MTWhen dealing with ethnically diverse older patients, it is important to understand and respect their cultural beliefs on health and wellness. Understanding the health belief paradigms that the per

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MTWhen dealing with ethnically diverse older patients, it is important to understand and respect their cultural beliefs on health and wellness. Understanding the health belief paradigms that the per

 MT

When dealing with ethnically diverse older patients, it is important to understand and respect their cultural beliefs on health and wellness. Understanding the health belief paradigms that the person may relate to can assist in designing a health and wellness plan specific to that individual. Each culture has their own health belief system; Latino, African, Caribbean, African American, and Middle Eastern groups often believe in the Magico-Religious paradigm, Asian, North American, and Indian groups may follow the Holistic paradigm and the Scientific paradigm is common among Western cultures including the United States and Canada (Murray, 2019). Knowing their belief system can help the caregiver make informed decisions on their care. The Magico-Religious paradigm believes  the health of the community comes before the health of the individual where the Holistic paradigm views the whole person in relation to the environment. 

This knowledge can help decide what type of exercise regimen to begin a patient with a chronic condition on. Patients may benefit more from an individual exercise routine such as walking, cycling or swimming if they are more focused on holistic views. Patients with Magico-Religious views could benefit more from group exercise sessions. With group exercise the individual finds that the social connections improve the importance and effectiveness of physical activity (Beauchamp, Bennett, Dunlop, Estabrooks, Harden, Hurd Clark, Liu, Rhodes, Wolf, 2018). Knowing their preferences can assist the elderly in programs that are comfortable to their personal tastes. 

A second strategy would focus on nutrition for the elderly person. While many dietary restrictions may apply to the individual based upon their chronic condition such as low salt, low cholesterol, low potassium or many other various restrictions, the individual needs to enjoy the food they consume or the risk of malnutrition from not eating may develop. It is important to include the older individual in decisions about their food to increase their appetite and quality of life (Dorner, Friedrich, 2018). Sometimes the rules of the diet have to be compromised with the individual to ensure proper nutritional intake. 

Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease? This can be nutrition, ADLs, exercise, etc.

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original question: Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease? This can be nutrition, ADLs, exerci

original question:

 Identify two strategies you can implement to provide comfort to maintain function with an ethnically diverse older adult with a chronic disease? This can be nutrition, ADLs, exercise, etc. 

MY ANSWER:

The management of chronic conditions is becoming an integral part of medical care in most parts of the world. The elderly, in particular, are living with one or more chronic illnesses for very long periods. Access to care is not easy, given that most of them are not insured. The situation gets worse when the patient is from an ethnical minority background. Since it can be hard to reach such patients, the first strategy that both the medical staff and the care givers of the patient should put in place is fostering positive communication. Putting a lot of focus in disease prevention, health promotion and early detection is a very effective strategy for enduring successful chronic disease management. This is especially helpful for the frail seniors (Hitchcock, 2016).  It is, therefore, important for the care givers to listen carefully, show compassion and work with the patient to ensure care goals.

            The second strategy would be to embark on a patient-centered approach. Such an approach is supposed to be responsive to, and respectful of, the preference, needs and values of the patient. Physicians should never make assumptions about the treatment option that the patient would choose. Rather, they should discuss also the available options. Doctors should also recognize when such senior patients need help in managing their chronic illness (Iecovich, 2018). Again, it may be important to carefully watch the interactions between different medications that are used to treat different conditions. The physicians and the patient should further come up with an action-plan and always keep it up to date.

While caring for the elderly patients can pose a big challenge for physicians, it does not mean that it is an impossible mission. With the right strategies in place and with the coordination of the doctors, the patients and their caregivers, it will be easier to manage such chronic conditions.

teacher question

  Would this approach be different for a patient of a different age range? 

Describe the patient who uses CAM the most.

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Write a short (50-100-word) paragraph response for each question posed below. Submit this assignment as a Microsoft Word document.Define CAM. Describe the patient who uses CAM the most. List some co

Write a short (50-100-word) paragraph response for each question posed below. Submit this assignment as a Microsoft Word document.

  1. Define CAM.
  2. Describe the patient who uses CAM the most.
  3. List some common misconceptions about CAM.
  4. Identify methods of including the use of CAM in patient education.
  5. Discuss the safe use of CAM.
  6. List ways in which conventional medicine and CAM can be integrated.
  7. Define ethical theories, ethical principles, and values.
  8. Provide examples of ethical issues in patient education and compliance, and describe ways in which an effective professional/patient relationship and a poor health professional/patient relationship can impact these issues.
  9. Explain what is meant by “ethical patient education practices”.
  10. Explain the purpose of informed consent.
  11. Discuss what factors determine the patient’s ability to give informed consent.
  12. Compose a sample informed consent form. .
  13. Discuss the process of communication to use with the patient and the family when obtaining informed consent.

· How might you communicate your concerns about or support for this bill based on nursing practice, standards, or patient outcomes?

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PurposeIn this assignment, you will assess the impact of health legislation on nursing practice and communicate your analysis to your peers. GovTrack.us provides a list of federal health bills that ar

Purpose

In this assignment, you will assess the impact of health legislation on nursing practice and communicate your analysis to your peers. GovTrack.us provides a list of federal health bills that are currently in process in Congressional Committees.

Course Outcomes

This assignment enables the student to meet the following course outcomes:

CO4: Integrates clinical nursing judgment using effective communication strategies with patients, colleagues, and other healthcare providers. (PO#4)

CO7: Integrates the professional role of leader, teacher, communicator, and manager of care to plan cost-effective, quality healthcare to consumers in structured and unstructured settings. (PO#7)

Points

The assignment is worth 175 points.

Due Date

Submit your completed assignment by Sunday of Week 3 by 11:59 p.m. MT.

Directions

A short tutorial with tips for completing this assignment may be viewed here: Healthcare Policy (Links to an external site.)Links to an external site.

1. This assignment will be in the format of a PowerPoint presentation (Bullet points may be used).

2. You are educating your peers through this presentation regarding a federal bill you believe may be of interest to nurses.

3. Go to https://www.govtrack.us/congress/bills/subjects/health/6130 (Links to an external site.)Links to an external site.

4. Choose a health-related federal bill of interest. Read through the bill and develop a summary in your own words. Include the bill number and name.

5. Here is a link to our U.S. legislative process (bill to law) for review, if needed.

https://www.congress.gov/legislative-process (Links to an external site.)Links to an external site.

Tutorial: For those not familiar with the development of a PowerPoint slideshow, the following link to the Microsoft website may be helpful –

https://support.office.com/office-training-center?redirectSourcePath=%252fen-us%252farticle%252fb8f02f81-ec85-4493-a39b-4c48e6bc4bfb (Links to an external site.)Links to an external site.

Include the following information in your presentation

· Title slide (Your name, NR451, session, Healthcare Policy assignment)

· Bill name and number (indicate either H.B. or S.B.)

· Bill summary (in your own words)

· Address how this bill might impact professional nursing practice standards if passed? If not passed?

· How might the bill impact your own nursing practice?

· How might you communicate your concerns about or support for this bill based on nursing practice, standards, or patient outcomes?

· How might this bill impact your community?

· References slide to include the Bill source in APA format.

· No more than 12 slides

Template

There is no required form or template for this assignment. Please use PowerPoint best practices throughout your presentation.

Best Practices

The following are best practices in preparing this presentation.

· Review directions and rubric thoroughly prior to beginning assignment.

· Watch short Kaltura video.Incorporate graphics, clip art, or photographs to increase interest.

· Make slides easy to read with short bullet points and large font.

Source Citations

Cite all sources on the appropriate slides with (author, year) as well as on the Reference slide.

· Spell check for spelling and grammar errors prior to final submission.

· Use the rubric as a final check prior to submission to ensure all content is clearly addressed.

**Academic Integrity Reminder**

College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on this page.

Please see the grading criteria and rubrics on this page.

NOTE: Please use your browser’s File setting to save or print this page.

Standards of care – what were the standards of care that were violated? Who was responsible for the violations?

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Assignment DetailsUsing the information from the case study below, discuss the following issues from the perspective of an APN role:Administrator Practitioner Educator Standards of care – what we

Assignment Details

Using the information from the case study below, discuss the following issues from the perspective of an APN role:

  • Administrator
  • Practitioner
  • Educator 

Standards of care – what were the standards of care that were violated? Who was responsible for the violations?

In your role as an educator, administrator, or practitioner, what risk management steps needs to be taken before or after the incident to alleviate the issue?

Page length should be 3-4 pages exclusive of cover page and references.

Support your paper with a minimum of three scholarly references.

Case Study: Malpractice Action Brought by Yolanda Pinellas

Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.

During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an infiltration to the IV.

Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.

The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units.

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements:

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary;
  • utilize spelling and grammar check to minimize errors; and
  • review APA formatting and citation information found in the Writing Center, online, or elsewhere in the course.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.)
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th edition formatting and citation style.

What assessment data is relevant that must be recognized as clinically significant to the nurse?

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Pediatric Clinical Reasoning Case Study: Poison IngestionCreated by Kathleen Mixson, RN, MS, JDI. Data CollectionChief complaint/History of Present Illness: Brandy is a 22 month .old female presenti

Pediatric Clinical Reasoning Case Study: Poison IngestionCreated by Kathleen Mixson, RN, MS, JDI. Data CollectionChief complaint/History of Present Illness:   Brandy is a 22 month .old female presenting with ingestion at 10:30 pm yesterday of estimated 1/2 tsp of solder flux and immediately had vomiting of about 12 times, taken immediately to the emergency room.  No vomiting since around 3 am but continues to have gagging and retching.  No diarrhea. Has raspy voice, fussiness.   Had chemistries, LFTs, CBC, IV started in ER.   Acute ingestion of zinc chloride-containing solder flux (contains 30-36% zinc chloride), which is caustic to GI tract, skin, and eyes.  Also if significant systemic absorption occurs, systemic toxicity may include altered mental status, renal insufficiency.  Patient to be admitted for observation and monitoring for systemic effects.  If no respiratory distress or abnormal labs the plan is to discharge this afternoon.       What data is relevant  to this patient that must be recognized as clinically significant to the nurse?

Rationale:

Personal/Social History:  Mom and dad at bedside.  Lives with parents. English speaking

PMH:  Allergic rhinitis, night-time cough, thought to have seasonal allergies as a cause of chronic vomiting. Born at 36 weeks gestation, no complications, SVD. 

Current Medications: None

Patient Care Begins:Your Initial VS:T: 97.9º FP:  118R:  38BP:  100/76O2 sats:  98%  on 2L per NC Weight:  15,2 kgPain:  3/10 FLACC 

What VS data is relevant  to this patient that must be recognized as clinically significant to the nurse?

Rationale:  

Your Initial Nursing Assessment:GENERAL APPEARANCE: Fussy, irritable and requiring frequent comforting from parents.RESPIRATORY:  Breath sounds equal and with good aeration bilaterally.  No stridor or nasal flaring. Mom states continued raspy voice.CARDIAC: Heart rate regular-S1S2. Pulses palpable and equal bilaterally. Capillary refill less than 3 seconds.NEUROLOGIC:   Alert with normal muscle tone and movement of extremities.ABDOMEN/GI: Currently NPO.  Mouth and throat red and raw looking.  Abdomen soft, non-tender with active bowel sounds all four quads. GENITOURINARY: Voiding per diaper. EXTREMITIES/SKIN:  Skin is warm and dry-normal for color of skin. IV in place to right hand, infusing D5 ½NS  at 42 per hour.  Site without redness or edema.  Hands equal bilaterally.

What assessment data is relevant that must be recognized as clinically significant to the nurse?

Rationale:

II. Clinical Reasoning BeginsWhat is the most likely medical problem that your patient is presenting with?

What is the underlying cause /pathophysiology of this concern?

What is your primary nursing priority right now?

In an APA format paper, approximately 3-5 pages in length, address the following questions. (Please note that you will continue to write in the same document you completed for part 1 and 2 of this ass

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In an APA format paper, approximately 3-5 pages in length, address the following questions. (Please note that you will continue to write in the same document you completed for part 1 and 2 of this ass

In an APA format paper, approximately 3-5 pages in length, address the following questions. (Please note that you will continue to write in the same document you completed for part 1 and 2 of this assignment (completed in modules 2 and 4) – you can keep the same cover page, correcting any errors noted on your previous feedback. Please correct your reference page as noted from your previous submission feedback and update it with your new material). In addition, although you are submitting your entire project to date (with revisions), your actual grade will be based only on the current section, as addressed below:

Locate two different quantitative studies related to your topic of interest.

For help locating the right types of quantitative research articles review these excellent tutorials:

How to find quantitative research articles

Research versus evidence based practice

For each study, answer these questions:

What is the study type?

What threats to internal and external validity were noted? Are there others you think might be present that the author(s) didn’t describe?

Do you think this study will be applicable to your population? Why or why not?

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

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The Assignment: (1 page)Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact she

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

  • Briefly and generally explain the policy or regulation you selected.
  • Address the impact of the policy or regulation you selected on system implementation.
  • Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
  • Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

To Prepare:

  • Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
  • Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
  • Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study

write a 1-2 page paper using proper spelling/grammar, addressing the items below each scenario.Scenario 1Dr.

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Consider the two (2) scenarios below, and then write a 1-2 page paper using proper spelling/grammar, addressing the items below each scenario.Scenario 1Dr. Crunch is a busy orthopedist. He is increasi

Consider the two (2) scenarios below, and then write a 1-2 page paper using proper spelling/grammar, addressing the items below each scenario.Scenario 1Dr. Crunch is a busy orthopedist. He is increasingly challenged by his practice because he keeps working harder and still has some cash flow challenges. Dr. Crunch therefore asks a data analyst to prepare reports for his review to include:A table of his “Top 20 Procedures” – the high volume procedure codes he performed over the past 12 months.Total dollar payments received broken down by those procedures. Based on the information provided in Scenario 1 above, address the items below:What data sources and/or data systems would you suggest that an analyst might consult to generate these reports? Briefly explain your recommendations and be as specific as possible.When Dr. Crunch gets the report, give two (2) examples of ways you think he could use the information to restructure his practice and be sure to consider comparisons with local, regional, and national data for other orthopedists.Scenario 2 Dr. Serena is a Dermatologist. She serves a varied patient clientele, both young and old. She is curious about certain skin cancer cases she has been seeing, and she is wondering if the rates differ by age group. She has asked her analyst to extract a table listing all patients she treated for skin cancers (over past 3 years) that includes:Female or maleSmoking statusAgeZip code and city of residenceSingle vs. marriedBased on the information provided in Scenario 2 above, address the items below:Describe what kinds of data tables or databases would contain the information requested for Dr. Serena. Briefly explain why you chose those particular databases or tables. Be as specific as possible.Explain how the doctor could use this information in her practice in at least two (2) ways and be sure to consider quality of care, patient safety, and dermatology comparison data.

Where on the body would be the ideal position for the clinician to auscultate for a systolic murmur associated with the mitral valve? 2 marks

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Case Study ThreeHans Dietz is a 25 year old male patient with a family history of Marfan Syndrome (MFS). He is generally well and enjoys attending regular fitness sessions in his local gymnasium.

Case Study Three

Hans Dietz is a 25 year old male patient with a family history of Marfan Syndrome (MFS).  He is generally well and enjoys attending regular fitness sessions in his local gymnasium.  During a recent gym session, he experienced dizziness followed by a fainting episode.  He presented at the emergency department and a new systolic murmur was heard.  Mr Dietz subsequently underwent screening for cardiovascular abnormalities associated with his family history of Marfan Syndrome.

Question 1

The fibrous structure of the heart is comprised predominantly of connective tissue proteins. 

Describe the microscopic composition of the layers of the mitral valve.  Your answer must include a description of the connective tissue element, the cell types found in each layer and how the layers are arranged (i.e. their structure or architecture).                     3 marks            

Question 2

Upon further evaluation with an echocardiogram (cardiac ultrasound), Mr Dietz was found to have an enlarged (dilated) proximal ascending aorta, mitral valve prolapse with myxomatous changes and elongated chordae.

The patient was noted as having myxomatous changes in the mitral valve leaflets and associated elongation of the chordae tendineae.  Explain what is meant by the term myxomatous changes. Your answer must include a description of the cellular and structural changes that occur within the valve. 2 marks

Question 3

Where on the body would be the ideal position for the clinician to auscultate for a systolic murmur associated with the mitral valve? 2 marks

Question 4

Describe the secondary complications (or consequences) that will occur as a result of the changes in the structure of the mitral valve in a patient with Marfans syndrome.  Your answer should link to the clinical sign noted in this patient of the new systolic murmur.  3 marks