1-which of the following behaviors may be

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1-which of the following behaviors may be

1-which of the following behaviors may be (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical.

A. Working in a clinic that performs abortions

b. Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

c. Respecting the health surrogate’s wishes regarding termination of life support of her friend

d. Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient.

2-differentiate among the following: deontological theories, utilitarianism, and principlism.

3-what do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress.

4-What do they think about health-care professionals disclosing information to clients against family wishes?

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do?

6.Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? .

8-You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication?

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​Politics and the Law.

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​Politics and the Law.

Chapter 11 The Health Care System Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of

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Elsevier Inc. U.S. Health Care System Figure 11-1 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 U.S. Health Care System (Cont.)  Private health care subsystem ➢ ➢ ➢ ➢ Focus on the individual Nonprofit and for-profit agencies Models of services • Solo practice • Single specialty group practice • Multispecialty group practice • Integrated health maintenance model • Community health center Voluntary or nonofficial agencies Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 U.S. Health Care System (Cont.)  Public health care system ➢ Mandated by the U.S. Constitution ➢ Focus on the population • “promote the general welfare of its citizens.” ➢ Federal policies and practices influence local and state governments ➢ Coordination of services under Department of Health and Human Services Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Public Health Public health refers to the efforts organized by society to protect, promote, and restore the people’s health. ➢ Concerned with a healthy population ➢ Concerned with a healthy environment ➢ Scope is broad ➢ Encompasses activities that promote good health ➢ Organized into multiple levels (federal, state, local) ➢ Provides services for those unable to obtain health care without assistance ➢ Establishes laws, rules, and regulations to protect the public Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Public Health System  Federal level subsystem ➢ ➢ ➢ ➢ U.S. Department of Health and Human Services Surgeon General and numerous other agencies Targets general population, special populations, and international health IOM Report, HHS in the 21st Century: Charting a New Course for a Healthier America (2008), recommended transformation of system Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Current HHS Strategic Plan 1. Transform health care 2. Advance scientific knowledge and innovation 3. Advance health, safety, and well-being of the American people 4. Increase efficiency, transparency, and accountability of HHS 5. Strengthen the nation’s health and human services infrastructure and workforce Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Public Health System (Cont.)  State level subsystem ➢ State health departments ➢ Responsible for the health of their citizens ➢ Central authorities in the public health care system ➢ Dependent on federal level for guidance and resources ➢ Establish own state laws Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Public Health System (Cont.)  Local health department subsystem ➢ Local health departments (LHD) ➢ Responsible for direct delivery of public health services and protection of the health of citizens ➢ Not all communities have LHDs ➢ Responsible for: • Community health services • Environmental health services • Personal health services • Mental health services Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Health Care Providers  Provider organizations ➢  Health care professionals ➢  Any organization that provides health care to the community The interprofessional health care team • Professionals and nonprofessionals Nontraditional health care providers ➢ Complementary and alternative therapies Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Quality Care    To Err Is Human: Building a Safer Health System (IOM, 1999) focused on safety within the health care delivery system Crossing the Quality Chasm (IOM, 2001) focused on developing a new health care system for the twentyfirst century, one that improves care Leadership by Example (IOM, 2003) was a report requested by Congress that examined the federal government’s quality enhancement processes Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Quality Care (Cont.)  Who Will Keep the Public Healthy? (IOM, 2003) brought public health into the forefront by focusing on issues including globalization, rapid travel, scientific and technological advances, and demographic changes ➢ ➢ In-depth exploration of educational needs for improved public health Need for appropriately prepared public health professionals Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Quality Care (Cont.)  Who Will Keep the Public Healthy? (Cont.) ➢ New content areas for public health professionals: • Informatics, genomics, communication, cultural competence, community-based anticipatory research, global health, policy and law, and public health ethics ➢ Old content areas for public health professionals: • Epidemiology, biostatistics, environmental health, health services administration, and social and behavioral science Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Quality Care (Cont.)  Health Professions Education (IOM, 2003), the education of all health professionals is viewed as a bridge to quality care. ➢ Provide patient-centered care ➢ Work in interdisciplinary teams ➢ Employ evidence-based practice ➢ Apply quality improvement ➢ Utilize informatics Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Quality Care (Cont.)  Priority Areas for National Action (IOM, 2003) identified priority areas that should be addressed to improve quality ➢ ➢ ➢ ➢ ➢ ➢ ➢ ➢ Patient and family engagement Population health Safety Care coordination Palliative care Overuse Access Health systems infrastructure capabilities Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Quality Care (Cont.) • Keeping Patients Safe: Transforming the Work Environment (IOM, 2004) addressed critical quality and safety issues with a focus on nursing care and nurses • Focused on nurses in acute care and the work • environment for safer patient care Also looked at nursing shortage, health care errors, patient safety risk factors, nurse’s role in quality improvement, and work environment threats to patient safety Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Quality Care (Cont.)  The Future of Nursing. Leading Change, Advancing Health (IOM, 2011) focuses on the nursing profession and how it might fit into the change process 1. Nurses should practice to the full extent of their education and training. 2. Nurses should achieve higher levels of education and training through an improved education system that promotes seamless academic progression. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Quality Care (Cont.)  The Future of Nursing. Leading Change, Advancing Health (Cont.) 3. Nurses should be full partners with physicians and other health professionals in redesigning health care in the United States. 4. Effective workforce planning and policy making require better data collection and an improved information infrastructure. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Accreditation   Joint Commission National Committee for Quality Assurance (NCQA) ➢    Health Plan Effectiveness Data and Information Set (HEDIS) American Healthcare Commission Consumer Assessment of Healthcare Providers and Systems (CAHPS) Agency for Healthcare Research and Quality (AHRQ) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 … the ultimate test of the public health subsystem is whether it effectively serves the people by their measurements, not those of the public health profession. – Koop (1989) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Critical Issues in Health Care Delivery   Managed care Information technology ➢ ➢ ➢  Consumer advocacy and client rights ➢   Telehealth Electronic medical records (EMRs) Social media Client/consumer-centered health care Coordination and access to care Disparity in health care delivery Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 21 Critical Issues in Health Care Delivery (Cont.)  Globalization and international health ➢ World has no real boundaries ➢ CDC active in responding to preparedness and international travel ➢ WHO fosters collaborative global initiatives ➢ ICN gives nursing perspective  Health care reform ➢ ➢ The Clinton Health Reform Initiative Patient Protection and Affordable Care Act of 2010 Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 22 Future of Public Health ● ● ● ● ● What services? Who has access? Who pays? How is it delivered? What is the role of government? Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 23 Impact on Community Health Nursing  Principles of change that focus on quality, access, and cost… ➢ The need for patient-centered care ➢ The need for stronger primary care services ➢ The need to deliver more care in the community ➢ The need for seamless, coordinated care ➢ The need for reconceptualized roles for health professionals ➢ The need for interprofessional collaboration – The Future of Nursing. Leading Change, Advancing Health (IOM, 2011) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 24 Chapter 12 Economics of Health Care Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. Factors Influencing Health Care Costs          Historical payment systems Unnecessary use of services Lack of preventive care Lifestyle/health behaviors Societal belief that disease would be eradicated Technological advances Aging of society Utilization of drugs Shift from nonprofit to for-profit health care Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 2 Public Financing of Health Care: Medicare Entitlement program to provide health care to the growing population of those 65 years of age or older  Part A ➢ ➢ ➢ Includes inpatient care in hospitals/skilled nursing facilities, hospice care, some home health care Must pay a deductible for health services Does not pay for all health care costs of enrollees; co-payments required after 60 days Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 3 Public Financing of Health Care: Medicare (Cont.) Entitlement program to provide health care to the growing population of those 65 years of age or older  Part B ➢ Purchased by monthly fee ➢ Not compulsory ➢ Helps pay for out-of-pocket costs for physician services, hospital outpatient care, durable medical equipment, and other services, including some home health care ➢ Enrollees must pay deductibles and coinsurance Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 4 Public Financing of Health Care: Medicare (Cont.) Entitlement program to provide health care to the growing population of those 65 years of age or older  Part C ➢ Medicare Advantage Plans ➢ Optional “gap” coverage ➢ Provided by private insurance companies approved by, and under contract with, Medicare ➢ May include HMOs and PPOs ➢ May include vision, hearing, dental care, and other services not covered by Medicare Parts A, B, or D Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 5 Public Financing of Health Care: Medicare (Cont.) Entitlement program to provide health care to the growing population of those 65 years of age or older  Part D ➢ Initiated in 2006 to help defray costs of prescription drugs ➢ Optional; must enroll in an approved prescription drug plan ➢ Monthly premium, deductibles, and co-payments ➢ Must pay 100% of costs when costs reach “coverage gap” or “donut hole” Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 6 Public Financing of Health Care: Medicaid Title XIX of the Social Security Act—a public welfare assistance program     Provides universal health care coverage for the indigent and children A joint state and federal venture Eligibility for this program depends on the size and income of the family; federal government sets baseline eligibility requirements, but states can lower eligibility Priority participation is given to children, pregnant women, and the disabled Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 7 Public Financing of Health Care: Medicaid (Cont.)  Federal government sets baseline services, but state governments may provide more services ➢   Must include inpatient and outpatient hospital care, pregnancy-related care, vaccines for children, family planning services, rural health clinics, home health care, lab and x-ray services, and EPSDT Care by pediatric and family nurse practitioners is covered Children under 18 also eligible for Children’s Health Insurance Program (CHIP) Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 8 Public Financing of Health Care: Governmental Grants       Directed toward funding large populations and different aggregates Historically for health promotion and disease prevention measures Administered by DHHS “Block grants” provided to states to impact the health of the public as a whole Health care providers and programs compete for funds through grant proposals and applications Closely related to Healthy People 2020 objectives Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 9 Philanthropic Financing of Health Care   Often research or disease oriented Eligibility for services limited to the specific disease or population of interest ➢ ➢ ➢ May include services rendered plus ancillary needs like transportation, parental housing, or wigs Informational and research activities constitute the majority of services provided by these organizations Examples include American Heart Association and the Shriners Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 10 Health Insurance Plans   First established in 1930s Types of plans ➢ ➢  Reimbursement mechanisms ➢  Indemnity, HMO, PPO, POS Private insurance, cooperatives, cafeteria plans Retrospective and prospective plans Scope of services covered ➢ Routine care, catastrophic, ambulatory Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 11 Cost Containment  Capitated reimbursement ➢  Access limitation ➢ ➢  Prospective reimbursement for services Primary care provider as gatekeeper Managed care plans—preauthorization requirements for additional services Rationing ➢ Determining the most appropriate use of health care or directing the health care where it can do the most good Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 12 Trends in Health Financing New and innovative health care approaches  Cost sharing  Health alliances  Self-insurance  Flexible spending accounts  Health promotion and disease prevention Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 13 Health Care Financing Reform Lack of insurance is the major factor associated with lack of access to medical care. The current dilemma is how to provide health care to all Americans that is acceptable and affordable. Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 14 Caring for the Uninsured   Should health care be one of those necessities available to all without cost? Should health care be a right for all rather than a commodity to be available only to those who can afford it? Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 15 Access to Health Care—Barriers   Insufficient financial support Physical barriers ➢ Structural inaccessibility, lack of appropriate equipment, or inability to communicate ➢ Inequality in the distribution of services, transportation difficulty, conflict with work hours, and failure to provide services  Sociological barriers ➢ Language difficulties and fear of reprisals Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 16 Health Care Reform 2010         Individual mandate Employer requirements Expansion of Medicaid Expansion of CHIP Premium and cost-sharing subsidies to individuals Changes to private insurance Cost-containment provisions Prevention and wellness Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 17 Nurse’s Role in Economics  Researcher ➢ ➢ Investigate efficient, cost-effective care, culturally sensitive treatment modalities, health education, disease prevention, and factors to change behaviors Investigate, develop, and evaluate the effectiveness of health promotion and disease prevention Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 18 Nurse’s Role in Economics (Cont.)  Educator ➢ ➢ ➢ ➢ Health education is the foundation of community health nursing practice Understand that knowledge empowers clients to actively participate in their health care Demonstrate the effectiveness and value of education Outcome measures for health education need to be established Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 19 Nurse’s Role in Economics (Cont.)  Provider of care ➢ Care must be appropriate, necessary, and cost effective. ➢ Judicious application of the nursing process is imperative. ➢ Serve as program service provider, health education provider, and heath program participant ➢ Participate in grant proposal process, program design, and evaluation of these programs ➢ Participate in statistical information–gathering process as basis for determining needs Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 20 Nurse’s Role in Economics (Cont.)  Advocate ➢ Become more involved in the economics of health care ➢ Increase knowledge of health care funding and policy making ➢ Use political power to influence health care funding ➢ Advocate for increase in health promotion/disease prevention funding ➢ Plan programs, seek funding, and evaluate program effectiveness through outcome measures Copyright © 2015, 2011, 2007, 2001, 1997, 1993 by Saunders, an imprint of Elsevier Inc. 21
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Assignment 3

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Assignment 3

1-which of the following behaviors may be (1) ethical but illegal, (2) legal but unethical, (3) illegal and unethical, and (4) legal and ethical.

A. Working in a clinic that performs abortions

b. Respecting the wishes of a client suffering from ALS that he be permitted to die with dignity and not placed on “breathing machines”

c. Respecting the health surrogate’s wishes regarding termination of life support of her friend

d. Observing a coworker take out two tablets of oxycodone as ordered for pain management for his patient but keeping one for himself, administering only one tablet to the patient.

2-differentiate among the following: deontological theories, utilitarianism, and principlism.

3-what do you think about health-care professionals disclosing information to clients about a poor prognosis, even though the information may cause severe distress.

4-What do they think about health-care professionals disclosing information to clients against family wishes?

5. You see a colleague use another nurse’s password to access the medication administration system and take out a narcotic. What would you do?

6.Your colleague’s child fell and was brought to the emergency department. She comes back up to the unit and tells you that they cleaned and debrided the wound, and she needs to change the dressings twice a day using a wet to dry method. You see her go into the supply system and remove the dressings and saline using a patient’s identification number. What would you do?

7. You are caring for a patient who has a terminal disease. He asks you if he is dying. Would you tell him? If yes, how? If no, what might you say? .

8-You are administering hydromorphone to a patient. The patient asks you what you are administering. Would you tell the patient about the medication?

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The role of the community health nurse

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The role of the community health nurse

Explain the role of the community health nurse in partnership with community stakeholders for population health promotion. Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion

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Topic 1 DQ2

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Topic 1 DQ2

Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population.

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Critical Thinking Questions

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Critical Thinking Questions

In this exercise, you will put in to practice what you have learned in the previous modules. Read the THREE scenarios on the next pages and write a ½-1 page description of what could be a solution in each situation. Provide rationales for each solution. Post your responses in the D2L Assignment box. This assignment will count towards your participation grade. Scenario #1: A 72 year-old woman is being cared for at home after a heart attack. She is able to get out of bed and use the bedside commode unaided, but she cannot do much more than that. Her husband and adult children care for her on a daily basis. In general, they do a satisfactory job, except for the fact that they will not empty the bucket on the commode. When the home health aide comes for a visit, the bucket is always full and the room has the stench of feces and urine. The home health nurse has been to the home and discussed this with the family on several occasions. The patient does not seem to object to the stench. The family is adamant that this is the job of the nurses. You are the new home health nurse assigned to the patient. You have decided that this is a problem with a solution. Approach the family with a new and fresh attitude toward the problem. Keep in mind your legal, ethical, and personal responsibilities and limitations. Scenario #2 A home care patient is experiencing pain secondary to surgery for right foot amputation. She takes a liquid narcotic in suspension form. Her doctor ordered 2 teaspoons q. 4 hrs, PRN for pain and gave orders to the home health nurse to titrate the dose to the patient’s pain level. The nurse is to report on the patient’s pain level and response to the analgesics every week. Given the patient’s condition and level of pain and previous response to analgesics, there is no fear of addiction in this patient. The nurse has explained the treatment plan to the patient, and she concurs with the analgesia plan. However, the patient will not measure the amount of medication she takes each time. Every time the nurse visits, the patient reports that she takes a “couple of swigs” and that it relieves the pain. She does not see the need to make a detailed record of her use of medication because the system she is using works. Design a program that will be agreeable to this patient and still meet the nursing need of documenting episodes of pain and how much medication was needed for relief of pain. You must consider your legal and ethical role as a nurse and the ideal of patient autonomy. Scenario #3 With the major emphasis in downsizing and restructuring health care to be financially successful, issues of quality nursing care come up frequently. One common issue related to quality nursing care is medication errors. In a downsized work environment, medication errors may increase due to limited staffing with licensed nursing personnel. Often staffing is just enough to be adequate or slightly below what is necessary for safe and quality patient care. You are a nursing supervisor, and you want to research a medication that was omitted during a change of shift period. What questions are you going to ask? Who will you look to for information? How will I know if a medication error is a result of a nursing colleague’s mistake or a result of an understaffed nursing unit?
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Tags: health nursing

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Paragraph 2

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Paragraph 2

Please write a paragraph responding to the discussion bellow. Add citations and references in alphabetical order.

These manifestations are positive for SIRS and meets Sepsis criteria. This requires immediate intervention. Sepsis is “an overwhelming infection that may lead to shock, multiple organ failure, and death” (Copstead & Banasik, 2010). The patient must meet minimum of two of the Sepsis criteria which include:

1.Temp >38°C (100.4°F) or < 36°C (96.8°F)

2. Heart rate > 90

3. WBC > 12,000/mm³, < 4,000/mm³, or > 10% bands

4.Respiratory rate > 20 or PaCO₂ < 32 mm Hg

5. Suspected or present source of infection

6. Lactic acidosis, SBP <90 or SBP drop ≥ 40 mm Hg of normal (MDCalc, 2016)

Also, the presence of immature neutrophils (bands) in the circulating blood is often used as a clinical indicator of sepsis (Cavallazzi, Bennin, Hirani, Gilbert & Marik, 2010). A band count greater than 10% is one of the American College of Chest Physicians/Society of Critical Care Medicine’s systemic inflammatory response syndrome (SIRS) criteria used to diagnose sepsis and Mrs. G’s band count is 12%

ii.) To manage the Sepsis diagnosis, I would begin immediate treatment.

  1. Measure lactate level which will determine the presence and severity of sepsis
  2. Obtain blood cultures prior to administration of antibiotics
  3. Administer broad spectrum antibiotics like Vancomycin and piperacillin tazobactam
  4. Administer 30 ml/kg crystalloid for hypotension or lactate ≥4mmol/L (Critical Care Medicine, 2015)
  5. Reassess Lactate Level after fluid administration

b.) For the obvious open wound infection on the leg I would order a wound consult. I would anticipate a debridement and possibly a wound vac application depending on how deep they had to go.

c.) Next, I would have the hospitalist order a consult with infectious disease to manage the positive Staphylococcus aureus infection.

d.) Lastly, glucose testing and a consult to endocrinology to help manage the diabetes.

2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”

  1. The muscle groups affected by the wound on Ms. G’s lower left leg are the gastrocnemius (large calf muscle forming the bulge visible beneath the skin) medial and lateral head, fibularis longus, extensor and flexor digitorium longus, tibialis anterior, soleus, and the extensor hullucis longus .(at the ankle) (ARC, Media). These are primarily superficial muscles from the knee to the ankle

3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.

The subjective data allows us to understand how Ms. G is feeling and what she is experiencing (DuPont, 2017). Ms. G informed the health care provider that she is unable to care for herself and that her wound is too painful and swollen for her to manage.

She also admitted that she is not eating. Here she is demonstrating that she cannot make rational decisions regarding her diabetes and she states that she has no one to help her at home. I would recommend a consult to social work to provide options for her after discharge such as home health nursing for wound care and PT/OT for muscle strengthening. She might also need a home health aide to assist with ADL’s and meal preparation. Along with these recommendations, is providing education for Ms. G such as diabetic education including ADA diet (Collins & Sloan, 2013), wound care, medications and disease process.

I would recommend follow-up lab work along with routine assessments of the wound, noting color, temperature, edema, and presence of drainage. She will also need social work follow-up visits and counseling sessions to assess Ms. G’s home life, diabetes, access to medications as ordered, and any other issues, questions or concerns that that she may have about her situation (Medical social worker, n.d.).

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Hindu Heritage and Polish​

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Hindu Heritage and Polish​

from the list of cultural and sociocultural groups, select Hindu Heritage and Polish and prepare a PowerPoint presentation

Preparation for the presentation will include synthesizing the information from readings, scientific literature, Internet resources and other sources.This presentation should address the following:

History, values, and worldview, language and communication patterns, art and other expressive forms, norms and rules, lifestyle characteristics, relationship patterns, rituals, the degree of assimilation or marginalization from mainstream society, and health behavior and practices.

In addition to describing these characteristics, the presentation must include:

a) a comparative and contrast analysis of common characteristics and distinguishing traits between the groups

b) a discussion of differential approaches needed by health care professionals

The assignment will be posted in Turnitin for grading and verify originality and in the discussion tab of the blackboard for your peers to view and comment. The assignment must be presented in an APA format, PowerPoint, Times New Roman 12 font.

 

Chinese Heritage and African American Heritage

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Chinese Heritage and African American Heritage

from the list of cultural and sociocultural groups, select Chinese Heritage and African American Heritage and prepare a PowerPoint presentation

Preparation for the presentation will include synthesizing the information from readings, scientific literature, Internet resources and other sources.This presentation should address the following:

History, values, and worldview, language and communication patterns, art and other expressive forms, norms and rules, lifestyle characteristics, relationship patterns, rituals, the degree of assimilation or marginalization from mainstream society, and health behavior and practices.

In addition to describing these characteristics, the presentation must include:

a) a comparative and contrast analysis of common characteristics and distinguishing traits between the groups

b) a discussion of differential approaches needed by health care professionals

The assignment will be posted in Turnitin for grading and verify originality and in the discussion tab of the blackboard for your peers to view and comment. The assignment must be presented in an APA format, PowerPoint, Times New Roman 12 font.

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Nursing Interventions Related to Disaster

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Nursing Interventions Related to Disaster

Please respond to the following post with a long paragraph add citations and references.

Throughout this course, you have viewed the “Diary of Medical Mission Trip” videos dealing with the catastrophic earthquake in Haiti in 2010. Reflect on this natural disaster by answering the following questions:

  1. Propose one example of a nursing intervention related to the disaster from each of the following levels: primary prevention, secondary prevention, and tertiary prevention. Provide innovative examples that have not been discussed by a previous student.
  2. Under which phase of the disaster do the three proposed interventions fall? Explain why you chose that phase.
  3. With what people or agencies would you work in facilitating the proposed interventions and why?

Link to the “Diary of Medical Mission Trip” videos:

http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs427v_nrs427v.php

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