Week 7: Discussion

Purpose

The purpose of the graded collaborative discussions is to engage faculty and students in an interactive dialogue to assist the student in organizing, integrating, applying, and critically appraising knowledge regarding advanced nursing practice. Scholarly information obtained from credible sources as well as professional communication are required. Application of information to professional experiences promotes the analysis and use of principles, knowledge, and information learned and related to real-life professional situations. Meaningful dialogue among faculty and students fosters the development of a learning community as ideas, perspectives, and knowledge are shared.

Activity Learning Outcomes

Through this discussion, the student will demonstrate the ability to:

1. Compares and contrasts the pathophysiology between Alzheimer’s disease and frontotemporal dementia. (CO1)
2. Identifies the clinical findings from the case that supports a diagnosis of Alzheimer’s disease. (CO3)
3. Explain one hypothesis that explains the development of Alzheimer’s disease (CO3)
4. Discuss the patient’s likely stage of Alzheimer’s disease (CO4) Nursing homework help

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Due Date

A 10% late penalty will be imposed for discussions posted after the deadline on Wednesday, regardless of the number of days late. NOTHING will be accepted after 11:59pm MT on Sunday (i.e. student will receive an automatic 0). Week 8 discussion closes on Saturday at 11:59pm MT.

Total Points Possible: 100

Requirements

1. Read the case study below.
2. In your initial discussion post, answer the questions related to the case scenario and support your response with at least one evidence-based reference by Wed., 11:59 pm MT.
3. Respond to at least one peer and all faculty questions directed at you, using appropriate resources, before Sun., 11:59 pm MT.

Case Scenario

A 76-year -old man is brought to the primary care office by his wife with concerns about his worsening memory. He is a retired lawyer who has recently been getting lost in the neighborhood where he has lived for 35 years. He was recently found wandering and has often been brought home by neighbors. When asked about this, he becomes angry and defensive and states that he was just trying to go to the store and get some bread.

His wife expressed concerns about his ability to make decisions as she came home two days ago to find that he allowed an unknown individual into the home to convince him to buy a home security system which they already have. He has also had trouble dressing himself and balancing his checkbook. At this point, she is considering hiring a day-time caregiver help him with dressing, meals, and general supervision why she is at work. Nursing homework help

Past Medical History: Gastroesophageal reflux (treated with diet); is negative for hypertension, hyperlipidemia, stroke or head injury or depression

Allergies: No known allergies

Medications: None

Family History

• Father deceased at age 78 of decline related to Alzheimer’s disease
• Mother deceased at age 80 of natural causes
• No siblings

Social History

• Denies smoking
• Denies alcohol or recreational drug use
• Retired lawyer
• Hobby: Golf at least twice a week

Review of Systems

• Constitutional: Denies fatigue or insomnia
• HEENT: Denies nasal congestion, rhinorrhea, or sore throat.
• Chest: Denies dyspnea or coughing
• Heart: Denies chest pain, chest pressure or palpitations.
• Lymph: Denies lymph node swelling.
• Musculoskeletal: denies falls or loss of balance; denies joint point or swelling

General Physical Exam  

• Constitutional: Alert, angry but cooperative
• Vital Signs: BP-128/72, T-98.6 F, P-76, RR-20
• 178 lbs., Ht. 6’0″, BMI 24.1

HEENT

• Head normocephalic; Pupils equal and reactive to light bilaterally; EOM’s intact

Neck/Lymph Nodes

• No abnormalities noted

Lungs 

• Bilateral breath sounds clear throughout lung fields.

Heart 

• S1 and S2 regular rate and rhythm, no rubs or murmurs.

Integumentary System 

• Warm, dry and intact. Nail beds pink without clubbing.

Neurological

• Deep tendon reflexes (DTRs): 2/2; muscle tone and strength 5/5; no gait abnormalities; sensation intact bilaterally; no aphasia

Diagnostics

• Mini-Mental State Examination (MMSE): Baseline score 12 out of 30 (moderate dementia)
• MRI: hippocampal atrophy
• Based on the clinical presentation and diagnostic findings, the patient is diagnosed with Alzheimer’s type dementia. Nursing homework help

Discussion Questions

1. Compare and contrast the pathophysiology between Alzheimer’s disease and frontotemporal dementia.
2. Identify the clinical findings from the case that supports a diagnosis of Alzheimer’s disease.
3. Explain one hypothesis that explains the development of Alzheimer’s disease
4. Discuss the patient’s likely stage of Alzheimer’s disease.

Category	Points	%	Description
Application of Course Knowledge	30	30%	The student: 1.  Compares and contrasts the pathophysiology between Alzheimer’s disease and frontotemporal dementia. 2.  Identifies the clinical findings from the case that supports a diagnosis of Alzheimer’s disease. 3.  Explains one hypothesis that explains the development of Alzheimer’s disease. 4.  Discusses the patient’s likely stage of Alzheimer’s disease.
Support from Evidence-Based Practice	30	30%	1.  Initial discussion post is supported with appropriate, scholarly sources; AND 2.  Sources are published within the last 5 years (unless it is the most current CPG); AND 3.   Reference list is provided and in-text citations match; AND 4.  All answers are fully supported with an appropriate EBM argument.
Interactive Dialogue	30	30%	In addition to providing a response to the initial post due by Wednesday, 11:59 p.m. MT, student provides a minimum of two responses weekly on separate days; e.g., replies to a post from a peer; AND faculty member’s question; OR two peers if no faculty question. A response to faculty could include a question posed to a student or the entire class or a faculty question directed towards another student. AND ·     Evidence from appropriate scholarly sources are included; AND ·     Reference list is provided and in-text citations match
	90	90%	Total CONTENT Points= 90 pts
DISCUSSION FORMAT
Category	Points	%	Description
Organization	5	5%	Organization:  1.  Case study responses are presented in a logical format; AND 2.  Responses are in sequence with the numbered questions; AND 3.  The case study response is understandable and easy to follow; AND 4.  All responses are relevant to the case topic.
Format	5	5%	·     Discussion post has minimal grammar, syntax, spelling, punctuation, or APA format errors.* (*) APA style references and in text citations are required; however, there are no deductions for errors in indentation or spacing of references. All elements of the reference otherwise must be included.
	10	10%	Total FORMAT Points= 10 pts
	100	100%	DISCUSSION TOTAL=____ out of 100 points

 

Scenario

You are the new project manager for the operations unit of Charleston General Hospital. The hospital is facing challenges of long wait times at the ED resulting in a high number of patients leaving without being seen (LWBS) and long admission holds in the ED. Upon initial assessment, you determine that the two challenges are related and are caused by inefficiencies in process flow. Nursing homework help

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Instructions

Develop a process map to evaluate and suggest a redesign of the current challenges. Process maps are graphical depictions of a process. The process map (flow chart) shows the sequence of tasks, decisions, and all other related activities that results from inputs and outputs.

Your map should include a visual illustration of different processes that can be employed by Charleston General to improve the flow of operations in the ED. Attach a summary of the proposed changes reflected in the process map to explain how the changes can improve performance outcomes for the ED.

Rubric

 

Process map thoroughly evaluated the selected health organization challenges with strong detail and supporting information and made connections between the identified challenges.

 

Suggested a detailed redesign of the selected challenge with strong detail and supporting information.

 

Process map was clearly organized, professional, and easy to read.

 

1. Yirlem

Whistleblowing is a widely discussed issue today because people have different perceptions of this behavior. Whistleblowing can help medical personnel improve the quality of healthcare services and avoid multiple failures. Thus, whistleblowing’s primary advantages include healthcare providers’ chance to protect patients, improve quality of care, and satisfy professional expectations, while its disadvantages involve the possibility of job loss and deterioration of relations with colleagues.

A few years ago, my colleague behaved aggressively and mistreated patients. When another healthcare provider saw that situation, she made managers aware of the nurse’s behavior. Employers communicated with the nurse and fined her but provided an additional chance to change her attitude. Although that situation negatively affected the relationships between two healthcare providers, the nurse improved her behavior. The whistleblower had to discuss that issue with the nurse before communicating with managers, though her decision was also effective.

In conclusion, whistleblowing significantly influences healthcare quality and protects patients but can lead to job loss and deterioration of relationships between nursing staff members. Healthcare providers should attempt to solve the existing problems themselves through effective communication and mutual understanding. Nevertheless, whistleblowing can be the only suitable method to overcome current challenges in specific situations. Nursing homework help

2. Tatiana:

The most common forms of cheating in the classroom and clinical area include cheating, professional misconduct, bribery, plagiarism, and deception. Cheating occurs when a student copies from another or uses an external source to copy exams. Professional misconduct occurs when one violates the rules or boundaries set by governing body of a profession, such as a nurse who fails to meet the standards of practice.

Bribery may occur when someone gives some money to be employed or be given good grades in school that they do not deserve. Plagiarism involves the act of taking someone else’s work or ideas, such as from a research paper, and making them their own work. Lastly, deception occurs when a student provides wrong information to a lecturer on academic activities, such as giving the wrong fieldwork report.

In case nursing students notice others being involved in any form of cheating, they should report to any faculty member available so that necessary action is taken. When cheating is not reported, students might face the consequences such as being assumed that they were all cheating and their grades being deducted. It is also important that nursing students maintain integrity when in nursing school because what they learn in school equips them with the right knowledge and skills for practice. This means that when they cheat, they might not meet the nursing professional’s standards and not deliver the best services to their patients.

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3. Marta

As people get old, their body parts keep on aging too, therefore, developing some normal healthy conditions experienced by the old. The pamphlet talks about a loot into normal conditions developed by aging people. Lipofuscin, an “aging pigment,” is deposited in the heart as part of the normal aging process. The cardiac muscle cells have a minor degeneration (Eliopoulos, 2018). Thickening and stiffening of the heart valves, which govern blood flow, occur throughout the disease. It is pretty typical in elderly adults to have a cardiac murmur due to valve stiffness.

With age, the heart tends to increase slightly, gaining thicker walls and somewhat bigger chambers than before. Individual cardiac muscle cells have grown in size, primarily responsible for the rise in overall size. The hardening of the heart walls that occurs with age leads the left ventricle to fill less efficiently, resulting in heart failure.

During rest, the older heart behaves virtually identically to the younger heart, except that the heart rate the number of times the heart beats in a minute is slightly lower in the older heart (Eliopoulos, 2018). Furthermore, when older individuals exercise, their heart rates do not rise as much as they do when younger ones do.

Because arterioles and arteries become less elastic as individuals get older, they cannot relax as rapidly during the heart’s regular rhythmic pumping action. Therefore, as the heart contracts during systole, blood pressure climbs higher than in younger individuals, often to dangerously high levels above normal. Blood pressure abnormally high during systole and normal during diastole is particularly prevalent in elderly persons. A combination of factors causes it.Nursing homework help

Regular physical activity may help mitigate many of the adverse effects of aging on the heart and blood vessels. In addition, cardiovascular and muscular fitness may be maintained with regular exercise throughout one’s lifetime.

4. Marta

Factors That Promote Cardiovascular Health

Cardiovascular disease is the leading cause of death worldwide. Furthermore, it is well recognized that the risk of developing CVD rises with age. Among the risk factors for cardiovascular disease include tobacco use, an unhealthy diet, inactivity, and sedentary behavior, all of which are related to an increased incidence of hypertension, diabetes, and overweight and obesity (Rees et al., 2018). In addition, with age comes a rise in the incidence of various noncommunicable illnesses, which leads to a significant increase in mortality among the elderly and disabled, functional decline, and healthcare.

Even while scientists have long recognized that age-related changes in the heart might result in heart disease, it is becoming more evident that many of these changes are determined as much by one’s way of life as by their age. For example, we have known for years that various lifestyle variables, such as food, exercise, and smoking, are associated with an increased cardiovascular health risk.

Heart changes occur due to aging, laying the groundwork for heart disease. Thickened and stiffened heart walls make it difficult for the muscle to rest and fill appropriately between beats (Eliopouos, 2018). Because of this, inadequate pumping during times of activity might result in tiredness and exercise intolerance. In addition, it is possible that the left atrium could grow in size, resulting in a disordered heart rhythm emanating from the higher heart chambers, known as atrial fibrillation.

 

Rhythm disturbances may occur due to the slowing of the pacemaker cells in the atria. Additionally, when blood flows through the heart, the arteries grow stiffer and have thicker walls, reducing their potential to expand. Also possible is the development of high blood pressure, which increases the risk of developing heart disease and stroke even higher (Rees et al., 2018). Regular exercising and o bserving a proper lifestyle that avoids taking the risks factors one can avoid suffering from cardiovascular diseases.

 

NUR2755 Section BNPH1A0S Multidimensional Care IV (11 Weeks)

Module 06 Assignment – Burn Victim Assessment

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Module 06 Content

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Scenario

You are working the night shift on a medical-surgical unit. You assignment includes a 19 year old woman admitted early this morning. She has sustained burns over 30% of her body surface area, with partial-thickness burns on her legs and back. NUR2755 Section BNPH1A0S Multidimensional Care IV (11 Weeks)

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Instructions

1. In a two-page APA formatted paper, discuss the following:
2. The staff are following the Parkland Formula for fluid resuscitation. The client arrived at 0200 and was admitted at 0400. She weighs 110 pounds. Calculate her fluid requirement, using the Parkland formula. Explain the time intervals and amounts for each.
3. The client was sleeping when the fire started and managed to make her way out of the house through thick smoke. You are concerned about possible smoke inhalation. What assessment finding would corroborate this concern?
4. The client is in severe pain. What is the drug of choice for pain relief and how should it be given?
5. What nutritional requirements are necessary for the client’s burns to heal?
6. What measures are taken with the client to prevent infection?

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