Advanced practice nurses often treat patients with vein and artery disorders such as chronic venous insufficiency (CVI) and deep venous thrombosis (DVT). While the symptoms of both disorders are noticeable, these symptoms are sometimes mistaken for signs of other conditions, making the disorders difficult to diagnose. Nurses must examine all symptoms and rule out other potential disorders before diagnosing and prescribing treatment for patients. In this Assignment, you explore the epidemiology, pathophysiology, and clinical presentation of CVI and DVT.

To Prepare

Review the section “Diseases of the Veins” (pp. 598-599) in Chapter 23 of the Huether and McCance text. Identify the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Consider the similarities and differences between these disorders.

Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of CVI and DVT. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic venous insufficiency and one for venous thrombosis. Consider the epidemiology and clinical presentation of both chronic venous insufficiency and deep venous thrombosis.

To Complete

Write a 2- to 3-page paper that addresses the following:

Compare the pathophysiology of chronic venous insufficiency and deep venous thrombosis. Describe how venous thrombosis is different from arterial thrombosis.

Explain how the patient factor you selected might impact the pathophysiology of CVI and DVT. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

Construct two mind maps—one for chronic venous insufficiency and one for deep venous thrombosis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.ignment: Disorders of the Veins and Arteries

A 60-year-old man is brought to the ER by ambulance because of slurred speech and left side weakness. His wife states they went to bed at 11pm and woke up at 5am when she noticed his symptoms. He is right handed with a history of coronary artery disease, hypertension, and hypercholesterolemia and a heart attack at age 50. He currently is unable to move his left arm and leg. He had an episode of amaurosis fugux (blindness)in his right eye one month ago that lasted for 5 minutes. Around 3 months ago his wife states he had bilateral pain in his legs while they were on a walk that lasted about 15 minutes. He is taking a baby aspirin a day an ACE inhibitor, and statin as well. He does have a history of alcohol use and smoking in the past but stopped after his heart attack. His blood pressure is 195/118 Pulse 106, Respiratory rate 18, Temperature 99.8, o2 sat is 97% on room air. Although his pupils are equal and reactive, and the ocular movements are intact, he is unable to turn his eyes voluntarily toward the left side. The neck is supple, there is no jugular vein distension, and there are no bruits. The lungs are clear heart sounds regular without murmurs, and abdomen is normal. The limbs are not well perfused distally. The neurologic examination reveals that he is alert and oriented, although he does not recognize he is sick. He shows loss of awareness and attention with respect to objects or stimuli on his left side. He has mild dysarthria but, his speech is fluent, and he understands and follows commands very well. There is mild weakness on the left side of the face and left sided homonymous hemaianopsia, but there is no nystagmus or ptosis, and no tongue or uvula deviation. He is not able to move his left arm and leg, has hyperreflexia, and the left great toe is upgoing.

What are two questions you would ask this patient?

Identify the subjective data for this patient.

Identify the objective data for this patient.

What is the likely diagnosis?

Your response should include evidence of review of the course material, websites, and literature through proper citations using APA format.

Through communication—inquiry and dialogue—every person makes a contribution, and by being involved in the process, people can shift their attention and action away from a problem-oriented focus to dreams that are worthy to them and to productive possibilities for the future.

—Watkins & Mohr, 2001

Without a doubt, promoting health care quality and patient safety presents a meaningful aim.

To achieve this goal, nurse leader-managers need to be able to evaluate a situation from many different viewpoints and frame questions that elicit valuable insights. They must be able to promote skillful problem solving and interdisciplinary teamwork.

In this Discussion, you examine how you can use emotional intelligence and appreciative inquiry to facilitate positive changes that lead to improved quality and safety.

To prepare:

Review the information on emotional intelligence and appreciative inquiry presented in this week’s Learning Resources.

If you have not already done so, follow the instructions in the course text, Emotional Intelligence 2.0 to complete the online assessment.

Consider the results of the assessment. Review your strengths and opportunities for growth related to self-awareness, self-management, social awareness, and relationship management. What insights, questions, or concerns arise as you think about these results?

Think about how your identified emotional intelligence strengths and opportunities for growth relate to your current role as a leader-manager and to the professional contributions that you hope to make now and in the future. Give focused attention to patient safety and health care quality. How and why is emotional intelligence valuable for promoting optimal patient outcomes and creating systems-level change?

As indicated on pages 53–55 of the Bradberry and Greaves text, develop a plan for improving your skills in one area of emotional intelligence. Evaluate strategies for applying your strengths in the workplace. Identify at least two that you can use to add value to a team or workgroup to improve quality and safety.

Also review the information on appreciative inquiry in this week’s Learning Resources. Have you used appreciative inquiry before? If so, how? How does the application of appreciative inquiry relate to your role as nurse leader-manager and/or to efforts to promote health care quality?

Reflect on your experiences working in health care and identify an issue or problem that required, or requires, a change. Consider how you could apply emotional intelligence and appreciative inquiry strategies to this situation to facilitate positive results that lead to improved quality.

By Day 3

Post a brief description of an issue or problem in a health care setting that required, or requires, a change. Explain how you, as a nurse leader-manager, could apply both emotional intelligence and appreciative inquiry strategies to address this issue and facilitate positive results that lead to improved quality.

Read a selection of your colleagues’ responses.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Bradberry, T., & Greaves, J. (2009). Emotional intelligence 2.0. San Diego, CA: TalentSmart.

Chapter 1, “The Journey” (pp. 1–12)

Chapter 2, “The Big Picture” (pp. 13–22)

Chapter 3, “What Emotional Intelligence Looks Like: Understanding the Four Skills” (pp. 23–50)The first three chapters of this book introduce foundational concepts related to emotional intelligence, and provide the background for the online assessment that you will take in preparation for this week’s Discussion. In addition to these chapters, you should read the rest of the book once you have completed the assessment.

Note: You must purchase a new, unopened copy of this book in order to acquire the access code that you will need to complete the online assessment.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Chapter 1, “Understanding the U.S. Healthcare System” (pp. 1–30)

This chapter sets the context for understanding quality-related issues within the U.S. health care system (macroenvironment). The authors discuss health care access and costs, which may be viewed as part of a triad with quality.

Ingram, J., & Cangemi, J. (2012). Emotions, emotional intelligence and leadership: A brief, pragmatic perspective. Education, 132(4), 771–778.

Retrieved from the Walden Library databases.

Nel, H., & Pretorius, E. (2012). Applying appreciative inquiry in building capacity in a nongovernmental organization for youths: An example from Soweto, Gauteng, South Africa. Social Development Issues, 34(1), 37–55.

Retrieved from the Walden Library databases.

This article examines how appreciative inquiry can be used to foster meaningful change in organizations. It outlines the principles of appreciative inquiry and the four phases: discovery, dream, design, and delivery.

Sadri, G. (2012). Emotional intelligence and leadership development. Public Personnel Management, 41(3), 535–548.

Retrieved from the Walden Library databases.

Emotional intelligence has been proposed as a key element of leadership. This article examines that argument, with attention to how and why it has been challenged.

Application: Systems Theory

As noted in the Learning Resources, systems theory provides a meaningful and beneficial means of examining challenges in health care organizations. To do this effectively, however, it is essential to assess all system components, as some may be relatively healthy while others are problematic.

For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)

To prepare:

· Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).

· Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.

· Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.

· Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.

· Research professional standards that are pertinent to your identified problem.

· Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)

To complete:

Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:

· Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.

· Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).

· Based on this information, explain how you would address the problem as follows:

o Formulate a desired outcome.

o Identify goals and objectives that would facilitate that outcome.

o Translate those goals and objectives into policies and procedures for the department or unit.

o Describe relevant professional standards.

· Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

                                                             Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Review Chapter 7, “Organizational Planning”

Chapter 8, “Planned Change”

o Organizational Change Associated With Nonlinear Dynamics

Read this section of Chapter 8 on planned change. Consider the role of leaders in effectively managing planned change.

Chapter 12, “Organizational Structure”

o “Organizational Culture”

There are many structures organizations take, and these structures influence how the organization functions. This chapter discusses many different organizational structures and provides insights into how these structures influence the change process, as well as leadership and management.

Johnson, J. K., Miller, S. H., & Horowitz, S. D. (2008). Systems-based practice: Improving the safety and quality of patient care by recognizing and improving the systems in which we work.

This article addresses the importance of systems-based practice (SBP) in health care workplaces. The authors state that SBP knowledge is one of six core competencies that physicians have to know in order to provide safe and proper care for their patients.

Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology. FoNS 2014 International Practice Development Journal 4-(1).

Meyer, R. M., & O’Brien-Pallas, L. L. (2010). Nursing services delivery theory: An open system approach. Journal of Advanced Nursing, 66(12), 2828–2838.

Retrieved from the Walden Library databases.

In this article, the authors examine the effects of nursing services delivery theory in large-scale organizations. Among other benefits, this theory supports multilevel phenomena and cross-level studies, and it can guide future research and the management of nursing services.

Optional Resources

Glennister, D. (2011, July). Towards a general systems theory of nursing: A literature review. Paper presented at the 55th Annual Meeting of the International Society for the System Sciences, Hull, United Kingdom.