Ethical Frameworks 

Week 2 Discussion Prompt 2 

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Discuss the nurse’s role in the policy development model. Additionally, talk about the policy meeting you have attended or will be attending. What key points could a nurse bring to this meeting and subject?

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Week 2 Discussion Prompt 1 

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Evaluate and discuss clinical and business solutions for hospital improvement. Include in your discussion improvement of outcomes, reduction in costs, optimization of payment, and improvement in the overall patient experience.

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Week 2 View or Attend Public Policy Meeting

· Week 2 Position Paper

Position Paper Written Assignment

A position paper is a document you could present to a legislator to seek support for an issue you endorse. Present your position on a current health-care issue in a one-page paper, following the assignment guidelines below. You can select your issue topic from newspapers, national news magazine articles, professional journals, or professional association literature; and this can be the topic you choose for your ethical issues debate.

Your position paper should:

· Be quickly and easily understood.

· Be succinct and clear.

· Appear very professional with the legislator’s name and title on top and your name and your credentials at the bottom.

· Condense essential information in one, single-spaced page, excluding the title and reference list pages.

· Be written using correct grammar, spelling, punctuation, syntax, and APA format.

· Clearly describe the issue that you are addressing in the opening paragraph.

· Include 3–4 bullet points regarding why you are seeking the legislator’s vote, support, or opposition. Bullet points should be clear and concise but not repetitive and should reflect current literature that substantiates your position.

· Summarize the implications for the nursing profession and/or patients.

· Conclude with two recommendations that you wish to see happen related to your issue, such as a vote for or against, a change in policy, or the introduction of new legislation.

· Use APA format (6th ed.), correct grammar, and references as appropriate.

The literature you cite must be from peer-reviewed journals and primary source information. You may use this paper as preliminary research for your ethical issues debate project that occurs in weeks 4-7.

Due Sunday reply to 2 students in discussion

Nur 521

Discussion 2 

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Apply the framework of The Five R’s approach to ethical nursing practice from this week’s reading to answer the questions about values and choices.

What are values?

Q. What are your personal values?

Q. Why do you value them?

Q. What are the values in your society?

Q. How do you make choices?

Q. Are your choices based on your values?

Q. What values are useful in society?

What are the limits to personal choice?

Q. Who limits your choices?

Q. Are limits to choices good?

Q. Do you limit other people’s choices?

Q. Should the health care organization or the government limit people’s choices? If so, how, and under what circumstances?

In your responses to peers, feel free to agree, disagree, question, compare, and discuss each other’s responses in a way that fosters thoughtful and respectful dialog. You may also address the following: Did any responses surprise you? If so, how? Did reading your peers’ responses to the questions expand your own view of ways to answer questions?

Finally, consider this: A common idea in health care is that if you are drawn to health care as a profession, you are inherently guided by an inner compass that is composed of a strong moral framework. Why is this a dangerous assumption?

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Discussion 1 

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Explain the statement, “What may be an ethical dilemma for one registered nurse may not be an ethical dilemma for another registered nurse.” Be sure to define an ethical dilemma in the course of your discussion. Describe a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. (Be sure to respect and maintain patient and colleague confidentiality.)

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Due Sunday

· Week 2 Ethical Frameworks Essay

Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below).  Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way?  Does this seem like a valid process for you to apply in your practice?

Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

Optional: You may download this pdf, complete it using correct grammar and APA, and submit it as your assignment in lieu of writing a paper. *You will need Adobe Acrobat in order to utilize this fillable .pdf form.

· TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Due Sunday reply to 2 students discussion

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Organizational Analysis

Organizational

Organizational

Module 3 Assignment 2: Organizational Analysis – The Organization

Name: Date:

Overview: Organizational Analysis – The Organization

The major assignment for this course is analysis of your organization. In this assignment, you will report the organization’s mission, philosophy, and administrative structure. You will compare and contrast what you find with the characteristics of organizations you have learned about in the lectures and presentations and in your own investigative reading.

Complete this assignment to demonstrate your analysis of the big picture of your organization.

Objectives

· Explain how organizations function.

· Compare and contrast characteristics of leadership and management.

· Apply trends, issues, theories, and evidence as guidelines for management decisions.

· Evaluate effectiveness of communication patterns using specific management situations.

Expected elements for scholarly writing:

· Ensure correct grammar and spelling

· Assignment should be submitted as an APA Paper, including title page and references.

· Title page is required for this Assignment and the UTACON version is expected format.

· 1-inch margins, 12 size Times New Roman font.

· Please provide all references used to support your opinions and clarify positions in the paper.

· The reference list begins on a separate page from the content.

· Headings are expected and must be connected to the assignment criteria following APA style.

· An introduction is expected providing a brief look at what is planned within the body of the paper. However, no heading is used over the introduction in APA format. A Summary is used and should have a heading over it.

· For all other style questions refer to the American Psychological Association. (2010). Publication manual of the American Psychological Association (6th ed.) Washington, DC: Author.

Rubric

Use this rubric to guide your work on the Week 2 Organizational Analysis – The Organization.

N4455 Nursing Leadership and Management

©2015 University of Texas at Arlington

Page 1 of 4

Introduction of the Organization

Provide a concise description of the healthcare organization, including type of agency, size, geographic location, services provided, target clientele, accreditation status, and community relationships.

Examination of the Organization

Identify the organization’s mission, philosophy, and the administrative structure. Identify the type of organizational structure the facility represents (functional, matrix reporting, joint practice, etc.). Give examples that support the type you selected.

Strengths and Limitations

Discuss major strengths and limitations of the organization.

Care Delivery System

Describe the nursing care delivery system(s) used. Include delegation examples of manager, charge nurse, licensed staff to unlicensed staff.

Outcomes and Measurements

Discuss two specific patient outcomes and explain how they are measured and monitored. Include one system–wide outcome and one nurse–sensitive clinical indicator.

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Details: Collaborative Decision Making Through Shared Governance

Details: Collaborative Decision Making Through Shared Governance

Attend a committee meeting in your health care organization
Attend a committee meeting in your health care organization. If you are not currently employed in a health care setting, you may elect to attend a committee meeting at another company, a community center, a local school, local chamber of commerce or other professional organization.

Observe the interactions between committee members and the process used by the committee to arrive at decisions.

In 500-750 words, describe the function of the committee and the roles of those in attendance. Describe your observations of the interactions between members of the committee and determine whether the process used to arrive at decisions is a form of shared governance.

Prepare this assignment according to the APA guidelines

In addition to your textbook, “The Interprofessional Health Care Team: Leadership and Development”. A minimum of FOUR academic references from credible sources are required for this assignment.

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Nurs 6551 Week 2 Journal

Nurs 6551 Week 2 Journal

think about common screenings for women. Explain how screenings differ for younger women and older women, and explain the implications of these differences.

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Week 3: Assignment 1: Practicum – Assessing Client Families

Learning Objectives

Students will:

· Assess client families presenting for psychotherapy

· Develop genograms for client families presenting for psychotherapy

To prepare:

· Select a client family that you have observed or counseled at your practicum site.

· Review pages 137–142 of Wheeler (2014) and the Hernandez Family Genogram video in this week’s Learning Resources.

· Reflect on elements of writing a comprehensive client assessment and creating a genogram for the client you selected.

The Assignment

Part 1: Comprehensive Client Family Assessment

Create a comprehensive client assessment for your selected client family that addresses (without violating HIPAA regulations) the following:

Demographic information

Presenting problem

History or present illness

Past psychiatric history

Medical history

Substance use history

Developmental history

Family psychiatric history

Psychosocial history

History of abuse and/or trauma

Review of systems

Physical assessment

Mental status exam

Differential diagnosis

Case formulation

Treatment plan

Part 2: Family Genogram

Develop a genogram for the client family you selected. The genogram should extend back at least three generations (parents, grandparents, and great grandparents).

Required Readings

American Nurses Association. (2014). Psychiatric-mental health nursing: Scope and standards of practice (2nd ed.). Washington, DC: Author.

· Standard 5B “Health Teaching and Health Promotion” (pages 55-56)

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

· Chapter 8, “Experiential Family Therapy” (pp. 129–147)

· Chapter 13, “Narrative Therapy” (pp. 243–258)

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

· “Genograms” pp. 137-142

Cohn, A. S. (2014). Romeo and Julius: A narrative therapy intervention for sexual-minority couples. Journal of Family Psychotherapy, 25(1), 73–77. doi:10.1080/08975353.2014.881696

Note: Retrieved from Walden Library databases.

Escudero, V., Boogmans, E., Loots, G., & Friedlander, M. L. (2012). Alliance rupture and repair in conjoint family therapy: An exploratory study. Psychotherapy, 49(1), 26–37. doi:10.1037/a0026747

Note: Retrieved from Walden Library databases.

Freedman, J. (2014). Witnessing and positioning: Structuring narrative therapy with families and couples. Australian & New Zealand Journal of Family Therapy, 35(1), 20–30. doi:10.1002/anzf.1043

Note: Retrieved from Walden Library databases.

Phipps, W. D., & Vorster, C. (2011). Narrative therapy: A return to the intrapsychic perspective. Journal of Family Psychotherapy, 22(2), 128–147. doi:10.1080/08975353.2011.578036

Note: Retrieved from Walden Library databases.

Saltzman, W. R., Pynoos, R. S., Lester, P., Layne, C. M., & Beardslee, W. R. (2013). Enhancing family resilience through family narrative co-construction. Clinical Child and Family Psychology Review, 16(3), 294–310. doi:10.1007/s10567-013-0142-2

Note: Retrieved from Walden Library databases.

Governors State University (Producer). (2009). Emotionally focused couples therapy [Video file]. Chicago, IL: Author.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 115 minutes.

Laureate Education (Producer). (2013b). Hernandez family genogram [Video file]. Baltimore, MD: Author.

Note: The approximate length of this media piece is 3 minutes.

Psychotherapy.net (Producer). (1998). Narrative family therapy [Video file]. San Francisco, CA: Author.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 111 minutes.

Psychotherapy.net (Producer). (2007). Existential psychotherapy [Video file]. San Francisco, CA: Author.

Note: You will access this media from the Walden Library databases. The approximate length of this media piece is 61 minutes.

Cardiology/Endocrine Case Study

Course Student Learning Outcomes

Upon completion of the case study, students will be able to …

1. Apply the principles of pharmacology relative to pharmacotherapeutics across age levels including the effect of race, gender, ethnic group, and special populations.

2. Describe the uses, actions, effects and nursing implications of general classifications of drugs and selected specific drugs.

3. Investigate media resources and information technologies to enhance knowledge base of pharmacology.

4. Analyze the responsibilities of the nurse when administering drugs.

5. Apply pharmacological research to nursing practice.

Purpose The purpose of this case study is to apply concepts from pharmacology and

pathophysiology, national guidelines, and evidenced based clinical practices in the management of chronic disease. Remember this paper must follow APA guidelines for font, in text citations, reference list etc. No abstract is needed. Provide headings for the different questions in your paper.

Setting This case study takes place in a primary care setting in a small rural hospital clinic that provides health care services to predominately Latino field workers and their families. The rural clinic serves children and adults for all medical needs including well care, acute care, and chronic conditions. Some clients have seasonal insurance, state health insurance, or no insurance. Many live below poverty level according to the federal guidelines. Most do not own a vehicle. Most do not speak English; so, a translator is provided at each visit. The clinic is one hour from the nearest city where higher level of care can be offered to patients in need of specialty care. The clinic is staffed by one family medicine physician, an internist, two nurse practitioners, an RN, two LVNs, a lab tech, eight MAs and support staff. Once a week a cardiologist, podiatrist, pain specialist, orthopedist and ophthalmologist service the clinic. There is an on-site lab and a pharmacy two blocks away. There are two ambulances servicing the entire south end of the county with poor availability for emergencies.

Client

Jose is a 47 year old morbidly obese Latino male who presents to the clinic for follow up evaluation of headaches, dizziness, ringing in his ears and frequent urination. He reports having a headache that “comes and goes” with ringing in his ears and sometimes he sees spots. Jose has taken acetaminophen and states that seems to help. Due to his work schedule of six 12 hour days, Jose has not had preventive care. He reports fatigue and is depressed regarding his current income situation. Jose has just been laid off for the season and will lose his insurance in 30 days until the restart of the harvesting season in March. He is concerned about paying for any health care that may go beyond his benefit period. Jose lives with his pregnant wife, who does not work, and their seven children in a three bedroom one bath house that they share with his parents and his brother’s family of three.

Review of Systems Subjective Data

General: occasional fatigue, gradual weight gain over the past ten years

HEENT: (+) visual and hearing changes with HA; (-) cold or recent upper respiratory

changes, (-) rhinorrhea or nose bleeds,

Cardiac: (-) chest pain or tightness, no palpitations

Respiratory: no asthma, (+) snores at night

GI: (-) pain, nausea, vomiting, constipation, visible fecal blood, (+) GERD, reports occasional indigestion after meals,

GU: (+) frequent urinary for 1 month with increased thirst

MS: (+) chronic bilateral shoulder and low back pain for 7+/- years, takes ibuprofen prn.

Neuro: (+) headaches 2- 3 times a week relieved with acetaminophen, (+) dizziness, sees spots with HA which are not related to activity, (-) weakness, (+) numbness and tingling in both feet,

(-) changes in speech or memory

Skin: (-) rashes or lesions

Allergies (-)

Psych: (+) Depressed about income, wife is unable to work and is pregnant

7 children ages 2 years-13 years.

Past Medical History: Denies problems No preventative care. Only acute care for cold or flu.

Past Surgical History: None

Medications: None

Social History: (-) substance abuse, (+) ETOH, drinks 1-2 beers a day and 5-6 beers on the weekend with family on Saturday and Sunday. Drinks 2 cups of coffee with cream and sugar in the AM, does not exercise except working in the fields picking broccoli, likes to watch TV at night, eats a high carbohydrate diet of rice, beans, potatoes, corn and tortillas (8-10 a day) eats at home, does not eat out often. Drinks water, no sodas or junk food. Reports drinking freshly made jimaca (hibiscus) tea with sugar and fresh cucumber lime drink with sugar three times a week. Rarely eats deserts.

Family History: Parents and siblings all living. 2 brothers and 3 sisters. (+) hypertension – father and mother, 2 brothers and 2 sisters (+) diabetes-father, mother, 1 brother and 1sister, (+) coronary heart disease- father, mother, 1 brother, (+) hypercholesterolemia- father, mother, 1 brother, 2 sisters

Physical Examination – Objective Findings

Ht. 64 inches Wt. 294 lbs. BP 176/104 mmHg HR: 92 RR: 24 T: 98.8 F

General: Well appearing, well groomed, NAD, looks stated age, morbidly obese

Eyes: PERRLA, Fundoscopy with no AV nicking or copper or silver appearance, no

papilledema, EOMI

Neck: supple, (-) lymphadenopathy, (-) thyromegaly,

CV/Heart: RRR, (-) murmur, rubs or gallops, lifts or heaves, tenderness to palpate, (-) carotid bruits, (-) pedal edema

Lungs: CTA bilaterally, respirations equal and unlabored

Abdomen: (+) BS x 4, soft, round, non-tender, (-) masses, organomegaly, bruits

MS: (+) steady gait, FROM all EXT, no cyanosis, clubbing, pedal pulses present, feet warm, monofilament test abnormal at R great toe, 2+ patellar DTR,

Neuro: CN 2-12 grossly intact, (-) Rhomberg, (-) Pronator drift, (-) Dix Hallpike

Skin: (-) rashes or lesions, color even WNL, hair normal distribution

Psych: appears anxious

Previous Lab and Diagnostic Testing: None available. Reports labs done in Mexico 10 years ago, does not remember results.

Current Lab Test Results – Fasted 12 hours – completed 1 week prior to clinic

appointment

Complete Blood Count/ Basic Metabolic Panel

WBC 5.0

RBC 4.8

Hgb 14

HCT 45.2

MCV 78

MCH 27

Glucose 238

Creatinine 0.6 mg/dl

Carbon dioxide 25 mEq/L

Chloride 100 mEq/L

Potassium 4.0 mEq/L

Sodium 142 mg/dl

Calcium 9 mg/dl

BUN 16 mg/dl

AST 68

ALT 82

Triglycerides 457

Cholesterol 368

LDL 325

HDL 38

Vit D 16

A1c 10.9

TSH 4.95

CRP 6

UA

Clear, pale yellow

pH 5.4

Specific gravity 1.021

Protein negative

Glucose 500++

Ketones Neg

Blood Neg

Cardiology/Endocrine Case Study

Answer the questions below using current national clinical practice guidelines, your pharmacology course textbook, previous pathophysiology coursework, and other sources such as journal articles to support your answers. Please review the grading rubric that will be used to evaluate your submission (100 points = 20% of total grade)

1. Based on the patient’s labs and the Subjective and Objective data, what are the patient’s diagnoses? (Hint: There are at least 8.)

2. Briefly discuss the pathophysiology of the top three diagnoses.

3. Discuss the guidelines for diabetes management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Explain the importance of aspirin in diabetes. Describe how these medications work to stabilize and provide optimum health.

4. Discuss the JNC 8 guidelines for hypertension management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Describe how these medications work to stabilize and provide optimum health.

5. Discuss the AACE 2017 guidelines for dyslipidemia management. What is the best drug(s) of choice for this patient? What are the benefits of the drug(s) for this patient? Explain the pharmacological action of the drug(s). Describe how these medications work to stabilize and provide optimum health.

6. Discuss non-pharmacological interventions to assist Jose in reaching his optimal health. This includes supplements/alternative/integrative medicine….

7. List factors that increase the patient’s risk for cardiovascular disease (including labs).

Calculate Jose’s 10 year atherosclerotic cardiovascular disease (ASCVD) risk using the Framingham and Mesa calculators.

8. Discuss consequences of obesity as the one major cause of this patient’s problems that if corrected can impact all of his diagnoses. Explain how the related factors of his lifestyle affect his diagnoses. What type of diet is recommended according to the latest research? Is Jose a candidate for bariatric surgery and how does bariatric surgery help?

9. Jose has expressed his inability to afford all of the medications he needs. What medication is required and how can his other diagnoses be treated? List other disciplines that could provide a multidisciplinary team approach to assist Jose in reaching optimal health.

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Con-Position Proposal

Con-Position

Instructions
Please review the Counterpoint: Vaccines: Caution Advised, an example of a con article.

Note: The article was pulled from our Chamberlain library’s Points of View Reference Center database. This resource is highly recommended, as it presents many of the topics in the General Education Healthcare field that may be applicable this term. To access the resource from our library website, choose “Databases” on the homepage, and scroll down to “Points of View.” Click “Go.” Scroll down to Health and Medicine. You will see a large list of potential topics ranging from Allergies in Schools to Vegetarianism. When you click on a topic (Vaccines, for example), you will see an overview of the topic, as well as points, counterpoints, and a guide to critical analysis.

The goal of the proposal is to create a working thesis statement and basic research plan that considers context, audience, purpose, and presents potential sources. A proposal is not an outline, as it does not structure the paper. Rather, a proposal offers direction for research needs and gives your professor an opportunity to provide feedback before the drafting process.

Access the Con-Position Proposal Template and complete the six required sections:

For an example proposal, refer to pages 269-270 of our textbook.

Writing Requirements (APA format)

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Case Study 14

Case Study, Chapter 14, Shock and Multiple Organ Dysfunction Syndrome

1. Adam Smith, 77 years of age, is a male patient who was admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. The patient has a Foley catheter in place from the nursing home with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. The patient is confused, afebrile, and hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min and the pulse oximeter reading is at 88% room air, so the physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. The patient has diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for inflammation, is elevated. The patient is being treated with broad-spectrum antibiotics and norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and verified by chest x-ray for correct placement. An arterial line was placed in the right radial artery to closely monitor the patient’s blood pressure during the usage of the vasopressor therapy.

1. What predisposed the patient to develop septic shock?
2. What potential findings would suggest that the patient’s septic shock is worsening from the point of admission?
3. The norepinephrine concentration is 16 mg in 250 mL of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of a vasoactive medication?
4. Explain why the effectiveness of a vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient?
5. Explain the importance for nutritional support for this patient and which type of nutritional support should be provided?

2. Carlos Adams was involved in a motor vehicle accident and suffered blunt trauma to his abdomen. Upon presentation to the emergency department, his vital signs are as follows: temperature, 100.9°F; heart rate, 120 bpm; respiratory rate, 20 breaths/min; and blood pressure, 90/54 mm Hg. His abdomen is firm, with bruising around the umbilicus. He is alert and oriented, but complains of dizziness when changing positions. The patient is admitted for management of suspected hypovolemic shock.

The following orders are written for the patient:

Place two large-bore IVs and infuse 0.9% NS at 125 mL/hr/line

Obtain complete blood count, serum electrolytes

Oxygen at 2 L/min via nasal cannula

Type and cross for 4 units of blood

Flat plate of the abdomen STAT

(Learning Objectives 1, 4, and5)

1. Describe the pathophysiologic sequence of events seen with hypovolemic shock.
2. What are the major goals of medical management in this patient?
3. What is the rationale for placing two large-bore IVs?
4. What are advantages of using 0.9% NS in this patient?
5. What is the rationale for placing the patient in a modified Trendelenburg position?

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NR 531 Week 7

NR 531 Week 7

Requirements:

1. This paper will be graded on quality of paper information, use of citations, use of Standard English grammar, sentence structure, and organization based on the required components.
2. Create this assignment using Microsoft (MS) Word, which is the required format for all Chamberlain documents. You can tell that the document is saved as a MS Word document because it will end in “.docx”.
3. Submit to the appropriate assignment area by 11:59 p.m. MT on Sunday of the week due. Any questions about this paper may be discussed in the weekly Q & A Discussion topic.
4. The length of the paper is to be no greater than three (3) pages, excluding title page and reference page.
5. APA format using the sixth edition manual is required in this assignment, including a title page and reference page. Use APA level 1 headings for the organizational structure of this assignment. Remember that the introduction does not carry a heading that labels it as a level heading in APA format. The first part of your paper is assumed to be the introduction. See the APA manual sixth edition for details. Use the suggested format and headings to organize your assignment:
   1. Include introduction (do not label as a heading in APA format)
   2. Issue and Magnet Model Component Identified
   3. Key Components of Executive Summary
   4. Supporting Evidence
   5. Conclusion

Preparing the paper

Note: Please use the resources in your Roussel textbook, Chapter 15, to assist with how to write an executive summary format to articulate the results of your Magnet report from ANCC.

1. Clearly introduce your executive summary in the introduction paragraph. Include a sentence that states the purpose of your assignment.
2. Clearly identify and articulate the issue and component from the Magnet model to be communicated to the board of directors at SLMC by you, the nurse executive. Discuss how your choice may affect your healthcare environment and transform healthcare.
3. Key components of an executive summary format, related to the results of the Magnet report, should be included and clearly articulated. (Examples are in your textbook or you may search for them on the web). Include in your executive summary how this assignment relates to the Person-centred Framework by McCormack and McCance (2017).
4. Include of a minimum of three sources of scholarly, empirical evidence to support the issue to be communicated.
5. Provide concluding statements that should summarize your overall assignment content.
6. The paper will be no longer than three pages maximum, excluding title and reference page(s).

Note: There are several formats of an executive summary in your text or on the internet. As the nurse executive, you may choose which style you prefer.

1. Title and reference page(s) must be in APA format using the sixth edition manual.
2. Use 12 Times New Roman font and one-inch margins on all sides of the paper.
3. Note: After submitting your assignment to the Week 7 assignment area, please also upload your completed assignment to the Week 8 designated threaded discussion to share with your peers.

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Critical Evaluation Of Mr.M

Critical Evaluation Of Mr.M

Critical Evaluation Of Mr.M

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. M., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

1. Temperature: 37.1 degrees C

2. BP 123/78 HR 93 RR 22 Pox 99%

3. Denies pain

4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

1. WBC: 19.2 (1,000/uL)

2. Lymphocytes 6700 (cells/uL)

3. CT Head shows no changes since previous scan

4. Urinalysis positive for moderate amount of leukocytes and cloudy

5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. M.’s situation. Include the following:

1. Describe the clinical manifestations present in Mr. M.

1. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.

2. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.

3. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.

4. Discuss what interventions can be put into place to support Mr. M. and his family.

5. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to 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.

RUBRICS. Subjective and objective clinical manifestations are detailed. The clinical manifestations are accurate and clearly report the observed and perceived signs and symptoms. A detailed discussion on what primary and secondary medical diagnoses should be considered for Mr. M. is presented. Strong rationale and reliable data are used to explain why the diagnoses are relevant and should be considered. A thorough discussion of abnormalities a nurse would expect to find during a nursing assessment is presented. Strong rationale and evidence are provided for support. A thorough discussion of the effects of the health status on the physical, psychological, and emotional aspects of the patient, and the impact the health status has on the family, is presented. Strong support for the discussion is provided. All relevant interventions that can be put into place to support Mr. M. and his family are thoroughly discussed. Four or more actual or potential problems faced by the patient are thoroughly discussed. The posed problems are clearly related to his condition. Strong rationale is provided and supports the discussion. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. Writer is clearly in command of standard, written, academic English. All format elements are correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.

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