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. Describe how clinical pathways are used to coordinate care of caseloads of patients.

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Nursing homework help

 complete each case study utilizing collegiate formatting (MLA or APA); typed in Cambria or New Times Roman 12 point font in ONE document.  Citations required.

Case studies are case specific. Your answers should reflect the assessment and your analysis of the information in the case study… no generalized answers of all matter regarding the content.

QUESTION 1: Healthcare Delivery and Evidenced –Based Nursing Practice

The registered nurse working in the cardiac care clinic is tasked with implementing quality improvement measures. To educate the clinic staff, the nurse plans an in-service program to introduce concepts of quality improvement and evidence-based practice. Additionally, the role of the case manager will be included in the presentation. The nurse plans on using care of the patient with Congestive Heart Failure as a template, and prepares sample clinical pathways, care maps, and multidisciplinary action plans. (Learning Objective 3)

a. Describe how clinical pathways are used to coordinate care of caseloads of patients.

b. What is the role of the case manager in evaluating a patient’s progress?

c. What are examples of evidence-based practice tools used for planning patient care?

QUESTION 2: Community-Based Nursing Practice

Mrs. Johnson, a 67-year-old female patient, has recently been discharged from the hospital following an admission for COPD. She has a past medical history of a colon resection related to acute diverticulitis. She developed a surgical wound infection that requires daily wet to dry wound packing and IV Zosyn. Mrs. Johnson was discharged with home oxygen. To manage her care at home, home care visits were ordered. (Learning Objective 5). 

a. What would be involved in setting up the first home care visit?

b. Describe the nursing assessments and management that would occur during the visit.

QUESTION 3: Case Study, Chapter 3, Critical Thinking, Ethical Decision Making, and the Nursing Process

1. Mrs. Elle, 80 years of age, is a female patient who is diagnosed with end-stage cancer of the small intestine. She is currently receiving comfort measures only in hospice. She has gangrene of her right foot and has a history of diabetes controlled with oral agents. She is confused and the physician has determined that she is unable to make her own informed decisions. The hospice nurse, not realizing that the weekly order for CBC and renal profile had been discontinued, obtained the labs and sent them to the nearby laboratory for processing. The abnormal lab results obtained later that day revealed that the patient needed a blood transfusion. The hospice nurse updated the patient’s medical power of attorney who was distressed at the report. The patient’s wishes were to die peacefully and to not have to undergo an amputation of her right foot. But if the patient receives the blood transfusion, she may live long enough to need the amputation. The patient’s physician had previously informed the medical power of attorney that the patient would most likely not be able to survive the amputation. The patient’s medical power of attorney had made the request to cease all labs so that the patient would receive comfort measures until she died. The patient has no complaint of shortness of breath or discomfort. (Learning Objective 4)

What ethical dilemma exists?

Who are the stakeholders and what gains or losses do each have?

What strategies should the hospice nurse take to resolve the ethical dilemma?

QUESTION 4:

Chapter 4, Health Education and Health Promotion

he community health nurse is planning a health promotion workshop for a high school PTSO (Parent-Teacher-Student Organization). The choice of topics was suggested by the high school’s registered nurse who has observed a gradual increase in student obesity. The two nurses have collaborated to develop this workshop to provide parents, students, and teachers with information about the importance of health promotion. (Learning Objectives 6, 8, and 9)

a. Describe the importance of a focus on health promotion.

b. According to the health promotion model developed by Becker (1993), what four variables influence the selection and use of health promotion behaviors?

c.       Describe four components of health promotion.

QUESTION 5: Chapter 5, Adult Health and Nutritional Assessment

The registered nurse prepares to conduct a nutritional assessment on Mrs. Varner, a 52-year-old Caucasian female who describes herself as “overweight most of my adult life.” The client states that her health is good. She works part time as a receptionist and volunteers about 10 hours per week in her church. The nurse obtains Mrs. Varner’s height as 64 inches and her weight as 165 pounds. (Learning Objective 8)

a. What is the rationale for computing body mass index? What is Mrs. Varner’s BMI?

b. Calculate her ideal body weight. What is your assessment of her BMI and weight?

c. Based on Mrs. Varner’s BMI and weight, the nurse measures her waist circumference. Describe the proper procedure for this assessment.

d. Mrs. Varner’s waist circumference is 38 inches. What is your assessment?

e. What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?

QUESTION 6: Chapter 6, Individual and Family Homeostasis, Stress, and Adaptation

Mary Turner stepped on a nail 5 days ago and sustained a puncture about 1 inch deep. She immediately cleaned the area with soap and water and hydrogen peroxide, and applied triple antibiotic ointment to the site. Today she comes to the clinic with complaints of increased pain and swelling in her foot. On assessment, the nurse notes that the puncture site is red and edematous, and has a moderate amount of yellowish drainage. (Learning Objective 9)

a. Describe the sequence of events that caused the local inflammation seen in Mary’s foot.

b. What is the role of histamine and kinins in the inflammatory process?

c. Which of the five cardinal signs of inflammation does Mary exhibit?

d. Because Mary’s injury occurred 5 days ago, the nurse should assess for what systemic effects?

QUESTION 7:

Chapter 7, Overview of Transcultural Nursing

The nurse manager of an ambulatory care clinic has noted an increased number of visits by patients from different countries and cultures, including patients from Mexico and other Latin American countries. Concerned about meeting the needs of this culturally diverse population, the nurse manager convenes a staff meeting to discuss this change in patient demographics, and to query the staff about any learning needs they have related to the care of these patients. (Learning Objective 3)

a. What strategy to avoid stereotyping clients from other cultures should the nurse include in this meeting?

b. Identify culturally sensitive issues to be discussed in the staff meeting.

c. One technician on the staff complains that some patients never make eye contact, and this makes it difficult for him to complete his work. How should the nurse respond?

QUESTION 8: Chapter 8, Overview of Genetics and Genomics in Nursing

Mr. Wayne is a 38-year-old man with a significant family history of elevated cholesterol levels. His father died at age 42 from a massive heart attack secondary to elevated cholesterol and triglycerides, and two of his older siblings are currently taking medications to lower their cholesterol levels. Mr. Wayne makes an appointment to discuss his risk for hypercholesterolemia. The nurse recognizes that Mr. Wayne is at risk for familial hypercholesterolemia because this is an autosomal dominant inherited condition. (Learning Objective 2)

a. Describe the pattern of autosomal dominant inheritance.

b. Mr. Wayne asks what chance his children have of developing familial hypercholesterolemia. How should the nurse respond?

c. Explain the phenomenon of penetrance observed in autosomal dominant inheritance.

QUESTION 9: Chapter 9, Chronic Illness and Disability

Mr. Edwards is 20-year-old male patient who is admitted for treatment of recurring pyelonephritis (kidney infection) and surgical treatment of a urinary stricture, which has decreased the urinary stream. Mr. Edwards has paraplegia; he is paralyzed from the waist down secondary to an automobile accident when he was 16. He came by ambulance to the hospital, leaving his wheelchair and wheelchair pressure-relieving cushion at home. According to the nursing history, the patient is a nonsmoker and he does not drink alcohol or take any illegal drugs. (Learning Objective 5)

a. What nursing considerations should be made for Mr. Edwards related to his disability?

b. What health promotion and prevention education does Mr. Edwards need?

QUESTION 10: Chapter 10, Principles and Practices of Rehabilitation

You are assigned to care for David Ramsey, a 22-year-old male patient who sustained a back injury secondary to being thrown from a motorcycle. He did not damage the spinal cord, but the computed tomography revealed a compression fracture at L-2 (lumbar area). David complains of severe lower back pain with numbness and tingling in the lower extremities. You identify the following nursing diagnosis: Impaired Physical Mobility.

(Learning Objective 4)

a. What assessments are indicated based on this nursing diagnosis?

b. List other major nursing diagnoses based on David’s clinical presentation.

QUESTION 11:

Chapter 11, Health Care of the Older Adult

The nurse working at the senior center notices Mrs. Jones, a 78-year-old, crying. The nurse approaches Mrs. Jones and asks if she needs help. Mrs. Jones states “I am so embarrassed. I had another accident and my pants are all wet. It’s like I’m a baby. I never should have come to the senior center.” (Learning Objectives 3 and 4)

a. What factors may be contributing to the urinary incontinence?

b. How should the nurse respond to Mrs. Jones?

QUESTION 12:

Chapter 12, Pain Management

Mr. Rogers is 2 days postoperative of a thoracotomy for removal of a malignant mass in his left chest. His pain is being managed via an epidural catheter with morphine (an opioid analgesic). As the nurse assumes care of Mr. Rogers, he is alert and fully oriented, and states that his current pain is 2 on a 1-to-10 scale. His vital signs are 37.8 – 92 – 12, 138/82. (Learning Objective 6)

What are benefits of epidural versus systemic administration of opioids?

b. The nurse monitors Mr. Rogers’ respiratory status and vital signs every 2 hours. What is the rationale for these frequent assessments?

c. The nurse monitors Mr. Rogers for what other complications of epidural analgesia?

d. Mr. Rogers complains of a severe headache. What should the nurse do?

e. Mr. Rogers’ epidural morphine and decreased mobility increase his chances of constipation. What interventions should be included in his plan of care to minimize constipation?

QUESTION 13:

Chapter 13, Fluid and Electrolytes: Balance and Disturbance

Mrs. Dean is 75-year-old woman admitted to the hospital for a small bowel obstruction. Her medical history includes hypertension. Mrs. Dean is NPO. She has a nasogastric (NG) tube to low continuous suction. She has an IV of 0.9% NS at 83 mL/hr. Current medications include furosemide 20 mg daily and hydromorphone 0.2 mg every 4 hours, as needed for pain. The morning electrolytes reveal serum potassium of 3.2 mEq/L. (Learning Objective 4)

a. What are possible causes of a low potassium level?

b. What action should the nurse take in relation to the serum potassium level?

c. What clinical manifestations might the nurse assess in Mrs. Dean?

Question 14:

Chapter 14, Shock and Multiple Organ Dysfunction Syndrome

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. (Learning Objectives 6 and 7)

a. What predisposed the patient to develop septic shock?

b. What potential findings would suggest that the patient’s septic shock is worsening from the point of admission?

c. 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?

d. 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?

QUESTION 15:

Chapter 15, Oncology: Nursing Management in Cancer Care

The oncology clinical nurse specialist (CNS) is asked to develop a staff development program for registered nurses who will be administering chemotherapeutic agents. Because the nurses will be administering a variety of chemotherapeutic drugs to oncology patients, the CNS plans on presenting an overview of agents, classifications, and special precautions related to the safe handling and administration of these drugs. (Learning Objectives 6 and 8)

a. What does the CNS describe as the goals of chemotherapy?

b. How should the CNS respond to the following question: “Why do patients require rounds of chemotherapeutic drugs, including different drugs and varying intervals?”

c. In teaching about the administration of chemotherapeutic agents, what signs of extravasation should the nurse include?

d. What clinical manifestations of myelosuppression, secondary to chemotherapy administration, should the CNS include in this program?

QUESTION 16:

Chapter 16, End-of-Life Care

Joe Clark, 79 years of age, is a male patient who is receiving hospice care for his terminal illnesses that include lung cancer and chronic obstructive pulmonary disease (COPD). He developed bilateral pleural effusion (fluid that accumulates in the pleural space of each lung), which has compromised his lung expansion. He states that he is short of breath and feels anxious that the next breath will be his last. The patient is admitted to the hospital for a thoracentesis (an invasive procedure used to drain the fluid from the pleural space so the lung can expand). The thoracentesis is being used as a palliative measure to relieve the discomfort he is experiencing. Low dose morphine is ordered to provide relief from dyspnea or discomfort. The patient is prescribed Proventil (albuterol) inhaler 2 puffs per day, as needed, and Flovent (fluticasone propionate) inhaler 2 puffs twice a day. The patient has 2 L/min of oxygen ordered per nasal cannula as needed for comfort. (Learning Objective 9)

a.       What nursing measures should the nurse use to manage the patient’s dyspnea?

b. The patient complains that he has no appetite and struggles to eat and breathe. What nursing measures should the nurse implement to manage this physiologic response to the terminal illnesses?

QUESTION 17:

Chapter 17, Preoperative Nursing Management

The nurse in a gynecology clinic is completing preoperative teaching for a patient scheduled for an abdominal hysterectomy next week. The patient states that she is currently taking 325 mg of aspirin daily for chronic joint pain, along with a multivitamin. The patient has type 2 diabetes; she closely monitors her blood glucose levels. Currently, she is taking an oral hypoglycemic agent. The nurse advises her to ask the anesthesiologist whether she should take this medication the morning of surgery. (Learning Objectives 2 and 4)

a. The nurse instructs the patient to stop taking the aspirin. What is the rationale for this action?

b. Why is it important to assess the patient for use of herbal products prior to surgery?

c.       The patient asks how surgery could affect her blood glucose; how should the nurse respond?

QUESTION 18: Chapter 18, Intraoperative Nursing Management

Pearl Richards, 69 years of age, is a female patient who is in the operating room for a repair of an abdominal aortic aneurysm. The patient has a history of hypertension controlled with medications, osteoporosis, chronic obstructive pulmonary disease, and has smoked two packs of cigarettes per day for 40 years. (Learning Objectives 2, 6, and 9)        

a. What nursing interventions are instituted to reduce the surgical risk factors related to the patient’s age?

b. Explain the role of the nurse in providing patient safety measures during the intraoperative period.

QUESTION 19: Chapter 19, Postoperative Nursing Management

1. Rita Schmidt, 74 years of age, is a female patient who was admitted to the surgical unit after undergoing removal of a section of the colon for colorectal cancer. The patient does not have a colostomy. The patient has several small abdominal incisions and a clear dressing over each site. The incisions are well approximated and the staples are dry and intact. There is a Jackson-Pratt drain intact with minimal serous sanguineous drainage present. The patient has a Salem sump tube connected to low continuous wall suction that is draining a small amount of brown liquid. The patient has no bowel sounds. The Foley catheter has a small amount of dark amber-colored urine without sediments. The patient has sequential compression device (SCD) in place. The nurse performs an assessment and notes that the patient’s breath sounds are decreased bilaterally in the bases and the patient has inspiratory crackles. The patient’s cardiac assessment is within normal limits. The patient is receiving O2 at 2 L per nasal cannula with a pulse oximetry reading of 95%. The vital signs include: blood pressure, 100/50 mm Hg; heart rate 110 bpm; respiratory rate 16 breaths/min; and the patient is afebrile. The patient is confused as to place and time. (Learning Objectives 4 and 7)

a. Explain the assessment parameters used to provide clues to detect postoperative problems early and the interventions needed.

b. What gerontological postoperative considerations should the nurse make?

2. Mr. John Smith is admitted to the hospital for surgical incision and drainage (I&D) of an abscess on his right calf, which resulted from a farm machinery accident. The right calf has an area 3 cm × 2.5 cm, which is red, warm and hard to touch, and edematous. (Learning Objective 5)

a. Explain the wound healing process according to the phase of Mr. Smith’s wound?

b. The surgeon orders for wet-to-dry sterile saline dressing twice a day with iodoform gauze to the wound, covered with the wet-to-dry dressing. Explain how to perform this dressing change

REFERENCE TEXTBOOK:

Fundamentals of Nursing Second Edition Theory, Concepts and Applications by Judith M. Wilkinson, Leslie S Treas .

perform a complete head-to-toe assessment on one of your chosen participants

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Nursing homework help

head-to-Toe Assessment  For this assignment, perform a complete head-to-toe assessment on one of your chosen participants. Your analysis should include the following:
•Topical headings to delineate systems.

•For any system for which you do not have equipment, explain how you would do the assessment.

•Detailed review of each system with normal and abnormal findings, along with normal laboratory findings for client age.

•An analysis of age-specific risk reduction, health screen, and immunizations.

•Your expectation of normal findings and what might indicate abnormal findings in your review of systems.

•The differential diagnosis (disease) associated with possible abnormal findings.

•A plan of care (including nursing diagnosis, interventions, evaluation).

•Client and age-appropriate evidenced based practice strategies for health promotion.

•Pharmacological treatments that can be used to address health issues for this client.   Provide your answers in a 6- to 7-page Microsoft Word document.   Support your responses with examples.   On a separate references page, cite all sources using APA format.

•Use this APA Citation Helper as a convenient reference for properly citing resources.

•This handout will provide you the details of formatting your essay using APA style.

•You may create your essay in this APA-formatted template.

How do you judge Palin’s quote?

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Nursing homework help

Read the section titled “Reflective Practice: Pants on Fire” from chapter “Health Policy, Politics, and Professional Ethics” and address the questions below:
  • How do you judge Palin’s quote? [“And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.] Effective strategy to oppose Democrats’ plans for health care reform or unethical scaremongering?
  • Reflect on what informs your judgment: commitment to advance care planning, analysis of facts, and/or political party loyalties?
  • Is it right for nurses to endorse health reform legislation even if the legislation is not perfect? Does this apply to the recently failed American Health Care Act?

Can you describe to me all of the foods that the child has eaten in the past 24-48 hours? How many sugary drinks such as soda and juice, does the child drink each day? 

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Nursing homework help

I need 1 comment per each post in APA with citation and 2 references per comment not older that 2013.

Post 1

For this week’s discussion, I chose the 5-year old girl with normal weight with obese parents.  Unfortunately, this topic hits close to home as our youngest daughter is 4 ½ and both my husband and I have gained significant weight over the past few years and are in the obese category.  Most children are able to self-regulate diet and balance what they eat with the amount of energy that they are expending. Parental influence at a young age can have a significant effect on the child’s ability to regulate on their own.  Obesity places adults and children alike at a higher risk for hypertension and diabetes than those of normal weight.  A child who has obese parents is at a higher risk of becoming obese due to unhealthy eating habits that are learned at home.  Obesity is defined in the course text as BMI > 95th percentile for age and gender in children ages 2-18 (Ball, Dains, Flynn, Solomon and Stewart, 2015).

During the child’s health assessment the provider needs to be watchful for any signs of malnutrition as well as over-nutrition.  In addition to standard screening using height, weight and BMI, additional nutritional screening should be performed. Below are three specific questions that could be utilized to further assess nutrition and risk for obesity.

  1. Can you describe to me all of the foods that the child has eaten in the past 24-48 hours? How many sugary drinks such as soda and juice, does the child drink each day?
  2. How many minutes/hours of screen time does your child have per day?
  3. Do you have a standard bedtime? How many hours of sleep does the child typically get per night?

Describing the foods that the child has eaten over 24-48 hours will provide a more accurate account of overall nutrition.  Specifically asking about sugary drinks such as soda and juice can provide opportunity to discuss the health risks that can be associated with too much sugar intake. Specific questions related to amounts of fruits and vegetables are important as well.  Determining if the child is receiving adequate nutrients from the food that they are eating is important.  If there is concern that the child may not be receiving enough vitamins and minerals from food, it may be necessary to recommend a multi-vitamin to supplement what the child is missing from diet.

There are multiple studies that have shown that an increased amount of screen time can have devastating effects on children’s health.  High volume of screen time whether that is from television, video games, computers or other hand-held devices can lead to increased risk of obesity as well as behavioral problems.  Asking questions related to screen time also provides the opportunity to determine where the child eats most of their meals.  Does the family eat together at the table? Do they eat while watching television? How often do they eat in the car or on the go due to busy schedules?  These factors can be used to determine the risk of the normal weight child at age 5 becoming overweight or obese as they get older.  These questions also provide an opportunity to educate parents on healthy eating habits that they can utilize as well to improve the overall health of the family.

Another important factor to determine overall health of the child is determining if the child is getting enough sleep each night.  Children are in a period of rapid growth in early childhood and the body needs time to rest so that it can develop appropriately.  Asking if the child has a standard bedtime and how many hours of sleep the child gets each night can help determine if the child is getting adequate sleep.  In relation to screen time it is important to discuss bedtime habits that the child and parents may have as well.  Does the child have their own bedroom?  Or do they share with an older sibling or parent?  Is there a television in the room? Video games in the room?  There are many children whose parents will tell providers that their children are in bed by 8 pm each evening and while that may be a true statement, the child may not actually be going to sleep until much later due to television or other distractions present in the room. This again provides the opportunity to educate family members on the importance of a good night sleep for overall family health.

Strategies to encourage parents to be proactive about child’s health

In addition to the above strategies, maintaining a food dairy can be an excellent tool to determine over time whether there is adequate nutrition for both the child and parents.  There are many tools that can be utilized to keep a food diary.  A simple notebook and pen works well and with all of the technology available, there are multiple apps such as My Fitness Pal that can be used to track more than the type of food.  They can help track calories, fat, cholesterol, sugar as well as exercise.  These apps are only as good as the information that the user puts in them. “Parents influence a child’s weight through interactions that shape the development of child eating behaviors.” (Pietrobelli and Agosti, 2017).  Parents can be educated on modeling good habits of eating such as eating at the table versus in the care or while watching television. Avoid using food as a reward that can lead to child becoming an emotional eater when they are older. (Pietrobelli and Agosti, 2017). Providing good habits that can be passed on to children can also decrease their risk of depression and eating disorders such as anorexia and bulimia.

Reference

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.

Pietrobelli, A., & Agosti, M. (2017). Nutrition in the First 1000 Days: Ten Practices to Minimize Obesity Emerging from Published Science. International Journal Of Environmental Research And Public Health, 14(12), doi:10.3390/ijerph14121491

Rub, G., Marderfeld, L., Poraz, I., Hartman, C., Amsel, S., Rosenbaum, I., & … Shamir, R. (2016). Validation of a Nutritional Screening Tool for Ambulatory Use in Pediatrics. Journal Of Pediatric Gastroenterology And Nutrition, 62(5), 771-775. doi:10.1097/MPG.0000000000001046

Watkins, F., & Jones, S. (2015). Reducing Adult Obesity in Childhood: Parental Influence on the Food Choices of Children. Health Education Journal, 74(4), 473-484

Post 2

Diagnostic Tests: Mammography

Mammography is an effective diagnostic test that can help practitioners identify breast cancer at an early stage (Jerome-D’Emilia & Chittams, 2015). Typically, a mammogram is a series of x-ray images capable of detecting tumors too small to be palpated as well as calcium microcalcifications that are associated with breast cancer growth (National Cancer Institute, 2016). Screening mammograms are performed routinely and diagnostic mammograms, specific targeted imaging, are used when changes are identified on screening exams or when visibility is compromised, for example with breast implants (National Cancer Institute, 2016).

It is important to evaluate the validity and reliability of important screening tests like mammography to ensure proper screening and early diagnosis and treatment in affected patients. This early detection allows for a greater array of treatment options and an improved overall prognosis (Jerome-D’Emilia & Chittams, 2015). The reliability and validity of the mammogram increases when used in accordance to recommendations, for instance, in patients over the age of 30, as younger women have increased breast density that affects the diagnostic value (Dains, Baumann, & Scheibel, 2016). In addition, for best results, it is important to adhere to regularly scheduled mammograms, typically done annually for women over the age of 40 (National Cancer Institute, 2016). The National Health Service Breast Screening Programme has developed national guidelines to standardize image assessments and screening programs (Hill & Robinson, 2015). The Breast Imaging Reporting and Database System provides radiologists a uniform way to describe and report findings from mammograms, which helps physicians to appropriately coordinate necessary plans of care (National Cancer Institute, 2016).

At times, mammogram imaging can lead to false-positive results, when radiologists identify abnormalities without the presence of cancer. This can result in over treatment with follow up diagnostic mammograms, ultrasounds, and biopsies to rule out findings (National Cancer Institute, 2016). Predictive values can change if screening is not done properly, and Taylor et al. describes breast positioning as being the most important factor in producing quality mammography images (2017). Ensuring that diagnostic tests provide valuable, accurate, and useful information is key to preventative health care services and early management and treatment of identified disease processes.

References

Jerome-D’Emilia, B., & Chittams, J. (2015). Validation of a cultural cancer screening scale for mammogram utilization in a sample of African American women. Cancer Nursing, 38(2), 83-88. Retrieved from

https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=psyh&AN=2015-07872-002&site=eds-live&scope=site

National Cancer Institute. (2016). Mammograms. Retrieved from https://www.cancer.gov/types/breast/mammograms-fact-sheet

Dains, J. E., Baumann, L. C., & Scheibel, P. (2016). Advanced health assessment and clinical diagnosis in primary care  (5th ed.). St. Louis, MO: Elsevier Mosby.

Hill, C., & Robinson, L. (2015). Mammography image assessment; validity and reliability of current scheme. Radiography, 21, 304-307. Retrieved from https://ezp.waldenulibrary.org/login

url=https://search.ebscohost.com/login.aspx?direct=true&db=edselp&AN=S1078817415000899&site=eds-live&scope=site

Taylor, K., Parashar, D., Bouverat, G., Poulos, A., Gullien, R., Stewart, E., & … Wallis, M. (2017). Mammographic image quality in relation to positioning of the breast: A multicentre international evaluation of the

assessment systems currently used, to provide an evidence base for establishing a standardised method of assessment. Radiography, 23(4), 343-349. Retrieved from https://ezp.waldenulibrary.org/login

url=https://search.ebscohost.com/login.aspx?direct=true&db=mnh&AN=28965899&site=eds-live&scope=site

Analyze these drivers and challenges and compare them with your own experience to date as an advocate.

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Nursing homework help

The Nurse as Advocate  Whether nurses are advocating for their patients, health care, and/or policies that improve people’s lives, the advocacy processes have commonalities that transcend the subject of their advocacy. There are also differences, although these differences may be more nuanced than obvious.

Tasks:  Write a 5-page brief to answer the following questions. Be sure to use APA guidelines for writing style, spelling and grammar, and citation of sources.  Read the following chapters from your course textbook:

•Taking Action: Nurse, Educator, and Legislator: My Journey to the Delaware Senate

•Taking Action: A Nurse in the Board Room  Answer the below questions: •Describe what you believe to be the drivers for each of the individuals? What factors led them to become advocates?

•Discuss the challenges that each of them identified in their writings.

•Analyze these drivers and challenges and compare them with your own experience to date as an advocate. In what ways do you believe that you can expand your advocacy skills within the next five years?

Analyze the unique role each plays within nursing and within health care as a whole. 

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Nursing homework help

 Paper needs to be original, APA Format. Follow Instructions down bellow carefully. Provide true information. Thank you.

Create an infographic of the four nurse titles that are classified as being APRNs to illustrate and educate on the unique role of each.

Write a 400 -word paper in which you:

1. Provide a succinct description of each of the four types of APRNs.

2. Analyze the unique role each plays within nursing and within health care as a whole.

3. Describe the challenges faced by APRNs with regard to professional relationships. What challenges do you anticipate personally as a NP? How will you deal with these challenges?

4. Define advanced practice nursing in your own words.

What is prime reality?

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Nursing homework help

Write an 800-1,000 word essay on your personal worldview. Briefly discuss the various possible meanings of the term “spirituality,” and your understanding of the concepts of pluralism, scientism, and postmodernism. Primarily, address the following seven basic worldview questions:
  1. What is prime reality?
  2. What is the nature of the world around you?
  3. What is a human being?
  4. What happens to a person at death?
  5. Why is it possible to know anything at all?
  6. How do people know what is right or wrong?
  7. What is the meaning of human history?

An abstract is not required.

What are 2 specific changes you can make in your nutritional intake to improve your diet?

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Nursing homework help

NAME

DATE

CLASS/SECTION

KINE 205 Nutrition Assessment

Instructions:

· Use data form ChooseMyPlate.gov and information to answer the following questions.

· Be specific and detailed in your answers!

· Attach this discussion to your 3 reports from ChooseMyPlate.gov. and upload all documents.

1. Using your reports and information identify 3 specifics ways that your diet could be improved. (highlight each area of concern on your analysis and list here)

2. What are 2 specific changes you can make in your nutritional intake to improve your diet? These should be specific to the things you listed in question #1.

3. How would these changes impact your health?

4. Using the SMART goal format, create a behavior change goal to help you accomplish these nutritional changes.

5. What did you learn about your diet from tracking your intake with ChooseMyPlate.gov?

. Was an expert witness needed for the jury to understand the issues being tried?

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Nursing homework help
Please write the discussion for #2 and write 2 short answers for #1 and 3 with references.

the heading: Discussion # 3

Use references from scholarly literature to support all postings. APA format required.

You Be the Judge

Mrs. M. was admitted to an acute care facility for removal of a noncancerous brain lesion. Following her surgical procedure, she had problems swallowing, but no difficulty with respirations and breathing. On x-ray, her lungs showed no signs of congestion or infiltration. She was receiving humidified oxygen via an oxygen mask.

During transport from her hospital room to x-ray for a repeat chest film, the humidifier attached to her oxygen line was allowed to lay on its side, allowing water to accumulate and enter the patient’s lungs. The sole person who transported Mrs. M. to the x-ray department was an untrained patient transporter. The patient subsequently experienced aspiration pneumonia and was readmitted to the intensive care unit.

Following her recovery, the patient brought suit for the mishandling of the oxygen humidifier, subsequent aspiration pneumonia, and additional recovery time. At the trial, the patient transporter admitted that he had received no training regarding the transportation of patient receiving humidified oxygen and was not aware that there were any special precautions needed for transporting a patient who was receiving humidified oxygen. The plaintiff’s attorney presented no expert witness testimony regarding professional standards for patient transporter. The court ruled in favor of the medical center, noting that expert testimony was required. The patient appealed. (Guido, p. 71)

Questions:

1. Was an expert witness needed for the jury to understand the issues being tried?

2. Did the patient transporter’s testimony negate the need for expert testimony regarding standards for patient transporter when the patient was receiving humidified oxygen via an oxygen mask?

3. If it was determined that expert testimony was needed, what type of qualifications would you have chosen for the expert in this case?

4. How would you decide the appeal?

Comparing Frameworks for Analyzing Organizations

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Nursing homework help
Discussion: Comparing Frameworks for Analyzing Organizations

Avedis Donabedian’s work generated a pivotal means of assessing organizational performance relative to structure, process, and outcomes. However, it is clearly not sufficient to view health care quality merely in terms of outcomes—the structures and processes that facilitate these outcomes are equally as important.

In this Discussion, you consider multiple frameworks that can be used to analyze an organization. As you proceed, consider how these frameworks allow you to examine the interplay of interdependent and related parts and processes that comprise the systems within an organization, as well as the arrangements or structures that connect these parts.

To prepare:

Investigate and reflect on the systems and structures of an organization with which you are familiar. Consider the following:

What is the reporting structure?

Who holds formal and informal authority?

How many layers of management are there between the frontline and the highest office-holders of the organization?

How are interdisciplinary teams organized?

How is communication facilitated?

How well integrated is decision making among clinical personnel and administrative professionals?

How are particular service lines organized?

Which departments, groups, and/or individuals within the organization are responsible for monitoring matters related to performance, such as quality and finances?

Select two of the following frameworks:

Learning organizations, presented in the Elkin, Haina, and Cone article

Complex adaptive systems (CAS), presented in the Nesse, Kutcher, Wood, and Rummans article

Clinical microsystems, presented in the Sabino, Friel, Deitrick, and Sales-Lopez article

Good to great, presented in the Geller article

The 5 Ps, presented in the ASHP Foundation article

Review the Learning Resources for each of the frameworks that you selected. Also conduct additional research to strengthen your understanding of how to use each framework to assess an organization.

Compare the two frameworks. How could each framework be used to identify opportunities to improve performance? In particular, how would you use each of these frameworks to analyze the organization that you have selected?

By Day 3

Post an analysis of the systems and structures of the organization you selected, sharing specific examples. Explain insights that you gained by comparing the two frameworks, and how each can be used to assess an organization, identify a need for improvement, and, ultimately, enhance the performance of an organization.

Hickey, J. V., & Brosnan, C. A. (2017). Evaluation of health care quality in for DNPs (2nd ed.). New York, NY: Springer Publishing Company.

Chapter 1, “Evaluation and DNPs: The Mandate for Evaluation” (pp. 3-36)

Chapter 3, “Conceptual Models for Evaluation in Advanced Nursing Practice” (pp. 61-86)

Chapter 6, “Evaluating Organizations and Systems” (pp. 127-142)Chapter 1 defines microsystem, mesosystem, and macrosystem and notes that evaluation can focus on one of these levels or all three. Chapter 5 examines the evaluation of organizations and systems.

Sadeghi, S., Barzi, A., Mikhail, O., & Shabot, M. M. (2013). Integrating quality and strategy in health care organizations, Burlington, MA: Jones & Bartlett Publishers.

Chapter 2, “Understanding the Healthcare Organization” (pp. 31–43)Although this chapter focuses on hospitals, the authors provide information about strategic planning and organizational structure that is applicable in many health care settings. The authors examine financial and quality issues as key aspects of performance measurement.

Elkin, G., Zhang, H., & Cone, M. (2011). The acceptance of Senge’s learning organisation model among managers in China: An interview study. International Journal of Management, 28(4), 354–364.

Retrieved from the Walden Library databases.

This article outlines the five disciplines that Senge argued could be found in a learning organization. The authors also discuss the worldview that is inherent in business organizations in China and explain how this relates to Senge’s theory.

Geller, E. S. (2006). From good to great in safety: What does it take to be world class? Professional Safety, 51(6), 35–40.

Retrieved from the Walden Library databases.

Geller reviews and applies Collin’s foundational Good to Great theory from its focus on financial success to safety.

Nesse, R. E., Kutcher, G., Wood, D., & Rummans, T. (2010). Framing change for high-value healthcare systems. Journal for Healthcare Quality, 32(1), 23–28.

Retrieved from the Walden Library databases.

This article explores how to implement change in complex adaptive systems (CAS) such as health care. The authors purport that an understanding of the principles of change management in CAS is critical for success.

Sabino, J. N., Friel, T., Deitrick, L. M., & Salas-Lopez, D. (2009). Striving for cultural competence in an HIV program: The transformative impact of a microsystem in a larger health network. Health & Social Work, 34(4), 309–313.

Retrieved from the Walden Library databases.

The authors discuss cultural competence as part of a patient-centered perspective on health care delivery. They examine an approach to creating innovation that originates at the unit (microsystem) level and can be diffused to the larger health care environment (macrosystem).