Immunization Case Study Assignment

Week 3: Immunization Case Study Assignment

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

1. Identify vaccines available in the US market for vaccine-preventable disease and describe their features.

2. Identify contraindications and precautions for the use of vaccines available.

3. Use recommendations from the Advisory Committee on Immunization Practice (ACIP) to identify target groups for receipt of each vaccine.

Requirements

1. The Immunization assignment is worth 100 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.

2. Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer when creating your assignment.

3. Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty.

4. The length of the paper should be 2-3 pages, excluding title page and reference page(s). The title and reference pages should be in APA format.

5. Vaccination schedules should be obtained directly from the Centers for Disease Control and Prevention: Resources for Healthcare Providers website and reflect the most current recommendations from the Advisory Committee on Immunization Practices (ACIP). Additional scholarly resources may be used and all sources must be cited appropriately.

Following the directions above, answer each of the following case scenario questions:

Case # 1

You are rotating in the newborn nursery. Your next admission is a term newborn born at 3.5 kg, and all maternal labs are negative. The infant’s exam is normal.

1. What vaccine(s) should she receive and why?

2. What would you do if the mother tested positive for Hepatitis B?

3. What would you do if the mother’s Hepatitis B status was unknown?

Case # 2

Your first patient in primary care clinic is a healthy 2-month-old. She received Hep B #1 in the nursery. She is a term infant and parents have no concerns. Her exam is normal and there are no contraindications to giving her vaccines.

1. Which vaccines should the child receive at this visit?

2. When should she return and which ones would you administer at the next visit?

3. Which vaccination combinations can be used to minimize the number of needle injections, if available?

Case # 3

A healthy 5-year-old comes in with her mother for a well-child check in November. Her routine vaccines are up to date through 2 years old, but she has never received a vaccine for influenza. Her exam is normal.

1. Which vaccines do you recommend at this visit?

2. What anticipatory guidance should be given for a child receiving a flu vaccine at this age?

3. Are there any contraindications for the vaccines that you recommended today?

Case # 4

An 11-year-old girl presents for a routine well-child check. Her immunizations are up to date. Her exam is normal and there are no contraindications to giving her vaccines.

1. Which vaccine(s) do you recommend at this visit?

2. The mother is states that she only wants her daughter to have “the one required for school this year but not the others”. How should the Nurse Practitioner counsel the mother and the patient?

3. The mother is agreeable to proceed with vaccine administration today. Are additional doses needed? If yes, state which ones and when.

Rubric

Immunizations Case Study Assignment

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Benchmark – Capstone Project Change Proposal

Benchmark –

Benchmark –

In this assignment, students will pull together the change proposal   project components they have been working on throughout the course to   create a proposal inclusive of sections for each content focus area in   the course. At the conclusion of this project, the student will be   able to apply evidence-based research steps and processes required as   the foundation to address a clinically oriented problem or issue in   future practice.

Students will develop a 1,250-1,500 word paper that includes the   following information as it applies to the problem, issue, suggestion,   initiative, or educational need profiled in the capstone change proposal:

1. Background
2. Problem statement
3. Purpose of the     change proposal
4. PICOT
5. Literature search strategy   employed
6. Evaluation of the literature
7. Applicable     change or nursing theory utilized
8. Proposed implementation     plan with outcome measures
9. Identification of potential     barriers to plan implementation, and a discussion of how these could     be overcome
10. Appendix section, if tables, graphs, surveys,     educational materials, etc. are created

Review the feedback from your instructor on the Topic 3 assignment,   PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use   the feedback to make appropriate revisions to the portfolio components   before submitting.

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. Please refer   to the directions in the Student Success Center.

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PEDS REVIEW

PEDS REVIEW

PEDS REVIEW

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Case Study 8

Case Study 8

561 Replies Week 3

561 Replies Week 3

561 Replies Week 3

Complete your Week 3 replies 4

APA and References need it.

Discussion Prompt #1

How should you use Gordon’s Functional Health Patterns to assess individual health? What health screening interventions do you regularly participate in?

Reply 1 Ingrid

Gordon’s functional health patterns provides the groundwork for the development of the NANDA-I nursing diagnosis nomenclature. The Functional Health Patterns should be utilized in a manner that through the assessment and collection of data will lead to identifying the problem or diagnostic statement (Mandle, 2013). To have an effective health assessment, physiological parameters must be considered along with how the patient interacts with their surroundings and environment. The Functional Health Patterns is utilized by obtaining the following data:

· Objective data: observations of nurse, physical examination findings, information from health record, results of clinical testing.

· Function data: description of person’s health status.

· Structure data: Organization of interdependent parts describing health, function, patterns of behavior that reflect whole individual and environment.

· Process: Interview, observation, and examination

· Format: Systematic but flexible, individualized to each person, nurse, and situation.

· Goal: Nursing diagnosis or problem identification (Mandle, 2013).

Health screening interventions I participate in is when a patient is a patient is seeking treatment regarding drug addiction. At my place of employment, patients who seek drug addiction treatment are provided with the medication Suboxone which is a combination medication of buprenorphine and naloxone. The medication has the potential to slow or stop breathing and has the tendency to cause addiction, overdose, and death (n.d.). Patients interested in participating in this treatment program are often screened for last alcohol use, last smoking, and last drug use. They are also questioned regarding preferred drug of choice and are subjected to a urine toxicology screening every 3 weeks.

Reply 2 Kristine

Gorden’s functional health pattern was deployed by Marjorie Gordon. This functional health framework provides a sequence of repeated behavior from different patterns that consists of health perception and management, elimination, nutritional-metabolic pattern, activity-exercise, sleep-rest, cognitive perceptual and role-relationship and stress tolerance patterns. Gordon’s health pattern is considered ideal to evaluate an individual’s health because it includes all those factors that put influence on the person’s health such as biological, development, cultural, social and spiritual factors. By considering all these factors in Gordon’s health patterns, healthcare professionals do a complete evaluation of an individual’s health. In this evaluation, some interventions are confronted by practitioners like other health pattern frameworks. Basically, in this framework, data is collected in subjective form and it is possible that some data can be manipulated by an individual about his or her health. This depicts an inaccurate assessment of his or her health. Hence, it is suggesting to use objective information about a person during this health’s assessment to obtain an accurate health assessment (NursingAnswers.net, 2020).

Discussion Prompt #2

What family characteristics may contribute to potential or actual dysfunctional health patterns?

Reply 1 Valery

Culture and environment can contribute greatly to health patterns.  Family is the main component of many patients environment especially when socio economics is considered.  In my position one of the assessments we complete is home environment and family history.  Just by questioning patients regarding their family and living situation we gain lots of insight.  For example, I had a patient that always complained of cough and chest pain but reported no smoking or tobacco use.  When I asked about her family history she mentioned that her mom recently was diagnosed with lung cancer due to smoking.  I remembered that she told me they lived together so I investigated further asking if the mother smoked in the house.  She said yes and I was able to let the physician know all of the details.  Orders for pulmonary function tests and chest xrays were processed with a diagnosis code of family history of lung cancer, and contact with and (suspected) exposure to environmental tobacco smoke (acute) (chronic).  This helps insurance understand the reasoning for request for the further diagnostic tests.

Reply 2 Kristopher

Family history, roles-relationship patterns, and lifestyle can influence some probable dysfunctional health patterns. Family history encompasses health-related patterns of values, goals, or beliefs through which people make choices or decisions. In essence, this takes into account quality of life, expectations, what is perceived to be important, and any perceived conflicts in the values and beliefs a person holds.

Family structure and functions occur at different stages and pose varied risk factors that contribute to health complications. Socioeconomic status, whether measured by income, education or occupational status, and lack of safety can lead to illness, child abuse, injuries, accidents, and sudden infant death syndrome. Also literacy, educational level, cultural beliefs and habits may contribute to dysfunctional health pattersn such as noncompliance with medical treatment.

Families with school-aged children may also influence health patterns due to poverty, abuse or neglect, poor nutrition, and repeated infections, accidents, or hospitalization (Mandle, 2013).

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Nurse Practitioner Role Transition: A Concept Analysis

See attached the selected article needed for writing. Carefully follow all the instructions given below.

Select one of the articles from this week’s Electronic Reserve Readings to use as the basis for this assignment. Article selected(Nurse Practitioner Role Transition: A Concept Analysis)

Create 18 to 20-slide Microsoft® PowerPoint® presentation on the article with detailed speaker notes.

Include the following in the presentation:

–Describe the credentials of the author(s): academic credentials, position held, and any other information available which is usually located at the bottom of first page of article or after the reference list.

-Explain why you selected the concept analysis.

-Describe each step of concept analysis from the article. The number of steps in the concept analysis will depend on the method selected by the author(s).

-Describe how you could apply the concept analysis to your practice.

Provide references for all sources cited on a separate slide and format according to APA guidelines.

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Knee Pain

I need a respond to this assignment

three references

zero plagiarism

Case 3 : KNEE PAIN.

A 15-year-old male reports dull pain in both knees. Sometimes one or both knees click, and the patient describes a catching sensation under the patella. In determining the causes of the knee pain, what additional history do you need? What categories can you use to differentiate knee pain? What are your specific differential diagnoses for knee pain? What physical examination will you perform? What anatomic structures are you assessing as part of the physical examination? What special maneuvers will you perform?

Assessing Musculoskeletal Pain: Knee

Patient Initials: MA    Age: 15 years  Gender: Male

SUBJECTIVE DATA:

Chief Complaint (CC):  “My knees hurt, panful and with clicking sound. I experience catching sensation under the patella. ”  The additional history will be assessed by asking questions related to the onset of the pain in terms of acute or gradual, duration of the pain and its associated symptoms and previous treatment for the pain.

History of Present Illness (HPI): MA is a high school sophomore who came to the doctor complaining of knee pain.  He is an active basketball player for his school team. He started experiencing knee pain in the last week. He claims to be suffering clicking sounds from both knees.

Location: bilateral knees.

Onset: Eight days while playing basketball.

Character: Dull intermittent pain.

Associated signs and symptoms: A catching sensation under kneecaps.

Timing: For the past 8 dyas.

Exacerbating/ relieving factors: gets worst while patient treks to school.  The pain subsides with mediciation rest and ice pack.

Severity: 7 on a pain scale of 1-10 after pain medication Ibuprofen 200mg 2 tabs orally was taken and 10/10 worst pain level after a trek to school.

Medication: Ibuprofen.

Allergies: No allergy to medication but allergic to shellfish.

Past Medical History (PMH): The patient sprained his left knee four months ago, and history of Rheumatic fever during his early childhood.

Past Surgical History (PSH): No history of medical surgery.

Sexual/Reproductive History:  None. The patient is not sexually active.

Personal/Social History: Denies smoking, drinking alcohol, or using any other drugs.

Immunization History: All immunizations are up to date as per the parents. Received flu vaccine 10/5/19.

Significant Family History:  MA lives with his parents. Both grandfathers have diabetes, his mother is obese. His two other siblings are healthy. The family has a history of obesity.

Review of Systems: MA has presented a complaint of dull knee pain that he experiences in both knees.  The pain is clicking and accompanied with a catching sensation under the patella.  The pain mostly persists during physical activity.

OBJECTIVE DATA:

General: MA is a healthy 15 years old who has maintained a healthy body. MA is alert and oriented and very active in school when it comes to basketball and running. No complaint of pain in other joints.

HEENT:  He denies headache or any sign syncope. Denies loss of vision, has no hearing loss and last visited dentist two months ago.

RESPIRATORY:  MN denies a cough and shortness of breath.

Cardiac: No irregular heart rate noted

Extremities: Both knees show no sign of edema and tenderness, but the knees are slightly misaligned with the thigh bone.

Physical Exam: Vital signs: BP 112/72, P 76, regular, T 98.6 temporal, RR 18, and regular. His current weight is 165. Height 5 feet 8inch.

Cardiovascular/Peripheral Vascular: Heart rate is regular and has good S1, S2; no S3 or S4; no murmur. There is no pedal edema or erythema.

Genitourinary: No abnormalities reported with frequencies urination

Psychiatric: The patient appears to be alert and oriented x3.  Denies depressive mode

Neurologic: Alert and oriented to persons, place, and time.

Skin: Skin is intact and is warm to touch and appears moist.

Hematologic:  No evidence of clotting conditions reported.

Allergic/Immunologic: Allergy to shellfish.

Manual Muscle Testing: Knee flexion 5/5, pain. Knee extension 5/5, painful. Knee ER 5/5, Knee IR 5/5.

Musculoskeletal Tests:  The patient can perform a regular activity such as walking, bending the knee with slight discomfort noted.

Diagnostic tests: Computerized tomography (CT) scan, Bilateral Knee X-ray, CBC, and Magnetic resonance imaging (MRI).

The practitioner must assess for abnormalities during musculosketal examination. The lower extremities must be examined for alignment with the edge between the femur and tibia under 15 degrees (Ball, Dains, Flynn, Solomon, and Stewart, 2015). Range of motion must be assessed in patients with suspected fracture (Ball et al., 2015). McMurray test to rule out tear of the meniscus, Varus-valgus stress test to check for knee stability, and Lachman test for anterior cruciate ligament.  The three diagnostic test will help to examine the tissues around the knee, check for patella abnormalities or dislocation, and rule out knee fracture.

ASSESSMENT/Differential Diagnosis:

Priority diagnosis would be Osgood Schlatter Disease: A common cause of knee pain in adolescents. This in an inflammation underneath the knee where the ligament from the patellar tendon attaches to the tibia.

Differential Dx:  These include

1. Osteogenic Sarcoma – This condition is associated with people age 10-25 yrs, and it is characterized by intermittent pain (Ryan, Maryam, & Hue, 2016).
2. Patellar dislocation. This condition is associated with shifting of the knee patella from its normal positioning and is characterized by pain in the patella (Rudavsky & Cook, 2014)
3. Patella fracture. The condition is where the kneecap suffers breakage or cracking and result to pain in the knee, accompanied by swelling and bruising around the knee (Reinking, 2016). Though the patient does not have all these symptoms, it is a probability.
4. Medial meniscus– This condition is associated with knee pain, difficulty flexing, clicking, or catching of the knee movement, just like in the case of the patient (Wu et al. 2018).
5. Patellar chondromalacia. This is when the cartilage in the kneecap gets worn by age or injury and is accompanied by discomfort of the inner knee and pain that aggravate from the physical activity just like in the case of the patient (Pak, Lee, & Lee, 2013).

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to

physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Rudavsky, A., & Cook, J. (January 01, 2014). Physiotherapy management of patellar tendinopathy (jumper’s knee). Journal of Physiotherapy, 60, 3, 122-129.

Reinking, M. F. (January 01, 2016). Current concepts in the treatment of patellar tendinopathy. International Journal of Sports Physical Therapy, 11, 6, 854-866.

Pak, J., Lee, J. H., & Lee, S. H. (January 01, 2013). A novel biological approach to treat chondromalacia patellae. Plos One, 8, 5.

Wu, J. L., Lee, C. H., Yang, C. T., Chang, C. M., Li, G., Cheng, C. K., Chen, C. H., Lai, Y. S. (January 01, 2018). Novel technique for repairing posterior medial meniscus root tears using porcine knees and biomechanical study. Plos One, 13, 2.

Ryan, A. D., Maryam, M., & Hue, H. L. (December 01, 2016). Review of Osteosarcoma and Current Management. Rheumatology and Therapy, 3, 2, 221-243.

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NURS 6550 FINAL EXAM / NURS6550 FINAL EXAM (3 VERSIONS) (100 CORRECT Q & A IN EACH VERSION, TOTAL: 300 Q & A)

Walden University NURS 6550 Final Exam / Walden University NURS6550 Final Exam

QUESTION 1

1. Mr. Jeffers was admitted 2 days ago for a carotid endarterectomy. A Foley catheter was inserted intraoperatively and remains in place. His urine output has declined markedly despite continued IV fluid infusion. Today his morning labs reveal a BUN of 19 mg/dL and a creatinine of 2 mg/dL. A leading differential includes:

A.

Foley lodged in the urethra causing post-renal   failure

B.

Decreased renal perfusion causing prerenal   failure

C.

Age-related decreased eGFR causing prerenal   failure

D.

Post-surgical rhabdomyolysis causing intrarenal   failure

QUESTION 2

1. Janet is admitted with symptomatic tachycardia. Her pulse is 160 b.p.m. and she is weak, diaphoretic, and anxious. Physical examination reveals a 5’4” 107 lb black female who is awake, alert, and oriented, anxious, with moist skin and racing pulse. Her blood pressure is 140/100 mm Hg. Temperature and respiratory rate are within normal limits. The patient admits to having a “thyroid condition” but she never followed up on it when she was advised to see an endocrinologist. The AGACNP anticipates a diagnosis of:

A.

Hashimoto’s thyroiditis

B.

Cushing’s syndrome

C.

Grave’s disease

D.

Addison’s disease

QUESTION 3

1. Systemic lupus erythematosis (SLE) is a multiorgansystem autoimmune disorder that can prevent with a wide variety of manifestations. Which clinical triad should prompt an evaluation for SLE?

A.

Fever, normal white count, elevated sedimentation   rate

B.

Hyperkalemia, hyponatremia, low blood pressure

C.

Leukocytosis, hyperglycemia, hypokalemia

D.

Joint pain, rash, fever

QUESTION 4

1. A patient presents with profound vertigo of acute onset yesterday. She can barely turn her head without becoming very vertiginous; she is nauseous and just doesn’t want to move. This morning when she tried to get out of bed she felt like she was pushed back down. The vertigo is reproducible with cervical rotation. The patient denies any hearing loss or tinnitus, she has no fever or other symptoms. The AGACNP knows that the most helpful intervention will probably be:

A.

Meclizine

B.

Diazepam

C.

Bed rest

D.

Epley’s maneuvers

QUESTION 5

1. Mrs. Mireya is an 85-year-old female who is admitted for evaluation of acute mental status change from the long term care facility. She is normally ambulatory and participates in lots of facility activities. Today a nursing assistant found her in her room, appearing confused and disconnected from her environment. When she tried to get up she fell down. Her vital signs are stable excepting a blood pressure of 90/60 mm Hg. The AGACNP knows that the most likely cause of her symptoms is:

A.

Osteoarthritis

B.

Drug or alcohol toxicity

C.

Hypotension

D.

Urosepsis

QUESTION 6

1. A patient with SIADH would be expected to demonstrate which pattern of laboratory abnormalities?

A.

Serum Na+ 119 mEq/L, serum osmolality 240 mEq/L,   urine Na+ of 28 mEq/L, urine osmolality of 900 mOsm/kg

B.

Serum Na+ 152 mEq/L, serum osmolality 315 mEq/L,   urine Na+ of 5 mEq/L, urine osmolality of 300 mOsm/kg

C.

Serum Na+ 121 mEq/L, serum osmolality 290 mEq/L,   urine Na+ of 7 mEq/L, urine osmolality of 850 mOsm/kg

D.

Serum Na+ 158 mEq/L, serum osmolality 251 mEq/L,   urine Na+ of 20 mEq/L, urine osmolality of 420 mOsm/kg

QUESTION 7

1. Sean is a 29-year-old male who presents to the emergency department for evaluation and treatment of foreign body in the eye. Ophthalmic anesthesia is achieved and removal is attempted unsuccessfully with a moist cotton tipped swab. A wet fluorescein stain is applied to the lower eyelid, and a corneal abrasion ruled out but the AGACNP notes a positive Seidel sign. This indicates:

A.

Penetration of the cornea with resultant aqueous   leak

B.

A rust ring remnant due to metal foreign body

C.

An elevated intraocular pressure

D.

Paradoxical pupil dilation in response to light

QUESTION 8

1. Mrs. Lowen is an 82-year-old female who comes to the emergency department for evaluation of a fever of 102.9° F. She complains of a headache in the right side of her temple and some right-sided jaw pain. A urinalysis, chest radiograph, complete blood count (CBC) and 12-lead ECG are all non-contributory. A comprehensive metabolic panel is significant only for a slightly elevated BUN and creatinine. The AGACNP appreciates distinct right temple tenderness to percussion. Which laboratory test is necessary to support the suspected diagnosis?

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Name:

Institution:

Class: HTL 362V What Is Statistics and Why It Is Important to Health

Sciences?

EXCERCISE 6

1-What are the frequency and percentage of the COPD patients in the severe airflow limitation group who are employed in the Eckerblad et al. (2014) study?

Answer: The frequency of the COPD is 7

The percentage of the COPD is 14

2-What percentage of the total sample is retired? What percentage of the total sample is on sick leave?

Answer: 61% of the total sample is retired.

15% of the total sample is on sick leave.

3- What is the total sample size of this study? What is the frequency and percentage of the total sample were still employed? Show your calculations and round your answer to the nearest whole percent.

Answer: The total sample size is 91

Frequency:14

Percentage: 14/91 = 0.1538 X 100 = 15%

4- What is the total percentage of the sample with a smoking history – either still smoking or former smoker? Is the smoking history for study participants clinically important? Provide a rationale for your answer.

Answer: Total percentage of still smoker is:25%

Total percentage of Former Smoker is: 63%

Total: 63+25 = 88/91 x100 = 97%

Yes, It is important due to lung cancer.

5- What are pack years of smoking? Is there a significant difference between the moderate and severe airflow limitation group regarding pack years of smoking? Provide rationale for your answer.

Answer: The pack years of smoking is the amount of packs that are smoked in a specific number of years, those are the numbers that show how much the person has smoked over their lifetime. A pack a year is equal to smoking a pack of cigarettes per day for one year. There is no difference between moderate and severe groups regarding the pack year of smoking because the p value is 0.177 (less than 5%) due to Moderate 29.1 and Severe 34.

6-What were the four most common psychological symptoms reported by this sample of patients with COPD? What percentage of these subjects experienced these symptoms? Was there a significant difference between the moderate and severe airflow limitation groups for psychological symptoms?

Answer: The four most common psychological symptoms were:

· Feeling Irritable 28%

· Worrying 33%

· Feeling Sad 22%

· Difficulty of Sleeping 52%

· ( There were not significant difference between groups.)

7-What frequency and percentage of the total sample used short-acting Beta 2 agonist? Show your calculations and round to the nearest whole percent.

Answer: Frequency Moderate 13. Severe 32

32+13=45/91=0.494 x 100 = 49%

8- Is there a significant difference between moderate and severe airflow limitation groups regarding the use of short-acting Beta 2 agonist? Provide a rationale for your answer.

Answer: Yes because in Moderate, 31% is used in medication and in Severe, 65% is used in medication which makes a total difference of 34%.

9- Was the percentage of COPD patients with moderate and severe airflow limitation using short-acting Beta 2

agonist what you expected? Provide rationale with documentation for your answer.

Answer: Yes, In the treatment of COPD, Beta 2 agonist is the first-line therapy. It is used both in long and short-term relief of symptoms. It is used when symptoms such as wheezing, SOB, and coughing appear. Beta 2 agonist work by stimulating beta 2 receptors in the muscles that line in airways, which causes them to relax and allows the airway to dilate.

10- Are these findings ready for use in practice? Provide rationale.

Answer: Yes. I think all this information provided a broad insight on COPD and is very helpful for people and nurses that suffer this condition which is very common in today’s population

Reference

Beta2-Agonists for Chronic Obstructive Pulmunary Disease (COPD). (2017). Retrieved from

http://www.webmd.com/lung/copd/beta2-agonists-for-chronic-obstructive-pulmonaty-disease-copd

EXCERCISE 8

1-The number of nursing students enrolled in a particular nursing program between the years of 2010 and 2016,

respectively, were 563, 593, 606, 520, 563, 610, and 577. Determine the mean(x), median (MD), and mode of the number of the nursing students enrolled in this program. Show calculations.

Answer: Mean: 563 + 593 + 606 + 520 + 563 + 610 + 577 = 403/7 = 576

Median: 577

Mode: 563

2- What is the mode for the variable inpatient complications in Table 2 of the Winkler et al. (2014) study? What percentage of the study participants had complication?

Answer: Inpatient Complication in Table 2: AMI post admission for patients admitted in UA.

The percentage is 8%.

3- Does the distribution of inpatient complications have a single mode, or is this distribution bimodal or multimodal? Provide rationale.

Answer: Single Mode because, no other complication has the same number.

4- As reported in Table 1, what are the three most common cardiovascular medical history even in the study, and why is it clinically important to know the frequency of these event?

Answer: Jaw, neck, arm, or back pain: Frequency 152 (55%)

SOB: Frequency 189 (68%)

Chest Pain: Frequency 255 (92%)

The nurses and health care providers should closely follow the patients with these signs and

Symptoms, therefore it is important to know the frequency and apply the right intervention on time.

5- What are the mean and median lengths of stays (LOS) for the study participants?

Answer: Median: 4 days.

Mean: 5.37 days.

6- Are the mean and median for LOS similar or different? What might this indicate about the distribution of the sample? Provide a rationale for your answer.

Answer: The mean and median is very close. This indicates the distribution of the sample was normal.

7- Examine the study results and determine the mode for arrhythmias experienced by the participants. What was the

Second most common arrhythmia in this sample?

Answer: The most frequent arrhythmia experiences in participants were PVCs arrhythmia and non-sustained Ventricular tachycardia.

8- What the most common arrhythmia in Question 7 related to LOS? Was the result statistically significant? Provide rationale.

Answer: Yes, the result is significant because the most common arrhythmia was PVCs had an a increase length of stay(if patient had more than 50 PVCs an hour, independently predicted an increase LOS, with statistically significant results.

9- What study variables were independently of the 50 premature ventricular contractions (PVCs) per hour in the study?

Answer: Around 22% of the patients, aged greater than 65 years old.

10- In Table 1, what race is the mode for this sample? Should these study findings be generalized to American Indian

with ACS? Provide a rationale four your answer.

Answer: The mode of race is the white population having 51% while the American Indians have only 8% in the study.

EXCERCISE 9

1- What were the name and type of measurement method used to measure Caring Practices in the Roch, Dubois, and Clarke (2014) study?

Answer: The name is Caring Nurse-Patient Interaction short scale. It is a quantitative measure with five point likert scale.

2- The data collected with the scale identified in Question 1 were at what level measurement? Provide a rationale for your answer.

Answer: The level of measurement in Question 1 was an interval level measurement and it involved quantitative research and carrying out survey.

3- What were the subscales included in the CNPISS used to measure RNs’ perceptions of their Caring Practices?

Do these subscales seem relevant? Document your answer.

Answer: The subscales included are: Comforting Care, Caring Care, and Relational Care. These Scales are relevant to break down the types of care given.

4- Which subscale for Caring Practices had the lowest mean? What does this result indicate?

Answer: The subscale with lowest mean is Relational Care. It is indicating that it is the least performed care by nurses surveyed.

5- What were the dispersion results for the Rational Care subscale of the Caring Practices in the Table 2? What do these results indicate?

Answer: The standard deviation is 1.01 with the range being 1.00-5.00. This means that there is a wide range of answers, the data is between 1.9-3.9 from the mean. The larger range indicates that the participants have different points of view on how often they participate in relational care.

6- Which subscale of Caring Practices has the lowest dispersion or variation of scores? Provide a rationale for your answer.

Answer: The lowest dispersion is Clinical Care due to responses ranging from 2.44-5.00 with the standard of deviation being 0.57. This means that the responses were all close to the mean of 4.02.

7- Which subscale of Caring Practices had the highest mean? What do these results indicate?

Answer: The highest mean was Comforting Care. This means the participants feel they provide this care more than the other types of care.

8- Compare the Overall rating for Organizational Climate with the Overall rating of Caring Practices. What do these results indicate?

Answer: The Overall Organizational Climate is moderately positive (3.13) and the Overall Caring Practices were significantly more negative (3.62).

9- The response rate for the survey in this study was 45%. Is this a study strenght or limitation? Provide a rationale for your answer.

Answer: The study is strength. The results indicated that nurses generally assessed the organizational climate as moderately positive.

10- What conclusions did the researchers make regarding the caring practices of the nurses in this study? How might these results affect your practice?

Answer: Researches concluded that care practices are regularly performed and the mean score was above 2.5 on the five-point scale. This results might affect my practice in trying to increase my relational care with patients.

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Evidence

Select a challenging nursing care issue (examples include falls, medication errors, pressure ulcers, and other clinical issues that can be improved by evidence in nursing). Do not select a medical issue (disease, medical treatment). Do not select a workforce issue (staffing, call-offs, nurse to patient ratios). Explain the following for the selected clinical issue.

• State the issue.
• Explain the process you would use to search CINAHL for evidence. Include your search terms.
   

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