week 10

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BACKGROUNDMrs. Maria Perez is a 53 year old Puerto Rican female who presents today due to a rather “embarrassing problem.”SUBJECTIVEMrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past 2 years, she has been having more and more difficulty maintaining her sobriety since the opening of the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during its grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past 2 years and she is concerned about the negative effects of the cigarette smoking on her health.She states that she attempts to abstain from drinking but she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much,” but she enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much. She currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.Mrs. Perez is quite concerned today because she borrowed over $50,000 from her retirement account to pay off her gambling debts, and her husband does not know.

 
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Case Study – Self care. (week 8)

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Theory of Dependent-CareThis case study documents an ongoing interaction between a wife and her husband who live in a spacious home in a gated community.When Dan (now 80) and Jane (now 65) began dating more than 15 years ago, both were emotionally charged to begin their lives anew. Well-educated and financially secure, they had a lot in common. Dan was a protestant minister, and Jane’s deceased husband had been a protestant minister. Both had lost their spouses. Jane’s first husband had suffered a catastrophic cerebral aneurysm 2 years earlier. Dan had conducted the funeral service for Jane’s husband. Dan’s wife had died of terminal cancer a little over a year earlier. Dan’s first wife had been a school counselor; Jane was a school teacher. Both had children in college. They shared a love for travel. Dan was retired but continued part-time employment, and Jane planned to continue teaching to qualify for retirement. Both were in great health and had more than adequate health benefits. Within the year they were married. Summer vacations were spent snorkeling in Hawaii, mountain climbing in national parks, and boating with family. After 7 years, Dan experienced major health problems: a quadruple cardiac bypass surgery, followed by surgery for pancreatic cancer. Jane’s plans to continue working were dropped so she could assist Dan to recover and then continue to travel with him and enjoy their remaining time together. Dan did recover—only to begin to exhibit the early signs and symptoms of Alzheimer’s disease. One of the early signs appeared the previous Christmas as they were hanging outdoor lights. To Jane’s dismay, she noted that Dan could not follow the sequential directions she gave him. As time passed, other signs appeared, such as some memory loss and confusion, frequent repeating of favorite phrases, sudden outbursts of anger, and decreased social involvement. Assessments resulted in the diagnosis of early Alzheimer’s disease. Dan was prescribed Aricept, and Jane began to prepare herself to face this new stage of their married life. She read literature about Alzheimer’s disease avidly and organized their home for physical and psychological safety. A kitchen blackboard displayed phone numbers and the daily schedule. Car keys were appropriately stowed. It was noted that she began to savor her time with Dan. Just sitting together with him on the sofa brought gentle expressions to her face. They continued to attend church services and functions but stopped their regular swims at their exercise facility when Dan left the dressing room naked one day. Within the year, Jane’s retired sister and brother-in-law relocated to a home a short walk from Jane’s. Their intent was to be on call to assist Jane in caring for Dan. Dan and Jane’s children did not live nearby so could only assist occasionally. As Dan’s symptoms intensified, a neighbor friend, Helen, began to relieve Jane for a few hours each week. At this time, Jane is still the primary dependent-care agent. She prides herself in mastering a dual shower; she showers Dan in his shower chair first, and then, while she showers, he sits on the nearby toilet seat drying himself. Her girlfriends suggested that this was material for an entertaining home video! Although Jane is cautious in her care for Dan, she often drives a short distance to her neighborhood tennis court for brief games with friends or spends time tending the lovely gardens she and Dan planted. During these times, she locks the house doors and leaves Dan seated in front of the television with a glass of juice. She watches the time and returns home midway through the hour to check on Dan. On one occasion when she forgot to lock the door while she was gardening, Dan made his way to the street, lost his balance, reclined face-first in the flower bed, and was discovered by a neighbor. Jane has given up evenings out and increased her favorite pastime of reading. Her days are filled with assisting Dan in all of his activities of daily living. And, often, her sleep is interrupted by Dan’s wandering throughout their home. At times, when the phone rings, Dan answers and tells callers Jane is not there. Jane, only in the next room, informs him “Dan, I am Jane.” Friends are saddened by Dan’s decline and concerned with the burdens and limitations Jane has assumed as a result of Dan’s dependency.Explain Imogene King’s theory and how does it applies to your nursing profession? Minimum of 150 words

 
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coder homework

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As a medical coder you will be responsible for reviewing patient documentation for encounters that has been added to an Electronic Health Record by a provider. You will ensure the accuracy and integrity of the codes that are used. Additionally, you will review each medical record for compliance purposes and report issues that may be apparent. When there is a question, you will ask or query your provider to confirm that the medical record supports the code selection. It really begins with the medical coder as they are the gatekeepers or coding accuracy and complianInclude the following aspects in the assignment:ú ÿDescribe what you feel a day may be like once you become a coderú ÿWhat do you think will be most challenging?ú ÿSummarize why it is essential to collaborate with clinical staff (MDs/APRNs) to resolve coding questions/discrepanciesú ÿProvide an example of a time when it may be necessary to query a physician.

 
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Part 3: Critical Appraisal of Research

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The PICOT QUESTION:For Patient with immobility and elderly patients 60 years and above, will negative pressure wound therapy compared to Standard moist wound therapy, Improve the therapeutic process of pressure ulcer within two months of hospitalization.SELECTED ARTICLES1. Dumville, J. C., Webster, J., Evans, D., & Land, L. (2015). Negative pressure wound therapy for treating pressure ulcers. Cochrane Database of Systematic Reviews.https://doi.org/10.1002/14651858.cd011334.pub22. Shi, C., Dumville, J. C., Cullum, N., Rhodes, S., Jammali-Blasi, A., Ramsden, V., & McInnes, E. (2021). Beds, overlays and mattresses for treating pressure ulcers. The Cochrane Database of Systematic Reviews, 5, CD013624.https://doiorg.ezp.waldenulibrary.org/10.1002/14651858.CD013624.pub23. Fernandez, L., Ellman, C., & Jackson, P. (2017). Initial Experience Using a Novel Reticulated Open Cell Foam Dressing with Through Holes during Negative Pressure Wound Therapy with Instillation for Management of Pressure Ulcers. Journal of Trauma & Treatment, 06(05).https://doi.org/10.4172/2167-1222.10004104. M„ki-Turja-Rostedt, S., Stolt, M., Leino-Kilpi, H., & Haavisto, E. (2019). Preventive interventions for pressure ulcers in long-term older people care facilities: A systematic review. Journal of Clinical Nursing, 28(13-14), 2420?2442.https://doi.org/10.1111/jocn.147675. Xie, X., McGregor, M., & Dendukuri, N. (2010). The clinical effectiveness of negative pressure wound therapy: a systematic review. Journal of Wound Care, 19(11), 490?495.https://doi.org/10.12968/jowc.2010.19.11.79697The Assignment (Evidence-Based Project)Part 3A: Critical Appraisal of ResearchSelect four articles from the above five articles and conduct a critical appraisal of any of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template.Part 3B: Critical Appraisal of ResearchBased on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research articles you reviewed.Briefly explain the best practice, justifying your proposal with APA citations of the four research articles.

 
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readiness in Transforming Healthcare

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readiness in Transforming Healthcare – 2000-2500 word addressing each of the following points/questions.Describe a recent change you experienced in your professional practice. Describe in detail three things that were successful and three things that were not successful. Include a discussion of why the successes worked and what could have been done to make the less successful actions effective.

 
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Muddiest point off Course advance nursing inquiry and evidence based practice

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Course advance nursing inquiry and evidence based practiceThis week you will reflect onÿ the ?muddiest point? in your course so far. Consider what topics still seem a bit ?muddy? or unclear to you.You have covered a lot of material in this course and hopefully learned a lot. With so much to do and learn it is not unusual for some points to escape you. Here is your opportunity to ask that question and get it answered.Personalize a list of muddiest points you would like clarification for.This week you will reflect onÿ the ?muddiest point? in your course so far. Consider what topics still seem a bit ?muddy? or unclear to you.You have covered a lot of material in this course and hopefully learned a lot. With so much to do and learn it is not unusual for some points to escape you. Here is your opportunity to ask that question and get it answered.Personalize a list of muddiest points you would like clarification for.

 
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Healthcare Policy and Delivery Systems

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Select Health Policy Analysis on a local, state, or federal policy in united states that you have explored along with recommendations based upon the analysis.Analyze and evaluate the Health PolicyIdentify application of health policy into clinical practice.the assignment must have an Introduction and a ConclusionMaximum of 5 pages (not including Title and Reference page).APA format 7At least 5 references within 5 years.free plagiarism

 
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probiotics

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Microbes can have a major impact on a person’s digestive tract.Choose a current research article discusses the potential health effects of probiotics in a person’s diet.To locate articles, you may use https://www.ncbi.nlm.nih.gov/pubmed/ or LIRN Library.Share your article’s findings with the class.Include whether or not your article supports the use of probiotics or was against the use of probiotics.Share whether or not you agree with the findings from the article.  Explain your answer.

 
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teaching plan for treating the potential Psychological issues that may result from health crises in either the elderly or young children.

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Health complications can be stressful, especially in more vulnerable populations like young children and the elderly. With stress and loss of function often come depression and other psychological manifestations. As a nurse, part of your job is to recognize and educate patients and caregivers on how to deal with the psychological complications of a health crisis.In this Assignment, you will educate either a caregiver of an elderly patient or a caregiver of a young child patient on ways to prevent and manage psychological manifestations. Review the Learning Resources dealing with injuries and depression and anxiety.The Assignment:Develop a teaching plan for treating the potential psychological issues that may result from health crises in either the elderly or young children. You will use PowerPoint to present your teaching plan. Some considerations to make include:ú In what ways does mental health need to be considered across the illness/injury continuum?ú How can nurses help both patients and caregivers work through mental blocks and depression associated with an illness or injury?ú Although treatment will take place in a medical facility, how can non-medical treatments be used as a supplement?Support your idea with a minimum of five references from the professional nursing literature. ÿIf they are relevant, you may use one or two professional Web sites in addition to the literature references.Include the main elements of your presentation to a group of parents or elderly or their caregivers.This PowerPoint presentation should include between 8?10 slidesProvided an overview slide on the purpose of the presentation.Described ways mental health needs should be considered across the illness/injury continuum and focused on population to consider and target audience.Outlined a teaching plan to help both patients and caregivers prevent/manage psychological manifestations associated with an illness, injury, or health crisis.Addressed possible non-medical treatments to be used as a supplement.Provided a summary of the main points of the teach plan/presentation.APA Formatting: cover page, title of paper on second page, level headings, Times New Roman 12 font, 1″” margins, and page numbers. APA References: Uses in-text citations appropriately and format correctly. Paraphrases to avoid plagiarizing the source.Reference list is in alphabetical order, hanging indent, double spaced in format. Each specific entry contains all information required by APA format including author, year of publication, title of publication, pages, DOI, website, as appropriate.

 
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Sustaining Performance

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Discussion QuestionsCreating and sustaining a high level of quality performance is a goal in healthcare.Answer the following questions. Your post should look like:Paragraph one: Why is it challenging for health care organizations to create a high level of quality?Paragraph two: Why is it challenging for health care organizations to sustain improvements?Paragraph three: What is the leader’s role in sustaining improvements? What is the staff’s role?Resources: Where did you find your data?

 
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