Respiratory Case Studies

Respiratory Case Studies

56-year-old man present to you with the following symptoms: 24-hour history- Complaints of SOB, chills, malaise, and yellowish-green sputum. Medical history of hypertension patient currently on Lisinopril 10mg daily. Pleuritic rub on both inspiration and expiration and dullness to percussion on the right base and right lower lobe chest infiltrates from chest Xray.

V/S: BP:120/75 Temp- 100.7, HR 100, Pulse Ox92% , RR 22, WBC 14.4, BUN16, Creatine 1.0

DX: Community Acquired Pneumonia (CAP)

According to the guidelines:

a) Where would you treat this gentleman?

b) What would be your treatment choices and why?

c) What bugs are you covering?

d) What would you expect the recovery period?

e) Is there any vital sign that particularly worries you?

70-year-old mild COPD and smoker no other comorbidities present with the last 72 hours of worsening pleuritic chest pain, Xray reveals lower lobe chest infiltrates Chest x-ray infiltrates and evidence of consolidation BUN 17 creatine 1.1 WBC-14.4 130/78, T-100.8, HR 98, RR 32 Pulse Ox 90%

DX of CAP

f) Where would you treat this gentleman?

g) What would be your treatment choices and why?

h) What bugs are you covering?

i) What would you expect the recovery period?

j) Is there any vital sign that particularly worries you?

NO citation required

NO reference required

original work please.

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected.

APA format

2 scholarly references within the last 5 years

Intext citation

Turnitin and plagiarism free

Assignment: Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

· Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.

· Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).

· Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page not including the title and reference page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

· Briefly and generally explain the policy or regulation you selected.

· Address the impact of the policy or regulation you selected on system implementation.

· Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

· Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

Explore the difference between telemedicine and telehealth and address when it is appropriate to use each of these by addressing the benefits and limitations of each.  

Explore the difference between telemedicine and telehealth and address when it is appropriate to use each of these by addressing the benefits and limitations of each.  

Expectations

Initial Post:

  • Length: A minimum of 250 words, not including references
  • Citations: At least one high-level scholarly reference in APA from within the last 5 years

Identify ways the nurse practitioner can promote healthy lifestyles and improved exercise compliance of their patients.

Healthy People 2020 identifies objectives related to exercise and fitness. Identify ways the nurse practitioner can promote healthy lifestyles and improved exercise compliance of their patients. What technologies are available that can assist patients and providers?

Expectations

Initial Post:

  • Length: A minimum of 250 words, not including references
  • Citations: At least one high-level scholarly reference in APA from within the last 5 years

Discuss your design for a cross-functional training program that aligns strategic plant goals with each work group.

 5–7 slides, excluding title and reference slides, and speaker notes of 200–250 words per slide 

Your organization is building a new plant in the southwestern United States. This is the first time that a human resources professional will be part of the design team that is establishing the new personnel systems for the plant. You expect your candidates to be very diverse in their backgrounds and experience levels.

The plant director has asked you to focus on how you will develop the newly hired personnel into a strong team that crosses organizational boundaries within the plant. Prepare a presentation that addresses the following elements of a diverse workforce:

  • How will you determine whether the candidates are a fit for the team?
  • Discuss your design for a cross-functional training program that aligns strategic plant goals with each work group.
  • Identify the training topics that you will use to foster diversity, intergroup relationships, and productivity within the plant.

You must include a minimum of 2 scholarly references.

What are the prescriptive authority requirements for the state in which you intend to practice?

Instructions

After passing your certification exam, the next step is to obtain your Nurse Practitioner (RN/NP) license. Then you should apply for prescriptive authority in the state in which you plan to practice. In some states, this requires a collaborating/ supervising physician; in some states, there are restrictions for NP prescribing. After you obtain a state prescriptive license, you must apply for a federal drug enforcement administration (DEA) certificate so that you can prescribe controlled substances. Use the following resources to complete this week’s IPPD assignment

· Nurse Practitioner Interactive Map

· Drug Enforcement Administration (DEA)

· DEA Forms and Applications

Using the document you started in Week 1 Assignment 2: Individual Professional Practice Document: NP Title, Definition, and Consensus Model and added to in Week 5 Assignment 1: Individual Professional Practice Document: Scope of Practice,, please add the following information to the Week 6 area. Using the  Nurse Practitioner Interactive Map , select the state or states where you plan to practice and become familiar with each state’s regulations related to NP prescriptive authority. In some states, prescriptive authority is explained in the Board of Nursing (BON) and the Department of Public Health (DPH), so you might have to search the DPH website as well. You must also meet the federal DEA regulations for your state to be licensed to prescribe controlled substances.

· What are the prescriptive authority requirements for the state in which you intend to practice? Is there a MD collaborative or supervisory regulation related to non-controlled substances or controlled substances? Are there any restrictions for NP prescriptive practice? Does the state utilize a system-wide drug monitoring program to assist with the prevention of overprescribing?

· Include a hyperlink to the state prescriptive authority regulations.

· Does the state allow DEA licensure? What are the requirements to obtain a DEA certificate? Are there any MD collaborative/ supervisory regulations related to controlled substance prescribing? Are there any restrictions to prescribing controlled substances, including opioids and naloxone authority?

· Include the federal DEA hyperlink.

In your initial post, please identify the prescriptive authority regulations in the state where you are going to practice. Are there any restrictions, supervision, or collaboration required from a physician?

Initial Post

To get started, review the Nurse Practitioner Interactive Map.

In your initial post, please identify the prescriptive authority regulations in the state where you are going to practice. Are there any restrictions, supervision, or collaboration required from a physician? If so, please explain. If you will be practicing in multiple states, do the regulations in those states differ? If you are in a clinical placement, please ask your preceptors about the prescriptive regulations and if an agreement is needed. If so, ask to see a copy of the agreement so that you can review what will be required when you begin to practice. Share with one another on the discussion board what you have found. If you are precepting at more than one facility, discuss whether these agreements differ at all, what your thoughts are about any differences, and which agreements you like best.

Reply Posts

Reply to at least one of your classmates. In your reply post, compare and contrast the state regulatory requirements of the state in your initial post with a different state. Discuss with your colleague rationales behind these differences and how the difference affects healthcare access, quality and cost.

Discuss the benefits and disadvantages of a facility using supplemental and floating staff.

  • Discuss the benefits and disadvantages of a facility using supplemental and floating staff.
  • Compare and contrast how a staffing plan would differ with different nursing units. How does that affect the staffing budget?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 3 academic sources. No websites allow.
  • Plagiarism needs to be less than 10%. Report need to be send.

Develop a graphical concept map for the patient based on the best available evidence for treating your patient’s health, economic, and cultural needs.

Diabetes patient

Reason for Referral: Carole Lund a 44 year old, mixed Native American and European descent, and a new mother. She is concerned that she is not recovering from gestational diabetes.

Situation:

Carole is here with her daughter, Kassandra, who is 10 weeks old. Carole was diagnosed with gestational diabetes at week 30 of her pregnancy. She has carefully logged her blood glucose since the diagnosis and it shows 150-200 fasting, over 200 following meals.

Assessment

Q- what diabetes treatments did you receive during your pregnancy?

A- Well, they gave me a glucometer, so I started using that. I could see right away that the way I was eating was a problem; I would usually work straight through the day and then have one big meal in the evening, and that was making my numbers bounce all over. So I set alarms on my laptop, so three times a day I would get interrupted, have a small meal, take a short walk, and then test my blood sugar. That helped. And then I stopped drinking juice and soda, which I should have done years ago, and that helped too. But I don’t think my numbers improved as much as my OB/GYN wanted them to, but she said my blood sugar should return to normal after delivery.

Q-Did your obstetrician advise you to take insulin during your pregnancy?

A- She did, yeah, and we talked about it. I don’t like the idea of being dependent on a drug. I called my mother. She’s still on the reservation, so she called the elders, and we all agreed that injecting my body with an animal hormone was a bad idea. But then the doctor told me that they make synthetic insulin now, but that means it’s made in a laboratory somewhere, and I’m not sure that’s any better. By then I was in my third trimester, and all the tests said Kassandra was big but healthy, so I thought we would just ride it out. It was supposed to clear up after she was born. But it hasn’t, and I know you must be careful having a baby my age. I want to do what’s best, but I don’t want to believe that insulin is my only option.

Q-Are there any challenges in your life that you think maybe interfere with your ability to follow a treatment plan?

A- It’s harder now than it was before she was born. It’s just the two of us in the apartment, which is wonderful, but I don’t remember the last time I had a good night’s sleep. A lot of my work is freelance, so I make my own hours, but that also means if I’m not working, I don’t get paid. I had family help while I was recovering from the C-section, and they helped cook healthy meals for me, and kept me on my schedule. Now it’s all on me — work, caring for my daughter, and managing my blood sugar. If I fall behind on anything, it will be looking after my health.

Q-Do you have any other concerns you would like to have addressed?

A- I worry about Kassandra. She’s healthy and perfect, but I know that she’s at a greater risk for developing Type 2 Diabetes. I want to do whatever I can to reduce that risk, to care for her, and as she grows, to teach her how to care for herself.

Based on the above patient information follow the following guidelines to complete the paper

Integrate relevant evidence from 3–5 current scholarly or professional sources to support your assertions.

Part 1: Concept Map

· Develop a graphical concept map for the patient based on the best available evidence for treating your patient’s health, economic, and cultural needs.

. Many organizations use the spider style of concept maps (see the Taylor and Littleton-Kearney article for an example)..

. If a particular style of the concept map is used in your current care setting, you may use it in this assessment.

Part 2: Narrative Report

· Develop a narrative (2–4 pages) for your concept map.

· Analyze the needs of a patient and his or her family to ensure that the intervention in the concept map will be relevant and appropriate for their beliefs, values, and lifestyle.

. Consider how your patient’s economic situation and relevant environmental factors may have contributed to your patient’s current condition or could affect future health.

. Consider how your patient’s culture or family should inform your concept map.

· Determine the value and relevance of the evidence you used as the basis of your concept map.

. Explain why your evidence is valuable and relevant to your patient’s case.

. Explain why each piece of evidence is appropriate for the health issue you are addressing and for the unique situation of your patient and the family.

· Propose relevant and measurable criteria for evaluating the outcomes the patient needs to achieve.

. Explain why your proposed criteria are appropriate and useful measures of success.

· Explain how you will communicate specific aspects of the concept map to your patient and the family in an ethical, culturally sensitive, and inclusive way. Ensure that your strategies:

. Promote honest communications.

. Facilitate sharing only the information you are required and permitted to share.

. Are mindful of your patient’s culture.

. Enable you to make complex medical terms and concepts understandable to your patient and his or her family, regardless of language, abilities, or educational level.

Additional Requirements

· Organization: Use the following headings for your Diabetes Patient Concept Map assessment:

. Concept Map.

. Patient Needs Analysis.

. Value and Relevance of the Evidence.

. Proposed Criteria for Patient Outcome Evaluation.

. Patient and Family Communication Plan.

· Length: Your concept map should fit on one page (possibly a horizontal layout) and your narrative report will be 2–4 double-spaced pages, not including title and reference pages.

· Font: Times New Roman, 12 points.

· APA Format: Your title and reference pages must follow current APA format and style guidelines. The body of your paper does not need to conform to APA guidelines. Do make sure that it is clear, persuasive, organized, and well written, without grammatical, punctuation, or spelling errors. You also must cite your sources according to APA guidelines.