesity in a middle-school population and discovering that soda machines are present in the schools. Identifying a problem and being a positive change agent is an essential component of the NP role. Understanding the lawmaking process and how to initiate a local or state change empowers the NP to impart Social Change.

This week you will focus on the importance of leadership in advanced practice nursing. You will have an opportunity to examine how you can execute positive social change in your state for salient advanced practice nursing issues. Role as an Advanced Practice Nurse

Consider the following:

During NP clinical practicum experiences, we identify, as nurses, many health care issues that need to be addressed at the local, state, or national level. Addressing the need for change in health care policy is now an intricate part of your role as a social change agent.

For this Discussion, you will identify a change needed in your community and what your nursing legacy for positive social change will be.

To prepare:

· 1. Consider the health care issues and deficits you have recognized in your professional practice.

· 2. Identify a change needed in your community in health care policy and discuss how you could impart change during your career as an NP.) (A change needed in my community is Obesity ).

· 3. Consider your future as a NP and what your nursing legacy will be. How will you impart Social Change?

1. Post a change needed in your community and an explanation for how you will begin to implement that change. 

2. Then, share with your colleagues a brief explanation of what your nursing legacy will be:(My nursing legacy  will be (Being an advocate for health promotion through disease screenings and illness prevention)

3.  How will you impart Social Change. 

4.  Provide  at least one suggestion for a colleague in your class on how they could implement this change and for their nursing legacy.

REFERENCES: Required Readings

Buppert, C. (2018). Nurse practitioner’s business practice and legal guide (6th ed.). Sudbury, MA: Bartlett & Jones Learning.

· Chapter 12, “Lawmaking and Health Policy” (pp. 421-433)

This chapter covers the legal process, the judicial system and health policy. Additionally, law and rules that affect NPs, how to initiate a change in law and the process involved from beginning until law or rule is finalized.

Christensen, C. M., Bohmer, R. M. J., & Kenagy, J. (2000). Will disruptive innovations cure health care? Harvard Business Review, 78(5), 102-112, 199.

Note: Retrieved from the Walden Library databases.

Heidesch, T. (2008). Disruptive innovation NPs are true Health Care Reformers. Advance Healthcare Network for NPs & PAs, 16(12), 94. Retrieved from http://nurse-practitioners-and-physician-assistants.advanceweb.com/Article/Disruptive-Innovator.aspx

National Conference of State Legislatures (n.d.). Glossary of Legislative Terms. Retrieved from http://www.ncsl.org/research/about-state-legislatures/glossary-of-legislative-terms.aspx

No plagiarism. Due Jan.30.18 by 12noon

Write 1 page only on each discussion (2 pages $20)

Use references provides ONLY

Check your grammar and sentences on gramerler.com. its free. Role as an Advanced Practice Nurse    

Relationship of Risk Management Programs

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Relationship of Risk Management Programs

This assignment builds on the Risk Management Program Analysis Part One assignment you completed in Topic 1 of this course.

Assume that the example risk management program you analyzed in Topic 1 was developed by and is now currently implemented by your health care employer/organization. Further assume that your supervisor has asked you to present a high-level summary brief of this new risk management program to a group of administrative personnel from a newly created community health organization in your state who has enlisted your organization’s assistance in developing their own risk management policies and procedures. Relationship of Risk Management Programs

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Compose a 1,250-1,500 word summary brief that expands upon the elements you addressed in the Risk Management Program Analysis Part One assignment. In addition, analyze the following:

  1. Explain the Joint Commission’s role in the evaluation of an organization’s quality management processes.
  2. Describe the roles that different levels of administrative personnel play in establishing or sustaining operational policies that are focused on employer-employee organizational risk management policies.
  3. Explain the relationship of risk management programs and compliance with ethical standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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

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 Turnitin. Please refer to the directions in the Student Success Center.

Part one assignment is

For this assignment, you will research risk management programs for health care facilities or organizations. Review the criteria below in order to select an exemplar that applies to your current or anticipated professional arena. (Note: Select an example plan with sufficient data to be able to complete the assignment successfully.)

In a 1,000-1,250 word paper, provide an analysis that includes the following:

Brief summary description of the type of risk management plan you selected (new employee, specific audience, community-focused, etc.) and your rationale for selecting that example.

Description of the recommended administrative steps and processes in a typical health care organization risk management program contrasted with the administrative steps and processes you can identify in your selected example plan. (Note: Select an example plan with sufficient data to be able to complete the assignment successfully.)

Analyze the key agencies and organizations that regulate the administration of safe health care and the roles each play in the risk management oversight process.

Evaluation of the selected exemplar risk management plan regarding compliance with the American Society of Healthcare Risk Management (ASHRM) standards relevant to privacy, health care worker safety, and patient safety.

Proposed recommendations or changes you would make to your selected risk management program example to enhance, improve, or to secure compliance standards.

In addition to your textbook, you are required to support your analysis with a minimum of three peer-reviewed references.

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

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 Turnitin. Please refer to the directions in the Student Success Center. Relationship of Risk Management Programs 

Child and Adolescent Clients with Psychiatric Disorders

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  Child and Adolescent Clients with Psychiatric Disorders                                      

Mental Health Practicum–Week 10 Journal Entry

                                                          Learning Objectives

Students will:

· Develop effective documentation skills to examine group therapy sessions with 

  children and adolescents *

· Develop diagnoses for child and adolescent clients receiving group 

  psychotherapy *

· Analyze legal and ethical implications of counseling child and adolescent clients with psychiatric disorders * Child and Adolescent Clients with Psychiatric Disorders

                                                                    ASSIGNMENT

            Select two clients you observed or counseled this week during a group therapy session for children and adolescents. Note: The two clients you select must have attended the same group session.

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                    Then, address in your Practicum Journal the following:

· Using the Group Therapy Progress Note in this week’s Learning Resources, 

  document the group session.

· Describe each client (without violating HIPAA regulations), and identify any 

   pertinent history or medical information, including prescribed medications.

· Using the DSM-5, explain and justify your diagnosis for each client.

· Explain any legal and/or ethical implications related to counseling each client.

· Support your approach with evidence-based literature.

                                                        Learning Resources

Required Readings

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

  • Chapter 17, “Psychotherapy with Children” (pp. 597–624)
  • Chapter      20, “Termination and Outcome Evaluation” (pp. 693–712) Child and Adolescent Clients with Psychiatric Disorders

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

McGillivray, J. A., & Evert, H. T. (2014). Group cognitive behavioural therapy program shows potential in reducing symptoms of depression and stress among young people with ASD. Journal of Autism and Developmental Disorders, 44(8), 2041–2051. doi:10.1007/s10803-014-2087-9

Restek-Petrović, B., Bogović, A., Mihanović, M., Grah, M., Mayer, N., & Ivezić, E. (2014). Changes in aspects of cognitive functioning in young patients with schizophrenia during group psychodynamic psychotherapy: A preliminary study. Nordic Journal of Psychiatry, 68(5), 333–340. doi:10.3109/08039488.2013.839738

Document: Group Therapy Progress Note (SEE ATTACHED PROGRESS NOTE)

                                                         Required Media

Microtraining Associates (Producer). (2009). Leading groups with adolescents [Video file]. Alexandria, VA: Author. 

Psychotherapy.net (Producer). (2002). Adlerian parent consultation [Video file]. Mill Valley, CA: Author. 

                                                          Optional Resources

Psychotherapy.net (Producer). (2012). Group counseling with adolescents: A multicultural approach [Video file]. Mill Valley, CA: Author.

N:B. PLEASE PART OF THE CONTRACT IS TO HAVE IT READY IN 12 HOURS

Group Therapy Progress Note

American Psychological Association | Division 12 http://www.div12.org/ 1

Client: __________________________________________________ Date: ___________ Group name:________________________________________________ Minutes:________ Group session # ______ Meeting attended is #:______ for this client. Number present in group _____ of _____ scheduled Start time:________ End time: ________

Assessment of client

1. Participation level: ❑ Active/eager ❑ Variable ❑ Only responsive ❑ Minimal ❑ Withdrawn

2. Participation quality: ❑ Expected ❑ Supportive ❑ Sharing ❑ Attentive ❑ Intrusive

❑ Monopolizing ❑ Resistant ❑ Other: _____________________________________

3. Mood: ❑ Normal ❑ Anxious ❑ Depressed ❑ Angry ❑ Euphoric ❑ Other: _______________

4. Affect: ❑ Normal ❑ Intense ❑ Blunted ❑ Inappropriate ❑ Labile ❑ Other:_______________

5. Mental status: ❑ Normal ❑ Lack awareness ❑ Memory problems ❑ Disoriented ❑ Confused

❑ Disorganized ❑ Vigilant ❑ Delusions ❑ Hallucinations ❑ Other:__________________

6. Suicide/violence risk: ❑ Almost none ❑ Ideation ❑ Threat ❑ Rehearsal ❑ Gesture ❑ Attempt

7. Change in stressors: ❑ Less severe/fewer ❑ Different stressors ❑ More/more severe ❑ Chronic

8. Change in coping ability/skills: ❑ No change ❑ Improved ❑ Less able ❑ Much less able

9. Change in symptoms: ❑ Same ❑ Less severe ❑ Resolved ❑ More severe ❑ Much worse

10. Other observations/evaluations:________________________________________________________

In-session procedures:  _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

 _______________________________________________________________________________

 __________ _____________________________________________________________________

Homework: 1.

2.

3.

Other Comments: _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ Signatures Date

Child and Adolescent Clients with Psychiatric Disorders

Health Care Beliefs Assignment

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Health Care Beliefs Assignment

Read chapter 15 and 32 of the class textbook and review the attached Power Point presentations.  Read content chapter 32 in Davis Plus Online Website.  Once done answer the following questions; Health Care Beliefs Assignment

1.  Discuss the historical background of these two heritages.

2.  Discuss the health care beliefs of these two heritages and mention if there is any similarity with the health care beliefs in United States.

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3.  Do you think that the health care beliefs of these two heritages influence the delivery of evidence base nursing care?  Explain why.

As previous weeks and stated in the syllabus please present your assignment in an APA format word document, Arial 12 font, attached to the forum in the discussion tab of the blackboard title “week 8 discussion questions”.  A minimum of 2 evidence based references (excluding the class textbook) are require.  You must post two replies sustained with the proper references to any of your peers postings.  A minimum of 500 words are required.

i send the power point but you can take internet information, thanks

Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health Care Beliefs Assignment

Copyright © 2013 F.A. Davis Company

Transcultural Health Care
Haitian Americans
Larry Purnell, PhD, RN, FAAN

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview

  • Haiti shares the Island of Hispaniola with the Dominican Republic.
  • Dominican Republic and Haiti have little in common culturally.
  • Haiti is the poorest country in the Western hemisphere with a per capita income of less than $450.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

  • Over 500,000 Haitians live in the United States, with more arriving after the Haitian earthquake in 2010. Their numbers may exceed 1.5 million.
  • Most live in NYC, FL, Boston, Chicago, and CA
  • Most come here for better economic opportunities and political freedom

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health Care Beliefs Assignment

Overview Continued

  • Haitians are a mix of Arawak Indian, Spanish, French, and African Black resulting in sharp class stratification and color consciousness
  • 1791 ended slavery in Haiti

*

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

  • Languages are primarily Creole (for the poor) and French (wealthier) and English although many speak all three languages
  • Black, mulatto, or white and colors in-between
  • Most Blacks are poor and underprivileged

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview

  • Early immigration to the United States was the wealthier groups for education, followed by general immigration after 1920 and the United States occupation of Haiti
  • After 1964, Duvalier became president for life, mass exodus because of oppression politically and economically

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

  • 1980 immigration with the Mariel Boat Lift from Cuba brought first legal and then the Boat People from Haiti.
  • Many had left Haiti to Cuba in previous generations and this group joined in coming to the United States.
  • Resulted in Cuban-Haitian entrant: status pending

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Overview Continued

  • French model of education with liberal arts, philosophy, classics, and languages—Latin and Greek and de-emphasizes technical and vocational training and the social and physical sciences
  • Educated Haitians are multilingual
  • Only 15% to 20% receive an education—high illiteracy rates

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications

  • French and Creole official languages
  • 15% speak French, 100% speak Creole
  • Oral communication patterns to pass on culture through proverbs and storytelling
  • Smile timidly to hide lack of education and understanding
  • Nod of the head does not mean “I understand” Health Care Beliefs Assignment

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications Continued

  • Most are private individuals who do not want friends or family to interpret for them
  • Traditional Haitians do not usually maintain eye contact
  • Touching is common
  • Women may hold hands while walking in public

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications Continued

  • Most are present oriented out of necessity, the past is cherished and the future is predetermined —many remain rather fatalistic
  • Punctuality is not valued—flexible time is the norm

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Communications Continued

  • First and middle name are usually hyphenated
  • Woman takes her husband’s name upon marriage
  • Last names are usually French or Arabic in origin
  • Formality in name is the norm

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles

  • Matriarchal or shared decision-making is the norm—although there are variations
  • Male is the primary breadwinner
  • Concept of machismo prevails
  • Not uncommon to have more than one mistress or for women male partners

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles Continued

  • Children are valued and expected to be well behaved—otherwise physical punishment may be used
  • Most feel US society is too permissive
  • Boys are given more freedom and permissive behavior
  • Girls cannot go out alone until age 17+

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles Continued

  • Nuclear, consanguine, and affinal relatives are the norm
  • Family lineage is what denotes respect, not money
  • Children expected to care for parents when self-care is a concern

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Family Roles Continued

  • Single parenting is well accepted
  • Homosexuality is taboo—if known, total denial from both sides
  • Mistress supports her children with little to no financial help

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

The nurse is providing insulin injection instructions to Mrs. Paul, a 44-year-old Haitian. When the nurse asks her if she understands the instructions, she nods. To assure understanding, the nurse should

Ask her to repeat the instructions.

Give her written instruction to ensure.

Have her demonstrate an injection.

Give the instructions to a family member.

*

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: C

The best way to assure understanding is for the patient to demonstrate the injection.

*

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Health Conditions

  • Cholera, parasitosis, and malaria without malaria control measures
  • Hepatitis, tuberculosis, venereal disease have high rates
  • Most test positive for TBC because of Bacille bilie de Calmette-Guerin vaccinations
  • High rates of diabetes and hypertension

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition

  • For many, food means survival
  • Prefer eating at home and dislike fast food
  • When hospitalized, many prefer to fast rather than eat hospital food
  • Dislike yogurt, runny eggs, and cottage cheese
  • Staples are rice and beans, plantains, salad

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

  • Lists of foods are in the Haitian–American chapter
  • Foods are classified as cold (fret) and hot (cho), acid and non-acid, and heavy and light
  • Must balance fret and cho foods or illness occurs

*

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

  • Cough medicines are hot, laxatives are cold
  • Avoid citrus, causes acne
  • After ironing do not open refrigerator door
  • Do not shower when you are hot
  • Do not put warm feet directly on the cold floor Health Care Beliefs Assignment

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Nutrition Continued

  • Diet high in carbohydrates and fat
  • Being overweight is seen as positive
  • Major portion of meat protein is given to men

*

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Pregnancy

  • Pregnancy is not an illness so why seek prenatal care
  • Spicy foods will cause the fetus to be irritable
  • Vegetables and red fruits build blood for the fetus
  • Increased salivation—“use a spit cup”

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Pregnancy Continued

  • Prefer natural childbirth, although changing somewhat in the United States
  • Men usually not present during labor—female family members are preferred
  • Dress warmly and stay in bed 2 to 3 days after birth and use an abdominal binder to close the bones so cold air does not enter and cause illness

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Postpartum

  • Three baths postpartum, more difficult in the United States
  • Avoid food believed to increase vaginal discharge—lima beans, okra, mushrooms
  • Other foods are strength foods
  • Breastfeeding is encouraged
  • All infants receive lok to help meconium pass

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

ClickerCheck

Most Haitians practice the hot and cold dichotomy of foods. This is know in Haitian Creole as

a. Yin and yang.

b. Calor y frio.

c. Fret and cho.

d. Am and duong.

*

Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Correct Answer

Correct answer: C

Fret and cho are the Haitian Creole words for hot and cold.

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals

  • Prefer to die at home
  • Death watch by family who brings religious pictures and have bedside prayer
  • Male kinsman responsible for funeral arrangements, notifying all family members, and coordinating the service
  • Preburial veye to celebrate deceased’s life

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Death Rituals Continued

  • Seven consecutive days of prayer in the home to help the passage of the soul into the next life
  • Believe in resurrection so no cremation
  • Autopsy may relieve fear of deceased becoming a zombie

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Spirituality

  • Family is the center of life
  • Catholicism is the primary religion of Haiti
  • Religious practices combined with voodooism
  • Loa, the gods or spirits, believed to receive powers from God can provide protection and wealth

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices

  • Good health is balance between hot and cold, eat well, be plump, pray, be free of pain, eat and sleep right, and exercise
  • Illness is seen as punishment and comes of two types—natural and supernatural
  • Natural illnesses of two types—short duration caused by environmental factors

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices Continued

  • Natural longer term illness due to disequilibria between hot and cold and bone displacement
  • Supernatural illnesses are caused by angry spirits, which are placated by ceremonial feasts
  • Gas is a major cause of illness and can be in any part of the body

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices Continued

  • Certain foods can dispel gas
  • Postpartum more susceptible to gas
  • Traditional Haitians have a low pain (doule) threshold and is difficult to assess because of vague terms used to describe pain
  • Injections are preferred to oral medications Health Care Beliefs Assignment

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices Continued

  • Condition is deemed very serious if oxygen is needed
  • Special diet for physical weakness—vitamins, liver, pigeon meat, leafy green vegetables, and cow’s feet
  • Sezisman, similar to susto or magical fright, is caused by unexpected bad news and fright

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practices Continued

  • Strong stigma with mental illness
  • Self-treat and self-medicate or take friends medicine
  • May bring medicines from Haiti
  • Cultural bound illness—oppression

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Barriers

  • Delay seeking care because of self-care
  • No health insurance
  • View that Western medicine does not understand voodooism
  • Language difficulties
  • Very reluctant to receive blood transfusions or engage in organ donation

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Transcultural Health Care: A Culturally Competent Approach, 4th Edition

Healthcare Practitioners 

  • Use traditional and Western practices simultaneously
  • Respectful of Western healthcare providers
  • May have limited understanding of Western healthcare providers and their functions and capabilities Health Care Beliefs Assignment

Effect of Aldosterone on Fluid and Electrolyte Imbalances

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Effect of Aldosterone on Fluid and Electrolyte Imbalances

NR 507 Week No. 5 Discussion:

PART No. 1:

Ms. Blake is an older adult with diabetes and has been too ill to get out of bed for 2 days. She has had a severe cough and has been unable to eat or drink during this time. She has a history of Type I diabetes. On admission her laboratory values show: Effect of Aldosterone on Fluid and Electrolyte Imbalances

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Sodium (Na+) 

156 mEq/L H

Potassium (K+)

4.0 mEq/L N

Chloride (Cl–)

115 mEq/L H

Arterial blood gases (ABGs)

pH- 7.30; Pco2-40; Po2-70; HCO3-20

METABOLIC ACIDOSIS with respiratory compensation, High anion gap

Normal values

Sodium (Na+)

136-146 mEq/L

Potassium (K+)

3.5-5.1 mEq/L

Chloride (Cl–)

98-106 mEq/L

Arterial blood gases (ABGs)

pH- 7.35-7.45

Pco2- 35-45 mmHg

Po2-80-100 mmHg

HCO3–22-28 mEq/L

  • List      three (3) reasons on why she may have become bed ridden? 
  • Flu?      Pneumonia? 
  • Based      on these reasons what tests would you order? 
  • Accu      check? CXR? Lactic Acid level, serum and urine ketone levels
  • Describe      the molecular mechanism of the development of ketoacidosis. (p. 744) *Pt’s      who develop DKA do so bc bicarbonate buffering does not occur, which      begins the development of metabolic acidosis

pH 7.30 = acid

CO2 40 = Normal

O2 70 = Low

HCO3 20 = acid

PART No. 2:

A three-month-old baby boy comes into your clinic with the main complaint that he frequently vomits after eating. He often has a swollen upper belly after feeding and acts fussy all the time. The vomiting has become more frequent this past week and he is beginning to lose weight.

  • Write      three (3) differential diagnoses at this time?
  • Is      there any genetic component to the top of your differentials?
  • What      tests would you order?

PART No. 3:

Write a one (1) paragraph case study of your own for a patient with Ulcerative Colitis?

PEER:

NR 507 Week No. 5 Quiz:

1. Aldosterone synthesis and secretion are primarily regulated by the (Points : 2)

2. A surgical individual just arrived on the unit from the postanesthesia care unit. This person’s respirations are 4 per minute and shallow. As the nurse calls for assistance, the person suddenly feels jittery and breathing quickens. Which of the following feedback loops is operating for the nurse in this situation? (Points : 2)

3. What effect does aldosterone have on fluid and electrolyte imbalances? (Points : 2)

4. What effect does hyperphosphatemia have on other electrolytes? (Points : 2)

5. Where is oxytocin synthesized? (Points : 2)

6. Which mineral is needed for the synthesis of thyroid hormones? (Points : 2)

7. The portion of the pituitary that secretes oxytocin is the _____ pituitary. (Points : 2)

8. When insulin binds its receptors on muscle cells, an increase in glucose uptake by the muscle cells is the result. This is an example of a _____ effect by a hormone. (Points : 2)

9. Which of the following hormones acts on its target cell via a second messenger? (Points : 2)

10. Target cells for parathyroid hormone (PTH) are located in the (Points : 2)

11. Which hormone is involved in the regulation of serum calcium levels? (Points : 2)

12. A person who has experienced physiologic stresses will have increased levels of which hormone? (Points : 2)

13. The first lab test that indicates type 1 diabetes is causing the development of diabetic nephropathy is (Points : 2)

14. A deficiency of which of the following may result in hypothyroidism? (Points : 2)

15. Diagnosing a thyroid carcinoma is best done with (Points : 2)

16. The effects of syndrome of inappropriate antidiuretic hormone (SIADH) include solute (Points : 2)

17. Which of the following clinical manifestations is not common to both diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar nonketotic syndrome (HHNKS)? (Points : 2)

18. The signs of thyroid crisis resulting from Graves disease include (Points : 2)

19. What causes the microvascular complications of clients with diabetes mellitus? (Points : 2)

20. A man with a closed head injury has a urine output of 6 to 8 L/day. Electrolytes are within normal limits, but his antidiuretic hormone (ADH) level is low. Although he has had no intake for 4 hours, there is no change in his polyuria. These are indications of (Points : 2)

21. Amenorrhea, galactorrhea, hirsutism, and osteopenia are each caused by a (Points : 2)

22. The most common cause of hypoparathyroidism is (Points : 2)

23. The level of thyroid-stimulating hormone (TSH) in Graves disease is usually (Points : 2)

24. The most probable cause of low serum calcium following a thyroidectomy is (Points : 2)

25. Hyperpituitarism is generally caused by (Points : 2)  Effect of Aldosterone on Fluid and Electrolyte Imbalances

Difficulties Faced by Health Care Providers

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Difficulties Faced by Health Care Providers

With coinciding concerns about health care costs and the imperative to improve quality of care, health care providers and others face difficult decisions in the effort to achieve an appropriate balance. Such decisions often are addressed in the policy arena. How do policymakers evaluate which health care services should be financed through government programs? How do ethics-related questions and other considerations play into this evaluation process? Is it possible to contain costs and provide accessible, high-quality care to all, or is the tension between cost and care inherent in the U.S. health care delivery system? These questions are central to health care financing decisions in the United States. Difficulties Faced by Health Care Providers 

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For this Discussion, you will focus on the policy decision-making process that determines what types of care are covered by public and private insurers and the ethical aspects of such financial decisions.

To prepare:

  • Read the the case study “Economic Impact of States Declining Medicaid Expansion”  page 305 of the Milstead text.
  • Review the information in the Washington Post article “Review of Prostate Cancer Drugs Provenge Renews Medical Cost-Benefit Debate” in the Learning Resources.
  • Consider how policy decisions currently are made about what will and will not be paid for and what changes, if any, could improve the process.
  • Reflect on how the Washington Post example illustrates the tension between cost and care.

Post your analysis and assessment of the ethical and economic challenges related to policy decisions such as those presented in the Washington Post article. How does this type of situation contribute to the tension between cost and care? Substantiate your response with at least two outside resources.

Washington Post article:

http://www.washingtonpost.com/wp-dyn/content/article/2010/11/07/AR2010110705205.html Difficulties Faced by Health Care Providers 

Policy Process in Nursing Agenda Setting

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Policy Process in Nursing Agenda Setting

Agenda Setting

A key aspect of the policy process is agenda setting. How do topics get on that agenda? Agenda setting requires the support of stakeholders to move the issue forward. In this week’s media presentation, Dr. Kathleen White outlines the policy process and discusses how to move issues into the policy arena through agenda setting. The ultimate goal is to gain the attention of leadership whether at the organizational, local, state, national, or international level. Policy Process in Nursing Agenda Setting

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To prepare:

  • Review      this week’s media presentation, focusing on the insights shared by Dr.      White and Dr. Stanley on agenda setting and identification of      stakeholders.
  • Brainstorm      clinical practice issues that you believe are worthy of being on your      organization’s systematic agenda.
  • Who      are the stakeholders who would be interested in this clinical practice      issue?

By tomorrow 03/14/2018 3pm, write a minimum of 550 words in APA format with at least 3 scholarly references from the list of required readings below. Include the level one headings as numbered below”

Post a cohesive response that addresses the following:

1) In the first line of your posting, identify the clinical practice issue you would like to see on your organization’s systematic agenda.

2) What strategies would you use to inform stakeholders and persuade them of the importance of your identified clinical practice issue? Policy Process in Nursing Agenda Setting

Required Readings

Hyder, A., Syed, S., Puvanachandra, P., Bloom, G., Sundaram, S., Mahmood, S., … Peters, D. (2010). Stakeholder analysis for health research: case studies from low- and middle-income countries. Public Health, 124(3), 159–166.

This study demonstrates how the engagement of stakeholders in research and policy making can assist in the successful implementation of policy proposals. The authors propose that by engaging stakeholders, researchers and policy makers are provided with multiple perspectives on proposed policies, which can lead to greater success with policy adoption and implementation.

Lavis, J. N., Permanand, G., Oxman, A. D., Lewin, S., & Fretheim, A. (2009). SUPPORT Tools for evidence-informed health Policymaking (STP) 13: Preparing and using policy briefs to support evidence-informed policymaking. Health Research Policy & Systems, 71–79. doi: 10.1186/1478-4505-7-S1-S13

The purpose of a policy brief is to communicate an issue clearly and definitively to policy makers. The authors of this article propose an outline for policy briefs and also stress the importance of using research when creating a policy brief.

Lowery, B. (2009). Obesity, bariatric nursing, and the policy process: The connecting points for patient advocacy. Bariatric Nursing & Surgical Patient Care, 4(2), 133–138.

This article provides an example of nurse involvement in policy making by examining a bariatric nursing issue. The author stresses that nurses, in their patient-advocacy role, have a responsibility to be involved in the health care policy process.

Moore, K. (2006). How can basic research on children and families be useful for the policy process? Merrill-Palmer Quarterly, 52(2), 365–375.

Institute of Medicine. (2010). The future of nursing: Leading change, advancing health: Report recommendations. Retrieved from http://www.nationalacademies.org/hmd/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf Policy Process in Nursing Agenda Setting

Introduced in Week 2, this IOM report highlights four key recommendations in its proposal for the future directions of the nursing profession. These recommendations focus on nursing practice, education and training, partnerships with other healthcare professionals, and workforce planning and policymaking.

National Center for Policy Analysis (2010). Ideas changing the world: Free-market health care policy. Retrieved from http://www.ncpa.org/healthcare/

The NCPA is a nonprofit, nonpartisan organization that promotes private sector solutions to public policy issues.

Slack, B. (2011). The policy process. Retrieved from http://people.hofstra.edu/geotrans/eng/methods/ch9c2en.html 

The author presents a policy-making framework and provides details on the four steps of that process: problem definition, policy objectives and options, policy implementation, and policy evaluation and maintenance.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Agenda setting and the policy process. Baltimore: Author. 

Note: The approximate length of this media piece is 17 minutes.

Dr. Kathleen White and Dr. Joan Stanley share their insights into agenda setting and how issues are moved forward into the policy process.

Optional Resources

Barnes, M., Hanson, C., Novilla, L., Meacham, A., McIntyre, E., & Erickson, B. (2008). Analysis of media agenda setting during and after Hurricane Katrina: Implications for emergency preparedness, disaster response, and disaster policy. American Journal of Public Health, 98(4), 604–610.

Jennings, C. (2002). The power of the policy brief. Policy, Politics & Nursing Practice, 3(3), 261–263. doi: 10.1177/152715440200300310

Neumann, P. J., Palmer, J. A., Daniels, N., Quigley, K., Gold, M. R., & Chao, S. (2008). A strategic plan for integrating cost-effectiveness analysis into the US health care system. American Journal of Managed Care, 14(4), 185-188.

Plan, Policy, Procedure Relationship Diagram. (n.d.). Retrieved from http://www.informationsecurityintel.com/docs/Fig.%204.3.pdf Policy Process in Nursing Agenda Setting

Health Promotion and Disease Preventive Care

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Health Promotion and Disease Preventive Care

It is important to promote the professional role of the nurse to provide health promotion and disease preventive care. Collaborating with other health care professionals and consumer groups in the community in redesigning health care can help meet the goals for Healthy People 2020. Refer to http://www.healthypeople.gov/ to open the Healthy People 2020 home page. 1.Select the “Topics & Objectives” tab to access the 2020 Topics & Objectives – Objectives A-Z page. 2.Select one of the Healthy People “Topic Areas” for improving health.

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 Develop a PowerPoint presentation (15-20 slides) with accompanying speaker’s notes and citations.   In the presentation, address the following: Health Promotion and Disease Preventive Care

1.State the objective of the presentation.

 2.State the Healthy People 2020 focus area your group has selected and the rationale for selection of the specific focus area. 

3.Explain how the focus area relates to the individual, the family, and the community, as well as to all age groups throughout the life span.

 4.Identify ways to enhance or optimize health in the selected focus area using evidence-based research. A minimum of three peer-reviewed articles must be utilized. 

5.Address the health disparity among different segments of the population for the selected focus area. 

6.Provide a brief description of at least two community resources and at least two website resources for professionals and clients.

 7.Provide a brief profile of at least one health-related organization for the selected focus area.  APA style is required for essays only. Solid academic writing is always expected. For all assignment delivery options, 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.  Health Promotion and Disease Preventive Care

Voluntary and Involuntary Commitment Paper

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Voluntary and Involuntary Commitment Paper

Assignment : Practicum Journal: Voluntary and Involuntary Commitment

PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice. Voluntary and Involuntary Commitment Paper

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In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed? Voluntary and Involuntary Commitment Paper

Learning Objectives

Students will:

  • Evaluate      clients for voluntary commitment
  • Evaluate      clients for involuntary commitment based on state laws
  • Recommend      actions for supporting parents of clients not eligible for involuntary      commitment
  • Recommend      actions for treating clients not eligible for involuntary commitment

To Prepare for this Practicum:

  • Review      the Learning Resources concerning voluntary and involuntary commitment.
  • Read      the Week 7 Scenario in your Learning      Resources.
  • Research      your state’s laws concerning      voluntary and involuntary commitment.

The Assignment (2–3 pages):

  • Based      on the scenario, would you recommend      that the client be voluntarily committed? Why or why not?
  • Based      on the laws in your state, would the      client be eligible for involuntary commitment? Explain why or why not.
  • Did      understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing      the client? Explain.
  • If the      client were not eligible for involuntary commitment, explain what actions you may be able to take to support the      parents for or against voluntary commitment.
  • If the      client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client. Voluntary and Involuntary Commitment Paper