Lauren Underwood

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Lauren Underwood

Assignment 1

Congresswoman Lauren Underwood

Congresswoman Lauren Underwood is the first woman of color, and a millennial to be elected to the house of congress. She also serves as the youngest African American woman in the United States House of Representatives. Before she was elected, she served with the Medicaid plan in Chicago, ensuring it offered high-quality and cost-efficient healthcare services. She was also the US Department of Health and Human Services (HHS) senior advisor, aiding communities in the US to prevent, prepare, and respond to public health emergencies such as disasters and bioterror threats (American Nurses Association, n.d.). AT HHS, she supported the implementation of the Affordable Care Act to widen Medicare services, improve healthcare quality, and make progressive changes to private insurance. Congresswoman Lauren Underwood was also an educator, teaching future nurse practitioners via Georgetown University’s online master’s program. She graduated from Michigan University and Johns Hopkins University. (Lauren Underwood)

Congresswoman Lauren Underwood introduced the Momnibus Act 2021, a 12-bill package seeking to deal with long-standing pregnancy and birth outcomes disparities. She introduced the package on February 8 2021, supported by Black Maternal Health Caucus Co-Chair Congresswoman Alma Adams and Senator Cory Booker (Columbia School of Nursing, 2021). She persists in action to end the disparity, considering the US is among the leading countries in maternal mortality rates worldwide. Women of color are three to four times more likely to die during childbirth, despite being controlled for income, education, prenatal care, and insurance status. According to Congresswoman Lauren Underwood, African American women are six times more likely to die during childbirth or from pregnancy complications, which has been the same for decades. The package of bills offers an opportunity to address these disparities and save lives. She calls for relevant stakeholders to invest in social determinants of health, including nutrition, housing, transportation and community groups supporting maternal health and fostering equity (Columbia School of Nursing, 2021). The Perinatal Workforce Act is also part of the Momnibus, aiming to broaden nurse midwives, certified midwives, doulas and obstetricians’ proportions to increase provider availability during childbirth. (Lauren Underwood)

References

American Nurses Association. (n.d.). Nurses serving in congress. https://www.nursingworld.org/practice-policy/advocacy/federal/nurses-serving-in-congress/

Columbia School of Nursing. (2021, February 23). Why nurses should be guiding, making health policy: rep. Underwood offers view from the hill. https://www.nursing.columbia.edu/news/why-nurses-should-be-guiding-making-health-policy-rep-underwood-offers-view-hill

 
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Nursing Paper Example on Listeriosis [SOLVED]

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Nursing Paper Example on Listeriosis [SOLVED]

Nursing Paper Example on Listeriosis [SOLVED]

Listeriosis, caused by the bacterium Listeria monocytogenes, is a serious infectious disease with potentially grave consequences, particularly for vulnerable populations such as pregnant women, newborns, the elderly, and immunocompromised individuals. This bacterial infection is primarily transmitted through contaminated food, including unpasteurized dairy products, raw fruits, vegetables, and ready-to-eat meats, posing a significant challenge to food safety measures. The ability of Listeria monocytogenes to thrive even in refrigerated environments further complicates prevention efforts. Manifesting initially with flu-like symptoms, Listeriosis can progress to severe complications such as meningitis, septicemia, and adverse pregnancy outcomes if left untreated. Given its potential for significant morbidity and mortality, understanding the causes, symptoms, diagnosis, and treatment of Listeriosis is essential for healthcare providers and the general public alike to implement effective prevention and management strategies. (Nursing Paper Example on Listeriosis [SOLVED])

Causes

Listeriosis, an infectious disease caused by the bacterium Listeria monocytogenes, is primarily transmitted through the consumption of contaminated food. The bacterium has a remarkable ability to survive and thrive in various environments, including soil, water, and food processing facilities. This adaptability poses a significant challenge to food safety measures, as Listeria monocytogenes can persist even in refrigerated environments.

Contaminated food items commonly implicated in Listeriosis outbreaks include unpasteurized dairy products, raw fruits, vegetables, and ready-to-eat meats. The bacterium can contaminate these foods during production, processing, or storage, making it difficult to identify and eliminate the source of infection. Moreover, Listeria monocytogenes can proliferate at refrigeration temperatures, further complicating prevention efforts.

Of particular concern is the ability of Listeria monocytogenes to cross the placenta, leading to fetal infection in pregnant women. This can result in miscarriage, stillbirth, premature delivery, or life-threatening neonatal infections. Additionally, individuals with weakened immune systems, such as the elderly and those with certain medical conditions, are at increased risk of developing severe forms of Listeriosis.

Furthermore, Listeriosis outbreaks have been linked to contaminated food processing facilities, highlighting the importance of stringent sanitation practices in food production. The bacterium can persist in the environment, leading to recurrent outbreaks if not adequately controlled.

Overall, the complex interplay between Listeria monocytogenes and its environment underscores the need for comprehensive food safety measures to prevent Listeriosis transmission. Effective prevention strategies require a multifaceted approach, including proper food handling, storage, sanitation, and surveillance to mitigate the risk of infection and protect public health. (Nursing Paper Example on Listeriosis [SOLVED])

Signs and Symptoms

Listeriosis typically presents with a range of symptoms that can vary in severity depending on the individual’s immune status and the extent of infection. The onset of symptoms often occurs within a few days to several weeks after exposure to the bacterium. Pathognomonic signs of Listeriosis include flu-like symptoms such as fever, muscle aches, nausea, and diarrhea. These non-specific symptoms can initially mimic common viral infections, making diagnosis challenging in the early stages of the disease.

In pregnant women, Listeriosis can lead to more severe complications, including miscarriage, stillbirth, premature delivery, or life-threatening infections in the newborn. Pregnant women may experience symptoms such as fever, fatigue, and muscle aches, which can be mistaken for common pregnancy discomforts. However, prompt recognition and treatment of Listeriosis are essential to prevent adverse pregnancy outcomes.

In severe cases, Listeriosis can progress to invasive forms of the disease, including meningitis and septicemia. Meningitis, characterized by inflammation of the membranes surrounding the brain and spinal cord, can manifest with symptoms such as headache, stiff neck, confusion, and sensitivity to light. Septicemia, or blood poisoning, can lead to systemic symptoms such as high fever, chills, rapid breathing, and decreased urine output.

Furthermore, individuals with compromised immune systems, such as those undergoing chemotherapy or organ transplant recipients, are at increased risk of developing severe forms of Listeriosis. They may experience more pronounced symptoms and are susceptible to complications such as septicemia and organ failure.

Overall, early recognition of the signs and symptoms of Listeriosis is crucial for timely diagnosis and management, particularly in high-risk populations. Healthcare providers should maintain a high index of suspicion for Listeriosis in individuals presenting with compatible symptoms, especially during outbreaks or in settings with known Listeria contamination. (Nursing Paper Example on Listeriosis [SOLVED])

Etiology

Listeria monocytogenes, the causative agent of Listeriosis, is a gram-positive, facultative anaerobic bacterium belonging to the family Listeriaceae. It exhibits remarkable adaptability, allowing it to survive and proliferate in diverse environments, including soil, water, and food processing facilities. This adaptability poses a significant challenge to food safety measures, as Listeria monocytogenes can persist even in refrigerated environments where other bacteria may not survive.

Contaminated food products are the primary source of Listeria monocytogenes transmission to humans. Commonly implicated foods include unpasteurized dairy products, raw fruits, vegetables, and ready-to-eat meats. The bacterium can contaminate these foods during production, processing, or storage, leading to outbreaks of Listeriosis.

Of particular concern is the ability of Listeria monocytogenes to cross the placenta, leading to fetal infection in pregnant women. This can result in miscarriage, stillbirth, premature delivery, or life-threatening infections in the newborn. Pregnant women are advised to avoid high-risk foods and practice strict food safety measures to reduce the risk of Listeria exposure during pregnancy.

Furthermore, Listeriosis outbreaks have been linked to contaminated food processing facilities, highlighting the importance of stringent sanitation practices in food production. The bacterium can persist in the environment, leading to recurrent outbreaks if not adequately controlled. In healthcare settings, transmission of Listeria monocytogenes can occur through contaminated medical devices or exposure to infected individuals.

Overall, understanding the etiology of Listeriosis is essential for implementing effective prevention and control measures. By addressing the sources of Listeria contamination in food production and healthcare settings, and promoting public awareness of safe food handling practices, the risk of Listeriosis transmission can be minimized, ultimately protecting public health. (Nursing Paper Example on Listeriosis [SOLVED])

Pathophysiology

Upon ingestion, Listeria monocytogenes enters the body through the gastrointestinal tract, where it can invade the intestinal epithelial cells and penetrate the mucosal barrier. The bacterium possesses several virulence factors that enable it to evade the host immune response and facilitate systemic dissemination.

Once in the bloodstream, Listeria monocytogenes can disseminate to various organs and tissues, leading to systemic infection. It has a predilection for the central nervous system, where it can cause meningitis by crossing the blood-brain barrier and invading the meninges. Meningitis is characterized by inflammation of the membranes surrounding the brain and spinal cord, resulting in symptoms such as headache, stiff neck, confusion, and sensitivity to light.

In addition to meningitis, Listeria monocytogenes can cause septicemia, or blood poisoning, leading to systemic symptoms such as high fever, chills, rapid breathing, and decreased urine output. Septicemia can progress rapidly and result in multi-organ failure if not promptly treated.

Furthermore, Listeria monocytogenes has the ability to cross the placenta and infect the fetus in pregnant women. This can lead to fetal infection and adverse pregnancy outcomes, including miscarriage, stillbirth, premature delivery, or life-threatening infections in the newborn. The mechanisms by which Listeria monocytogenes crosses the placental barrier and infects the fetus are not fully understood but likely involve both maternal and fetal immune responses.

Overall, the pathophysiology of Listeriosis involves a complex interplay between the bacterium and the host immune system, leading to systemic infection and potentially severe complications. Understanding these mechanisms is crucial for developing effective treatment strategies and preventive measures to mitigate the impact of Listeriosis on public health. (Nursing Paper Example on Listeriosis [SOLVED])

DSM-5 Diagnosis

Diagnosing Listeriosis typically involves a combination of clinical evaluation, laboratory testing, and imaging studies to confirm the presence of Listeria monocytogenes infection. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), does not provide specific criteria for diagnosing Listeriosis, as it is primarily a medical condition rather than a psychiatric disorder. However, healthcare providers utilize established clinical guidelines and diagnostic criteria to identify and manage Listeriosis effectively.

Clinical evaluation involves assessing the patient’s medical history, including recent food consumption, travel history, and exposure to potential sources of Listeria contamination. Patients presenting with symptoms such as fever, muscle aches, nausea, diarrhea, headache, stiff neck, confusion, or sensitivity to light may raise suspicion for Listeriosis, particularly in high-risk populations.

Laboratory testing is essential for confirming the diagnosis of Listeriosis. Microbial culture of clinical specimens, such as blood, cerebrospinal fluid, or placental tissue, can isolate Listeria monocytogenes and facilitate antimicrobial susceptibility testing. Molecular techniques, such as polymerase chain reaction (PCR), may also be used to detect Listeria DNA in clinical samples, providing rapid and sensitive diagnostic results.

Imaging studies, such as magnetic resonance imaging (MRI) or computed tomography (CT) scans, may be indicated in cases of suspected central nervous system involvement, such as meningitis or brain abscesses. These imaging modalities can help identify characteristic findings suggestive of Listeriosis, such as meningeal enhancement or focal brain lesions.

Overall, a comprehensive diagnostic approach involving clinical evaluation, laboratory testing, and imaging studies is essential for accurately diagnosing Listeriosis and initiating timely treatment. Healthcare providers should maintain a high index of suspicion for Listeriosis in individuals presenting with compatible symptoms, particularly in high-risk populations or during outbreaks of the disease. (Nursing Paper Example on Listeriosis [SOLVED])

Treatment Regimens and Patient Education

The management of Listeriosis involves a combination of antimicrobial therapy, supportive care, and patient education to promote recovery and prevent recurrence of infection. Prompt initiation of antibiotics is essential for treating Listeriosis and preventing complications. Ampicillin or penicillin G are the first-line antibiotics for treating Listeriosis, as Listeria monocytogenes is typically susceptible to these agents. In cases of severe infection or allergy to penicillin, alternative antibiotics such as trimethoprim-sulfamethoxazole or vancomycin may be used.

Combination therapy with gentamicin may be considered in severe cases of Listeriosis or in patients with central nervous system involvement, as gentamicin has synergistic activity against Listeria monocytogenes. The duration of antibiotic therapy typically ranges from 2 to 6 weeks, depending on the severity of infection and clinical response to treatment.

Supportive care measures, such as intravenous fluids, pain management, and monitoring for complications, are important components of Listeriosis management. Patients with severe infection or systemic complications may require hospitalization for close monitoring and intensive care support.

Patient education plays a crucial role in preventing Listeriosis and reducing the risk of recurrence. Healthcare providers should educate patients about safe food handling practices, including the avoidance of high-risk foods such as unpasteurized dairy products, raw fruits, vegetables, and ready-to-eat meats. Patients should be advised to thoroughly cook meat, poultry, and seafood to kill any potential pathogens, and to wash fruits and vegetables before consuming them.

Pregnant women are particularly vulnerable to Listeriosis and should be counseled about the importance of food safety during pregnancy. They should avoid high-risk foods and practice strict hygiene measures, such as washing hands and utensils after handling raw foods, to reduce the risk of Listeria contamination.

Furthermore, patients should be instructed to seek medical attention promptly if they develop symptoms suggestive of Listeriosis, such as fever, muscle aches, nausea, diarrhea, headache, or stiff neck. Early diagnosis and treatment are crucial for preventing complications and improving outcomes in patients with Listeriosis.

Overall, a multidisciplinary approach involving healthcare providers, public health agencies, and the general public is essential for effectively managing Listeriosis and reducing its burden on public health. By implementing comprehensive treatment regimens and promoting patient education on food safety practices, the incidence of Listeriosis can be minimized, ultimately protecting vulnerable populations from this potentially life-threatening infection. (Nursing Paper Example on Listeriosis [SOLVED])

Conclusion

Listeriosis, caused by the bacterium Listeria monocytogenes, poses a significant threat to public health, particularly for vulnerable populations such as pregnant women, newborns, and immunocompromised individuals. Through an understanding of its causes, symptoms, diagnosis, and treatment, healthcare providers can implement effective prevention and management strategies to mitigate its impact. By emphasizing the importance of prompt diagnosis, antimicrobial therapy, and supportive care, patients can achieve better outcomes and reduce the risk of complications. Moreover, patient education on safe food handling practices is essential for preventing Listeria contamination and reducing the incidence of Listeriosis. With a multidisciplinary approach involving healthcare providers, public health agencies, and the general public, the burden of Listeriosis can be minimized, ultimately safeguarding public health and protecting vulnerable populations from this potentially life-threatening infection. (Nursing Paper Example on Listeriosis [SOLVED])

References

https://www.ncbi.nlm.nih.gov/books/NBK534838/

 
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Nursing Paper Example on Leukemia [SOLVED]

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Nursing Paper Example on Leukemia [SOLVED]Nursing Paper Example on Leukemia [SOLVED]

Leukemia, a formidable adversary in the realm of oncology, stands as a complex and pervasive challenge affecting individuals globally. This hematological malignancy, characterized by the abnormal proliferation of white blood cells in the bone marrow, demands comprehensive exploration to unravel its intricacies. From its elusive causes to its diverse manifestations and treatment modalities, leukemia commands attention from healthcare professionals and researchers alike. With its potential to impact individuals of all ages and backgrounds, understanding the nuances of leukemia is paramount for early detection, effective management, and improved patient outcomes. As we delve into the depths of this disease, we embark on a journey to dissect its genetic underpinnings, unravel its pathophysiological mechanisms, and explore novel therapeutic interventions. Through concerted efforts in research, education, and patient care, we endeavor to confront leukemia with diligence, compassion, and unwavering resolve. (Nursing Paper Example on Leukemia [SOLVED])

Causes

Leukemia, while multifactorial in nature, often stems from a complex interplay of genetic predisposition and environmental exposures. Genetic mutations within bone marrow cells, particularly those affecting the regulation of white blood cell production, lie at the heart of leukemia’s pathogenesis. These mutations can disrupt the normal processes of cell growth, differentiation, and apoptosis, leading to uncontrolled proliferation and accumulation of leukemic cells.

Moreover, certain environmental factors have been implicated in increasing the risk of leukemia. Exposure to ionizing radiation, such as that from medical treatments or nuclear accidents, can induce DNA damage within bone marrow cells, predisposing them to malignant transformation. Similarly, prolonged exposure to benzene, a chemical found in certain industrial settings and tobacco smoke, has been associated with an elevated risk of leukemia development.

Furthermore, lifestyle factors, including smoking and certain chemotherapy drugs, can also contribute to the development of leukemia. Smoking exposes individuals to a myriad of carcinogens, which can directly damage DNA and increase the likelihood of leukemic transformation. Additionally, some chemotherapeutic agents, while crucial for treating other cancers, may inadvertently damage healthy bone marrow cells, predisposing individuals to secondary leukemias.

In some cases, genetic predispositions and family history play significant roles in the development of leukemia. Certain genetic syndromes, such as Down syndrome and Li-Fraumeni syndrome, are associated with an increased risk of leukemia, highlighting the importance of genetic counseling and screening for at-risk individuals.

Overall, the causes of leukemia are multifaceted and encompass a wide array of genetic, environmental, and lifestyle factors. By elucidating these underlying mechanisms, researchers aim to identify novel targets for intervention and develop more effective strategies for leukemia prevention and treatment. (Nursing Paper Example on Leukemia [SOLVED])

Signs and Symptoms

Recognizing the signs and symptoms of leukemia is crucial for early detection and prompt medical intervention. However, the presentation of leukemia can vary widely depending on the type and stage of the disease. In many cases, symptoms develop gradually, often resembling common ailments, which can complicate diagnosis.

One of the hallmark signs of leukemia is persistent fatigue, which may result from anemia caused by a deficiency of red blood cells in the bloodstream. Additionally, individuals with leukemia may experience frequent infections due to a compromised immune system, leading to recurrent illnesses such as pneumonia or urinary tract infections.

Easy bruising or bleeding is another common manifestation of leukemia, attributed to a decreased number of platelets in the blood. Patients may notice excessive bruising or bleeding from minor injuries, nosebleeds, or gum bleeding. Furthermore, swollen lymph nodes, particularly in the neck, armpits, or groin, may indicate the involvement of the lymphatic system by leukemic cells.

Bone pain, often described as dull or aching, may occur as leukemic cells infiltrate the bone marrow and surrounding tissues. This pain can be localized or generalized, depending on the extent of bone marrow involvement. Additionally, unexplained weight loss may occur in some individuals with leukemia, attributed to a combination of factors such as decreased appetite, metabolic changes, and the body’s response to the underlying disease process.

Other less common symptoms of leukemia may include night sweats, fever, and abdominal discomfort or swelling. It is essential for individuals experiencing any of these symptoms, especially if they persist or worsen over time, to seek medical evaluation promptly. Early diagnosis and initiation of appropriate treatment can significantly improve outcomes for individuals with leukemia. (Nursing Paper Example on Leukemia [SOLVED])

Etiology

The etiology of leukemia encompasses a complex interplay of genetic predisposition, environmental exposures, and stochastic events that culminate in the development of this hematological malignancy. Genetic mutations within hematopoietic stem cells are believed to be a central driving force behind leukemogenesis. These mutations can disrupt critical pathways involved in cell proliferation, differentiation, and apoptosis, ultimately leading to the unchecked expansion of leukemic cells.

Environmental factors also play a significant role in the etiology of leukemia. Exposure to ionizing radiation, such as that from medical treatments, nuclear accidents, or occupational settings, is a well-established risk factor for leukemia development. Ionizing radiation induces DNA damage within hematopoietic stem cells, increasing the likelihood of malignant transformation and leukemogenesis.

Furthermore, certain chemical agents, such as benzene and alkylating agents, have been implicated in the pathogenesis of leukemia. Benzene, a ubiquitous industrial solvent and component of tobacco smoke, is known to cause DNA damage and disrupt hematopoiesis, predisposing individuals to leukemia development. Similarly, exposure to alkylating agents, commonly used in chemotherapy for other cancers, can induce DNA damage within bone marrow cells, leading to secondary leukemias.

In addition to genetic and environmental factors, inherited predispositions also contribute to the etiology of leukemia. Certain genetic syndromes, such as Down syndrome and Li-Fraumeni syndrome, are associated with an increased risk of leukemia. These syndromes often involve germline mutations in tumor suppressor genes or genes involved in DNA repair mechanisms, predisposing affected individuals to leukemic transformation.

Overall, the etiology of leukemia is multifactorial, involving a complex interplay of genetic, environmental, and inherited factors. Understanding these underlying mechanisms is crucial for elucidating the pathogenesis of leukemia and developing targeted strategies for prevention, early detection, and treatment. (Nursing Paper Example on Leukemia [SOLVED])

Pathophysiology

The pathophysiology of leukemia is characterized by a disruption of normal hematopoiesis and the unchecked proliferation of leukemic cells within the bone marrow and peripheral blood. At the core of leukemia pathogenesis are genetic mutations that confer a growth advantage to hematopoietic stem cells, allowing them to evade normal regulatory mechanisms and proliferate uncontrollably.

These genetic mutations can affect various signaling pathways involved in cell proliferation, differentiation, and apoptosis. For example, mutations in genes such as FLT3, NPM1, and CEBPA can lead to aberrant activation of signaling pathways that promote cell growth and survival, contributing to leukemic transformation.

As leukemic cells accumulate within the bone marrow, they disrupt the normal process of hematopoiesis, impairing the production of healthy blood cells. This disruption manifests clinically as cytopenias, including anemia due to decreased red blood cell production, thrombocytopenia due to decreased platelet production, and leukopenia due to decreased white blood cell production.

Furthermore, leukemic cells can infiltrate extramedullary sites such as the spleen, liver, and lymph nodes, leading to organomegaly and lymphadenopathy. These extramedullary manifestations can exacerbate symptoms such as abdominal discomfort, early satiety, and lymph node enlargement.

In addition to their direct effects on hematopoiesis and tissue infiltration, leukemic cells can also disrupt normal immune function, predisposing patients to infections and impairing their ability to mount effective immune responses. Moreover, leukemic cells may produce cytokines and other factors that promote a pro-inflammatory microenvironment, further contributing to disease progression and systemic symptoms.

Overall, the pathophysiology of leukemia is complex and multifaceted, involving a combination of genetic alterations, dysregulated signaling pathways, and interactions with the bone marrow microenvironment. Understanding these underlying mechanisms is essential for developing targeted therapies and improving outcomes for patients with leukemia. (Nursing Paper Example on Leukemia [SOLVED])

DSM-5 Diagnosis

While the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), primarily focuses on psychiatric disorders, it does not include specific diagnostic criteria for leukemia. Instead, the diagnosis of leukemia relies on a combination of clinical findings, laboratory tests, imaging studies, and histopathological examination of bone marrow samples.

Clinically, individuals with leukemia may present with symptoms such as fatigue, easy bruising or bleeding, frequent infections, swollen lymph nodes, and bone pain. These symptoms, along with findings from physical examination and medical history, may prompt further evaluation for possible leukemia.

Laboratory tests play a crucial role in the diagnosis of leukemia, with complete blood count (CBC) being one of the initial investigations. CBC may reveal cytopenias, such as anemia, thrombocytopenia, or leukopenia, suggestive of bone marrow dysfunction. Additionally, peripheral blood smear examination may reveal abnormal leukocyte morphology, such as the presence of blast cells, indicative of leukemia.

Further evaluation often includes bone marrow aspiration and biopsy to confirm the diagnosis and characterize the subtype of leukemia. Bone marrow examination allows for the assessment of cellularity, morphology, immunophenotype, and genetic abnormalities of leukemic cells. These findings help classify leukemia into specific subtypes based on established classification systems such as the French-American-British (FAB) and World Health Organization (WHO) classifications.

Imaging studies, such as computed tomography (CT) scans and magnetic resonance imaging (MRI), may be utilized to assess for organomegaly, lymphadenopathy, or extramedullary involvement of leukemia. These studies aid in staging the disease and determining the extent of involvement, guiding treatment decisions and prognostication.

Overall, the diagnosis of leukemia requires a comprehensive approach involving clinical evaluation, laboratory testing, imaging studies, and histopathological examination, with the goal of accurately characterizing the disease and guiding appropriate management strategies. (Nursing Paper Example on Leukemia [SOLVED])

Treatment Regimens and Patient Education

The management of leukemia encompasses a multidisciplinary approach aimed at inducing remission, preventing relapse, and optimizing quality of life for patients. Treatment regimens vary depending on factors such as the subtype of leukemia, stage of disease, patient’s age, overall health, and genetic profile of the leukemic cells.

Chemotherapy remains a cornerstone of leukemia treatment, with regimens tailored to the specific subtype and stage of the disease. Chemotherapeutic agents such as cytarabine, daunorubicin, vincristine, and prednisone are commonly used in induction and consolidation therapy to eradicate leukemic cells and induce remission. Additionally, targeted therapies, such as tyrosine kinase inhibitors (TKIs) and monoclonal antibodies, may be utilized in certain subtypes of leukemia to inhibit specific signaling pathways or target surface antigens expressed on leukemic cells.

For some patients, particularly those with aggressive or refractory disease, hematopoietic stem cell transplantation (HSCT) may be considered as a curative option. HSCT involves the infusion of healthy stem cells, either from a compatible donor (allogeneic transplant) or the patient themselves (autologous transplant), to replace diseased bone marrow and restore normal hematopoiesis.

In addition to medical treatments, supportive care measures are essential in managing the side effects and complications of leukemia therapy. These may include blood transfusions to correct cytopenias, antimicrobial prophylaxis to prevent infections, and supportive medications to alleviate symptoms such as nausea, pain, and fatigue.

Patient education plays a crucial role in empowering individuals to actively participate in their care and make informed decisions about treatment options, symptom management, and lifestyle modifications. Patients should be educated about the goals and potential risks of treatment, including common side effects such as hair loss, nausea, and increased susceptibility to infections.

Furthermore, patients should be encouraged to maintain a healthy lifestyle, including regular exercise, balanced nutrition, and smoking cessation, to optimize their overall well-being and treatment outcomes. Additionally, psychosocial support services, such as counseling and support groups, can help patients cope with the emotional and psychological challenges associated with a leukemia diagnosis and treatment.

By providing comprehensive education and support, healthcare professionals aim to empower patients to navigate their leukemia journey with resilience, optimism, and a sense of control. (Nursing Paper Example on Leukemia [SOLVED])

Conclusion

Leukemia poses a multifaceted challenge, demanding a comprehensive understanding of its causes, symptoms, diagnosis, and treatment regimens. From genetic mutations to environmental exposures, the etiology of leukemia encompasses a complex interplay of factors that contribute to its pathogenesis. Understanding the pathophysiological mechanisms underlying leukemia is crucial for developing targeted therapies and improving outcomes for patients. While the DSM-5 does not provide diagnostic criteria for leukemia, a combination of clinical evaluation, laboratory tests, and imaging studies is utilized to confirm the diagnosis and guide treatment decisions. Treatment regimens, including chemotherapy, targeted therapy, and hematopoietic stem cell transplantation, aim to induce remission and optimize quality of life for patients. Patient education plays a pivotal role in empowering individuals to actively participate in their care and make informed decisions about treatment options and lifestyle modifications. Through collaborative efforts in research, education, and patient care, healthcare professionals strive to advance the field of leukemia management and improve outcomes for individuals affected by this complex disease. (Nursing Paper Example on Leukemia [SOLVED])

References

https://www.ncbi.nlm.nih.gov/books/NBK560490/

 
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Nursing paper Example on Lice [SOLVED]

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Nursing paper Example on Lice [SOLVED]

Lice infestation, a pervasive parasitic condition affecting millions globally, transcends demographic boundaries, impacting individuals of all ages, genders, and socioeconomic backgrounds. These minuscule insects, including Pediculus humanus capitis (head lice), Pediculus humanus corporis (body lice), and Pthirus pubis (pubic lice), inhabit human hair and skin, causing discomfort and distress. Despite their diminutive size, lice pose significant health concerns if left untreated. In this paper, we explore the multifaceted aspects of lice infestation, delving into its causes, signs, symptoms, etiology, pathophysiology, DSM-5 diagnosis, treatment regimens, and patient education. By unraveling the intricacies of lice infestation, we aim to equip healthcare professionals, educators, and individuals with the knowledge and tools necessary for effective management and prevention, ultimately alleviating the burden of lice infestation on affected individuals and communities. (Nursing paper Example on Lice [SOLVED])

Nursing paper Example on Lice [SOLVED]

Causes

Lice infestation, often colloquially referred to as “having lice,” results from the transmission of tiny parasitic insects known as lice. These insects primarily include Pediculus humanus capitis (head lice), Pediculus humanus corporis (body lice), and Pthirus pubis (pubic lice). Transmission commonly occurs through direct contact with an infested individual, particularly through activities involving close proximity such as hugging, sharing personal items like hats, scarves, brushes, or combs, or sleeping in the same bed. Contrary to popular belief, lice do not discriminate based on personal hygiene, as they are equally adept at infesting clean or unwashed hair.

The transfer of lice can also happen indirectly through contact with contaminated personal items harboring lice or their eggs. Shared spaces where personal items come into contact, such as schools, daycare centers, and households, are frequent sites for lice transmission. Additionally, activities involving the exchange of clothing, such as trying on hats or costumes in stores, can facilitate lice transmission.

Once lice find a suitable host, they attach themselves firmly to the scalp, hair shafts, or body hair, feeding on human blood multiple times a day. The warm and conducive environment of the scalp or body provides an ideal habitat for lice to thrive and reproduce. Close quarters and crowded conditions exacerbate the spread of lice, making transmission more likely in environments like schools, camps, and shelters.

Overall, lice infestation stems from the parasitic nature of these insects, their ability to quickly transfer between hosts, and the conducive environments provided by human hair and skin. Understanding the causes of lice infestation is crucial for implementing effective prevention strategies and reducing its prevalence in communities. (Nursing paper Example on Lice [SOLVED])

Signs and Symptoms

Lice infestation manifests with several characteristic signs and symptoms, often causing considerable discomfort and distress to affected individuals. One of the most pathognomonic symptoms of lice infestation is intense itching, primarily localized to the affected area, which commonly includes the scalp, neck, or pubic region. This itching results from an allergic reaction to lice saliva, which contains compounds that act as anticoagulants to facilitate blood feeding.

Continuous scratching of the affected area can lead to further irritation and inflammation, potentially resulting in secondary bacterial infections. Consequently, individuals may experience swollen lymph nodes in the affected region, indicating the body’s immune response to the infestation.

A distinctive feature of lice infestation is the presence of nits, or lice eggs, attached to the hair shafts. Nits are small, oval-shaped structures that range in color from white to yellowish-brown and are firmly attached near the base of the hair close to the scalp. While adult lice may move quickly and may be challenging to detect, nits are often easier to identify upon close inspection.

In addition to itching and the presence of nits, individuals with lice infestation may experience irritability, difficulty sleeping, and feelings of embarrassment or shame due to the social stigma associated with the condition. Moreover, in cases of severe infestation or prolonged untreated cases, individuals may develop excoriation, or skin abrasions, resulting from persistent scratching.

Overall, recognizing the signs and symptoms of lice infestation is crucial for prompt diagnosis and initiation of treatment. By addressing the symptoms early, healthcare providers can prevent complications and alleviate discomfort for affected individuals. (Nursing paper Example on Lice [SOLVED])

Etiology

The etiology of lice infestation lies in the parasitic nature of lice and their unique adaptations for survival. Lice, including Pediculus humanus capitis (head lice), Pediculus humanus corporis (body lice), and Pthirus pubis (pubic lice), are obligate ectoparasites that exclusively feed on human blood. Their dependence on human hosts for sustenance necessitates close contact with humans for survival and reproduction.

Transmission of lice occurs primarily through direct contact with an infested individual or indirectly through contaminated personal items such as hats, clothing, bedding, or hair accessories. Contrary to popular belief, lice infestation is not indicative of poor personal hygiene, as lice can infest both clean and unwashed hair with equal ease.

The warm and conducive environment provided by the human scalp or body hair serves as an ideal habitat for lice to thrive and reproduce. Lice lay eggs, or nits, near the base of the hair shaft, where they are firmly attached to ensure the survival of the offspring. Nits hatch into nymphs, which undergo several molts before reaching adulthood.

Factors such as crowded living conditions, close contact in schools or daycare centers, and shared personal items facilitate the spread of lice infestation. Moreover, activities involving the exchange of clothing or headgear, such as trying on hats or costumes, can contribute to lice transmission.

Preventing lice infestation requires implementing measures to minimize direct contact with infested individuals and reducing opportunities for lice transmission through shared personal items. Educating individuals about proper hygiene practices, avoiding sharing personal items, and regularly inspecting for signs of infestation are essential components of lice prevention strategies. By understanding the etiology of lice infestation and implementing preventive measures, individuals can reduce their risk of infestation and mitigate its impact on their health and well-being. (Nursing paper Example on Lice [SOLVED])

Pathophysiology

The pathophysiology of lice infestation revolves around the interaction between the parasites and the host’s skin and immune system. Upon infesting a host, lice feed on human blood multiple times a day by piercing the skin with their specialized mouthparts. During feeding, lice inject saliva containing anticoagulant compounds to prevent blood clotting, facilitating continuous blood flow.

The introduction of lice saliva into the host’s skin triggers an immune response characterized by inflammation and itching. Individuals with lice infestation experience intense itching, primarily localized to the scalp, neck, or pubic region, as a result of this immune reaction. The persistent itching can lead to excoriation, or skin abrasions, and subsequent bacterial infections if left untreated.

Scratching the affected area exacerbates the irritation and inflammation, potentially leading to secondary complications such as swollen lymph nodes and skin infections. Additionally, the presence of nits, or lice eggs, attached to the hair shafts contributes to ongoing infestation and perpetuates the cycle of lice transmission.

The warm and humid environment of the scalp or body hair provides an optimal habitat for lice to thrive and reproduce. Lice lay eggs, or nits, near the base of the hair shaft, where they are securely attached to ensure the survival of the offspring. Nits hatch into nymphs, which undergo several molts before reaching adulthood and becoming capable of reproducing.

Overall, the pathophysiology of lice infestation involves a complex interplay between the parasites, the host’s skin and immune system, and environmental factors. Understanding the mechanisms underlying lice infestation is essential for developing effective treatment and prevention strategies aimed at disrupting the life cycle of lice and reducing their impact on affected individuals. (Nursing paper Example on Lice [SOLVED])

DSM-5 Diagnosis

Lice infestation, while not specifically classified in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), can cause significant distress and impairment in affected individuals, warranting clinical attention. Healthcare providers diagnose lice infestation based on the presence of live lice or nits upon close inspection of the affected area, typically the scalp, neck, or pubic region.

The diagnosis of lice infestation involves a thorough examination of the individual’s hair and skin, looking for adult lice, nymphs, or nits attached to the hair shafts. Nits are often easier to detect than adult lice, as they are firmly attached near the base of the hair close to the scalp.

Healthcare providers may use a fine-toothed comb to help identify and remove lice and nits from the hair shafts. Additionally, individuals may report symptoms such as itching, irritation, or visible signs of scratching, further supporting the diagnosis of lice infestation.

Although lice infestation itself does not constitute a psychiatric disorder, the distress and social stigma associated with the condition can impact an individual’s mental health and well-being. Feelings of embarrassment, shame, or social isolation may arise due to the perceived social stigma surrounding lice infestation, particularly in children or adolescents.

While lice infestation does not typically require psychiatric intervention, healthcare providers may address any psychological or emotional concerns arising from the condition. Counseling or psychoeducation may be beneficial in alleviating distress and providing support to affected individuals and their families.

In summary, while lice infestation is not classified as a psychiatric disorder in the DSM-5, healthcare providers diagnose the condition based on the presence of live lice or nits upon examination of the affected area. Understanding the psychological impact of lice infestation is essential for providing comprehensive care to affected individuals and addressing any associated distress or stigma. (Nursing paper Example on Lice [SOLVED])

Treatment Regimens and Patient Education

Effective management of lice infestation involves a multifaceted approach encompassing pharmacological treatment, meticulous hygiene practices, and patient education. Pharmacological treatment options for lice infestation include both over-the-counter and prescription medications designed to kill lice and their eggs, known as pediculicides. Commonly used pediculicides include permethrin, pyrethrins, and malathion, which are available in various formulations such as shampoos, lotions, and sprays.

In addition to pediculicides, manual removal of lice and nits through combing with a fine-toothed comb is an essential component of treatment. Wet combing, also known as combing with conditioner, involves applying a generous amount of conditioner to the hair to immobilize lice and facilitate their removal with a fine-toothed comb. This method can be particularly effective in cases of resistance to conventional pediculicides.

Patient education plays a pivotal role in the prevention and management of lice infestation. Educating individuals and families about proper hygiene practices, such as avoiding sharing personal items like combs, brushes, hats, scarves, or clothing, can help prevent lice transmission.

Regular inspection of the scalp and hair for signs of lice infestation, such as itching or the presence of nits, is essential for early detection and prompt treatment. Individuals should be encouraged to notify close contacts, such as family members, schoolmates, or childcare providers, if they discover they have lice to prevent further transmission.

Furthermore, educating individuals about the importance of thorough cleaning and disinfection of personal items and household surfaces can help reduce the risk of lice infestation. Washing clothing, bedding, and personal items in hot water and drying them on high heat can effectively kill lice and nits.

In addition to preventive measures, patient education should address misconceptions and myths surrounding lice infestation, such as the association with poor hygiene or socioeconomic status. Emphasizing that lice infestation can affect anyone and that prompt treatment is effective in eliminating lice can help alleviate stigma and promote understanding.

Overall, a comprehensive approach to lice infestation management includes pharmacological treatment, manual removal of lice and nits, and patient education on preventive measures and proper hygiene practices. By empowering individuals with knowledge and tools to prevent and manage lice infestation, healthcare providers can reduce the burden of this common parasitic condition on affected individuals and communities. (Nursing paper Example on Lice [SOLVED])

Conclusion

Lice infestation poses a significant public health concern, affecting individuals worldwide irrespective of age or socioeconomic status. Understanding the causes, signs, symptoms, etiology, and treatment options is essential for effective management and prevention of lice infestation. By unraveling the intricacies of lice infestation, including its pathophysiology and DSM-5 diagnosis, and emphasizing the importance of treatment regimens and patient education, healthcare providers can empower individuals and communities to combat this common parasitic condition. The comprehensive approach outlined above, encompassing pharmacological treatment, manual removal of lice and nits, and patient education on preventive measures and proper hygiene practices, is crucial for reducing the burden of lice infestation on affected individuals and communities. Through collaborative efforts and proactive measures, we can mitigate the impact of lice infestation and promote the health and well-being of individuals worldwide. (Nursing paper Example on Lice [SOLVED])

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2724133/

 
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NPV

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(NPV)

NPV

NPV

For this clinic scenario, the clinic is divided into three departments: the finance department, the human resource department, and the medical records department. Each department has projects categorized as high-risk, average-risk, or low-risk projects. The heads of the department are responsible for assigning the risk factor or rate for respective projects based on their risk categorization. The clinic has a cost of capital of 8%. Adopting similar adjustment amounts as in exhibit 15.8, high risk will be adjusted by 4 percentage and low risk by 2 percentage. Therefore, the clinic’s cost of capital is adjusted upward to 12 percent in the high-risk department and downward to 6% in the low-risk department. These adjustment amounts are also used in the specific departments for individual projects. After adjustments, the system has results running from 16% for the high risk project in the finance department, which is the installation of a new finance system to 4 percent for the low-risk projects in the medical records department, which is connecting medical records to patient portals. (NPV)

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10522956/

 
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Nursing Care Plan Form

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Nursing Care Plan Form

Nursing Care Plan Form

Student Name:                                                           Date:  

Patient Identifier:  L.D.                                        Patient Medical Diagnosis: Labor Stage IA: Latent Phase           

Nursing Diagnosis (use PES/PE format):

  1. Deficient knowledge related to information misinterpretation and lack of exposure or recall as evidenced by following through instructions inaccurately, asking a lot of questions, and misconception statements.

(Nursing Care Plan Form)

  1. Risk of ineffective coping related to personal vulnerability, situational crisis, severe pain, lack of rest, anxiety and fear as evidenced by client’s inappropriate behavior in maintaining control. (Nursing Care Plan Form)

Assessment Data

(Include at least three-five subjective and/or objective pieces of data that lead to the nursing diagnosis)

Goals & Outcome

(Two statements are required for each nursing diagnosis.  Must be Patient and/or family focused; measurable; time-specific; and reasonable.)

 

Nursing Interventions

(List at least three nursing or collaborative interventions with rationale for each goal & outcome.)

Rationale

(Provide reason why intervention is indicated/therapeutic; provide references.)

 Outcome Evaluation & Replanning

(Was goal met?  How would you revise the plan of care according to the patient’s response to current plan ?)
  1. Patient presents with contractions and pain similar to cramping felt during period.

 

 

  1. Patient experiences back and thigh pain.

 

 

 

 

  1. Patient has blood-streaked discharge and intermittent vaginal bleeding.

 

 Statement #1

Patient is anxious, fearful, and was reluctant to report to the hospital because she has experienced cramping before but not as intense. Patient was not expecting the pain to be labor, indicating deficient knowledge, which is a condition impacting client’s decision-making and coping during early labor and before active labor. This diagnosis is indicated by client asking multiple question, inaccurate following through instructions, and misconception statements.

 

 

 

 

 

 

Statement #2

Coping allows clients to process emotions and stress during pregnancy and labor. Patient indicates risk of ineffective coping related to anxiety and fear, situational crisis, and severe pain.
  1. Evaluate the client’s basic knowledge and expectations during pregnancy.

 

  1. Inquire about the client’s preference nursing care in early labor

 

  1. Evaluate cultural aspects influencing the client’s labor experience.

 

 

 

 

 

 

 

 

 

 

 

  1. Examine uterine contraction- relaxation pattern, vaginal bleeding, fetal status, and cervical dilatation.

 

 

 

  1. Examine the client’s labor pain levels.

 

  1. Note the client’s age and a partner’s or support presence.

 

 

 

 

 

 
  1. This intervention will help develop learning needs and set priorities to help clients make informed decisions regarding their care (Martin, 2022).

 

  1. Establishing the client’s preference of nursing care will help determine whether she might benefit from specific care approaches (Hutchison & Mahdy 2019).

 

  1. Cultural factors affect the client’s experience with labor (Martin, 2022).

 

  1. This approach will help rule out potential complication that might be causing the pain or the bloody discharge (Hutchison & Mahdy 2019).
  2. Linking labor pain with typical circumstances can help client gather her resources and decide a workable pain relief intervention (Martin, 2022).

 

  1. Negative coping is associated with heightened anxiety, and the patient may request medication too early in labor. Stress and discomfort are associated with younger clients, who experience problems maintaining control (Martin, 2022).
 Outcome #1

The patient responded as expected to the nursing care and the interventions adopted. The patient verbalized psychological and physiological changes understanding, participated in making decisions, and demonstrated appropriate breathing and relaxation mechanisms. Continued monitoring is required to determine extended client’s response to current plan.

 

 

 

 

 

 

 

 

 

 

Outcome #2

Outcome two was achieved as the client identified her appropriate behavior to maintain control in early labor. The client identified ineffective coping behaviors and resultants and verbalized awareness of her coping ability. The client used the medication appropriately to manage her pain and discomfort in early labor.

 

 

 

 

(Nursing Care Plan Form)

References

Hutchison, J., & Mahdy, H. (2019). Stages of labor. In StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK544290/#:~:text=The%20first%20stage%20starts%20when,when%20the%20placenta%20is%20delivered.

Martin, P. (2022, September 9). 45 labor stages, induced and augmented, dystocia, precipitous labor nursing care plans. https://nurseslabs.com/labor-stages-labor-induced-nursing-care-plan/

 

 
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Nursing Care Plan of a Child with Asthma

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(Nursing Care Plan of a Child with Asthma)

Student Name:                                                           Date:                                                

Patient Identifier: D.M.                                            Patient Medical Diagnosis: Asthma

Nursing Diagnosis (use PES/PE format):

Nursing Care Plan of a Child with Asthma

  1. Ineffective breathing patterns related to bronchial tubes swelling and spasm responding to irritant inhalation, allergic reaction, infection, or a drug as evidenced by continuous coughing, nasal flaring, cyanosis, and respiratory depth changes.
  2. Ineffective airway clearance related to mucosal edema, heightened pulmonary secretions, and bronchospasms as evidenced by cough, cyanosis, respiratory rate and rhythm changes, wheezes, rhonchi, and atypical arterial blood gasses. (Nursing Care Plan of a Child with Asthma)

Assessment Data

(Include at least three-five subjective and/or objective pieces of data that lead to the nursing diagnosis)

Goals & Outcome

(Two statements are required for each nursing diagnosis.  Must be Patient and/or family focused; measurable; time-specific; and reasonable.)

 

Nursing Interventions

(List at least three nursing or collaborative interventions with rationale for each goal & outcome.)

Rationale

(Provide reason why intervention is indicated/therapeutic; provide references.)

 Outcome Evaluation & Replanning

(Was goal met?  How would you revise the plan of care according to the patient’s response to current plan ?)
Subjective

  1. Patient complains of unending cough and tightness in the chest.

Objective

 

  1. Patient is wheezing

 

  1. Patient has bronchospasms

 

  1. Patient has changing respiratory rate and rhythm

 

  1. Respiratory depth changes are noted

 

  1. Nasal flaring and cyanosis are noted

 

 Diagnosis #1

  1. The patient will achieve and maintain an optimal breathing pattern, indicated by relaxed breathing, typical respiratory rate, and dyspnea absence.
  2. The patient will achieve normal arterial blood gas outcomes and be free of cyanosis.

 

 

 

Diagnosis #2

  1. The patient will demonstrate comprehension of the cause and therapeutic management intervention.
  2. The patient will display improved airway clearance behavior.
  1. Establish rest periods between activities.

 

 

  1. Assess fatigue and stress

 

 

  1. Monitor vital signs

 

 

 

 

  1. Pace the patient’s activities

 

 

  1. Foster deep breathing and coughing exercises

 

 

  1. Advise patient to maintain appropriate positions to ease breathing

 

 

 1. This intervention helps increase breathing patterns’ effectiveness by reducing work of breathing. Rest periods help reduce fatigue that is associated with respiratory failure (Martin, 2023).

 

 

2. Fatigue is a sign of distress and can cause respiratory failure, hence the need to evaluate for fatigue and stress (Martin, 2023).

 

 

3. Assessing vital signs can help identify issues like vasoconstriction potential, hypotension, and tachycardia (Martin, 2023).

 

 

 

 

1. It is critical to pace the patient’s activities by dividing them into parts and taking rest breaks between the activities to prevent fatigue and enhance proper breathing efforts.

 

 

2. Breathing and coughing exercises help ease and spat excess secretions, contributing to effective mucus clearance from the lungs. The exercises also act as coping mechanisms to minimize air trapping (Macêdo et al., 2016).

 

 

 

3. Positions that aid or ease breathing can help reduce muscle fatigue and help with chest expansion, reducing breathing distress (Hashmi et al., 2021).

 

 

 Outcome #1

 

Outcome one was achieved when the patient achieved an optimal breathing pattern, relaxed breathing, and respiratory rate and with the disappearance of dyspnea. Outcome was also attained when the patient demonstrated normal arterial blood gas outcomes and was free of cyanosis.

 

 

 

 

 

 

 

 

Outcome #2

Outcome two was also achieved as the patient verbalized comprehension of the cause and therapeutic management intervention. The patient also demonstrated improved clearance behavior.

 

 

 

 

 

(Nursing Care Plan of a Child with Asthma)

References

Hashmi, M. F., Tariq, M., Cataletto, M. E., & Hoover, E. L. (2021). Asthma (Nursing).

Macêdo, T. M., Freitas, D. A., Chaves, G. S., Holloway, E. A., & Mendonça, K. M. (2016). Breathing exercises for children with asthma. The Cochrane database of systematic reviews, 4(4), CD011017. https://doi.org/10.1002/14651858.CD011017.pub2

Martin, P. (2023, January 3). Asthma nursing care plans. https://nurseslabs.com/asthma-nursing-care-plans/

 
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Placenta Previa Nursing Care Plan Revised

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Nursing Care Plan Form

(Placenta Previa Nursing Care Plan Revised)

Student Name:                                                Date: 1/24/2023                                               

Patient Identifier:  W.M.                               Patient Medical Diagnosis:   Placenta Previa

Nursing Diagnosis (use PES/PE format):

Placenta Previa Nursing Care Plan Revised

(Placenta Previa Nursing Care Plan Revised)

  1. Risk of fluid volume deficiency related to severe vaginal bleeding and uterine blood vessels damage.
  2. Low cardiac output related to significant blood loss as evidenced by severe vaginal bleeding.

Assessment Data

(Include at least three-five subjective and/or objective pieces of data that lead to the nursing diagnosis)

Goals & Outcome

(Two statements are required for each nursing diagnosis.  Must be Patient and/or family focused; measurable; time-specific; and reasonable.)

 

Nursing Interventions

(List at least three nursing or collaborative interventions with rationale for each goal & outcome.)

Rationale

(Provide reason why intervention is indicated/therapeutic; provide references.)

 Outcome Evaluation & Replanning

(Was goal met?  How would you revise the plan of care according to the patient’s response to current plan ?)
  1. Patient reports blood clots on her innerwear and on the toilet bowl over the past one week.

 

 

  1. Patient reports noticing severe vaginal bleeding as she was using the bathroom in the morning she was transported to the hospital

 

  1. Patient reports feeling weak, diminished vision, and headache before being transported by an ambulance to the hospital.

 

 

 Statement #1

The patient will maintain an appropriate fluid volume, determined by assessing urinary output and stability of vital signs

 

Statement #2

The patient will stop bleeding and display homeostasis.

 

 

 

Statement #1

The patient will engage and indicate activities and activity level that lower heart workload.

 

Statement #2

The patient will achieve a hemodynamic stability.
  1. Assess blood color, odor and amount and vaginal bleeding consistency.

 

  1. Evaluate and monitor vital signs.

 

  1. Examine intake and output every hour.

 

 

 

 

  1. Monitor vital signs, particularly blood pressure.

 

  1. Monitor and closely observe the patient usual consciousness levels.

 

  1. Observe intake and output

 

 
  1. Placenta Previa is associated with painless, bright red, sudden, and abrupt bleeding (Anderson-Bagga & Sze, 2019).

 

  1. It is critical to monitor vitals to determine risk of hypovolemic shock (Vera, 2022).

 

  1. Monitoring urine output helps determine whether the patient has adequate blood volume to perfuse the kidneys (Vera, 2022).

 

 

 

  1. Monitoring blood pressure is fundamental to determine development of systemic vascular resistance (Trammel & Sapra, 2020).

 

  1. Diminished cardiac output can cause confusion, restlessness, and/or disorientation (Vera, 2022).

 

  1. Monitoring input and output allows the determination that kidneys are functioning properly or not (Vera, 2022).

 

 

 

 

 Outcome #1

The desired outcome was achieved as the patient managed to maintain appropriate fluid volume, shown by the normal urinary output and steady vital signs. The patient stopped bleeding, displaying homeostasis.

 

 

Outcome #2

The expected outcome was achieved as the patient demonstrated activities that lower heart workload. The patient also achieved hemodynamic stability.

 

 

 

 

 

 

(Placenta Previa Nursing Care Plan Revised)

References

Anderson-Bagga, F. M., & Sze, A. (2019). Placenta previa. In: StatPearls [Internet]. StatPearls Publishing.

Trammel, J. E., & Sapra, A. (2020). Physiology, Systemic Vascular Resistance. In: StatPearls [Internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK556075/

Vera, M. (2022, September 15). Placenta Previa nursing care plans. https://nurseslabs.com/placenta-previa-nursing-care-plans/2/

 
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ASSIGNMENT ON Healthcare Finances ** CHART

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Healthcare Finances

(ASSIGNMENT ON Healthcare Finances ** CHART)

Student

Institution

Course

Instructor

ASSIGNMENT ON Healthcare Finances ** CHART

Healthcare Finances

Capital investment decisions are the most fundamental decisions in a company, involving a current outlay in return for future benefits. All companies make investments to realize benefits or profits in the future. These investments take a substantial percentage of the company’s resources, and actions are irreversible, necessitating a comprehensive decision-making process to increase the chances of success. Capital investments are planned through capital budgeting, which involves evaluating potential big projects or investments, like installing a new system or building a new plant (Gapenski & Reiter, 2016). Capital budgeting entails evaluating the project’s cash inflows and outflows to compute potential returns to be generated to meet a particular benchmark (Gapenski & Reiter, 2016). There are various methods used to appraise capital investments, including the net present value (NPV), Internal Rate of Return (IRR), Modified Internal Rate of Return (MIRR), and the Payback method. (ASSIGNMENT ON Healthcare Finances ** CHART)

The net present value represents the difference between the current cash inflows value and the present cash outflows value over a period (Wang, 2021). The internal rate of return helps estimate the profitability of potential capital investments (Wang, 2021). An assumption of the modified internal rate of return is that the positive cash flows are reinvested into the company’s cost of capital, and the initial cash outlay is financed at the company’s financing cost (Qi et al., 2022). The payback method assesses the period it will take for an investment to pay back or recover the capital investment. (ASSIGNMENT ON Healthcare Finances ** CHART)

To compute the NPV, a company estimates a project’s future cash flows and uses a discount rate representing the project’s cost of capital and at risk to discount them into the present value amounts. Next, all the future positive cash flows of investment are reduced into the present value amount, and the NPV is obtained by subtracting the number from the initial project’s cash outlay (Wang, 2021). The IRR helps compute the rate of return an investment will potentially generate. The IRR is computed by first recalculating the NPV equation, with the NPV factor at zero, and solving for the unknown discount rate, which becomes the IRR (Wang, 2021). Calculating the MIRR also uses the NPV formula, but it assumes the positive cash flows are reinvested at the company’s cost of capital and the initial outlays are invested at the company’s financing cost (Qi et al., 2022). According to Konstantin et al. (2018), the payback period is obtained by dividing the investment amount by the annual cash flows. (ASSIGNMENT ON Healthcare Finances ** CHART)

The NPV is often preferred over the IRR, especially when cash flow shifts from positive to negative or from negative to positive over time and when multiple discount rates are used. The IRR is more suitable when a company is comparing across many investments or projects or in circumstances where it is challenging to compute an appropriate discount rate (Yan & Zhang, 2022). However, the IRR does not consider changing factors, including different discount rates. Because the MIRR assumes positive cash flows are financed at the capital cost and the initial outlay at the company’s financing cost, it tends to be more accurate in reflecting a project’s cost and profitability than the IRR (Qi et al., 2022). The MIRR can be used to rank investments of unproportioned sizes, addressing two major flaws associated with the IRR method. The MIRR offers a single solution for a particular project and a more valid and practical reinvestment rate of positive cash flows. Managers can also use the MIRR to change the reinvestment growth rate at different project stages (Qi et al., 2022). The MIRR has its limitations, including requiring the computation of a cost of capital estimate to make a decision, which can be subjective and vary per the assumptions made. MIRR information can sometimes lead to suboptimal decisions that do not increase value when considering several investment options at a go. Individuals lacking a financial background find MIRR computation difficult to understand because its theoretical basis is disputed across academics (Qi et al., 2022). The payback method helps managers determine the time length the initial investment will take to recover. It is suitable for managers more concerned regarding cash flows. Some limitations of the payback method include not considering the time value of money and only considering the cash inflows until the project’s cash outflows are recovered (Konstantin et al., 2018). The payback method does not take into account the cash inflows after investment recovery in the analysis. (ASSIGNMENT ON Healthcare Finances ** CHART)

All methods can help determine the desirability of an investment and have varying uses with capital budgeting. The NPV is the most preferable over the other capital budgeting methods because it offers more insights into capital investment and is more refined from mathematical and time-value-of-money perspectives (Wang, 2021). It is also the basis for calculating the IRR and the MIRR. The NPV is more dynamic because it can handle different discount rates or varying cash flow directions. The NPV has higher flexibility when appraising investments for individual periods. This method is more theoretically insightful in determining whether a capital investment like an acquisition will be valuable to a firm (Yan & Zhang, 2022). The interpretation is simple because a positive NPV shows inflows are greater than outflows, and the project would add value to the company, assuming no capacity constraints, and a project or investment should not be accepted when the NPV is negative.

Clinic Scenario

For this clinic scenario, the clinic is divided into three departments: the finance department, the human resource department, and the medical records department. Each department has projects categorized as high-risk, average-risk, or low-risk projects. The heads of the department are responsible for assigning the risk factor or rate for respective projects based on their risk categorization. The clinic has a cost of capital of 8%. Adopting similar adjustment amounts as in exhibit 15.8, high risk will be adjusted by 4 percentage and low risk by 2 percentage. Therefore, the clinic’s cost of capital is adjusted upward to 12 percent in the high-risk department and downward to 6% in the low-risk department. These adjustment amounts are also used in specific departments for individual projects. After adjustments, the system has results running from 16% for the high-risk project in the finance department, which is the installation of a new finance system, to 4 percent for the low-risk projects in the medical records department, which is connecting medical records to patient portals. (ASSIGNMENT ON Healthcare Finances ** CHART)

References

Gapenski, L. C., & Reiter, K. L. (2016). Healthcare finance: An introduction to accounting & financial management.

Konstantin, P., Konstantin, M., Konstantin, P., & Konstantin, M. (2018). Investment appraisal methods. Power and Energy Systems Engineering Economics: Best Practice Manual, 39-64. https://content.e-bookshelf.de/media/reading/L-10685619-9ba9df8716.pdf

Qi, J., Wang, Y., & Xu, Y. (2022, December). Research on Project Investment: Methods of NPV, IRR and MIRR. In 2022 International Conference on mathematical statistics and economic analysis (MSEA 2022) (pp. 710-715). Atlantis Press. https://www.atlantis-press.com/proceedings/msea-22/125982665

Wang, Y. (2021, December). The development and usage of NPV and IRR and their comparison. In 2021 3rd International Conference on Economic Management and Cultural Industry (ICEMCI 2021) (pp. 2044-2048). Atlantis Press. https://www.atlantis-press.com/proceedings/icemci-21/125966320

Yan, R., & Zhang, Y. (2022, March). The Introduction of NPV and IRR. In 2022 7th International Conference on Financial Innovation and Economic Development (ICFIED 2022) (pp. 1472-1476). Atlantis Press.

 
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 Ethical SWOT Analysis of RPM

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 Ethical SWOT Analysis of RPM

LAS432 Technology, Society, and Culture

 Ethical SWOT Analysis of RPM

Ethical SWOT Analysis of Remote Patient Monitoring (RPM)

Strengths

·         Lack of physical contact reduces the risk of exposure because contact is via telecommunication.

·         Leads better utilization of human resources because one physician can see more patients in a day.

·         Teleconsultation makes primary and tertiary healthcare accesible to all even those geologically marginalized.

·         The current digitalized trends means that most patients are confortable with telecommunication. For instance, most patients know how to use a smartphone or a computer.

·         The technology requires mínimum infrastructure, only internet access and a digital device, specifically a smartphone or computer.

 

 Weaknesses

·         Internet speed, reliability, and connectivity impacts the effectiveness and efficiency of the RPM.

·         Telemedicine through RPM provides mínimum emergency services.

·         Report exchange is limited because of lack of physical contact.

·         Services might not be equitable because RPM services can be inaccessible to illeterate individuals or those without internet connectivity.

·         Most contacts made through RPM are primarily for inquiry rather than consultation.

·         Patient data collected can be of poor quality.

·         There is a shortage of trained staff to operate RPM systems.

·         The same physician might be unavailable during follow-up.

 
Opportunities

·         Increased use of RPM can help strengthen the referral mechanism, increasing healthcare utilization.

·         EHR digitazes patient’s records and helps link to patients’ Unique Health Identification Number (UHID), increasing quality of data collected and stored.

·         Patient’s geolocations can help with early disease identification, especially during an outbreak.

·         Stringest guidelines like the HIPPA can be adopted in using RPM to avoid legal issues associated with violation of privacy to enhance patient safety.

 

 Threats

·         Record keeping is an issue of concern linked to RPM because of hackers and unauthorized access.

·         Vulnerable groups can be exposed to privacy violations when communicating with physicians.

·         Poor internet speeds and connectivity impact negatively on quality of patient care.

·         Beneficiaries or patients lack awareness regarding specific services offered by the RPM system, impacting growth in use.

·         Social media trends regarding risk of patients’ privacy violations and stealing of patient data impacts the acceptance of the RPM system. Patients need assurance of the safety of their data.

References

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8300556/

 
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