Assignment 1: Personal Reflection Journal Entry

Assignment 1: Personal Reflection Journal Entry

Due in Week 4 and worth 175 points  (Assignment 1: Personal Reflection Journal Entry)

In this assignment, you will review your current level of adjustment.

Write a one to two (1-2) page paper in which you:

  1. Reflect on how well you are:
    1. adjusting to your life in terms of subjective well-being, diversity, contexts, and / or thinking critically.
    2. balancing your priorities, specifically with home, work, school, recreation, and / or family.
    3. developing your identity, specifically self-esteem, self-concept, ethnicity, and / or gender.
    4. coping with stress, specifically social support, multiple coping strategies, and / or self-control.

Your assignment must follow these formatting requirements:

  • Be typed, double-spaced, using Times New Roman font (size 12), with one-inch margins on all sides; Since the only resources you will be using for this assignment are the article and your textbook, you need not include a reference page. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page is not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Define psychology and psychological adjustment.
  • Identify contextual variables (e.g., culture) that impact psychological adjustment.
  • Describe self-concept, self-esteem, and identity.
  • Define stress, stressors, and coping strategies, and contemplate their relationship to health and wellness.
  • Use critical thinking skills to reflect on personal experiences with adjustment and identify new strategies for personal growth.
  • Use technology and information resources to research issues in psychology.
  • Write clearly and concisely about psychology using proper writing mechanics. (Assignment 1: Personal Reflection Journal Entry)

Resources

https://www.sciencedirect.com/topics/medicine-and-dentistry/psychological-adjustment

 
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Power Politics and Collective Bargaining on Organizational Climate

Power Politics and Collective Bargaining on Organizational Climate

Submit Assignment (Power Politics and Collective Bargaining on Organizational Climate)

Due Feb 20 by 11:59pm  Points 10  Submitting a file upload

Power, politics, and Collective Bargaining on Organizational Climate

List and support your reasons for or against striking.

You are a staff nurse in the ICU in one of your city’s two hospitals. You have worked at this hospital for 5 years and transferred to the ICU 2 years ago. You love nursing but are sometimes frustrated in your job due to a short supply of nurses, excessive overtime demands, and the stress of working with such critically ill patients.

The hospital has a closed shop, so union dues are deducted from your pay even though you are not actively involved in the union. The present union contract is up for renegotiation, and union and management have been unable to agree on many issues. When management made its last offer, the new contract was rejected by the nurses. Now that the old contract has expired, nurses are free to strike if they vote to do so. (Power Politics and Collective Bargaining on Organizational Climate)

You had voted for accepting the management offer; you have two children to support, and it would be devastating to be without work for a long time. Last night, the nurses voted on whether to return to the bargaining table and try to renegotiate with management or to go out on strike. Again, you voted for no strike. You have just heard from your friend that the strike vote won. Now, you must decide if you are going to support your striking colleagues or cross the picket line and return to work tomorrow. Your friends are pressuring you to support their cause. You know that the union will provide some financial compensation during the strike but believe that it will not be adequate for you to support yourself and your children. Yo agree with union assertions that the organization has overworked and underpaid you and that it has been generally unresponsive to nursing needs. On the other hand, you believe that your first obligation is your children.

 

Using a problem-solving and decision making skills model discussed in class outline how you would approach solving this difficult decision. Describe how you arrived at your decision. How many alternatives did you generate? If you were financially stable without a family would your decision have been the same?

Resources

 
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Nursing Leadership Experience

Nursing Leadership Experience

For 6 years I worked with whom I consider the best nurse leader I could ever had. Participative (Democratic) style describes exactly how she was. She always took into consideration the staff’s opinions before making any decision, she was humble enough to tell us “hey, great idea! thanks for helping me with your opinion to get to a final determination”. On this theory, everyone is given the opportunity to participate, ideas are exchanged freely, and discussion is encouraged. While the democratic process tends to focus on group equality and the free flow of ideas, the leader of the group is still there to offer guidance and control. The democratic leader is charged with deciding who is in the group and who gets to contribute to the decisions that are made (Kendra Cherry, 2014) (Nursing Leadership Experience)

How has your experience been with the nurse leader? Provide a description of your interactions with him or her?

As I mention in the question above, I consider this nurse the best nurse leader I could ever had, besides being an excellent leader she was a great mentor for my professional growth, when I moved from Colombia as a Paramedic to Miami I met her at the first job I had for 6 years, it was a clinical research company and I had no idea this even existed, I just wanted a job, I was recently married and this job was looking for people with experience in the medical field to draw blood, admit patients, etc. I got my EMT but I wanted more, I wanted to go to school for something else, but I was kind of lost in regards to which school should I go? can I rollover some classes from Paramedic school? how can I start?  and this great nurse leader had faith on me, she DROVE me to Miami Dade College, she stayed there for almost 3 hours with me waiting for an advisor to help me get the information needed and during the entire program she never let me drop out even though sometimes that’s all I wanted to do, I started nursing school with a 3 month old and it was extremely hard to keep up with home, baby, full time job and school; but this leader was always there. She thought me throughout those years that being a great leader is not synonym of being a selfish leader, work wise she always had the best from me, and research have found that the democratic leadership style is one of the most effective types and leads to higher productivity, better contributions from group members, and increased group morale and this is EXACTLY what she obtained from me. Now, I’m the charge nurse at the GI center where I work and I consider myself to be a democratic leader as well since I totally understood this was the best way to get the whole team involved and to receive their best production. (Nursing Leadership Experience)

Resources

 
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Project Management- Planning_ Scheduling_ Scope and Strategy

Project Management- Planning_ Scheduling_ Scope and Strategy

Question description Project Management- Planning Scheduling Scope and Strategy

(WBS AND Gantt Chart (BOTH attached), Critical Path for the project- 2 pages long, Project Quality Plan- (you can search for template), Scope Statement- 1 page- (Project Scope and Business Objective Worksheet ATTACHED), Failure Mode and Effects Analysis (FEMA)- you can search for a template, and minimum of 2 pages long summary of the action items identified through the FMEA that will increase the probability of the project being considered a success with the customers.) (Project Management- Planning_ Scheduling_ Scope and Strategy)

I have attached the first part of the project which is what this project is a continuation from.

Part 1

1. Complete a WBS for your project. (Work Breakdown Structure ATTACHED)

This list of activities needs to contain enough detail so you can effectively plan and schedule your event.

2. Using the completed WBS as a reference, next complete a Gantt chart of your project using the template provided. If you discover in the process you overlooked activities make sure to include them in the WBS. (Gantt Chart ATTACHED)

3. In a paper that is a minimum of 2 pages longidentify the Critical Path for your project. Using the WBS and the Gantt chart you constructed for this project analyze how much longer you will need to start planning in advance of your event in order to complete the project?

Your submission should follow the essentials of APA (i.e., cover page, double-spaced, 12 pt. font, reference section at the end, in-text citations, etc.). (Project Management- Planning_ Scheduling_ Scope and Strategy)

Part 2

4. For this part of the Course Project, you will put together a Project Quality Plan.In order to provide the highest quality experience possible, attendees of the event were surveyed to determine what was most important to them when attending such an event. The result of this survey is listed below:

 90% of those completing the survey felt that having engaging and dynamic speakers is key to a successful event

– 90% felt that it was important that the accommodations were physically located where the convention is being held; they didn’t want to have to take a bus or a shuttle from their hotel to the convention.

– 85% stated the food provided should be wonderful and meet any dietary restrictions, such as vegetarian or gluten-free.

For your assignment, you will need to do the following:

4. Complete a Project Scope Statement for your project (Use the templates for Project Scope and Business Objective Worksheet provided). Your project Scope should be at one page in length. (Project Scope and Business Objective Worksheet ATTACHED)

Using the WBS for your project, identify which of the Work Activities listed could potentially impact those items identified by attendees as critical for the success of the project.

5. Complete a Failure Mode and Effects Analysis (FMEA)Only include those activities that impact the four issues identified by your customers as critical to producing a quality event. For each of the activities listed:

– Based on your knowledge of the activity analyze the severity of the impact on the project if the activity failed to produce a quality result as Low, Medium, or High

– Also based on your knowledge of the activity analyze the probability of the poor quality result occurring as (Project Management- Planning_ Scheduling_ Scope and Strategy)

– For the three activities that were evaluated as having the most severe quality consequences AND having the highest impact generate an action plan to reduce or eliminate these failures from occurring

6. In a paper that is a minimum of 2 pages long, clearly and concisely summarize the action items identified through the FMEA that will increase the probability of your project being considered a success with your customers.

Your submission should follow the essentials of APA(i.e., cover page, double-spaced, 12 pt. font, reference section at theend, in-text citations, etc.).

Save Part 1 of your assignment as a Microsoft Excel document. And the paper as a Microsoft Word document.

Save Part 2 of your assignment as a Microsoft Word document.

Resources

https://www.projectmanager.com/guides/work-breakdown-structure

 
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CEU program for Family Nurse practitioner

CEU program for Family Nurse practitioner

Question description (CEU program for Family Nurse practitioner)

  • Write substantive response of 200 words to the question below and include in-text citation. APA format.
  • References and citations should conform to the APA 6th edition.

The FNP must maintain his or her license to practice. In order to obtain and maintain your license, you must be certified. An important requirement for maintaining your license and certification is obtaining the specified ANCC Continuing Education Units (CEU). It is important for FNPs to keep up with continuing education. They must maintain at least 75 CEUs. Identify at least two approved ANCC CEU providers. Give an example of each CEU program. Discuss at least one other method of obtaining CEU credits than attending workshops, seminars, and conventions.

Part B.

Respond to other student’s responses with substantive comments. Substantive comments add to the discussion and provide your fellow students with information that will enhance the learning environment.The postings should be at least one paragraph (approximately 100 words) and include references. (CEU program for Family Nurse practitioner)

Sandra’s Response

There is general agreement that nurses must acquire and maintain the specialized knowledge needed to provide highly skilled care and to demonstrate their competence to the public, their employers, their profession, and patients on an ongoing basis throughout their work lives. Nurses report that continuing nursing education is the third most vital component of nursing skill building. Nurses from states that mandate continuing nursing education, as well as those from states that do not, rank continuing nursing education just after their workplace experience and their basic nursing education in importance. Continuing education units are required by different professions as well as nursing to keep up with updated information regarding practice guidelines, laws, and research among other valuable pearls of knowledge that help the profession distinguish itself from others. Two approved ANCC CEU programs that I found are the AANP and NPACE.

  • The American Association of Nurse Practitioners (AANP)- The CE Opportunities Calendar provided on the website features hundreds of current AANP-accredited programs, listed by date, with city, state and contact information for each activity. It also includes an updated listing of AANP-Approved Providers of continuing education for NPs.
  • The Nurse Practitioner Associates for Continuing Education (NPACE)– Founded in 1980, Is a non-profit organization based in the United States that provides continuing education to Nurse Practitioners and Advanced Practice Clinicians. This organization puts together seminars annually around the United States with qualified guest speakers that have been in the field for numerous years and that have experience in public speaking, research, and a multitude of specialties.

For those seeking CEU credits but are limited in traveling there are online webinars available, audiovisual programs, and monographs. In addition, online CE courses in a variety of specialty focuses and topics are available through the AACN. Moreover, there are always many opportunities to obtaining CE through publications and Journals as well. (CEU program for Family Nurse practitioner)

References

The American Association of Nurse Practitioners (2018) Retrieved from https://www.aanp.org/education/continuing-education-ce/ce-opportunities

The Nurse Practitioner Association for Continuing Education (2018) Retrieved from http://npace.org/online-ce/

Whitehead, T. D., & Lacey-Haun, L. (2008). Evolution of accreditation in continuing nursing education in america. The Journal of Continuing Education in Nursing, 39(11), 493-9; quiz 500-1, 516. Retrieved from https://prx-herzing.lirn.net/login?url=https://sea…

Stephen’s Response

The American Nurses Credentialing Center approves CE providers to issue continuing education to nurse practitioners in order for them to meet the 75 CE requirement of their license. The ANCC website makes finding approved providers easy. Two providers of CE that were generated by the website were The American Academy of CME and the American Association of Heart Failure Nurses (ANCC, 2018). The first one is a not for profit medical education company and offers CE classes like “CME Challenge An Interactive Session to Test Your Compliance Radar” and “Survey Says…Making Wise Choices About Compliance Today to Avoid Accreditor’s Regret Tomorrow (AACME, 2018).” The second is a professional nurses education that has multiple programs in research and patient education as well as CE offerings. An example of a course from this group is “pulmonary Hypertension Management (AAHFN, 2018). Other then workshops, seminars, and conventions, the NP can earn CE from the comfort of their own home. A number of organizations offer online multimedia CE that is text or video based. Examples of these organizations are the American Association of Nurse Practitioners, Advanced Practice Education Associates, and the Nurse Practitioner Association for Continuing Education (Decapua, 2016). (CEU program for Family Nurse practitioner)

References

AACME. (2018, January 4). AACME partners in education. Retrieved from https://www.academycme.org/

AAHFN. (2018, February 17). American Association of Heart Failure Nurses. Retrieved from https://www.aahfn.org/default.aspx.

ANCC. (2018, January 1). Find an accredited organization or program. Retrieved from https://www.nursingworld.org/organizational-programs/accreditation/find-an-accredited-organization/.

Decapua, M. (206, February 15). 6 great sources for NP continuing education. Retrieved from https://www.healthecareers.com/article/education/6…

 
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Integrating Theories

Integrating Theories

(Integrating Theories)

In this course, we have studied various approaches to therapy and explored the utility of each orientation with reference to the client.  For this assignment, take the perspective of a therapist working with clients. This will help you honestly assess your own development and more objectively evaluate the advantages and disadvantages of using an integrative approach to counseling. Answer each of the following questions thoroughly and provide examples where requested to substantiate your points.

  1. Do you think therapists should focus on becoming an expert in one particular counseling approach or should they try to become proficient in more than one approach? Provide an explanation for your answer and illustrate them with examples.
  2. Identify what the three most important characteristics of a successful counselor you consider to be. Describe how these characteristics can be developed or strengthened?
  3. Identify and describe some of the characteristics (from question 2) that are best developed in the counseling process with clients?  Support your points with examples? Identify and describe some areas of personal or professional development that would potentially be unethical for the counselor to develop in the counseling process with clients? Explain your rationale in detail and give examples.
  4. What are some of your own personal motivations and characteristics that may help or hinder you as a counselor (identify at least two)?
  5. What areas of your own personal and professional development need the most development before you will feel prepared to be an effective counselor (identify at least three)?
  6. What are two advantages and two disadvantages of practicing within the framework of one specific theory as opposed to developing a more integrative approach consisting of several therapies? Give a detailed description and rationale for both sides.
  7. What are the advantages and disadvantages of practicing within an integrated framework?
  8. Explain at least two techniques you would use in your treatment and describe how you would integrate these techniques in a therapy session.(Integrating Theories)

Your paper should be double-spaced and in 12 point, Times New Roman font with normal one-inch margins, written in APA style, and free of typographical and grammatical errors. It should include a title page with a running head, an abstract and a reference page. The body of the paper should be no less than 5 and no longer than 8 pages in length.

 
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Maintaining Confidentiality in the Age of Public Access

Assignment 1: Maintaining Confidentiality in the Age of Public Access

(Maintaining Confidentiality in the Age of Public Access)

In the digital age, where technology is more of a requirement than an option, counselors are often faced with the challenge of knowing how to effectively manage boundaries. The following case study will help students understand real-life challenges that counselors often face regarding boundaries and technologies.

Case Study:

Latisha is a 32-year-old African American doctoral student in a small, rural university. As part of her doctoral studies, she serves as a supervisor for students doing their master’s in counseling internship. One of her supervisees, Emma, is working with adolescent girls during her internship and has been assigned four clients she sees twice a week. Latisha is Facebook friends with several classmates and former supervisees but has avoided friending current supervisees, explaining this policy in her professional disclosure statement.

One weekend, she notices a Facebook exchange between a classmate and Emma whose page is public and visible. Latisha views Emma’s Facebook page where she discovers Emma has friended the mother of a client and the two have discussed the client through various posts. Emma’s client Jenn is a 15-year-old female who is the subject of a bitter custody dispute. Latisha is aware that Jenn has a 19-year-old African American boyfriend, and the two are sexually active, which conflicts with the mother’s fundamental Christian values. Latisha now realizes the mother is a member of her own church.

The next day, while attending church, Latisha is approached by the mother who states that she knows Latisha is Emma’s internship supervisor and proceeds to lay out the details of her pending divorce and custody issues. The parent mentions she intends to subpoena Emma and her records as part of the divorce litigation and wants her to testify to Jenn’s placement and well-being.

Tasks:

Using an ethical decision-making model, outline your response to this situation. Outline the proposed action(s) you would take in this case, providing justification for the proposed action(s) and a description of the decision-making model used to arrive at that decision. Your decision-making model should be one that has been discussed in the professional literature, and after explaining the model, you will need to offer a rationale regarding why you chose to apply that particular model to the case study. Remember:

  • You should be sure to cite appropriate literature and must give proper credit to authors of any decision-making models used to analyze the case.
  • Do not simply list the steps of the model; apply the steps and be sure to document and defend your courses of action and your final decision.
  • Cite all appropriate professional standards and relevant laws. Regardless of the model chosen, you need to clearly identify, describe, and evaluate what ethical codes and laws were violated. Be specific—use mental health statutes and specific ethical codes that apply.(Maintaining Confidentiality in the Age of Public Access)

Discuss in detail what actions you would take as you proceed through the steps of your chosen ethical decision-making model, each of the steps should take at least a paragraph (or more) to address. You may (and are encouraged to) respond in an outline form (i.e., develop a response to each ethical decision-making step); however, do not simply list the steps of the model but integrate them into a complete answer.

Your answer should be at a minimum approximately 250 words.

 
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Nursing Questions & case study

Nursing Questions & case study

(Nursing Questions & case study)

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

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

QUESTION 1: Healthcare Delivery and Evidenced –Based Nursing Practice

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

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

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

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

QUESTION 2: Community-Based Nursing Practice(Nursing Questions & case study)

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

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

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

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

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

What ethical dilemma exists?

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

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

QUESTION 4:

Chapter 4, Health Education and Health Promotion(Nursing Questions & case study)

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

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

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

c.       Describe four components of health promotion.

QUESTION 5: Chapter 5, Adult Health and Nutritional Assessment

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

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

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

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

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

e. What laboratory values would the nurse review to evaluate Mrs. Varner’s protein levels?(Nursing Questions & case study)

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

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

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

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

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

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

QUESTION 7:

Chapter 7, Overview of Transcultural Nursing

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

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

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

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

QUESTION 8: Chapter 8, Overview of Genetics and Genomics in Nursing(Nursing Questions & case study)

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

a. Describe the pattern of autosomal dominant inheritance.

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

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

QUESTION 9: Chapter 9, Chronic Illness and Disability

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

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

b. What health promotion and prevention education does Mr. Edwards need?(Nursing Questions & case study)

QUESTION 10: Chapter 10, Principles and Practices of Rehabilitation

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

(Learning Objective 4)

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

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

QUESTION 11:

Chapter 11, Health Care of the Older Adult

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

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

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

QUESTION 12:

Chapter 12, Pain Management

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

What are benefits of epidural versus systemic administration of opioids?

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

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

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

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

QUESTION 13:(Nursing Questions & case study)

Chapter 13, Fluid and Electrolytes: Balance and Disturbance

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

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

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

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

Question 14:

Chapter 14, Shock and Multiple Organ Dysfunction Syndrome

Adam Smith, 77 years of age, is a male patient who was admitted from a nursing home to the intensive care unit with septic shock secondary to urosepsis. The patient has a Foley catheter in place from the nursing home with cloudy greenish, yellow-colored urine with sediments. The nurse removes the catheter after obtaining a urine culture and replaces it with a condom catheter attached to a drainage bag since the patient has a history of urinary and bowel incontinence. The patient is confused, afebrile, and hypotensive with a blood pressure of 82/44 mm Hg. His respiratory rate is 28 breaths/min and the pulse oximeter reading is at 88% room air, so the physician ordered 2 to 4 L of oxygen per nasal cannula titrated to keep SaO2 greater than 90%. The patient responded to 2 L of oxygen per nasal cannula with a SaO2 of 92%. The patient has diarrhea. His blood glucose level is elevated at 160 mg/dL. The white blood count is 15,000 and the C-reactive protein, a marker for inflammation, is elevated. The patient is being treated with broad-spectrum antibiotics and norepinephrine (Levophed) beginning at 2 mcg/min and titrated to keep systolic blood pressure greater than 100 mm Hg. A subclavian triple lumen catheter was inserted and verified by chest x-ray for correct placement. An arterial line was placed in the right radial artery to closely monitor the patient’s blood pressure during the usage of the vasopressor therapy. (Learning Objectives 6 and 7)

a. What predisposed the patient to develop septic shock?

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

c. The norepinephrine concentration is 16 mg in 250 mL of normal saline (NS). Explain how the nurse should administer the medication. What nursing implications are related to the usage of a vasoactive medication?

d. Explain why the effectiveness of a vasoactive medication decreases as the septic shock worsens. What treatment should the nurse anticipate to be obtained to help the patient?

QUESTION 15:(Nursing Questions & case study)

Chapter 15, Oncology: Nursing Management in Cancer Care

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

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

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

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

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

QUESTION 16:

Chapter 16, End-of-Life Care

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

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

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

QUESTION 17:

Chapter 17, Preoperative Nursing Management

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

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

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

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

QUESTION 18: Chapter 18, Intraoperative Nursing Management

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

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

b. Explain the role of the nurse in providing patient safety measures during the intraoperative period.(Nursing Questions & case study)

QUESTION 19: Chapter 19, Postoperative Nursing Management

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

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

b. What gerontological postoperative considerations should the nurse make?

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

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

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

 
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The U.S. Health Care Delivery System

The U.S. Health Care Delivery System

 

Details:/ As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue( The U.S. Health Care Delivery System)

As the country concentrates on restructuring the U.S. healthcare delivery system, nurses play a crucial role in ensuring its success. Nurses, as frontline healthcare providers, are integral to delivering patient-centered care and bridging gaps in the evolving healthcare landscape. The restructuring emphasizes a shift towards preventive care, community health, and interprofessional collaboration, aligning with nurses’ holistic approach to patient well-being. With an increased focus on technology integration, nurses are adapting to electronic health records and telehealth, enhancing efficiency and accessibility. Furthermore, nursing education is evolving to equip professionals with the skills needed for contemporary healthcare challenges. As healthcare becomes more decentralized, nurses are at the forefront of providing care in various settings, promoting a more inclusive and accessible system. The ongoing collaboration between policymakers, healthcare institutions, and nursing professionals is paramount to successfully navigating and implementing the changes required for an effective and equitable healthcare delivery system in the United States.( The U.S. Health Care Delivery System)

Details:
As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

  1. Write an informal presentation   (500-700 words) to educate nurses about how the practice of nursing is      expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes,      and nurse-managed health clinics.
  2. Share your presentation with nurse  colleagues on your unit or department and ask them to offer their  impressions of the anticipated changes to health care delivery and the new      role of nurses in hospital settings, communities, clinics, and medical      homes.
  3. In 800-1,000 words summarize the      feedback shared by three nurse colleagues and discuss whether their      impressions are consistent with what you have researched about health  reform.
  4. A minimum of Five scholarly references are required for this assignment.

solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, an abstract is not required, CITE WEBSITE SOURCE.

 
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Personality Disorders Homework

Personality Disorders Homework

(Personality Disorders Homework)

I cannot believe these people. Don’t they know who I am? I deserve better treatment than this. That hostess should have seated me immediately, but I had to wait for 10 minutes and then she put me at this table right by the kitchen. I see an empty table right in the middle where I should be. I am just going to get up and move there. I don’t care what the hostess says, rules don’t apply to me.

 

Ashley, age 25

Personality disorders represent perhaps the most challenging disorders that the psychiatric mental health nurse practitioner will have to address in their professional careers. Personality disorders can co-occur in every mental health disorder and, in some cases, can mask as disorder . Although difficult to treat, the PMHNP must be able to identify personality disorders and endeavor to work with the client to not only recognize the disorder, but to treat a disorder that clients often do not believe they have.

This week, you will explore the many personality disorders and use the DSM-5 criteria for diagnosing individuals with specific personality disorders. You will use the Decision Tree format to diagnose and treat a client with a personality disorder.(Personality Disorders Homework)

Discussion: Treatment of Personality Disorders

Personality disorders occur in 10–20% of the population. They are difficult to treat as individuals with personality disorders are less likely to seek help than individuals with other mental health disorders. Treatment can be challenging as they do not see their symptoms as painful to themselves or others.

In this Discussion, you will explore personality disorders in greater detail and discuss treatment options using evidence-based research.

                                                       Learning Objectives

Students will:

· Analyze diagnostic criteria for personality disorders

· Analyze evidence-based psychotherapy and psychopharmacologic treatments for personality disorders

· Analyze clinical features of clients with personality disorders

· Align clinical features with DSM-5 criteria

· Compare differential diagnostic features of personality disorders

                                                                 ASSIGNMENT

· Explain the diagnostic criteria for your assigned personality disorder (PLEASE CHOOSE ANY PERSONALITY DISORDER OF YOUR CHOICE IN MENTAL HEALTH )

· Explain the evidenced-based psychotherapy and psychopharmacologic

treatment for your assigned personality disorder.

· Describe clinical features from a client that led you to believe this client had this

disorder. Align the clinical features with the DSM-5 criteria.

· Support your rationale with references to the Learning Resources or other

academic resources.((Personality Disorders Homework)

                                                                     Learning Resources

Required Readings

Sadock, B. J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 4, “Theories of Personality and      Psychopathology” (pp. 151–191)
  • Chapter 22, “Personality Disorders” (pp. 742–762)
  • Chapter      13, “Psychosomatic Medicine” (pp. 451–464)

Gabbard, G. O. (2014). Gabbard’s treatment of psychiatric disorders (5th ed.). Washington, DC: American Psychiatric Publications.

  • Chapter 68, “Paranoid, Schizotypal, and Schizoid      ”
  • Chapter 69, “Antisocial Personality Disorder”
  • Chapter 70, “Borderline Personality Disorder”
  • Chapter 71, “Histrionic Personality Disorder”
  • Chapter 72, “Narcissistic Personality Disorder”
  • Chapter 73, “Cluster C Personality Disorders

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

  • “Personality Disorders”

Perry, J. C., Presniak, M. D., & Olson, T. R. (2013). Defense mechanisms in schizotypal, borderline, antisocial, and narcissistic personality disorders. Psychiatry: Interpersonal & Biological Processes, 76(1), 32–52. doi:10.1521/psyc.2013.76.1.32

Rees, C. S., & Pritchard, R. (2015). Brief cognitive therapy for avoidant personality disorder. Psychotherapy, 52(1), 45–55. doi:10.1037/a0035158

                                                      Required Media

Laureate Education. (2017a). A woman with personality disorder. Baltimore, MD: Author. 

Kernberg, O. (n.d.). Psychoanalytic psychotherapy for personality disorders: An Interview with Otto Kernberg, MD. [Video file]. Mill Valley, CA: Psychotherapy.net

 
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