EMERGENCY RESPONSE

CC is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. On admission, he was tachycardic, hypotensive, unresponsive, and ventilating poorly. He was placed on a mechanical ventilator and given IV fluids for the treatment of his shock. CC responded well to fluids, with an increase in blood pressure and an improvement in urine output. EMERGENCY RESPONSE

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  1. Based on his case history and responsiveness to fluid therapy, what type of shock was CC experiencing?
  2. What other clinical findings would be helpful in confirming the type of shock? Why?
  3. Because of his many open wounds and invasive lines, CC is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed?
  4. What is the link between sepsis and multiple organ dysfunction syndrome (MODS)?
  • How does an understanding of the mechanisms of the heart help you in treatment of your patient regardless of the illness? How does basic cardiac monitoring factor into caring for your patient? How do you care for patients with dysrhythmia? Share some of your best practices. EMERGENCY RESPONSE

HEALTH RESEARCH

you will be researching an historical figure in the public health world, their contribution to public health, and how their work helped shape the public health system. Furthermore, you will be analyzing how their contribution from the past continues to contribute to today’s public health system and how it might guide future work within the industry.

Follow this outline to help formulate your paper or presentation:

ACTION:  Write a paper about this historical figure and their associated public health topic

Franklin D. Roosevelt/Health care administration

ACTION: Research the individual’s background

GRADED ELEMENT: Describe your selected person’s biographical background (i.e. experience).

HELP: This can include resume elements such as birthdate, location, education, and brief statement of their contribution to public health. (Reminder: biographical information can be easily plagiarized. Please do not copy from your biographical websites. Paraphrase and/or quote and cite everything according to APA.)

ACTION: Research the barriers and issue of the time

GRADED ELEMENT: Analyze the climate of the time period in terms of political, socioeconomic, environmental and technological context in which this person worked

HELP: Think about whether this person was up against resistance or was their work welcomed. [For example, if you were writing on Abraham Lincoln and the abolition of slavery, you would note that slavery was prevalent and accepted at the time and the change was welcomed by some and rejected by others] HEALTH RESEARCH

GRADED ELEMENT: Examine the personal beliefs of your person that prompted this work.

HELP: You are basically addressing the question: “Why did this person get involved with the issue at the time?” [In continuing the Lincoln example above, you would note that black people were considered property, not people; yet Lincoln believed everyone had equal rights regardless of skin color].

ACTION: Think about how this person overcame the barriers and issues

GRADED ELEMENT: Examine how this individual overcame and/or confronted any adversities to succeed in his/her task

HELP: Questions to consider: What did the person specifically do? Did they have any allies? How did their actions succeed/fail?

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ACTION: Think about the importance of the contribution to community/public health at the time

GRADED ELEMENT: Describe the final outcome of this individual’s contribution to community and/or public health

HELP: Think about this question: What occurred as a result of this person’s action?

GRADED ELEMENT: Explain what his/her contribution did for overall community and/or public health at the time

HELP: Think about this question: What was the purpose for the community and/or nation? [In the Lincoln example, the explanation would involve a national recognition of human rights of all people, regardless of skin color] HEALTH RESEARCH

GRADED ELEMENT: Explain why this contribution was so important at that particular point in history

HELP: Think about this question: What made this important for our nation? [In the Lincoln example, you would answer the question: Why was it so important that Lincoln freed the slaves?]

Written Paper

Must be at least 4 pages in length (not including title and reference pages) and formatted according to APA style as outlined in the Ashford Writing Center.

Must include a separate title page with the following:

Title of paper

Students name

Course name and number

Instructor’s name

Date submitted

Must use at least four scholarly sources (one of those may be the course text).

Must document all sources in APA style.

Must include a separate reference page that is formatted according to APA style. HEALTH RESEARCH

ELECTRONIC HEALTH RECORD

PART ONE- needs to have at least 3 pages at least 2 references APA format

Now that you have identified the data sets, discussed the electronic health record (EHR) and computerized physician order entry (CPOE), and identified patient demographic information data elements that are necessary for the new system, you will begin your needs analysis in preparation for selecting the vendor for the EHR.

  • Identify the appropriate department heads that need to be part of the EHR implementation committee.
  • The computers in the facility are outdated. Identify what will need to be done to prepare for the EHR implementation. ELECTRONIC HEALTH RECORD

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PART TWO- needs to have at least 3 pages at with 2 references APA format.

  • Choose 3 departments in your facility, and describe the specific needs that they have requested that will help enhance their work after implementation of the electronic health record (EHR).
  • Discuss what training will need to be done prior to implementation.
  • What type of vendor support and vendor maintenance will you need after implementation? How long will this be needed?
  • Write 5 questions that your facility can ask about the product the vendor will present to you as you start your vendor interviews and selection process.

APA references must be present for all sources used. ELECTRONIC HEALTH RECORD

Assessment of Cardiac Status

Assessment of Cardiac Status

Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report. Assessment of Cardiac Status

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Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.

Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.” Assessment of Cardiac Status

Please address the following questions related to the scenario.

  1. What do you suspect is the cause of the patient’s symptoms?
  2. Describe the course of action that you will take to confirm this suspicion and prevent further decline.
  3. What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.
  4. While you are caring for this patient, how will you ensure that the needs of your other patients are being met? Assessment of Cardiac Status

RESPIRATORY STATUS

RESPIRATORY STATUS

Please review the video on the assignments page under the discussion section as it will provide you with an opportunity to immerse yourself in the role of a nurse addressing tobacco use during routine patient care. In doing so, reflect on what you have learned about tobacco use and the role that nurses and other interdisciplinary team members play in helping to assist tobacco users with quitting. While viewing, it is also important to keep in mind that tobacco users move through stages of change in the process of quitting. They move from pre-contemplation to contemplation, contemplation to preparation; preparation to abstinence; abstinence to maintenance. Every stage requires a different strategy by a nurse. RESPIRATORY STATUS

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After watching the video, and reflecting on the information presented, address each of the following questions.

  1. What are the common symptoms associated with an exacerbation of COPD?
  2. What assessment techniques will you use to assess Mary?
  3. Identify smoking strategies that would be appropriate for each of the encounters that Mary had with the nurse throughout the video that could have been used to assist Mary in quitting smoking.
  4. Find a resource in your community that could assist Mary. Start by searching the Internet for your local health department’s website. What services are available to Mary? Briefly describe the services that the state quit line provides. Does it meet the 4 As? Is it accessible, acceptable, affordable, or available for Mary?
  5. What will you do to follow-up on Mary’s smoking cessation process? RESPIRATORY STATUS

Ethical Dimensions of Research Studies

Ethical Dimensions of Research Studies

Select a current health-related case involving research ethics. (If none come to mind, browse the Internet to familiarize yourself with recent cases.)

As you review the case that you have selected, reflect on the ethical principles discussed in “What Are the Major Ethical Issues in Conducting Research?” article found in this week’s Learning Resources. Which principles were breached in the case you have identified? Ethical Dimensions of Research Studies

In the best-selling book, The Immortal Life of Henrietta Lacks (Skloot, 2010), the author highlights the true story of an African-American woman who died in 1951 from cervical cancer. What makes her story unique is that prior to her death, cells from her tumor were removed and successfully grown in a petri dish. This was the first time scientists were able to successfully replicate cells outside the body, and it is estimated that billions of Lacks’ cells have been used in medical research. However, Henrietta Lacks was never asked for permission to take a sample and her family was never made aware of the widespread use of her cells. Although the culturing of her cells has been pivotal for advancing research, strong ethical concerns later arose about using these cells without patient or family approval. Ethical Dimensions of Research Studies

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This week’s readings describe historical examples of unethical research, such as a study of syphilis among African-American men in which treatment was withheld and a study in which live cancer cells were injected into elderly patients. Today, stricter controls that seek to protect study participants are placed on researchers, but breaches still occur. Careful attention must be given toward preventing unethical behavior. In this Discussion, you explore ethical considerations and issues in research.

Describe the case that you selected and the ethical issues involved. Analyze the ethical principles that were breached by the researchers or organizations in your selected case as well as the possible cause of the breach(es). Suggest how the research might have been conducted differently to avoid or minimize the ethical problems. Discuss how research can be done on sensitive issues while still protecting the rights of the research subjects.

Required References

Polit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.

·         Chapter 3, “Key Concepts and Steps in Qualitative and Quantitative Research” (for review)

·         Chapter 4, “Research Problems, Research Questions, and Hypotheses”

This chapter focuses on the steps in planning a study to generate evidence. These include developing a research question, identifying variables, articulating a problem statement, and generating hypotheses. Ethical Dimensions of Research Studies

·         Chapter 7, “Ethics in Nursing Research”

In this chapter, the focus is on the ethical dilemmas that occur when planning and conducting research and the ethical principles that have been enacted for protecting study participants.

Fouka, G., & Mantzorou, M. (2011). What are the major ethical issues in conducting research? Is there a conflict between the research ethics and the nature of nursing? Health Science Journal, 5(1), 3–14.

Retrieved from the Walden Library databases.

This article describes a literature review conducted to determine the most important ethical issues that nurses encounter when undertaking or participating in research. The authors detail the results of the review and make recommendations for solving some of the problems highlighted.

Newcomb, P. (2010). Evolving fairness in research on human subjects. Journal of Child and Adolescent Psychiatric Nursing, 23(3), 123–124.

Retrieved from the Walden Library databases.

In this article, the author describes some of the ethical controversies that may arise in conducting research in human subjects, especially with respect to ownership of genes. The author also stresses the importance of educating research subjects and their families about the ultimate purpose of research.

Yakov, G., Shilo, Y., & Shor, T. (2010). Nurses’ perceptions of ethical issues related to patients’ rights law. Nursing Ethics, 17(4), 501–510.

Retrieved from the Walden Library databases.

The authors of this article detail a study conducted to determine how nursing staff deal with ethical issues in relation to the law. The article emphasizes the difficulty staff had in distinguishing between legal and ethical problems. The authors make several recommendations to deal with legal and ethical problems.

Delwiche, F. (2008). Anatomy of a scholarly research presentation in the health sciences. Retrieved from http://dana.uvm.edu/Anatomy/

 

This presentation highlights the primary components of scholarly research articles. The presentation details the distinguishing factors of scholarly journals, the peer-review process, and the definition of “primary literature.” Ethical Dimensions of Research Studies

American Nurses Association. (2001). Code of ethics for nurses with interpretive statements. Retrieved from http://nursingworld.org/DocumentVault/Ethics-1/Code-of-Ethics-for-Nurses.html Ethical Dimensions of Research Studies

Health Policy

Health Policy

The purpose of this assignment is for you to identify an issue of concern for your role as an advanced practice nurse and to formulate a potential policy change to address that issue. There are many potential issues which can influence your practice setting or other issues which may negatively affect the patients with whom you work. All of the course reading will help you to identify a topic for this assignment. You can think about the issue as related to your health promotion project. The policy you consider may be in reaction to the health promotion issue or something larger that is still related to that issue. There are hundreds of possible issues, but here is a list of a few to consider: Health Policy

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  • Child and elder care
  • Civil rights
  • Domestic violence
  • Drug abuse/addiction
  • HIV/AIDS
  • Homelessness
  • Native American and migrant workers’ health
  • Long-term care
  • Immigration/illegal aliens
  • Legislative issues affecting advanced practice nursing
  • Barriers to practice
  • Access to care

As you begin to work on the possible policy change, the following ideas and steps should be considered:

  • Definition and description of the issue
  • Exploration of the background of the issue
  • Stakeholders
  • Issue statement or statement of clarity
  • Possible methods of addressing the issue
  • Goals and options for changes
  • Risks and benefits of the changes
  • Evaluation methodology
  • Recommendation or solution Health Policy

CAPITAL BUDGETING

CAPITAL BUDGETING

A quaint but well-established coffee shop, the Hot New Cafe, wants to build a new cafe for increased capacity. Expected sales are $800,000 for the first 5 years. Direct costs including labor and materials will be 50% of sales. Indirect costs are estimated at $100,000 a year. The cost of the building for the new cafe will be a total of $750,000, which will be depreciated straight line over the next 5 years. The firm’s marginal tax rate is 37%, and its cost of capital is 12%. CAPITAL BUDGETING

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For this assignment, you need to develop a capital budget. It is important to know what the cafe managers should consider within their capital budget. You must also define the key terms necessary to understand capital budgeting. In this assignment, please show all work, including formulae and calculations used to arrive at financial values. You must answer the following:

·         Using the information in the assignment description:

o    Prepare a capital budget for the Hot New Cafe with the net cash flows for this project over a 5-year period.

o    Calculate the payback period (P/B) and the net present value (NPV) for the project.

o    Answer the following questions based on your P/B and NPV calculations:

§  Do you think the project should be accepted? Why?

§  Define and describe Net Present Value (NPV) as it pertains to the new cafe. CAPITAL BUDGETING

§  Define payback period. Assume the company has a P/B (payback) policy of not accepting projects with life of over 3 years. Do you think the project should be accepted? Why?

Your submitted assignment must include the following:

o    A double-spaced, two page Word document that contains answers to the word questions.

o    You must include a Microsoft Excel spreadsheet for your calculations.

o    Either the Word document or the Excel spreadsheet must have all of your calculation values, your complete calculations, any formulae that you used, the sources you wish to cite, and your answers to the questions listed in the assignment guidelines. CAPITAL BUDGETING

DEMOGRAPHY AND HEALTH INDICATORS OF UNITED STATES AND NIGERIA

DEMOGRAPHY AND HEALTH INDICATORS OF UNITED STATES AND NIGERIA

For your dropbox assignment, using the South University Online Library or the Internet, research and compare the demography and health indicators for Nigeria and the United States.

Note: Click here to view the links that you can refer to for research about the demography and health indicators for the United States and Nigeria.

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Based on your research, create a 3- to 4-page report in a Microsoft Word document, answering the following questions:

  • Compare the annual population growth rate of both countries. What factors do you think are contributing to the differences observed between the two countries? DEMOGRAPHY AND HEALTH INDICATORS OF UNITED STATES AND NIGERIA
  • Compare the composition of the population of both countries. What does it suggest about each country?
  • Compare the dependency ratio of both countries. What does it suggest about each country?
  • Compare the mortality rates of both countries. Which age groups do you think are the most affected in each country? Is there a gender difference in mortality rates? Why or why not? In your opinion, what are the factors that might contribute to the differences in mortality rates of both countries?
  • Which age group is benefiting the most from healthcare interventions in each country?
  • What does the life expectancy at birth and at sixty years tell you about each country?
  • If you were a public health official looking at these data for the first time, what questions and assumptions might come up that you would want to further investigate?

Support your responses with examples.

Cite any sources in APA format. DEMOGRAPHY AND HEALTH INDICATORS OF UNITED STATES AND NIGERIA

ROLE AS A NURSE

ROLE AS A NURSE

The purpose of this assignment is for you to identify an issue of concern for your role as an advanced practice nurse and to formulate a potential policy change to address that issue. There are many potential issues which can influence your practice setting or other issues which may negatively affect the patients with whom you work. All of the course reading will help you to identify a topic for this assignment. You can think about the issue as related to your health promotion project. The policy you consider may be in reaction to the health promotion issue or something larger that is still related to that issue. There are hundreds of possible issues, but here is a list of a few to consider: ROLE AS A NURSE

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  • Child and elder care
  • Civil rights
  • Domestic violence
  • Drug abuse/addiction
  • HIV/AIDS
  • Homelessness
  • Native American and migrant workers’ health
  • Long-term care
  • Immigration/illegal aliens
  • Legislative issues affecting advanced practice nursing
  • Barriers to practice
  • Access to care

As you begin to work on the possible policy change, the following ideas and steps should be considered:

  • Definition and description of the issue
  • Exploration of the background of the issue
  • Stakeholders
  • Issue statement or statement of clarity
  • Possible methods of addressing the issue
  • Goals and options for changes
  • Risks and benefits of the changes
  • Evaluation methodology
  • Recommendation or solution ROLE AS A NURSE

By Monday, May 1, 2017, submit a Word document to the W3 Assignment 2 Dropbox. Be sure to use APA style and include all of your references.

Grading Criteria Maximum Points
Identify the type of legislation, such as state, federal, scope of practice, reimbursement, loan repayment, or others. 10
Review of the literature consists of a minimum of 3–4 peer-reviewed articles and 6–7 other outside sources. 15
Describe the current policy or health policy issue and specify how it would impact nursing or healthcare. 10
Describe the specific aspects of the proposed policy or policy change. 10
Identify the individuals who would benefit from the policy change and explain where support for the change would be found. 10
Describe the impact of the policy change on nursing practice and health care. 5
Provide an analysis of the policy from your point of view and how this will influence your practice. 10
Use good writing skills, appropriate grammar, and application of APA formatting throughout paper, citations, and references. ROLE AS A NURSE 5
Total: 75