Use of Psychosocial Theories in Nursing

Use of Psychosocial Theories in Nursing

For this Discussion, you will explore how social and behavioral theories apply in a clinical setting by analyzing a case study.

To prepare:

With information from this week’s Learning Resources in mind, reflect on the influence of sociological and behavioral factors on health.

Read the case study of the woman admitted for a mastectomy presented on page 328, #3 of the course text Theoretical Basis for Nursing. Consider which concepts from sociological and/or behavioral theories could be used in nursing practice for addressing the patient’s health care needs. Conduct additional research as necessary using credible websites and the Walden library. Also consider how these theories are used in your own clinical practice.

Write 2 pages on the following:

1) What concepts from the various theories could be used in planning the 65-year-old woman’s care?

2) How might her care be changed if the woman were 25 years old or 45 years old?

3) How have social psychology theories been used in promoting breast cancer awareness? Provide at least one example to support your response.

4) How have social psychology theories been used in your clinical practice area? Provide at least one example to support your response.

References

Required Readings

McEwin, M., & Wills, E.M. (2014). Theoretical basis for nursing. (4th ed.). Philadelphia, PA: Wolters Kluwer Health.

Chapter 13, “Theories From the Sociologic Sciences”

Chapter 14, “Theories From the Behavioral Sciences”

Carnegie, E., & Kiger, A. (2009). Being and doing politics: An outdated model or 21st century reality? Journal of Advanced Nursing, 65(9), 1976–1984. doi: 10.1111/j.1365-2648.2009.05084.x

Conrad, P., & Barker, K. (2010). The social construction of illness: Key Insights and policy implications. Journal of Health and Social Behavior: Special Issue, 51, S67–S79. doi: 10.1177/0022146510383495

Ford, C. L., & Airhihenbuwa, C. O. (2010). Critical race theory, race equity, and public health: Toward antiracism praxis. American Journal of Public Health, 100(S1), S30–S35. doi: 10.2105/AJPH.2009.171058

Patient Assessment

Question 1 A nurse is caring for a patient who is in severe pain and is receiving an opioid analgesic. Which of the following would be the nurse’s priority assessments?

A) Respiratory rate, seizure activity, and electrolytes

B) Pain intensity, respiratory rate, and level of consciousness

C) Liver function studies, pain intensity, and blood glucose level

D) Respiratory rate, pain intensity, and mental status

Question 2 A nurse is caring for a patient who has been admitted with acute cocaine intoxication. Which of the following vital signs would the nurse expect to find initially when assessing the patient?

A) Blood pressure (BP): 98/50, pulse (P): 120, respirations (R): 40

B) BP: 130/88, P: 92, R: 28

C) BP: 150/90, P: 80, R: 16

D) BP: 170/98, P:110, R: 20

Question 3 A nurse is providing care for a patient who suffered extensive burns to his extremities during a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the surfaces of all his burns in order to achieve adequate pain control. When considering this order, the nurse should be aware that

A) intravenous lidocaine may be preferable to topical application

B) lidocaine must be potentiated with another anesthetic in order to achieve pain control

C) pain relief is unlikely to be achieved due to the destruction of nerve endings in the burn site

D) there is a risk of systemic absorption of the lidocaine through the patient’s traumatized skin

Question 4 A patient has been prescribed zolpidem (Ambien) for short-term treatment of insomnia.Which of the following will the nurse include in a teaching plan for this patient? (Select all that apply.)

A) The drug should not be used for longer than 1 month.

B) It should be taken 1 hour to 90 minutes before going to bed

C) The drug does not cause sleepiness in the morning

D) One of the most common adverse effects of the drug is headache

E) It is available in both quick-onset and continuous-release oral forms

Question 5 A middle-aged patient was diagnosed with major depression after a suicide attempt several months ago and has failed to respond appreciably to treatment with SSRIs. As a result, his psychiatrist has prescribed phenelzine. When planning this patient’s subsequent care, what nursing diagnosis should the nurse prioritize?

A) Risk for Ineffective Peripheral Tissue Perfusion related to cardiovascular effects of phenelzine

B) Risk for Constipation related to decreased gastrointestinal peristalsis

C) Risk for Infection related to immunosuppressive effects of phenelzine

D) Risk for Injury related to drug–drug interactions or drug–nutrient interactions

Question 6 Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury. The nurse will advise the patient to avoid

A) alcohol

B) vitamin C

C) fatty foods

D) dairy product

Question 7 A 62-year-old woman has been prescribed a fentanyl transdermal patch for chronic cancer pain. The patient asks the nurse how long it will take for her to experience pain relief. The nurse will instruct the patient that she should feel pain relief in approximately

A) 6 hours

B) 12 hours

C) 24 hours

D) 32 hours

Question 8 A nurse is assigned to a patient who is taking lithium. Which of the following drug serum levels would indicate that the patient is at risk for adverse effects of the drug?

A) 0.3 mEq/L

B) 0.6 mEq/L

C) 1.7 mEq/L

D) 1.2 mEq/L

Question 9 A nurse who provides care on an acute medicine unit has frequently recommended the use of nicotine replacement gum for patients who express a willingness to quit smoking during their admission or following their discharge. For which of the following patients would nicotine gum be contraindicated?

A) A patient who received treatment for kidney failure due to an overdose of acetaminophen

B) A patient whose pulmonary embolism was treated with a heparin infusion

C) A patient with a history of angina who experienced a non-ST wave myocardial infarction

D) A patient whose stage III pressure ulcer required intravenous antibiotics and a vacuum dressing

Question 10 The wife of a patient who is taking haloperidol calls the clinic and reports that her husband has taken the first dose of the drug and it is not having a therapeutic effect. An appropriate response by the nurse would be

A) “Continue the prescribed dose. It may take several days to work.”

B) “I’ll ask the nurse practitioner if the dosage can be increased.”

C) “I’ll ask the nurse practitioner if the haloperidol can be discontinued and another drug started.”

D) “I’ll report this to the nurse practitioner and see if he will add another drug to enhance the effects of the haloperidol.”

Question 11 A male patient has been brought to the emergency department during an episode of status epilepticus. Diazepam is to be administered intravenously. The nurse will be sure to

A) avoid the small veins in the dorsum of the hand or the wrist

B) inject the diazepam very quickly, 15 mg in 10 to15 seconds

C) administer after diluting the drug with gabapentin in intravenous solution

D) inject very slowly, no faster than 100 mg/minute

Question 12 A homeless man who is well known to care providers at the local hospital has been admitted to the emergency department after having a seizure outside a mall. The man is known to be a heavy alcohol user and is malnourished with a very low body mass index. How are this patient’s characteristics likely to influence possible treatment with phenytoin?

A) The patient will require oral phenytoin rather than intravenous administration

B) Phenytoin is contraindicated within 48 hours of alcohol use due to the possibility of paradoxical effects

C) The patient’s heavy alcohol use will compete with phenytoin for binding sites and he will require a higher-than-normal dose

D) The patient’s protein deficit will likely increase the levels of the free drug in his blood

Question 13 A patient has been admitted to the ICU because of multiple traumas due to a motor vehicle accident. The physician has ordered propofol (Diprivan) to be used for maintenance of sedation. Before administration of propofol, a priority assessment by the nurse would be to check for a history of

A) seizure disorders

B) low blood pressure

C) increased intraocular pressure

D) diabetic hyperlipidemia

Question 14 A patient who is experiencing withdrawal from heavy alcohol use have developed psychosis and been treated with haloperidol. Which of the following assessment findings should prompt the care team to assess the patient for neuroleptic malignant syndrome?

A) The patient demonstrates a significant increase in agitation after being given haloperidol

B) The patient develops muscle rigidity and a sudden, high fever

C) The patient complains of intense thirst and produces copious amounts of urine

D) The patient develops yellowed sclerae and intense pruritis (itchiness)

Question 15 A patient who has been taking buspirone (BuSpar) for 1 week calls the clinic and reports to the nurse that the drug is not working. The patient informs the nurse that she is still having symptoms of anxiety. The nurse will tell the patient that

A) she will report this to the physician immediately

B) the drug is not going to work for her and the medication needs to be changed

C) optimum relief of anxiety usually occurs after 3 to 4 weeks of treatment

D) it may take up to 6 months for the drug to relieve her anxiety

Question 16 A nurse works in a sleep disorder clinic and is responsible for administering medications to the patients. Which of the following patients would be most likely to receive zaleplon (Sonata)?

A) A 35-year-old man who is having difficulty falling asleep, but once asleep can stay asleep

B) A 20-year-old woman who will take the drug about once a week

C) A 52-year-old woman who needs to fall asleep quickly and stay asleep all night

D) A 46-year-old man who receives an antidepressant and needs a sleep aid

Question 17 A patient has a history of tonic-clonic seizures that have been successfully treated with phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by

A) decreasing the influx of sodium into neurons.

B) increasing the levels of available glutamate.

C) simultaneously potentiating the effects of GABA and inhibiting reuptake.

D) by slowing the function of calcium channels within the neurological system.

Question 18 A patient has been hospitalized for treatment of substance abuse after being arrested and jailed for the past 24 hours. The patient is experiencing severe muscle and abdominal cramps, seizures, and acute psychosis due to abrupt withdrawal. Which of the following drug classes is the most likely cause of these severe and potentially fatal withdrawal symptoms?

A) Amphetamines

B) Sedative–hypnotic drugs

C) Benzodiazepines

D) Opioids

Question 19 Which of the following would be an expected outcome in a patient who has been given atropine during a medical emergency?

A) Reduction of severe hypertension

B) Increased level of consciousness

C) Restoration of normal sinus rhythm

D) Resolution of respiratory acidosis

Question 20 A postsurgical patient has been provided with a morphine patient-controlled analgesic (PCA) but has expressed her reluctance to use it for fear of becoming addicted. How can the nurse best respond to this patient’s concerns?

A) “You don’t need to worry. It’s actually not true that you can get addicted to the medications we use in a hospital setting.”

B) “If you do become addicted, we’ll make sure to provide you with the support and resources necessary to help you with your recovery.”

C) “It’s important that you accept that your current need to control your pain is more important than fears of becoming addicted.”

D) “It is not uncommon to develop a dependence on pain medications, but this usually takes place over a long period and is not the same as addiction.”

Question 21 A nurse is talking to an 18-year-old patient who has had a seizure disorder since she was 10 years old and is taking phenytoin (Dilantin). The nurse should suggest that she take which of the following?

A) A potassium supplement

B) An iron supplement

C) Folic acid

D) Vitamin C

Question 22 Which of the following drugs used to treat anxiety would be appropriate for a patient who is a school teacher and is concerned about feeling sedated at work?

A) Alprazolam (Xanax)

B) Buspirone (BuSpar)

C) Diazepam (Valium)

D) Lorazepam (Ativan)

Question 23 A 64-year-old-patient has been prescribed lorazepam (Ativan) because of increasing periods of anxiety. The nurse should be careful to assess for

A) a diet high in fat

B) a history of current or past alcohol use

C) current nicotine use

D) a diet high in carbohydrates

Question 24 A 30-year-old woman is taking phenelzine (Nardil) 30mg PO tid. The nurse knows that at that dosage, the patient will need to be carefully monitored for

A) dizziness

B) diarrhea

C) increased secretions

D) facial flushing

Question 25 A nurse will be prepared to administer naloxone (Narcan) to a patient who has had an overdose of morphine. Repeated doses of Narcan will be necessary because Narcan

A) has less strength in each dose than do individual doses of morphine

B) has a shorter half-life than morphine

C) combined with morphine, increases the physiologic action of the morphine

D) causes the respiratory rate to decrease

Question 26 A nurse who works at an outpatient mental health clinic follows numerous clients who have schizophrenia, many of whom are being treated with olanzapine (Zyprexa). Which of the following clients likely has the highest susceptibility to the adverse effects of olanzapine?

A) A client who is morbidly obese and who has a sedentary lifestyle

B) A client who has type 1 diabetes and who practices poor glycemic control

C) A client who has a body mass index of 16.5 (underweight) and who smokes one pack of cigarettes daily

D) A client who was recently treated with intravenous antibiotics because of cellulitis in his lower leg

Question 27 A patient has been prescribed lithium therapy.Which of the following signs and symptoms will the nurse tell the patient to report immediately?

A) Increased urination

B) Muscle twitching

C) Hair loss

D) Increased thirst

Question 28 A trauma patient has been receiving frequent doses of morphine in the 6 days since his accident. This pattern of analgesic administration should prompt the nurse to carefully monitor the patient’s

A) urine specific gravity

B) skin integrity

C) bowel patterns.

D) core body temperature

Question 29 A patient with mild low back pain has been advised to take acetaminophen. The nurse will inform him that excessive intake of acetaminophen may result in

A) gastrointestinal distress

B) acute renal failure

C) cognitive deficits

D) liver damage.

Question 30 A 39-year-old patient who is having trouble sleeping is beginning drug treatment with zaleplon (Sonata). The nurse will be sure to ask the patient if she is taking

A) secobarbital (Seconal)

B) oxycodone (Percodan)

C) cimetidine (Zantac)

D) meperidine (Demerol)

Leadership Action

  1. Develop a PowerPoint slideshow consisting of 8-15 slides. Include the following. Title slide, written speaker notes, and Reference slide. Do not use Voice Over recordings. All information needs to be written in slides and notes.
  2. You are required to complete the assignment using the productivity tools required by Chamberlain University, which is Microsoft Office Word 2013 (or later version), or Windows and Office 2011 (or later version) for MAC. You must save the file in the “.pptx” format. A later version of the productivity tool includes Office 365, which is available to Chamberlain students for FREE by downloading from the student portal at http://my.chamberlain.edu (Links to an external site.)Links to an external site.. Click on the envelope at the top of the page.
  3. As the leader, you have identified a problem or issue related to one of the National Patient Safety Goals 2018 created by the Joint Commission that will lead to quality improvement. You will find the National Patient Safety Goals using this link: NPSG (Links to an external site.)Links to an external site.
  4. Assess the problem or issue. State the problem/issue and identify three rationales (reasons) that the problem exists.
  5. Determine the people who are involved in the issue and explain three reasons as to how their role will contribute to the problem or issue solution.
  6. Identify three solutions and discuss the purpose, cost and desired outcome.
  7. Pick one solution to share with the director and discuss why this solution was chosen over the others.
  8. Make an action plan to share the solution with the director or staff.
  9. Summarize issue, plan and desired outcome and purpose for quality improvement on slide.
  10. Summarize your learning and value of doing the assignment.
  11. Include written speaker notes for all slides except title slide and reference slide.
  12. Submit your PowerPoint slideshow by 11:59 p.m. MT, Sunday, end of Week 6.

Nursing Case Study

Please make sure you include a title page and that you answer each question with a detailed rationale as well as credible sources to back up your answers. Make sure you use your textbook, peer reviewed journals or reliable websites like those ending in .edu, .gov and .org. There can be more than one correct answer to the multiple choice questions. They are choose all that apply.

Mr. Charles Lamont is a 45-year-old patient who is visiting his primary care physician for his an annual checkup. His wife is waiting for him in the lobby; she is hoping that Mr. Lamont will tell the physician about his recent bout of coughing and shortness of breath. Mr. Lamont works for a construction company as a heavy machine operator. He smokes 1½ packs of cigarettes per day. His wife has been encouraging Mr. Lamont to stop, but he has not showed any interest in quitting. Laura, the registered nurse, takes Mr. Lamont to an examination room. Laura asks him about his overall health and he tells her about a nagging cough and how he sometimes feels short of breath. He then denies any other health problems. Laura takes Mr. Lamont’s vital signs and gets the following results: blood pressure 156/94 mm Hg, temperature 99.8° F orally, apical pulse 104 beats/min, respirations 25 breaths/min and regular, and pulse oximetry 95%.

Mr. Lamont asks Laura if everything is normal. Before she answers, she reviews the results and determines which of the results are abnormal. What are Laura’s findings? What would be normal for any of these that are not normal?

The primary care physician examines Mr. Lamont and tells him he should quit smoking. He gives him an antihypertensive medication to help lower his blood pressure. Mr. Lamont asks Laura if she can teach his wife how to take his blood pressure. Laura agrees and brings Mrs. Lamont in to explain the process. Laura decides that she will use demonstration to teach Mrs. Lamont the procedure, but she also wants to explain some important concepts. What should she include? Select all that apply.
A. Choose a cuff that is the right size.
B. Ensure that the patient is sitting or lying.
C. Support the extremity.
D. Ensure proper cuff application.

Mr. Lamont tells Laura that he doesn’t understand how smoking could influence his blood pressure. How should Laura respond?

Mr. Lamont tells his wife that the physician told him his respiratory rate was increased. Mrs. Lamont asks Laura what could cause him to breathe faster. What factors could cause his increased respirations? Select all that apply.
A. Smoking
B. Medications
C. Increased activity
D. Pain

Analysis of an article using the Research Analysis Matrix section of the template

Assignment WK 4

Research Analysis

Architect Daniel Libeskind is credited with saying “To provide meaningful architecture is not to parody history, but to articulate it.” The suggestion is that his work does not copy the efforts of others but relies on it.

Understanding the work of others is critically important to new work. Contributions to the nursing body of knowledge can happen when you are able to analyze and articulate the efforts of previous research. Hence research analysis skills are critical tools for your toolbox.

In this Assignment, you will locate relevant existing research. You also will analyze this research using a tool helpful for analysis.

To Prepare:

Reflect on the strategies presented in the Resources this week in support of locating and analyzing research.

Use the Walden Library to identify and read one peer-reviewed research article focused on a topic of interest to you in your specialty field.

Review the article you selected and reflect on the professional practice use of theories/concepts as described by the article

The Assignment:

Using the ‘Week 4 | Part 4’ section of your Academic Success and Professional Development Plan Template presented in the Resources, conduct an analysis of the elements of the research article you identified. Be sure to include the following:

The topic of interest you have selected

Correctly formatted APA citation of the article you selected, along with link or search details

Identify a professional practice use of the theories/concepts presented in the article.

Analysis of the article using the Research Analysis Matrix section of the template

Write a 1-paragraph justification explaining whether or not you would recommend the use of this article to inform professional practice

Write a 2- to 3-paragraph summary that you will add to your Academic Success and Professional Development Plan that includes the following:

Describe your approach to identifying and analyzing peer-reviewed research

Identify at least two strategies that you would use that you found to be effective in finding peer-reviewed research

Identify at least one resource you intend to use in the future to find peer-reviewed research

Note: Add your work for this Assignment to the original document you began in the Week 1 Assignment, which was built off the Academic Success and Professional Development Plan Tem

Case Study: Meeting Individuals Health Needs

Directions:

  1. To complete this assignment:

· Read the case study above.

· Assume the role as the Public Relations Director for Purple Cross of North Carolina.

o The CEO directs you to interview the Telehealth Director regarding the use of Telehealth with Mrs. Smith. The CEO directs you to create one thought-provoking question for each of the following topics:

· Meeting the health needs of Mrs. Smith

· Decision-making process for technology selected for Mrs. Smith

· Benefits and risks in using Telehealth technology for Mrs. Smith

· Cost and staff involved in using Telehealth technology for Mrs. Smith

o Note: Your questions must be original; not copied or modified from any source, including your textbook. Your questions cannot simply rephrase the topic.

o For each question, the CEO requires that you provide your rationale. Describe how the question will yield a thorough response, and not simply a “yes” or “no” answer.

· Any cited sources to support your rationale statements must be identified, using APA formatting.

· Prior to submission, review your responses to ensure that they contain no spelling or grammatical errors.

  1. Submit the Week 4 Assignment via Blackboard by clicking on the “Week 4 Assignment” link.
  2. Include the proper file naming convention:

· CMP105_wk4_assn_jsmith_mmddyyyy.

For each topic, write your question and rationale.

Topic: Meeting the health needs for Mrs. Smith

Your question:

[Write your response here.]

Rationale:

[Write your response here.]

Topic: Decision-making process for technology selected for Mrs. Smith

Your question:

[Write your response here.]

Rationale:

[Write your response here.]

Topic: Benefits and risks in using Telehealth technology for Mrs. Smith

Your question:

[Write your response here.]

Rationale:

[Write your response here.]

Topic: Cost and staff involved in using Telehealth technology for Mrs. Smith

Your question:

[Write your response here.]

Rationale:

[Write your response here.]

Nursing Practice And School Health Privacy

Create a 6–8-slide PowerPoint presentation for a group of school nurses, which addresses the role of the school nurse in managing the unique health concerns of teenagers while adhering to privacy laws.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

Competency 1: Explain the effect of health care policies, legislation, and legal issues on health care delivery and patient outcomes.

Explain the laws that relate to adolescent safety and health privacy in a school setting.

Explain how the privacy laws affect schools, students, and school nurses.

Competency 3: Apply professional nursing ethical standards and principles to the decision-making process.

Describe health and wellness issues specific to the adolescent population.

Recommend evidence-based ethical strategies relating to health and wellness privacy communication by the school nurse.

Competency 4: Communicate in a manner that is consistent with expectations of nursing professionals.

Write content clearly and logically, with correct use of grammar, punctuation, and mechanics.

Correctly format citations and references using APA style.

Role of the School Nurse

It is the position of the National Association of School Nurses that the professional registered school nurse is the leader in the school community to oversee school health policies and programs. The school nurse serves in a pivotal role to provide expertise and oversight for the provision of school health services and promotion of health education. Using clinical knowledge and judgment, the school nurse provides health care to students and staff, performs health screenings, and coordinates referrals to the medical home or private health care provider. The school nurse serves as a liaison between school personnel, family, community and healthcare providers to advocate for health care and a healthy school environment (American Nurses Association & National Association of School Nurses, 2011).

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community.

What is FERPA?

What is HIPAA?

How do FERPA and HIPAA affect school health privacy?

What unique health concerns might young people have that differentiate them from adults?

Directions

Create a 6–8-slide PowerPoint presentation that examines the privacy issues unique to nurses serving the high-school age population. Address the following:

Describe the types of health and wellness issues that can affect adolescents in their high-school years. Be sure you think beyond the usual things and really research the types of issues that are affecting young people today.

Explain how privacy laws can impact the school nurse in regard to patient safety and health outcomes for adolescents.

Explain how privacy laws benefit the student, the school, and the school nurse.

Recommend two specific evidence-based ethical strategies regarding health and wellness privacy communications in a school environment.

Use the notes section of each slide to expand your points and cite your supporting evidence. Also, include a title slide and a reference slide that lists the resources you used in this assessment.

Be creative. Consider your intended audience.

The advantages and disadvantages of using smartphones and social media in healthcare

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NR360 INFORMATION SYSTEMS IN HEALTHCARE

Required Uniform Assignment: We Can, but Dare We?

PURPOSE The purpose of this assignment is to investigate smartphone and social media use in healthcare and to

apply professional, ethical, and legal principles to their appropriate use in healthcare technology.

Course Outcomes This assignment enables the student to meet the following course outcomes.

• CO #4: Investigate safeguards and decision‐making support tools embedded in patient

care technologies and information systems to support a safe practice environment for

both patients and healthcare workers. (PO 4)

• CO #6: Discuss the principles of data integrity, professional ethics, and legal

requirements related to data security, regulatory requirements, confidentiality, and

client’s right to privacy. (PO 6)

• CO #8: Discuss the value of best evidence as a driving force to institute change in the

delivery of nursing care (PO 8)

DUE DATE See Course Schedule in Syllabus. The college’s Late Assignment Policy applies to this activity.

TOTAL POINTS POSSIBLE This assignment is worth a total of 240 points.

Requirements 1. Research, compose, and type a scholarly paper based on the scenario described below, and

choose a conclusion scenario to discuss within the body of your paper. Reflect on lessons

learned in this class about technology, privacy concerns, and legal and ethical issues and

addressed each of these concepts in the paper, reflecting on the use of smartphones and social

media in healthcare. Consider the consequences of such a scenario. Do not limit your review of

the literature to the nursing discipline only because other health professionals are using the

technology, and you may need to apply critical thinking skills to its applications in this scenario.

2. Use Microsoft Word and APA formatting. Consult your copy of the Publication Manual of the

American Psychological Association, sixth edition, as well as the resources in Doc Sharing if you

have questions (e.g., margin size, font type and size (point), use of third person, etc.). Take

NR360 INFORMATION SYSTEMS IN HEALTHCARE

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advantage of the writing service SmartThinking, which is accessed by clicking on the link called

the Tutor Source, found under the Course Home area.

3. The length of the paper should be four to five pages, excluding the title page and the reference

page. Limit the references to a few key sources (minimum of three required).

4. The paper will contain an introduction that catches the attention of the reader, states the

purpose of the paper, and provides a narrative outline of what will follow (i.e., the assignment

criteria).

5. In the body of the paper, discuss the scenario in relation to HIPAA, legal, and other regulatory

requirements that apply to the scenario and the ending you chose. Demonstrate support from sources of evidence (references) included as in‐text citations.

6. Choose and identify one of the four possible endings provided for the scenario, and construct

your paper based on its implications to the scenario. Make recommendations about what should

have been done and what could be done to correct or mitigate the problems caused by the

scenario and the ending you chose. Demonstrate support from sources of evidence (references)

included as in‐text citations.

7. Present the advantages and disadvantages of using smartphones and social media in healthcare

and describe professional and ethical principles to the appropriate use of this technology, based

on facts from supporting sources of evidence, which must be included as in‐text citations.

8. The paper’s conclusion should summarize what you learned and make reflections about them to

your practice.

9. Use the “Directions and Assignment Criteria” and “Grading Rubric” below to guide your writing

and ensure that all components are complete.

10. Review the section on Academic Honesty found in the Chamberlain Course Policies. All work

must be original (in your own words). Papers will automatically be submitted to TurnItIn when

submitted to the Dropbox.

11. Submit the completed paper to the “We Can, but Dare We?” Dropbox by the end of Week 3.

Please refer to the Syllabus for due dates for this assignment. For online students, please post

questions about this assignment to the weekly Q & A Forums so that the entire class may view

the answers.

Preparing for the Assignment

BACKGROUND Healthcare is readily embracing any technology to improve patient outcomes, streamline operations,

and lower costs, but we must also consider the impact of such technology on privacy and patient care.

This technology includes the use of social media applications, such as Facebook, Instagram, MySpace,

Twitter, and LinkedIn on smartphones.

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In healthcare today, smartphones are widely used for communication, efficiency, and care. Obviously, a

variety of issues (ethical, professional, and legal) from both the personal and hospital perspectives

must be considered. SCENARIO

You are a nurse in the emergency room, working the Friday 7 p.m. to 7 a.m. shift, and your evening has

been filled with the usual mix of drunken belligerent teens, wailing babies, chronic obstructive

pulmonary disease (COPD) exacerbations, falls, fractures, and the routine, regular congestive heart

failure (CHF) patients. Your best friend is texting you from the concert that you had to miss tonight

because you were scheduled to work, and you respond to her between care of patients, jealous that she

is there and you are not. “What a jerk to torture me like this!” you think to yourself.

It is now 2 a.m., and the medics radio once again, notifying you of an incoming motor vehicle accident

victim, ETA of 5 minutes. You sigh and opt to use the restroom, rather than getting that much‐needed

cup of coffee, and prepare a room for your next patient. The medics roll in and begin to fill you in. The

patient is a 28‐year‐old male, a passenger on a bus that was involved in a crash, leaving the vehicle

overturned after rolling over an embankment. There were several fatalities among the bus passengers,

and “this victim has remained unconscious, though his vitals are currently” . . . and as you start to focus

on the patient, you take a second look. Can it be? It is! The lead singer, Jerod, from the band “Blue

Lizards,” who you have adored since you first heard his voice! The band had just left the concert that

you had missed last evening when the accident occurred. You quickly text your best friend . . . “Can you

believe?” and she responds with “Yeah, right. PROVE IT.” So you quickly snap a picture with your

smartphone, when alone with the patient, and send it to her. Can’t hurt, right? Celebrities are “public

property,” and that’s a part of their life, right? Just for good measure, you snap a few more pictures of

the unconscious singer in various stages of undress and then a shot of his home address, phone number,

and demographic information from his electronic health record. You sit your phone down on the

bedside table for a minute as you continue your assessment of the patient.

At 7:00 a.m., you drag your tired body home and straight to bed after a long but eventful night.

What happens next? Choose an ending to the scenario, and construct your paper based on those

reflections:

1. You are the following nurse on the day shift and discover the night nurse’s phone on the bedside

table. While trying to figure out to whom it belongs, you open the phone and see the

photographs taken the night before. Holy moly! What a find, and nobody could trace you to the

photos.

2. You receive a call from the gossip paper the Gossip Gazette, offering you $20,000 for the photos

you have taken (courtesy of your best friend). Your identity would never be revealed, and you

desperately need a new car and are behind on some bills.

3. You go on Facebook, on your day off, and talk about the night you had at work and how you

didn’t really feel as bad having to miss the concert, because you actually got to meet Jerod in

person and even “Got his number!” You then post a picture of Jerod on Facebook and

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Instagram, figuring that most of your contacts would never recognize him anyway. It’s your day

off and your personal time, so no harm, no foul, right?

4. You receive a message the next morning from a peer at work that there is a big investigation

being conducted at work due to a HIPAA violation and that it involved a celebrity who had been

admitted to the hospital. The word is that legal action is being taken against the hospital due to

some photos that were sold to the Gossip Gazette. Knowing that the photo you sent is safe with

your best friend, you reach for your smartphone, but it is nowhere to be found.

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Directions and Assignment Criteria

Assignment Criteria Points % Description

Introduction 40

points 40 17%

Catches the attention of the reader States

the purpose of the paper

Provides a narrative outline of the paper (i.e., the assignment criteria).

HIPAA, Legal, & Regulatory Discussion 40 points

40 17% Discussion the following as they apply to the use of cellphones and social media in healthcare: o

HIPAA/regulatory requirements o Other legal requirements appropriate to the

use of this technology Demonstrate support from sources of evidence

included as in‐text citations.

Scenario Ending & Recommendations

50 points

50 21%

Choose and identify one of the four possible endings provided for the scenario. Make recommendations about what should have been

done and what could be done to correct or mitigate

the problems caused by the scenario and the ending

you chose. Demonstrate support from sources of evidence

included as in‐text citations.

Advantages and Disadvantages

50 points

50 21% Discuss at least two (2) advantages and two (2) disadvantages of using smartphones and social media

in healthcare

Describe professional and ethical principles to the appropriate use of this technology

Demonstrate support from sources of evidence included as in‐text citations.

Conclusion and Reflections

30 points 30 12%

Summarize what you learned Make reflections about lessons learned to your

practice.

Scholarly Writing and APA Format

30 points

30 12%

Title page, running head, & page numbers are correct.

Use Microsoft Word and APA (6th ed.) formatting Length is 4‐5 pages (excludes title & reference pages).

At least 3 references are used, listed in APA format

References match in text citations in APA format

Spelling, grammar, & mechanics are correct.

Total 240 100%

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Grading Rubric

Assignment

Criteria Outstanding or Highest Level of Performance

A (92–100%)

Very Good or High Level of

Performance

B (84–91%)

Competent or Satisfactory

Level of Performance

C (76–83%)

Poor, Failing or

Unsatisfactory Level of

Performance F

(0–75%)

Introduction 40

points The student catches the reader’s attention, states the paper’s purpose, and provides a narrative outline of the paper’s body.

35–40 points

One of the following is missing or inadequate: attention‐catching statement(s), paper’s purpose, or a narrative outline of the paper’s body.

30–34 points

Two of the following are missing or inadequate: attention‐catching statement(s), paper’s purpose, or a narrative outline of the paper’s body.

26–29 points

Three of the following are missing or inadequate: attention‐catching statement(s), paper’s purpose, or a narrative outline of the paper’s body.

0–25 points

HIPAA, Legal, & Regulatory Discussion 40 points

The discussion of the following as they apply to the use of cellphones and social media in healthcare, is thoroughly addressed:

• HIPAA/regulatory requirements

• Other legal requirements appropriate to the use of this technology

Demonstrated support from sources of evidence included as intext citations.

35–40 points

The discussion of the following as they apply to the use of cellphones and social media in healthcare, is lacking in one or more component:

• HIPAA/regulatory requirements

• Other legal requirements appropriate to the use of this technology

or Support is not demonstrated adequately from sources of evidence included as in‐text citations.

30–34 points

The discussion of the following as they apply to the use of cellphones and social media in healthcare, is lacking in one or more component:

• HIPAA/regulatory requirements

• Other legal requirements appropriate to the use of this technology

and Support is not demonstrated adequately from sources of evidence included as in‐text citations.

26–29 points

The discussion of the following as they apply to the use of cellphones and social media in healthcare, is lacking both components: • HIPAA/regulatory requirements • Other legal requirements appropriate to the use of this technology

and Support is not demonstrated adequately from sources of evidence included as in‐text citations.

0–25 points

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Scenario Ending & Recommendations

50 points

Included all of the following elements sufficiently: • Identify one of the four possible

endings provided for the scenario.

Included all of the following elements but did not develop at least one area substantively : • Identify one of the four possible

endings provided for the scenario.

Included all of the following

elements but did not develop at

two or more area substantively : •

Identify one of the four possible

endings provided for the scenario.

Did not included the following elements substantively : • Identify one of the four possible

endings provided for the scenario.

• Made recommendations about what should have been done. • Made recommendations about what could be done to correct or mitigate the problems caused by the scenario and the ending chosen. • Demonstrated support from sources of evidence included as intext citations.

45‐50 points

• Made recommendations about what should have been done. • Made recommendations about what could be done to correct or mitigate the problems caused by the scenario and the ending chosen. Or • Did not demonstrated support from sources of evidence included as in‐text citations.

40‐44 points

• Made recommendations about what should have been done. • Made recommendations about what could be done to correct or mitigate the problems caused by the scenario and the ending chosen. Or • Did not demonstrated support from sources of evidence included as in‐text citations.

36‐39 points

• Made recommendations about what should have been done. • Made recommendations about what could be done to correct or mitigate the problems caused by the scenario and the ending chosen. Or • Did not demonstrated support from sources of evidence included as in‐text citations.

0‐35 points

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Advantages and Disadvantages

50 points

Met all of the following criteria: • Discussed at least two (2) advantages and two (2) disadvantages of using smartphones and social media in healthcare • Described professional and ethical principles to the appropriate use of this technology • Demonstrated support from sources of evidence included as intext citations.

45‐50 points

Did not meet one of the following criteria: • Discussed at least two (2) advantages and two (2) disadvantages of using smartphones and social media in healthcare • Described professional and ethical principles to the appropriate use of this technology • Demonstrated support from sources of evidence included as intext citations.

40‐44 points

Did not meet two or more of the following criteria: • Discussed at least two (2) advantages and two (2) disadvantages of using smartphones and social media in healthcare • Described professional and ethical principles to the appropriate use of this technology • Demonstrated support from sources of evidence included as intext citations.

36—39 points

Did not meet Three or more of the following criteria: • Discussed at least two (2) advantages and two (2) disadvantages of using smartphones and social media in healthcare • Described professional and ethical principles to the appropriate use of this technology • Demonstrated support from sources of evidence included as intext citations.

0‐35 points

Conclusion and Reflections 30 points

Met the following criteria substantively: • Summarized what you learned • Made reflections about lessons learned to your practice.

25‐30 points

Did not meet at least one of the following criteria substantively: • Summarize what you learned • Make reflections about lessons learned to your practice.

20‐24 points

Did not meet either of the following criteria substantively: • Summarize what you learned • Make reflections about lessons learned to your practice.

16‐19 points

Did not include a formal conclusion paragraph

0–15 points

Scholarly Writing and APA Format

30 points

The following

points

• 6 points

are achieved by successful implementation of each scholarly writing/APA element:

Title page, running head, & page numbers are correct.

• 4 points Use Microsoft Word and APA (6th ed.) formatting

• 2 point Length is 4‐5 pages (excludes title & reference pages).

• 6 points At least 3 references are used, listed in APA format

• 6 points References match in text citations in APA format

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• 4 points Spelling/mechanics & grammar are correct.

• 2 point Scholarly writing style is used

Total Points Possible = /240 Points

Diary Of Medical Mission Trip

Throughout this course, you have viewed the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions:

Propose one example of a nursing intervention related to the disaster from each of the following levels: primary prevention, secondary prevention, and tertiary prevention. Provide innovative examples that have not been discussed by a previous student.

Under which phase of the disaster do the three proposed interventions fall? Explain why you chose that phase.

With what people or agencies would you work in facilitating the proposed interventions and why?

Assessing the Ears, Nose, and Throat

Discussion: Assessing the Ears, Nose, and Throat

Most ear, nose, and throat conditions that arise in non-critical care settings are minor in nature. However, subtle symptoms can sometimes escalate into life-threatening conditions that require prompt assessment and treatment. Nurses conducting assessments of the ears, nose, and throat must be able to identify the small differences between life-threatening conditions and benign ones. For instance, if a patient with a sore throat and a runny nose also has inflamed lymph nodes, the inflammation is probably due to the pathogen causing the sore throat rather than a case of throat cancer. With this knowledge and a sufficient patient health history, a nurse would not need to escalate the assessment to a biopsy or an MRI of the lymph nodes, but would probably perform a simple strep test.

In this Discussion, you consider case studies of abnormal findings from patients in a clinical setting. You determine what history should be collected from the patients, what physical exams and diagnostic tests should be conducted, and formulate a differential diagnosis with several possible conditions.

Note: By Day 1 of this week, your Instructor will have assigned you to one of the following specific case studies for this Discussion. Also, your Discussion post should be in the Episodic/Focused SOAP Note format, rather than the traditional narrative style Discussion posting format. Refer to Chapter 2 of the Sullivan text and the Episodic/Focused SOAP Template in the Week 5 Learning Resources for guidance. Remember that all Episodic/Focused SOAP notes have specific data included in every patient case.

Case 1: Nose Focused Exam

Richard is a 50-year-old male with nasal congestion, sneezing, rhinorrhea, and postnasal drainage. Richard has struggled with an itchy nose, eyes, palate, and ears for 5 days. As you check his ears and throat for redness and inflammation, you notice him touch his fingers to the bridge of his nose to press and rub there. He says he’s taken Mucinex OTC the past two nights to help him breathe while he sleeps. When you ask if the Mucinex has helped at all, he sneers slightly and gestures that the improvement is only minimal. Richard is alert and oriented. He has pale, boggy nasal mucosa with clear thin secretions and enlarged nasal turbinates, which obstruct airway flow but his lungs are clear. His tonsils are not enlarged but his throat is mildly erythematous.

Case 2: Focused Throat Exam

Lily is a 20-year-old student at the local community college. When some of her friends and classmates told her about an outbreak of flu-like symptoms sweeping her campus over the past two weeks, Lily figured she shouldn’t take her three-day sore throat lightly. Your clinic has treated a few cases similar to Lily’s. All the patients reported decreased appetite, headaches, and pain with swallowing. As Lily recounts these symptoms to you, you notice that she has a runny nose and a slight hoarseness in her voice but doesn’t sound congested.

Case 3: Focused Ear Exam

Martha brings her 11-year old grandson, James, to your clinic to have his right ear checked. He has complained to her about a mild earache for the past two days. His grandmother believes that he feels warm but did not verify this with a thermometer. James states that the pain was worse while he was falling asleep and that it was harder for him to hear. When you begin basic assessments, you notice that James has a prominent tan. When you ask him how he’s been spending his summer, James responds that he’s been spending a lot of time in the pool.

To prepare:

With regard to the case study you were assigned:

· Review this week’s Learning Resources and consider the insights they provide.

· Consider what history would be necessary to collect from the patient.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least 5 possible conditions that may be considered in a differential diagnosis for the patient.

Note: Before you submit your initial post, replace the subject line (“Week 5 Discussion”) with “Review of Case Study _,” identifying the number of the case study you were assigned.

Post an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.