The Impact of Nursing Shortage on Healthcare

The Impact of Nursing Shortage on Healthcare

Part 1

Topic Project: The Impact of Nursing Shortage on Healthcare

Assessment Description

Review your problem or issue and the cultural assessment. Consider how the findings connect to your topic and intervention for your capstone change project. Write a list of three to five objectives for your proposed intervention. Below each objective, provide a one or two sentence rationale.

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After writing your objectives, provide a rationale for how your proposed project and objectives advocate for autonomy and social justice for individuals and diverse populations. The Impact of Nursing Shortage on Healthcare

 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. The Impact of Nursing Shortage on Healthcare

 

Part 2

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

  1. Evidence-based solution
  2. Nursing intervention
  3. Patient care
  4. Health care agency
  5. Nursing practice

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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 required to submit this assignment to LopesWrite.

 

Mental Health Movie Analysis

Mental Health Movie Analysis

 

Mental Health Movie Analysis  “Call Me Crazy” Mental Health Movie Analysis

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Watch the 5-part movie and write an APA style paper that addresses the following questions. This assignment is worth 100 points. See provided grading rubric. Integrate outside sources to support your points. Outside sources must be peer-reviewed journal articles or the textbook. Required: 1 peer-reviewed source; 1 textbook citation Mental Health Movie Analysis

 

Audience: your nursing colleagues                          Purpose: to explain/to inform

 

Content/Suggested Outline:

 

Episode 1

  1. What mental illness does Lucy have?
  2. What positive purpose does the group therapy session serve for Lucy in the beginning of episode one?
  3. Explain what positive and negative symptoms of this disease are?
  4. What specific positive symptoms does Lucy display?

 

Episode 2

  1. What mental illness does Grace’s mother have? Explain this disease.
  2. What behaviors does Grace’s mother display during her manic episodes?
  3. What compliance issues does Grace’s mother have with her disease?
  4. What type of cognitive distortion does Grace believe during the chaos of her mothers’ illness? (seeyour textbook for examples of cognitive distortions)
  5. What does Grace finally conclude about herself as related to her mother’s illness? Mental Health Movie Analysis

 

Episode 3

  1. Describe stigma as related to mental health in your own words.
  2. What is a command hallucination?
  3. What happened when Lucy had a command hallucination?
  4. How did Lucy’s mental illness affect her family members?

 

Episode 4

  1. What symptoms does Eddie Tannenbaum display with his depression?
  2. Describe how his wife is affected by Eddie’s depression.
  3. What is the irony with Eddie’s disease and his profession?

 

Episode 5

  1. What symptoms of PTSD does Maggie have?
  2. Define hope in your own words why is hope so important?

 

Overall

  1. What did you gain from watching this movie.
  2. Describe your feelings towards the movie and characters portrayed. Were they accurate depictions of the disease state?
  3. How did watching this movie change your perspective towards mental health patients.

 

Required Formatting & Length:  APA 7th ed; 6 pages (Cover page & Reference page are not included)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mental Health Writing Assignment Grading Rubric
Criteria Ratings Pts
APA Format
10 to 5 pts

Full Marks

Correct formatting, with title and reference page. Use of two references in correct form.

4.9 to 3.5 pts

Needs improvement

3-5 errors in APA formatting

3.5 to 0 pts

No Marks

Greater than 5 errors

10 pts
Grammar
20 to 10 pts

Full Marks

Minimal grammar errors. Correct sentence structure and no spelling errors.

9.9 to 3.5 pts

Needs improvement

Spelling errors, subject and verb agreement errors and incomplete sentence structure

3.5 to 0 pts

No Marks

More than 5 spelling errors, more than 3 incomplete sentences

20 pts
Nursing content
60 to 40 pts

Full Marks

Covers each area in a concise manner. All major areas covered. Evidence based practice is cited. Medical terminology is used properly.

39.9 to 20 pts

Needs improvement

Missing 3 basic areas of nursing knowledge, or appropriate answers to specific nursing related questions. Lacking a source of strong evidence.

19.9 to 0 pts

No Marks

No evidence cited and not covering major concepts.

60 pts
Assignment
10 to 5 pts

Full Marks

Paper 6 pages in length. Cover page and reference page included.

4.9 to 3.5 pts

Needs improvement

Missing 1 of the following- cover page, reference page. Less than 6 pages or excessive amount over 6 pages.

3.5 to 0 pts

No Marks

Greater than 1 of these criteria missing.

10 pts
Total Points: 100

 

 

 

 

 

Post Clinical Reflection

Post Clinical Reflection

CAMPBELL UNIVERSITY COLLEGE OF PHARMACY & HEALTH SCIENCES

School of Nursing Post Clinical Reflection

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Post Clinical Reflection

 

Objectives:

  1. Maintain an attitude of respect for others, even those with differing points of view or different backgrounds.
  2. Demonstrate an attempt to gain understanding of another’s position and reasoning when they differ from that of the healthcare professional.
  3. Demonstrate a belief in the intrinsic worth of others.
  4. Demonstrate a willingness to continually self-observe.
  5. Exhibit a sensitivity to the needs of others and respond in a professional and ethical manner. Post Clinical Reflection

 

 

In reviewing your experience pertaining to clinical, reflect on your pre-clinical perceptions about mental health patients, and evaluate how different (if so) your perceptions are after your experience in the clinical setting. Write a paper in which you:

 

  • Analyze both positive and negative experiences you were expecting before your clinical rotation and how they are either the same or different since your clinical experience.
  • List what methods you used to change your expectations of the clinical rotation experience.
  • List three concepts you learned from this clinical rotation and how they will better aid you as a nurse caring for a mentally ill patient.

 

 

Your paper should be at least 4 pages long and should follow APA format. A title page is required, which is not included in the paper length. You do not need references or a reference page for this assignment.  You will be graded according to the rubric provided.

 

 

 

Criteria Ratings
Grammar

 

20 pts

20 to 10 pts

Full Marks

Minimal grammar errors. Correct sentence structure and no spelling errors.

9.9 to 3.5 pts

Needs improvement

Spelling errors, subject and verb agreement errors and incomplete sentence structure

3.5 to 0 pts

No Marks

More than 5 spelling errors, more than 3 incomplete sentences

Nursing content

 

60 pts

60 to 40 pts

Full Marks

Covers each area in a concise manner. All major areas covered. Evidence based practice is cited. Medical terminology is used properly.

39.9 to 20 pts

Needs improvement

Missing 3 basic areas of nursing knowledge, or appropriate answers to specific nursing related questions. Lacking a source of strong evidence.

19.9 to 0 pts

No Marks

No evidence cited and not covering major concepts.

Assignment

 

20 pts

20 to 10 pts

Full Marks

Paper 4 pages in length. Cover page and reference page included.

9.9 to 3.5 pts

Needs improvement

Missing 1 of the following- cover page, reference page. Less than 2 pages or excessive amount over 2 pages.

3.5 to 0 pts

No Marks

Greater than 1 of these criteria missing.

Total Points: 100

 

Assessment of Health Promotion Case Two

Assessment of Health Promotion Case Two

Assessment of Health Promotion Case Two

Interaction patterns define how patients and nurses relate or interact with each other. For instance, the patients may feel comfortable sharing their personal information with a certain nurse and fail to trust another. Therefore, handling interaction patterns well could improve outcomes. Effective communication, except exchanging information, refers to understanding patients’ emotions, experiences, and opinions. For example, healthcare practitioners can maintain eye contact with their patients, growing their trust even when exhausted. Maintaining good composure, showing empathy, and understanding the patients could be show effectiveness in PQs practice within the community. Assessment of Health Promotion Case Two

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The ability to express emotions refers to showing emotions correctly in different situations. For example, when a patient is talking about a painful condition, a healthcare practitioner can show them how they feel by making an impression by showing empathy or smiling when they make a joke. Conversely, expressing conflicting emotions results in ineffectiveness. Responsiveness to members’ needs as individuals means the ability to assist patients in their capacities. For example, when a healthcare practitioner can help two patients with anxiety that different issues have caused, understand the uniqueness of each of them and address it, accordingly, ensuring each patients’ needs are met.

Problem-solving ability refers to dealing with problems timely and effectively devoid of any impediments, such as identifying a patient’s situation, such as depression, and assisting them with the issue before they harm themselves or the community. In addition, solving problems on time helps avoid complications resulting from delays. Understanding the psychological well-being of an individual is also critical as this can be a contributing factor to their conditions. Research suggests that individuals with psychological issues are more likely to have severe diseases than psychologically fit persons (Beck et al., 2021). Different cultures deal with varying issues that might be caused by unique circumstances such as systemic poverty that may limit their ability to buy healthy foods leading to, for instance, diabetes prevalence through consumption of cheap, unhealthy diets. Understanding where a person is coming from in terms of culture is essential in designing interventions, letting a healthcare practitioner apply the necessary approach to assist them. When designing interventions financial might of an individual may play an important role. Whether they will afford the prescriptions should be considered for each case.

Although family structures might be complex, the developmental family theory can aid in understanding the stages that families undergo. The family developmental cycle contains eight stages (Duvall & Young, 2019). The first stage is when the wife and husband establish their own family. The couple begins to plan for children and develops a mutually satisfying marriage. The second level starts with the birth of the couple’s first child. At this stage, the couple has a baby and is adjusting to raising it together, attempting to make their family happy. The third stage is when the family has a preschool-aged child. The couple adjusts to the children’s requirements during this period and handles the loss of energy and privacy. The fourth stage begins when children are of school age. At this stage, the couple seeks to assimilate into their societies while simultaneously supporting their children’s academic achievements.

Further, the fifth stage begins when teenagers learn to manage responsibility and autonomy and acquire post-parental interests throughout this developmental era. The next phase is the launch of children. Transitioning the youngster into adulthood while preserving a stable family environment is the goal of this stage. The seventh stage occurs when couples are in their 40s and 50s, focusing on their marriage since their children are grown up. Finally, on the eighth level elderly family members focus on their retirement plans and the possibility of selling the residential property.

Family relationships have a substantial-good and negative influence on health. A close-knit and loving family gives emotional support, financial security, and improved health. Conversely, the well-being of family members is significantly harmed when the social fabric is dominated by stress and conflict (Noh et al., 2017). One of the most critical ways that family has a beneficial influence on health is through social support. Growing up in an unsupportive, inattentive, or aggressive family is related to poor physical development and health. Therefore, ensuring that a family is closely knit and cohesive improves health outcomes.

References

Beck, K., Vincent, A., Becker, C., Keller, A., Cam, H., Schaefert, R., Reinhardt, T., Sutter, R., Tisljar, K., Bassetti, S., Schuetz, P., & Hunziker, S. (2021). Prevalence and factors associated with psychological burden in COVID-19 patients and their relatives: A prospective observational cohort study. PLOS ONE16(5). https://doi.org/10.1371/journal.pone.0250590

Duvall, J., & Young, K. (2019). Narrative family therapy. Encyclopedia of Couple and Family Therapy, 2003-2011. https://doi.org/10.1007/978-3-319-49425-8_241

Noh, J., Kim, K., Park, J., Hong, J., & Kwon, Y. D. (2017). Relationship between the number of family members and stress by gender: Cross-sectional analysis of the fifth Korea national health and nutrition examination survey. PLOS ONE12(9). https://doi.org/10.1371/journal.pone.0184235

 

Malnutrition associated with specific health conditions

Malnutrition associated with specific health conditions

TOPIC 3: Malnutrition associated with specific health conditions: What specific health conditions increase the risk of malnutrition?

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Has to be 2-3 pages

 

 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817125/

 

 

  • Bold for each Heading and Subheading Malnutrition associated with specific health conditions
  • Include in-text citations for all information/contents as needed
  • Summary paper MUST be written in this format

 

Introduction and Key Points

Chosen Topics and Question

  • Select one topic and question from five main topic list

 

Define the Topic and Question

  • How do you interpret and/or understand the topic and question you selected? Malnutrition associated with specific health conditions

 

Overview/Significance of Problem

  • Describe Overview and Significance of Problem of the topic and question you selected
  • Include in-text citations

 

Article Search

Current and credible resourcesList Chamberlain library Database(s) used

 

Database search-terms and methods

 

Number of articles located

 

List additional sources outside of ATI module List all sources you used for article search outside of ATI (CDC, American Diabetic Association, etc.)

 

Article Findings

Why this article chosen?

 

How it addresses the topic?State the “Purpose/Aim of Study” the author stated in article

 

Type of Research conducted

  • Quantitative, Qualitative, Descriptive, or Mixed-Method study?
  • Briefly describe what was done (sample, methods, measurement tools used)

 

Findings of ResearchComprehensively describe ALLFindings in the article.

 

Evidence for Practice

Summary of Evidence

  • Briefly summarize the findings.

 

How will this evidence improve current practice?

  • Briefly describe what the current practice is.
  • Describe how this evidence improve current practice?

 

How will this evidence decrease a gap in current practice?

  • Briefly describe difference between the current knowledge, skills, competence, practice, performance or patient outcomes and the ideal or desirable state
  • Describe how this evidence decrease a gap in the practice?

 

Any concerns or weaknesses in the evidence/finding? (Found in Discussion)

 

 

Sharing of Evidence

Who would you share the information with?

 

 

How would you share this information?(in-services, health fair for patients, educate healthcare professionals)

 

 

What resources would you need to accomplish this sharing of evidence?

  • List resources you may need for sharing the evidence as you stated in above 2 questions (who and how) (i.e. administrator, manager, support for materials….etc)

 

Why would it be important to share this evidence with the nursing profession?

 

 

Conclusion

  • Summarizes the Research processes, Findings, and Key points.
  • Do NOT include Conclusion/Implication on the article

 

 

 

Teen Pregnancy

Teen Pregnancy

Case #3: Teen Pregnancy

Teen pregnancy is when a woman younger than twenty years of age gets pregnant. Although the number of cases has dropped significantly, more than half-million young teens in the United States become pregnant (Centers for Disease Control and Prevention [CDC], 2021). Pregnant teenagers have difficulty coping with these new changes, which places them under much stress and risk for serious health conditions, such as gestational hypertension. Many contributing factors can increase the possibility of teen pregnancies, such as economic, education, and social status. Healthcare professionals should be aware of these factors and educate these individuals about preventative measures for teen pregnancies. Teen Pregnancy

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Health Assessment

Performing an accurate health assessment of the community can help healthcare professionals address different manners and develop a solution to the population’s health problems. There are several parameters that healthcare professionals should address when conducting community assessments concerning teen pregnancies. These parameters can include income, education, social support networks, and living environments.

Plan of Action for Teen Pregnancies

Preventative care and education are the first steps in addressing the situation. The Youth Risk Behavior Surveillance System has shown that one of the common health-risk behaviors among youth is sexual behaviors that have been linked to unintended pregnancies and STDs (Stanhope & Lancaster, 2017).  Teaching teenagers about safe sex practices, such as contraceptives and birth control pills, can help prevent these health problems. Schools should be able to provide classes to the students about sexual education. A healthcare professional should address contraceptive measures, safe sexual intercourse, and sexually transmitted conditions in these classes. These classes should be used for prevention, not to scare the students. If students are scared, they will feel intimidated to ask questions or seek help, risking their health. Many parents avoid talking to their children about this subject, so it is essential to provide parents with resources about the benefits of speaking to their children about safe sex practices and ways they can approach their children about the subject. Teen Pregnancy

Family Developmental Stages, Structure, and Function

There are different stages in the family cycle, each contributing to a family developmental task. Each family structure and function is different based on the individual. As healthcare professionals, it is essential to address the family structures of our patients, as this can contribute to or hinder the care we give to our patients.

Here is a list of some of the family stages with their essential tasks (Stanhope & Lancaster, 2017):

  • Married couple: Role development and establishing a relationship as a family begins.
  • Childbearing families with infants: Family routines and rituals are developed. New parents learn new roles and maintain couple time and intimacy.
  • Families with preschool children: Understanding growth and development for their child and discipline is established. Energy depletion is expected in this stage.
  • Families with school-age children: Family boundaries are established as the child spends more time with others outside of the home.
  • Families with adolescents: Teen increases autonomy, and the family adapts to new family communication changes.
  • Families launching young adults: Families adapt to their new roles as young adults move in and out of the home.
  • Middle-aged parents: Retirement and the future is addressed.
  • Aging parents: Adjust to new living situations and death.

References

Centers for Disease Control and Prevention. (2021, November 15). About teen pregnancy. https://www.cdc.gov/teenpregnancy/about/index.htm

Stanhope, M., & Lancaster, J. (2017). Foundations for population health in community/public health nursing (5th ed.). Mosby.

 

 

Malnutrition associated with specific health conditions

Malnutrition associated with specific health conditions

TOPIC 3: Malnutrition associated with specific health conditions: What specific health conditions increase the risk of malnutrition?

 

Has to be 2-3 pages

 

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6817125/

 

 

  • Bold for each Heading and Subheading
  • Include in-text citations for all information/contents as needed
  • Summary paper MUST be written in this format Malnutrition associated with specific health conditions

 

Introduction and Key Points

Chosen Topics and Question

  • Select one topic and question from five main topic list

 

Define the Topic and Question

  • How do you interpret and/or understand the topic and question you selected?

 

Overview/Significance of Problem

  • Describe Overview and Significance of Problem of the topic and question you selected
  • Include in-text citations Malnutrition associated with specific health conditions

 

Article Search

Current and credible resourcesList Chamberlain library Database(s) used

 

Database search-terms and methods

 

Number of articles located

 

List additional sources outside of ATI module List all sources you used for article search outside of ATI (CDC, American Diabetic Association, etc.)

 

Article Findings

Why this article chosen?

 

How it addresses the topic?State the “Purpose/Aim of Study” the author stated in article

 

Type of Research conducted

  • Quantitative, Qualitative, Descriptive, or Mixed-Method study?
  • Briefly describe what was done (sample, methods, measurement tools used)

 

Findings of ResearchComprehensively describe ALLFindings in the article.

 

Evidence for Practice

Summary of Evidence

  • Briefly summarize the findings.

 

How will this evidence improve current practice?

  • Briefly describe what the current practice is.
  • Describe how this evidence improve current practice?

 

How will this evidence decrease a gap in current practice?

  • Briefly describe difference between the current knowledge, skills, competence, practice, performance or patient outcomes and the ideal or desirable state
  • Describe how this evidence decrease a gap in the practice?

 

Any concerns or weaknesses in the evidence/finding? (Found in Discussion)

 

 

Sharing of Evidence

Who would you share the information with?

 

 

How would you share this information?(in-services, health fair for patients, educate healthcare professionals)

 

 

What resources would you need to accomplish this sharing of evidence?

  • List resources you may need for sharing the evidence as you stated in above 2 questions (who and how) (i.e. administrator, manager, support for materials….etc)

 

Why would it be important to share this evidence with the nursing profession?

 

 

Conclusion

  • Summarizes the Research processes, Findings, and Key points.
  • Do NOT include Conclusion/Implication on the article

 

 

 

Postoperative cerebrospinal fluid (CSF) leak

Postoperative cerebrospinal fluid (CSF) leak

Patrick Realon

Posted Date

Mar 31, 2022, 8:25 AM

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Postoperative cerebrospinal fluid (CSF) leak is a well-known complication following transsphenoidal surgery for sellar lesions, with a reported incidence in the range of 8.6%–15.9%. Its occurrence may result in meningitis, and prolonged treatment or reparative surgery are required in some patients. Following transsphenoidal surgery, patients are at risk for developing a variety of neuroendocrine or other postoperative complications, which can potentially be minimized or prevented by maintaining a high degree of awareness for such issues on the part of the neurosurgical team and nursing staff. Serial clinical monitoring of a patient’s neurological and visual status is imperative following transsphenoidal surgery, as patients may develop untoward complications such as postoperative hematomas, epistaxis, ischemic events, hydrocephalus, CSF leaks, or meningitis. Maintaining a constant state of vigilance for these uncommon, but serious, events in all patients is absolutely critical. If a CSF leak is suspected in the postoperative period, a noncontrast CT scan of the head is a useful study that may demonstrate the presence of intracranial air in the event of a CSF leak. Although the majority of patients do not require insertion of nasal packing at the time of surgery, some patients (especially those with or intraoperative CSF leaks requiring sellar floor reconstruction, Cushing’s Disease, and acromegaly) may benefit from their insertion. If used, nasal packing can typically be removed on postoperative day one. Postoperative epistaxis infrequently develops following transsphenoidal surgery and can typically be treated successfully with routine nasal packing for 2-3 days. In rare refractory cases of epistaxis, reoperation or endovascular embolization of an arterial bleeder may be required (Sun et al., 2018).  Postoperative cerebrospinal fluid (CSF) leak

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Aberrancies of fluid homeostasis and serum electrolytes occur quite commonly following transsphenoidal surgery. An understanding of the underlying physiology, coupled with monitoring of a patient’s volume status, as well as serum and urine laboratory studies, may make a significant difference in a patient’s postoperative course. Although a foley catheter is not inserted at the time of surgery in the majority of patients at our institution, strict measurement of a patient’s intake, output, and daily weight should be carried out in order to provide a continuous assessment of volume status.  Patients with preoperative evidence of hypopituitarism should be maintained on sufficient stress doses of hormonal replacement during the initial perioperative period, and then kept on physiological maintenance doses of replacement agents until it is appropriate to assess their pituitary function in a controlled manner. Patients with evidence of hormonal excess typically undergo appropriate lab testing during the first few days following surgery to assess for evidence of early endocrinological remission (Sun et al., 2018).

Primary reconstruction techniques use autologous grafts (e.g., fascia lata) or a pedicled nasoseptal flap to reconstruct the skull base when a CSF leak occurs during or after surgery. However, due to the unpopularity of endoscopy and unfamiliarity with this reconstruction method in surgery department, we used alternative repair methods and also obtained excellent results. Most patients chose conservative methods for CSF rhinorrhoea repair, with surgical repair used only if conservative treatment failed. Our strategies often eliminated the need for additional surgery; however, conservative treatment may increase the risk of infection, duration of hospitalization and economic and psychological burden on the patient. Surgical repair should be performed as soon as general clinical conditions allow if diagnostic assessments have detected CSF rhinorrhoea and identified the exact site of the leak. They concluded that clinical presentation and office-based endoscopic nasal exam were of primary importance to evaluate suspected CSF leaks. Prospective randomised controlled studies are needed to clarify the optimal approach and time window for surgical repair of CSF rhinorrhoea (Zhang et al., 2017).

Endoscopic endonasal pituitary surgery differs from the transsphenoidal microsurgery in the following aspects: plane vision, close-up view, no nasal speculum, endonasal approach and ample vision field. Microscopy features a three-dimensional visualisation, wider view and use of a transnasal speculum. Use of the endoscope during TSS is important in that it allows maximum tumoural excision and better visualisation of a small CSF fistula. Because of the enhanced illumination and visualisation of lesions, endoscopic surgery for CSF rhinorrhoea is more reliable and convenient than traditional TSS. In addition, we found that the endoscopic approach enables precise confirmation of the leakage site, sufficient exposure, minimal invasiveness and high rate of success. Although endoscopy was underutilised initially in our department, we subsequently used endoscopy to repair CSF leakage with excellent results. We therefore strongly recommend endoscopy for surgical repair as well as tumour removal (Zhang et al., 2017).

Following discharge, patients are usually seen in the clinic for routine follow-up one week after surgery, then again at the 6-week postoperative time point for routine endocrine and postoperative evaluation, to account for equilibration of the hypothalamic-pituitary-adrenal axis as well as the longer half-life of thyroid hormone. Postoperative MR imaging is obtained 3 months following the operation, to allow sufficient resolution of postoperative changes prior to any meaningful assessment regarding the extent of tumor resection. Routine imaging studies may then be obtained annually, or more often as indicated. Patients with sellar pathology may have delayed tumor recurrences occurring up to several years after successful remission, therefore mandating continued endocrinological and imaging surveillance, even beyond a decade following initial remission (Sun et al., 2018).

References:

Sun, I., Lim, J. X., Goh, C. P., Low, S. W., Kirollos, R. W., Tan, C. S., Lwin, S., & Yeo, T. T. (2018). Body mass index and the risk of postoperative cerebrospinal fluid leak following transsphenoidal surgery in an asian population. Singapore medical journal59(5), 257–263. https://doi.org/10.11622/smedj.2016159

Zhang, C., Ding, X., Lu, Y., Hu, L., & Hu, G. (2017). Cerebrospinal fluid rhinorrhoea following transsphenoidal surgery for pituitary adenoma: Experience in a Chinese centre. Rinoliquorrea dopo chirurgiadell’adenomaipofisario con approcciotransfenoidale: esperienza in un centrocinese. Acta otorhinolaryngologicaItalica : organoufficialedellaSocietaitaliana di otorinolaringologia e chirurgiacervico-facciale37(4), 303–307. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5584102/

 

Transsphenoidal surgery

Transsphenoidal surgery

Transsphenoidal surgery is the approach of choice for pituitary adenomas and is indicated when the mass impacts the function of other surrounding structures (Melmed & Jameson, 2018, p. 2672).  The common symptoms from a local mass effect of a pituitary tumor are headache and visual disturbances; and other symptoms that vary by adenoma type (Melmed & Jameson, 2018, p. 2671). Postoperative central diabetes insipidus (CDI) is a result of damage to the pituitary stalk, hypothalamic injury, or a disruption in the hypothalamic-neurohypophyseal connections (Elisaus & Ball, 2021). This results in a deficiency of AHD and prevents concentration of urine in the renal collecting tubule. DI can be classified into three different types: nephrogenic, central, and dipsogenic (Elisaus & Ball, 2021). Nephrogenic occurs when there is a lack of renal response to ADH and dipsogenic occurs secondary excess fluid intake. To determine which etiology of DI is present; a water restriction test is performed. If urine concentrates with water restriction, then there is no DI; next desmopressin (dDAVP) is given and if urine concentrates then it is CDI; in nephrogenic DI, urine will not concentrate with either intervention (Elisaus & Ball, 2021). In this scenario, we know the patient is manifesting CDI secondary to a pituitary adenoma resection. CDI occurs transiently in 10-20% of transsphenoidal pituitary surgeries and is permanent in 2-7% of patients (Swearingen, 2021). Thus, post-operative transsphenoidal surgical patient should be closely monitored for CDI by monitoring urine output. Polyuria (3L/d) and polydipsia are hallmark symptoms of DI (Elisaus & Ball, 2021). A diagnosis can be made by a low urine osmolality (<250mosmol/kg) with high serum osmolality (>290mosmol/kg) and no hyperglycemia (Elisaus & Ball, 2021). Treatment for CDI is with DDAVP 5-20mcg/day and fluid replacement. Serum sodium, urine osmolality, and urine output help guide the continued need for dDAVP and fluid therapy (Swearingen, 2021). Typically, only one or two doses of dDAVP are needed (Elisaus & Ball, 2021). CDI can vary from mild to severe with the major concern of life-threatening hypernatremia and dehydration. Hypernatremia can manifest with neurologic symptoms of: confusion, restlessness, lethargy, seizures, and death. Severe volume depletion can cause circulatory collapse. For these reasons, post-op transsphenoidal patients are typically monitored in the ICU for the first 48 hours to monitor for the development of DI.  Transsphenoidal surgery

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References

Elisaus, P., & Ball, S. (2021). Diabetes insipidus. Medicine49(8), 495–497. https://doi.org/10.1016/j.mpmed.2021.05.009

Melmed, S., & Jameson, J. L. (2018). Pituitary tumor syndromes. In Harrison’s principles and practice of hospital medicine (20th ed.). McGraw Hill.

Swearingen, B. (2021). Transsphenoidal surgery for pituitary adenomas and other sellar masses. UpToDate. Retrieved March 31, 2022, from https://www.uptodate.com/contents/transsphenoidal-surgery-for-pituitary-adenomas-and-other-sellar-masses?search=transsphenoidal%20surgery&source=search_result&selectedTitle=1~35&usage_type=default&display_rank=1#H21307966

REPLYRLRommel Lantajo

Posted Date

Mar 31, 2022, 1:53 AM

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Diabetes insipidus (DI) is an uncommon neurological condition that accounts for 1 in every 25,000-patient population (Christ-Crain et al., 2021). The underlying clinical issue with DI comes as part of the polydipsia-polyuria syndrome, which is characterized by hypotonic urine and excessive polydipsia (Christ-Crain et al., 2021; Christ-Crain, 2020). The postoperative neurosurgical patient is prone to developing the central form of DI (Christ-Crain et al., 2021; Christ-Crain, 2020). The pathophysiological underpinning of central DI is the lack or inability of the posterior pituitary to secrete arginine vasopressin (Christ-Crain et al., 2021; Christ-Crain, 2020). The insufficient synthesis of arginine vasopressin in the hypothalamic neurohypophyseal system causes this inappropriate osmotic stimulation (Christ-Crain et al., 2021; Christ-Crain, 2020).  Transsphenoidal surgery

The clinical manifestation of Di is excessive urinary excretion, usually more than 50 mL per kilogram in 24 hours, and increased oral intake of water (Christ-Crain & Gaisl, 2021). The patient with DI will also present with serum hyperosmolar and hypernatremia associated with urinary hypo osmolar (Christ-Crain & Gaisl, 2021). Some patients may or may not present with fever, excessive sense of thirst, irritability, etc. (Christ-Crain & Gaisl, 2021). The main treatment in DI is to identify the primary cause, postoperative neurosurgery in this case (Christ-Crain & Gaisl, 2021). Therefore, it is vital that the provider must keep in mind that severe hyperosmolality from dehydration should be managed promptly (Christ-Crain & Gaisl, 2021). The water should be replaced by at least 50 % of the calculated free water deficit within 24 hours (Christ-Crain & Gaisl, 2021). The overcorrection of water can lead to unwanted neurological consequences such as cerebral edema, seizures (Christ-Crain & Gaisl, 2021). Furthermore, the management of diabetes insipidus should be focused on the prevention of secondary complications of excessive water intake, which can further cause severe fluid and electrolyte imbalances (Christ-Crain & Gaisl, 2021). In addition, a single dose of desmopressin is sufficient to treat neurosurgery-related DI (Christ-Crain & Gaisl, 2021).

References

Christ-Crain, M, Winzeler, B, Refardt, J. (2021). (University Hospital Basel, University of Basel, Basel, Switzerland). Diagnosis and management of diabetes insipidus for the internist: an update (Review). J Intern Med.,290(1), 73– 87. https://doi.org/10.1111/joim.13261

Christ-Crain M: Diabetes Insipidus: New Concepts for Diagnosis. Neuroendocrinology 2020;110:859-867. doi: 10.1159/000505548

Christ-Crain, M. & Gaisl, O. (2021). Diabetes insipidus. La Presse Médicale, 50 (4), 104093. https://doi.org/10.1016/j.lpm.2021.104093.

Social Concepts of Nursing

Social Concepts of Nursing

Social Concepts of Nursing, Guidance for the Poster of Community Profile.

ORDER A PLAGIARISM FREE PAPER NOW

 

50% of your mark for the Social Concepts of Nursing Module will be assessed from creation and presentation of a Community Profile presented as an online Poster. You will be allocated a Ward from the Kirklees District and your task is to produce a poster giving a community profile of the allocated area. Social Concepts of Nursing

 

There maybe be more than one group looking at each ward, this provides the opportunity to learn how different groups approach a task. 

 

Below explains what a community Profile is, how to create one and aspects to include. You can be as creative as you like with your poster in terms of pictures, charts etc.  but you must produce a 2 Power-point slides one is the poster and the second references.  Please ensure that you support the information you use with appropriate references. Social Concepts of Nursing

 

What is a community profile?

A community profile provides an overview of the community at a certain point in time. It is auseful way to identify the strengths and weaknesses of a local area and the health challenges. There are many different types of community profiles that can be prepared using a variety of techniques. This guide will identify the areas that should be included.Your community profile MUST identify the health needs of your focus area and contributing factors to the health outcomes of the local population.

 

Basic Tools and Methods

 

Statistics

The Census provides the basic skeleton for any community profile. Information on a range of key statistics such as population, age and gender can be obtained. Census figures are available fromhttps://www.ons.gov.uk/census

Although the Census is from 2011 it is still a valuable starting point, and it is regarded as the highest quality data albeit somewhat out of date. The last Census took place on 21 March 2021 however the information will not be available for you to use in your community profile. 

 

Other official statistics produced by the Government are available at a local level found here for Kirklees-Joint Strategic Assessment: http://observatory.kirklees.gov.uk/jsna/population

 

 

Other methods

Kirklees district is divided into 23 wards and information on these different wards can be found here:

https://www.kirklees.gov.uk/beta/information-and-data/area-and-ward-profiles.aspx

 

When gathering informationto build a CommunityProfileyou need to research widely and include in your community profiledemographics of the population and the health needsof the specific ward. You need to consider the area you are focusing on and research the health of the population within the ward. Consider and explore the factors in the area which impact on the population.Considering aspects such as location, urban, rural, facilities- shops, library, fast food outlets, restaurants, leisure, green spaces parks, health care, clinics, gyms, transport networks, type of housing, traffic – pollution, social factors, education and education outcomes, crime affluence, poverty and social deprivation, employment etc. Think about the health topics covered in the module and how the aspects of the ward you are covering might contribute to better or poorer health outcomes.

 

This link provides information about public health within the Kirklees District

https://www.kirklees.gov.uk/beta/delivering-services/pdf/public-health-report.pdf

 

Question to consider
Topic: Brief summary of history and description of the area (covered by the plan)
Is the local area a village, town or city?
Is the local area urban or rural or a combination?
Is the community population growing or declining in general?
What is the physical character of the local area? E.g. lots of green spaces, large houses, rural lanes What type of housing? Council, private owned, private rented, general housing stock? Back to back terraced housing, large detached houses?
Population
What is the total population of the local area? Is it a diverse population in terms of age, ethnicity?
What is the gender break down? E.g. 50 / 50
What is the average age of the community? Creating a chart showing the age structure of your community could be very useful as it may help to showif

there may be a future demand for particular housing types eg if there is ahigh

 

 

proportion of elderly people there may be a demand for appropriate housing to cater for older people’s needs
What is the general state of health of the community? Any particular health focus, problems or targets for the community.
What proportion of your community has a disability?
What proportion of the community is working?
What is the ethnic breakdown of the community?
Are there changes taking place which may affect the size or makeup of the population? e.g. has significant development taken place since the Census?
Service provision
Which of the following services are provided within your local area? If not available within your local area how far is it to the nearest:

►       Police station

►       Fire Station

►       Post Office

►       Library

►       Food banks

Which of the following health facilities are provided within your local area? If not available within your local area how far is it to the nearest:

►       Doctor (or healthcentre)

►       Nurse

►       Dentist

►       Hospital

Education
Which of the following education facilities are available within the local area? If available in the local area please indicate how many. If not available within the local area how far is it to the nearest:

►       Pre-schoolfacility

►       Primaryschool

►       Secondaryschool

►       Further educationcollege

►       University

►       How many children are on free school meals in the area?

►       Number of children leaving school with GCSE Maths and English passes or 5 GCSEs and above?

Is provision made for pre-school and after school childcare?
Is childcare provision before and afterschool adequate for its purpose?
Is there a library service available in the local area? What services does it offer?
When the schools and colleges identified above are not in use do other community activitiesoccur use e.g. fitness classes? Adult education?
Work and economy
Where are the main concentrations of employment located within the local area?
Who are the major employers? E.g they employ more than 10 people
Where do most people who work in the local area live? E.g. proportion of people who commute in or out of the local area everyday to work
What is the level of unemployment in your local area?
Is the community’s economy generally vibrant or are many shops closing?
Would you be able to complete a weekly shop within the local area?

Is there a large number of fast food Outlets, restaurants?

*Is out of town shopping available?
Do local people have a means to obtain cash or pay bills? Please indicate which facility is available in your local area?

►       Banks

 

►       buildingsociety

►       postoffice

►       ATM

Please indicate which of the following facilities are available:

►       Shop(s)

►       Pub(s)

Transport
What public transport services are available in your local area?

►       Bus

►       Train

Is the frequency of service adequate?

Do the public transport services serve all parts of community?
Is there community transport available e.g. dial-a-ride
Where are the nearest train stations?
Is there a designed cycle route?
Leisure / recreation
Do you have a leisure centre?
*Which of the following leisure / recreation facilities are available

►       children’s playarea

►       skatepark

►       community / villagehall

Crime and Nuisance
What is the perceived level of non violent crime in your area eg vandalism, burglary?

Lots of incidents A few incidents

Very occasional incidents Not at all

Don’t know

Are there perceived issues relating to Anti- Social behaviour in your area?

Are there specific areas where crime levels are perceived to be concentrated?
Are you aware of what the police or community safety teams are doing to

tackle crime issues in your area?

 

 

Making a Profile work for your community

Doing a community profile can be hard work so it is always worth thinking about how to make the most of it and making sure it gives you useful and relevant information. Below are a few pointers:

 

  • Be clear about the area being profiled – clearly indicate boundaries on a map ifnecessary
  • Don’t do more than you have to; only look at topics/issues relevant to your plan beingproduced (see above for areas to focus on).
  • Ensure you give a description of the ward you are focusing on and include the demographics of the population, the health needs and how the area contributes to the health outcomes of the population.

 

  • Think about how the profile will be written up and presented; your target audience is your peers and University lecturers.Remember your work should consist of 2 power-point slides. The first slide should be the poster and the second the supporting references.