American Red Cross Assignment

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American Red Cross Assignment

Instructions

-Research THE AMERICAN RED CROSS. Determine how the organization or agency contributes to public health and safety improvements, promotes equal opportunity, and improves the quality of life within the community.

-Submit your findings in a APA 3–5-page report.

Graded Requirements The research requirements, outlined below, correspond to the grading criteria in the assessment scoring guide, so be sure to address each point.

  • Explain how the organization’s mission and vision enable it to contribute to public health and safety improvements.
  • Include examples of ways a local and/or global initiative supports organizational mission and vision and promotes public health and safety. American Red Cross Assignment

o Evaluate an organization’s ability to promote equal opportunity and improve the quality of life in the community.

  • Consider the effects of social, cultural, economic, and physical barriers.

o Assess the impact of funding sources, policy, and legislation on the organization’s provision of services.

  • Consider the potential implications of funding decisions, policy, and legislation for individuals, families, and aggregates within the community.

o Explain how an organization’s work impacts the health and/or safety needs of a local community. · Consider how nurses might become involved with the organization.

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Please pick at least 3 references from below

References

Diversity, equity & inclusion. (2022). American Red Cross. https://www.redcross.org/about-us/who-we-are/governance/corporate-diversity.html

Harris, M. D. (2018). Power in the blood. Journal of Christian Nursing, 35(2), 120–123. https://doi.org/10.1097/cnj.0000000000000476

Health & safety training. (2022). American Red Cross. https://www.redcross.org/about-us/our-work/training-education.html

International services. (2022). American Red Cross. https://www.redcross.org/about-us/our-work/international-services.html

Mission & values. (2022). American Red Cross. https://www.redcross.org/about-us/who-we-are/mission-and-values.html

Our federal charter. (2022). American Red Cross. https://www.redcross.org/about-us/who-we-are/history/federal-charter.html

Our history. (2022). American Red Cross. https://www.redcross.org/content/dam/redcross/National/history-full-history.pdf

Sound the alarm. (2022). American Red Cross. https://www.redcross.org/sound-the-alarm.html American Red Cross Assignment

 

Rough Draft Quantitative Research Critique And Ethical Considerations

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Research Critique Guidelines – Part II

Quantitative Studies

Background

  1. Summary of studies. Include problem, significance to nursing, purpose, objective, and research question.

How do these two articles support the nurse practice issue you chose?

  1. Discuss how these two articles will be used to answer your PICOT question.
  2. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question.

Method of Study:

  1. State the methods of the two articles you are comparing and describe how they are different.
  2. Consider the methods you identified in your chosen articles and state one benefit and one limitation of each method.

Results of Study

  1. Summarize the key findings of each study in one or two comprehensive paragraphs.
  2. What are the implications of the two studies you chose in nursing practice? Rough Draft Quantitative Research Critique And Ethical Considerations

Outcomes Comparison

  1. What are the anticipated outcomes for your PICOT question?
  2. How do the outcomes of your chosen articles compare to your anticipated outcomes?

Clinic issue: pressure ulcer (pressure injury)

An Ulcer of Pressure is a localized injury to the skin and underlying tissue, usually over a bony prominence, as a result of pressure alone or pressure in conjunction with shear (Dorner et al., 2009). Today, pressure ulcers rank third in terms of cost after cancers and cardiovascular diseases. This disease has a mortality rate of two to six times higher than most other diseases, with 60,000 deaths occurring every year due to this complication(Schindler et al., 2011). Inpatients are more susceptible to pressure ulcers in the tissues of the extremities and in bony extensions such as the sacrum and heel. Pressure ulcers are most often caused by low physical activity, decreased consciousness, urinary and fecal incontinence, malnutrition, and advanced age (Afzali Borojeny et al., 2011).

In the United States, pressure ulcers are estimated to cause about 2.5 million hospitalizations (Kottner & Dassen, 2010). Pressure ulcers can result in pain, reduced autonomy, increased infection and sepsis risks, more surgical procedures, long hospital stays, and higher costs for patients, families, and health care systems (Stinson et al., 2013). In addition to physical-social and self-care dysfunction, pressure ulcer patients may also experience several complications such as depression, pain, topical infection, osteomyelitis, sepsis, and even death (Senmar et al., 2017).

Despite advances in medicine, pressure ulcers remain one of the most common medical problems. There is currently no consensus on the risk factors of pressure ulcers, so identifying them is the first step in preventing an increase in their incidence (Donnelly et al., 2011). The development of counseling and prevention systems for pressure ulcers in the USA and Europe has become so important because pressure ulcers pose a major concern for patients and healthcare providers(Reddy, Gill, & Rochon, 2006).

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PICOT Question

Population: patients who have developed pressure ulcer

The intervention of interest: patients who utilize pressure ulcer prevention strategies

Comparison: patients who are not been used pressure ulcer strategyies

Outcome: better or faster wound healing

Time: in the monitoring phase.

 

 

 

Criteria Article 1 Article 2 Article 3
APA-Formatted Article Citation with Permalink  Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing Pressure Ulcers: A Systematic Review. JAMA, 296(8), 974.doi:10.1001/jama.296.8.974 McInnes, E., Jammali-Blasi, A., Bell-Syer, S. E., Dumville, J. C., Middleton, V., & Cullum, N. (2015). Support surfaces for pressure ulcer prevention. Cochrane Database of Systematic Reviews.doi:10.1002/14651858.cd001735 Schindler, C. A., Mikhailov, T. A., Kuhn, E. M., Christopher, J., Conway, P., Ridling, D., … Simpson, V. S. (2010). Protecting Fragile Skin: Nursing Interventions to Decrease Development of Pressure Ulcers in Pediatric Intensive Care. American Journal of Critical Care, 20(1), 26–35.doi:10.4037/ajcc2011754

 

 
How Does the Article Relate to the PICOT Question? This article is relevant to general pressure ulcer prevention strategyies among patients who suffer pressure ulcers The aim of this systematic review is to determine the extent to which pressure-relieving support surfaces reduce the incidence of pressure ulcers compared to standard support surfaces, as well as their comparative effectiveness in ulcer prevention. Rough Draft Quantitative Research Critique And Ethical Considerations This article is relevant to determine nursing strategies associated with a lower incidence of pressure ulcers.

 

 

 

 

 
Quantitative, Qualitative (How do you know?)                          methodological quality of randomized control trial                          Randomised controlled trials (RCTs) and quasi-randomised trials

 

  

Randomized clinical trial                                     multivariate logistic regression models

 

 

 

 
Purpose Statement To systematically review the evidence examining interventions to pre- vent pressure ulcers. To review which material of mattress or supportive surface can help relieve pressure ulcer To determine effective interventions associated with low pressure ulcer incident
Research Question  Studies assessed three categories of interventions, namely those that addressed impairments of mobility, nutrition, and skin health.

 

 People at high risk of developing pressure ulcers should use higher-specification foam mattresses rather than standard hospital foam mattresses.

 

 

 

 Effective nursing care with targeted interven- tions can reduce the incidence of pressure ulcers.

 

 

 

 

 
Outcome Examed difference approaches: reposition on the special mattress, incontinence care, skin care, nutritional supplement all benefit for decrease or prevention  pressure ulcer

 

 higher-specification foam mattresses show more evidence to prevent pressure injury In this multisite study, we focused on determining the incidence of pressure ulcers among critically ill and injured infants and children, comparing the characteristics of patients with and without pressure ulcers, and identifying prevention strategies associated with fewer pressure ulcers.

 
Setting

(Where did the study take place?)

 Participants  from acute care, long term care,  rehab, and mixed setting

 

 

 Participants who have hight risk of pressure ulcer or some of them have pressure ulcer In PEDs ICU
Sample The 59 selected studies enrolled a total of 13 845 patients: 9397 (67.9%) in acute care, 2367 (17.1%) in LTC, 333 (2.4%) in re- habilitation, and 1748 (12.6%) in mixed settings People receiving health care who were deemed to be at risk of developing pressure ulcers, in any setting, total of included trials to 59 , in comparison 1, participant including

2407

 

 

 

 

 

 

 

 5346 patients in pediatric inten- sive care units in whom pressure ulcers did and did not develop were compared
Method Based on whether the intervention being evaluated addressed mobility, nutrition, or skin health impairments, RCTs were divided into three categories.

 

 Randomised controlled trials (RCTs) and quasi-randomised trials .

Trials that evaluated the following interventions included:

1. “Low-tech” CLP support surfaces

2. “High-tech” support surfaces

3. Other support surfaces

 

 

 The 29 separate preventive measures evaluated in this way were entered into the multivariate logistic regression models described above in order to determine which preventive measures had the greatest influence on pressure ulcer development..

 
Key Findings of the Study  Re-position on the special mattress, skincare, nutritional supple all affectively reduce incident happen High special supportive surface show show more benefit for preventing pressure ulcer Infants and chil- dren sink into low–air loss beds and specialty beds in turning mode, increasing occipital friction and shearing. Pressure ulcers were more likely in children who remained in the pediatric intensive care unit at least 4 days

Some of the pressure ulcers in our patients were related to devices.

Strategies associated with less frequent development of pressure ulcers included use of specialty beds, egg crates, foam overlays, gel pads, dry-weave diapers, urinary catheters, disposable under-pads, body lotion, nutrition consultations, change in body position every 2 to 4 hours, blanket rolls, foam wedges, pillows, and draw sheets
Recommendations of the Researcher The in-complete reporting in the RCTs may have influenced our assessment.  In future studies, the interventions required to prevent pressure ulcers specifically among high-risk populations should be defined. There are several risk factors for pressure ulcers, including being bedridden or chairbound, being unable to reposition without assistance, difficulty ambulating, history of stroke, fecal incontinence (which is highly related to immobility), low body weight, lymphopenia, difficulty feeding independently, impaired nutritional intake, nonblanchable erythema of intact skin (ie, stage 1 pressure ulcer), and dry sacrum. The study also found that people who used sheepskin overlays for their mattresses tended to develop fewer pressure ulcers. In contrast to high-specification constant low-pressure or alternating-pressure support surfaces, there is little evidence that alternating-pressure mattresses can prevent pressure ulcers more effectively than alternating-pressure overlays. These patients may benefit from targeted nursing interventions to reduce pressure ulcers. We plan to conduct a prospective randomized clinical trial to confirm that specific nursing interventions improve outcomes.  During the study, critical care nurses will have access to a set of interventions that can significantly reduce pressure ulcer risk in critically ill children and infants

 

Criteria Article 4 Article 5 Article 6
APA-Formatted Article Citation with Permalink  Medical Advisory Secretariat (2009). Community-based care for chronic wound management: an evidence-based analysis. Ontario health technology assessment series, 9(18), 1–24. Lavallée, J. F., Gray, T. A., Dumville, J., & Cullum, N. (2019). Preventing pressure ulcers in nursing homes using a care bundle: A feasibility study. Health & social care in the community, 27(4), e417–e427. https://doi.org/10.1111/hsc.12742 Soban, L. M., Kim, L., Yuan, A. H., & Miltner, R. S. (2017). Organisational strategies to implement hospital pressure ulcer prevention programmes: findings from a national survey. Journal of nursing management, 25(6), 457–467. https://doi.org/10.1111/jonm.12416
How Does the Article Relate to the PICOT Question? Managing pressure ulcers with a multidisciplinary wound care team significantly increases wound healing Assessed pressure ulcer prevention strategies in nursing home Programs designed to prevent pressure ulcers include nursing interventions such as risk assessments, as well as organizational strategies such as policies and performance monitoring to embed these interventions into routine care. Rough Draft Quantitative Research Critique And Ethical Considerations
Quantitative, Qualitative (How do you know?) Randomized controlled trials and Controlled clinical Trials Quantitative and qualitative data were analyzed using descriptive statistics A cross-sectional survey ,Descriptive statistics
Purpose Statement To determine the effectiveness of a multidisciplinary wound care team for the management of chronic wounds.  To determine, the implementation bundle effective on pressure ulcer To describe the presence and operationalization of organizational strategies to support implementation of pressure ulcer prevention programs across acute care hospitals in a large, integrated healthcare system.

 

 
Research Question  Multidisciplinary team can help manage Chronic wounds assessed the feasibility of implementing our pressure ulcer prevention care bundle in a nursing home setting.

 

 Assess the presence and operationalization of organizational strategies to support implementation of pressure ulcer
Outcome The percentage of persons and/or wounds completely healed. Reduction in healing time, improved quality of life, and pain management.

 

 

 According to this study, a pressure ulcer prevention bundle is acceptable to nursing home staff and can improve care provision. Participants reported an increase in their motivation to provide more comprehensive care.

 

 Organizational strategies that support pressure ulcer prevention program implementation (policy, oversight committee, wound care specialist, staff education, performance data, and performance improvement activities) were reported at high levels
Setting

(Where did the study take place?)

 Nursing home Nursing home hospitals

 

 
Sample Population includes persons with pressure ulcers (anywhere) and/or leg and foot ulcers

In 2007, control Group 119, experimental  127.

Harrison et al, 2005: before 78, after 180

Vu et al, 2007 : 176 residents (342 wounds)

 

 collected data for 462 resident bed days prior to implementing the bundle; collected data for 1,181 resident bed days during the intervention phase achieved 97% response rate (N=116/120)

 

 
Method Randomized controlled trials and Controlled Clinical Trials (CCT), The intervention includes a multidisciplinary (two or more disciplines) wound care team, The control group does not receive care by a wound care team

 

 

 For 5 weeks before implementing the bundle, we collected quantitative data on nursing home staff pressure ulcer prevention behaviors, as well as pressure ulcer incidence rates. After implementation, we collected data for an additional 9 weeks.

The bundle comprised three evidence-based elements: support surfaces, skin inspection, repositioning

 

 A cross-sectional survey of key informants at all VHA acute care hospitals was conducted via email to assess pressure ulcer prevention programs. Surveys were sent to 124 nurse leaders
Key Findings of the Study Using a multidisciplinary wound care team, we’ve been able to reduce the pain and the need for daily wound care. And significantly increases wound healing Before the implementation of this period, five new pressure ulcers were recorded, and repositioning was the only documented way to prevent pressure ulcers.

Following implementation, no new pressure ulcers developed. Documented prevention strategies included repositioning, skin inspection, and checking support surfaces.

 For the year October 1, 2013 to September 31, 2014, the aggregated mean HAPU rate for acute care hospital medical/surgical units was 1.02% (range 0–3.1%)

 

 

 

 
Recommendations of the Researcher Evidence for these outcomes is low to very low, so further research will likely have a big impact on how confident we are in the estimate of effect. Further research is needed to enhance adherence and/or documentation to further investigate a bundle’s potential for preventing pressure ulcers in nursing homes.In spite of low completion rates of the bundle (or the documentation of this), feedback from participants indicates that the bundle was easy to follow, facilitated continuity of care, and resulted in comprehensive pressure ulcer prevention. Nurse leaders and committees and quality improvement teams play important roles in operationalizing patient safety initiatives such as pressure ulcer prevention.

 

Reference

Afzali Borojeny, L., Albatineh, A. N., Hasanpour Dehkordi, A., & Ghanei Gheshlagh, R. (2020). The Incidence of Pressure Ulcers and its Associations in Different Wards of the Hospital: A Systematic Review and Meta-Analysis. International journal of preventive medicine, 11, 171. https://doi.org/10.4103/ijpvm.IJPVM_182_19

Dorner BD, Posthauer ME, Thomas D. European Pressure Ulcer Advisory Panel and National Pressure Ulcer Advisory Panel. Role of Nutrition in Pressure Ulcer Healing Clinical Practice Guideline. 2009

Donnelly, J., Winder, J., Kernohan, W. G., & Stevenson, M. (2011). An RCT to determine the effect of a heel elevation device in pressure ulcer prevention post-hip fracture. Journal of wound care, 20(7), 309–318. https://doi.org/10.12968/jowc.2011.20.7.309

Kottner, J., & Dassen, T. (2010). Pressure ulcer risk assessment in critical care: interrater reliability and validity studies of the Braden and Waterlow scales and subjective ratings in two intensive care units. International journal of nursing studies, 47(6), 671–677. https://doi.org/10.1016/j.ijnurstu.2009.11.005

Reddy, M., Gill, S. S., & Rochon, P. A. (2006). Preventing pressure ulcers: a systematic review. JAMA, 296(8), 974–984. https://doi.org/10.1001/jama.296.8.974

Schindler CA, Mikhailov TA, Kuhn EM, Christopher J, Conway P, Ridling D, Scott AM, Simpson VS Am J Crit Care. 2011 Jan; 20(1):26-34; quiz 35.

Stinson, M., Gillian, C., & Porter-Armstrong, A. (2013). A literature review of pressure ulcer prevention: weight shift activity, cost of pressure care and role of the OT. British Journal of Occupational Therapy, 76(4), 1-10.

 

 

Senmar, M., Azimian, J., Rafiei, H., Habibollahpour, M., & Yousefi, F. (2017). The incidence of pressure ulcer in old patients undergoing open heart surgery and the relevant factors. Journal of Preventive Epidemiology, 2(2), e15-e15. Rough Draft Quantitative Research Critique And Ethical Considerations

 

 

 

 

 

The concept of population health management and what is needed to succeed in this environment

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Groups 1 and 3 will present Case 1 on 09/20/2018. All groups will be required to turn in a position brief. For the position brief, please answer the nine questions listed below. Please include the questions with the brief. When answering the questions, please ensure to use all information given to the class as a reference. For the questions requiring external research, please ensure to cite the information.  The group presentation should be between 20-25 minutes. The presenting group will be required to provide at least four PowerPoint slides. One set of slides are to be given to the professor and the other three are to be distributed among the other groups. When presenting, business casual attire will be required. Non-business casual attire will result in a reduction of points. Please have the group leader submit an electronic copy of the brief [as a word document (.doc/.docx)] and (when applicable) the PowerPoint slides under the Tests and Quizzes section on blackboard by 11:59 PM Monday (09/24/2018).

1: Please provide a detailed summary of the case. Please ensure to include and discuss all relevant material .

2: Please discuss at least four challenges facing inner city urban hospitals today (external research from respectable sources is required to answer this question) .

3: Please discuss the policy associated with the formation of 501C3 hospitals and the rationale associated with their existence. In addition, please discuss the community benefit obligations under the PPACA and how it may relate to Summit Regional Hospital (external research from respectable sources are required to answer this question) .

4: Please discuss the concept of population health management and what is needed to succeed in this environment (external research from respectable sources are required to answer this question) .

5: Please perform a SWOT (strengths, weaknesses, opportunities and threats) analysis on Summit Regional. Identify and explain at least four points for each category (please ensure to use information provided in the case to support your answer) .

6:  Please illustrate and discuss all of the steps in the Evidence Based Management (EBM) model to analyze three overall problems and arrive at three specific evidence based solutions.  Please analyze the solutions separately and use a table/chart to organize/explain the points in the mode and also ensure to use information provided in the case to support your answer . 

7: Please rank and explain the three evidence based solutions from most likely to implement to least likely to implement .

8: Please specifically identify how your group will implement the chosen solution and then identify how you will evaluate the effectiveness (impact) of the solution . 

9: Please identify at least three examples of courses (taken during the HCA program), which were most applicable in helping to apply the material in the case. Please ensure to explain why these courses were chosen .

Patient And Family Engagement During A Pandemic

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Reflective Journal Guide

  1. PATIENT –CENTERED CARE
Definition: Recognize the patient or designee as the source of control and full partner in providing compassionate and coordinated care based on respect for patient’ preferences, values, and needs.
Select one of the following statements to discuss Patient-Centered Care:

  1. Describe how diverse cultural, ethnic and social background function as sources of patient family, and community values.
  2. Describe how you demonstrated comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort?
  3. Describe strategies to empower patients or families in all aspects of the health care process.

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  1. TEAMWORK AND COLLABORATION
Definition: Function effectively within nursing and inter-professional teams, fostering open communication, mutual respect and shared decision-making to achieve quality patient care.
Select one of the following statements to discuss Teamwork and Collaboration:

  1. Describe own strengths, limitations, and values in functioning as a member of a team.
  2. Recognize contributions of other individuals and groups in helping patient/family achieve health goals.
  3. Describe examples of the impact of team functioning on safety and quality of care. Patient And Family Engagement During A Pandemic
  1. EVIDENCED-BASED PRACTICE (EBP)
Definition: Integrate best current evidence with clinical expertise and patient/family preferences and values for delivery of optimal health care.
Select one of the following statements to discuss Evidenced-based practice:

  1. Base individualized care plan on patient values, clinical expertise and evidence.
  2. Question rationale for routine approaches to care that result in less-than-desired outcomes or adverse events.
  3. Differentiate clinical opinion from research and evidence summaries.
  1. QUALITY IMPROVEMENT (QI)
Definition: Use data to monitor the outcomes of care processes and use improvement methods to design and est changes to continuously improve the quality and safety of health care systems.
Select one of the following statements to discuss Quality Improvement:

  1. Describe approaches for changing processes of care.
  2. Appreciate that continuous quality improvement is an essential part of the daily work of all health professionals.
  3. Recognize that nursing and other health professions students are parts of systems of care and care processes that affect outcomes for patients and families.
  1. SAFETY
Definition: Minimizes risk of harm to patients and providers through both system effectiveness and individual performance.
Select one of the following statements to discuss Safety:

  1. Value own role in preventing errors.
  2. Describe the benefits and limitations of selected safety-enhancing technologies (such as, barcodes, computer provider order entry, medication pumps, and automatic alerts/alarms.)
  3. Discuss effective strategies to reduce reliance on memory.
  1. INFORMATICS
Definition: Use information and technology to communicate, manage knowledge, mitigate error, and support decision making.
Select one of the following statements to discuss Informatics:

  1. Explain why information and technology skills are essential for safe patient care.
  2. Appreciate the necessity for all health professionals to seek lifelong, continuous learning of information technology skills.
  3. Describe examples of how technology and information management are related to the quality and safety of patient care. Patient And Family Engagement During A Pandemic

 

 

 

 

Interaction Between Nurse Informaticists and Other Specialists

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Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved. 

                                              To Prepare:

Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.

Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

                               Required Readings

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

· Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)

· Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

Rutherford, M. A. (2008). Standardized nursing language: What does it mean for nursing practice? Online Journal of Issues in Nursing, 13(1), 1–12. doi:10.3912/OJIN.Vol13No01PPT05.

Wang, Y. Kung, L., & Byrd, T. A. (2018). Big data analytics: Understanding its capabilities and potential benefits for healthcare organizations. Technological Forecasting and Social Change, 126(1), 3–13. doi:10.1016/j.techfore.2015.12.019.

Note: You will access this article from the Walden Library databases.

Health Screening And History Of An Adolescent Or Young Adult Client

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In this assignment, you will be completing a comprehensive health screening and history on a young adult. To complete this assignment, do the following:

Select an adolescent or young adult client on whom to perform a health screening and history. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one.

Complete the “Health History and Screening of an Adolescent or Young Adult Client” worksheet.

Complete the assignment as outlined on the worksheet, including:

  1. Biographical data
  2. Past health history
  3. Family history: Obstetrics history (if applicable) and well young adult behavioral health history screening
  4. Review of systems
  5. All components of the health history
  6. Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis)
  7. Rationale for the choice of each nursing diagnosis.
  8. A wellness plan for the adolescent/young adult client, using the three nursing diagnoses you have identified.

Format the write-up in a manner that is easily read, computer-generated, neat, and without spelling errors. Use correct acronyms or abbreviations when indicated.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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 not required to submit this assignment to Turnitin.

Respiratory/Cardiovascular Case Study

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Respiratory/Cardiovascular Case Study

Difficulty: Intermediate

Setting: Hospital

Index Words: asthma, status asthmaticus, assessment, prioritization of nursing care, education

Giddens Concepts: Caregiving, Development, Gas Exchange, Patient Education

HESI Concepts: Assessment, Caregiving, Developmental, Gas Exchange, Oxygenation, Patient

Education

Scenario

 

L.S. is a 7-year-old who has been brought to the emergency department (ED) by his mother. She

immediately tells you he has a history of ED visits for his asthma. He uses an inhaler when he

wheezes, but it ran out a month ago. She is a single parent and has two other children at home with

a babysitter. Your assessment finds L.S. alert, oriented, and extremely anxious. His color is pale,

and his nail beds are dusky and cool to the touch; other findings are heart rate 136 beats/min, R

(RR) 36 breaths/min regular and even, oral temperature T 99.1°F (37.3°C), Spo2 89%, breath

sounds decreased in lower lobes bilaterally and congested with inspiratory and expiratory wheezes,

prolonged expirations, and a productive cough. As you ask L.S.’s mother questions, you note that

L.S.’s respiratory rate is increasing; he is sitting on the side of the bed, leaning slightly forward, and

having difficulty breathing. You are concerned that he is experiencing status asthmaticus. Respiratory/Cardiovascular Case Study

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  1. You check the orders and need to decide which interventions are the priority at this time. Select all

that apply and explain the rationale.

  1. Have L.S. lie flat.
  2. Have L.S. perform incentive spirometry.
  3. Administer oxygen via face mask to keep his Spo2 above 90%.
  4. Administer albuterol (Proventil) and ipratropium bromide (Atrovent) via hand-held

nebulizer (HHN) STAT.

  1. Reassess in 20 minutes, and if no improvement, administer salmeterol (Serevent

Diskus) via dry-powder inhaler (DPI).

  1. Reassess in 20 minutes, and if no improvement, administer albuterol (Proventil)

and ipratropium (Atrovent) via hand-held nebulizer again.

  1. Start IV normal saline (NS) at 15 mL/hr and administer methylprednisolone 2 mg/kg

IV STAT × 1 dose.

 

  1. Explain what the nurse will assess before, during, and after the nebulizer treatment with albuterol.

 

CASE STUDY PROGRESS

You give L.S. the albuterol and Atrovent twice. His O2 saturation does not improve and remains at

88% with oxygen at 6 L/min via face mask. He says he “does not feel any better.” He is retracting

and his respiration rate remains 34 breaths/minute. You have started his IV infusion and

administered the methylprednisolone. L.S.’s mother is pacing and tells you she very upset and

worried. You overhead page the attending ED resident to assess, and you notify the patient-family

advocate. The ED resident, Dr. S., arrives within 2 minutes to assess L.S. and to speak to L.S.’s

mother. New orders are pending. Respiratory/Cardiovascular Case Study

 

  1. Chart your actions and the patient’s response using the SBAR

(Situation, Background, Assessment, and Recommendation) forma

 

 

CASE STUDY PROGRESS

L.S. is admitted to the pediatric intensive care unit (PICU) for close monitoring. His condition

improves, and 24 hours later he is transferred to the floor. Asthma teaching is ordered. You assess

Ms. S.’s understanding of asthma and her understanding of the disorder.

  1. Which statement by Ms. S. would indicate a need for further teaching? Explain your answer.
  2. “If he takes medications for a while, he will outgrow his asthma.”
  3. “Part of his treatment should be avoiding things that irritate his lungs.”
  4. “If I recognize early warning signs, he might be able to take medicine and not go to

the ED.”

  1. “He should go to the doctor regularly to make sure his asthma is being treated

correctly.”

 

  1. You are educating L.S. and his mother on possible asthma triggers in their environment. They live

in public housing in an apartment without air conditioning. Which statements indicate possible

asthma triggers? Select all that apply.

 

  1. “We have a pet fish.”
  2. “L. collects stuffed animals.”
  3. “There are hardwood floors.”
  4. “Our visitors smoke outside.”
  5. “The building has copper pipes.”
  6. “There are dark stains in our bathroom.”
  7. “We had to get the housing authority to treat for bugs.”
  8. “He coughs when we have cold nights after a warm day.”
  9. Discuss strategies to avoid the triggers you identified in the previous question.

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CASE STUDY PROGRESS

The following day, L.S. gets the discharge orders shown in the chart.

Chart View

Discharge Orders

Discharge to home

Follow up with primary care provider in 3 days for evaluation

Albuterol (Proventil HFA) MDI: 2 puffs with spacer every 4 hours prn

Prednisolone (Prelone) 1 mg/kg PO every day for 5 days (L.S. weighs 23 kg.)

Fluticasone (Flovent HFA) MDI: 1 puff with spacer twice a day

Montelukast (Singulair) 5 mg every evening PO

Provide peak flow meter

Regular diet

 

  1. Ms. S. asks why she will use the spacer with the medicine L.S. inhales. Explain the purpose of

using a spacer with the metered-dose inhaler (MDI).

  1. Place the steps of using the MDI with the spacer in the correct order (1 = first step, 5 = last step)
  2. ___ Depress the top of the inhaler to release medication, and breathe in slowly for

3 to 5 seconds, holding the breath for 5 to 10 seconds at the end of inspiration.

  1. ___ Shake the inhaler well, 10 to 15 times, and attach to the spacer.
  2. ___ Wait 1 to 2 minutes between puffs if more than one puff of the quick-relief

medication is ordered. Respiratory/Cardiovascular Case Study

  1. ___ Remove and exhale slowly through the nose.
  2. ___ At the end of expiration, place mouthpiece into the mouth, forming an airtight

seal.

  1. ___ Tilt the head back and exhale completely.
  2. During your medication teaching session with Ms. S. and L.S., you ask Ms. S. to teach back what

she has learned about taking two different inhalers. Ms. S. makes this statement: “So, if he has to

take both inhalers at the same time, he should take the Flovent first, then the albuterol. Right?” Is

this statement true or false? Explain your answer.

 

  1. Ms. S. then asks, “How long should we wait between giving the two inhalers if they are both due

at the same time? Can we just give them one after the other?” What is your response?

 

  1. As you continue your medication teaching, you explain the difference between long-term

controllers and quick relief medications. Place a C beside the controller medication(s) and

an R beside the quick relief medication(s).

_____ a. Albuterol

_____ b. Prelone

_____ c. Flovent

_____ d. Singulair

 

  1. After L.S. takes a dose of the inhaled corticosteroid Flovent, what is the most important action he

should do next? Explain your answer.

  1. Hold his breath for 45 seconds.
  2. Rinse out his mouth with water.
  3. Repeat the dose in 5 minutes if he feels short of breath.
  4. Check his PFM reading for an improvement of function.

 

  1. Ms. S. comes back from the pharmacy with the Prelone and asks you to show her how much to

give. Prelone is dispensed as 15 mg/5 mL. You give her a 10-mL oral dosage syringe. How much

will she draw up for this dose? (Round to tenths.)

 

 

  1. During the teaching session, you give L.S. a peak flow meter (PFM) and provide teaching for him

and Ms. S. But L.S. looks puzzled and asks you, “Is this another medicine I have to take?” How

would you explain the purpose of a peak flow meter to L.S.?

 

 

  1. L.S. tells you that he loves to play basketball and football and asks you whether he can still do

these activities. How will you respond?

 

 

  1. Discuss the points to include in your discharge teaching regarding prevention of acute asthmatic

episodes and symptom management.

 

  1. List three Internet sites to which you can refer them for further information.

CASE STUDY OUTCOME

L.S. is discharged to home and has a follow-up appointment scheduled in 2 weeks. His mother has

arranged for swimming lessons, and he plans to try out for his school’s swim team. Respiratory/Cardiovascular Case Study

Current Issues/Trends PowerPoint Presentation

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Current Issues/Trends PowerPoint Presentation

  1. Choose from one of the following topics:
    1. Nursing during an epidemic, pandemic or natural disaster across the country or around the globe
    2. Social media influences on health or health care delivery
    3. The effect of the media on nursing image. How can nurses educate the public and help portray the true image of nursing?
    4. The prevalence and impact of substance abuse among nurses (impaired nursing)
    5. Impact of collective bargaining on the nursing profession
    6. Impact of workplace harassment and violence on the nursing profession
    7. You may select from ONE of the following technological advances and discuss its impact on patient outcomes:
      1. Telehealth technology
      2. Health applications
      3. Health-related/electronic wearables

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  2. PPT Presentation will have 8-10 slides, NOT including the title and reference slides. You will also need to include graphics to make your slides interesting. Current Issues/Trends PowerPoint Presentation
  3. You are to create bullet points for each slide, not including the title and reference slides. Include speaker notes for each slide by including 4-5 sentences to address the bulleted items on each slide. Please follow APA style and include citations in your speaker notes.
  4. Including a minimum of 4-5 peer research articles as references in the presentation. All research articles needs to be within 5 years from today’s date. No blog, chat, other university or Wikipedia information allowed in presentation.  The PowerPoint presentation must follow APA style.
  5. Describe in detail your plan for how you would lobby your legislators or local government for funding and support for your chosen current issue or trend.
  6. Include the following elements in your presentation:
    1. How will the topic impact your role as a nurse in nursing workforce or clinical setting?
    2. Current relevance of the topic
    3. How your topic is integrated and used in clinical practice

You will need to follow these steps below for saving your PowerPoint so that your speaker notes are visible:  

  1. Open your PPT and go to “file” in top left corner.
  2. Click “print” option. Make sure “print all slides” and “print slides with notes” is selected.
  3. Go to “Save As” on the left hand side and be sure you save as a PDF.
  4. Under your save as selection, click “more options”. Select the “Options” button and click the “Publish What” pull-down and then select “Notes Pages.” (If you click slides it will not show the speaker notes)
  5. Click “OK.”
  6. Complete your selection process by checking “Open file after publishing” and selecting the “Optimize for: ‘Standard’ and ‘Minimum Size’” choices.
  7. Click on “Save” next to the “Tools” button at the bottom of the box. Current Issues/Trends PowerPoint Presentation

 

The pathophysiology of cardiovascular disorders

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Discussion: Cardiovascular Disorders

Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

To Prepare

  • Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 24 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.
  • Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.
  • Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected. 

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified.

Pick any that you want.

The pathophysiology of cardiovascular disorders

/in /by

Discussion: Cardiovascular Disorders

Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

To Prepare

  • Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 24 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.
  • Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.
  • Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected. 

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified.

Pick any that you want.