You have been assigned 4 patients on an Intermediate Medical Care Unit. Two of the patients are post myocardial infarctions at various stages of their infarctions with multiple types of arrhythmias, the third patient is having drastic blood sugar fluctuations 218 down to 50 within minutes and its rebounds back up with changes in mentation and the fourth is reported to be having frequent TIA’s. One of the MI patients is having some dizziness and your TIA patient is presenting signs of impending stroke.

How would you prioritize your assessments and activities? How would you describe your critical thinking process and how do you organize and prioritize implementation of care?

At least one full page with proper APA formatting

 

describes the clinical problem and the following:

• Reason for choosing this topic
• The PICOT question
• Possible integration of the evidenced that you found in clinical practice
• Methods to evaluate the effectiveness of implementation

 What do the four parts of the Christian biblical narrative (i.e., creation, fall, redemption, and restoration) say about the nature of God and of reality in relation to the reality of sickness and disease? From where would one find comfort and hope in the light of illness according to this narrative? Explain in detail each part of the narrative above and analyze the implications. 

Original Work, No Plagiarism, Cite and Reference

Hugo is a graduate student working on a research study that is seeking to explore the efficacy of a new medicine for the prevention of chemotherapy-induced peripheral neuropathy.  As part of his duties, he is asked to make himself available during participant recruitment to clarify any questions that the recruitment personnel or the participants may have. On one of these occasions, a research nurse named Phoebe is obtaining informed consent from a young adult named Simon. 

The informed consent form includes information on the purpose of the study, a double-blinded, randomized intervention trial to test the efficacy of a medicine for the prevention of chemotherapy-induced peripheral neuropathy.  The form explains the risks and benefits of participation at length, including the anticipated side effects of the new medicine. 

The benefits are thought to outweigh the risks.  The participants in the treatment arm of the study may benefit from the medicine's hypothesized prevention of chemotherapy-induced peripheral neuropathy. Participants in both groups will receive close monitoring of neuropathy symptoms and evidence-based care while being in the study. Finally, the form explains that the information collected may help to lead to the discovery of an agent that may reduce chemotherapy-induced peripheral neuropathy, of which there are currently no none effective preventative treatments. 

As Phoebe is reviewing the informed consent form, Simon appears somewhat uncomfortable and apprehensive. Hugo thinks that his response may be related to the surroundings and/or situation. They are sitting in the exam room shortly after Simon learned of the treatment options for advanced stage colorectal cancer and the doctor left without answering all of his questions. Simon also has additional oncology appointments shortly after the consent discussion. 

Hugo is also struck by Simon's interaction with Phoebe. He nods and his occasional brief responses sound more like someone receiving a set of instructions than an indication of understanding.

During the time it takes to complete the informed consent form, which is quite lengthy, Hugo begins to wonder whether Simon truly understands the research study and his part in it.  Hugo also questions whether Simon understands what randomization is and how this technique will affect him as a research participant. Hugo is distracted from his thoughts by movement from across the room. Simon is ready to place his signature on the informed consent form. He seems to be eager to do so. The form states that study subjects have the right to refuse to participate and that they may withdraw at any time, but Hugo begins to question whether Simon truly has a choice in giving his consent. Do the benefits from this study, overwhelm any concerns he may feel regarding being in the study?

Hugo is unsure how to address his discomfort with the informed consent process that he has just witnessed and he begins to deliberate about what course of action he should take to address his concerns.

Discussion Questions:

1. How could the informed consent form or the process of obtaining informed consent be modified to address Hugo's concerns?

2. What types of questions or techniques could have Phoebe provided to assess Simon's understanding of the study?

3. How would you describe “randomization” to a prospective study participant?

4. How would you respond to a participant who says “can we skip the rest of this and sign the form” during the informed consent discussion?

 

rt 2 Writing Assignment Week 7

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Health Promotion Proposal, Part 2 Content

1.

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Health Promotion Proposal, Part 2

This is a continuation of the health promotion program proposal, part one, which you submitted previously. 

Please approach this assignment as an opportunity to integrate instructor feedback from part I and expand on ideas adhering to the components of the MAP-IT strategy. Include necessary levels of detail you feel appropriate to assure stakeholder buy-in.

 

Directions 

You have already completed the steps 1-4. 
Do not resubmit part 1. Make sure you revise this initial submission according to your instructor’s comments. 

To assist in maintaining harmony between Part I and 2 here you have a reminder of the previous paper outline:

· 1. Describe the health problem. Using data and statistics support your claim that the issue you selected is a problem. What specifically will you address in your proposed health promotion program? Be sure your proposed outcome is realistic and measurable. 

· 2. Describe the vulnerable population and setting. What are the risk factors that make this a vulnerable population? Use evidence to support the risk factors you have identified. 

· 3. Provide a review of literature from scholarly journals of evidence-based interventions that address the problem. After completing a library search related to effective interventions for your chosen health promotion activity, you will write a review that evaluates the strengths and weaknesses of all the sources you have found. You might consult research texts for information on how to write a review of the literature found in your search. 

· 4. Select an appropriate health promotion/disease prevention theoretical framework or conceptual model that would best serve as the framework guiding the proposal. Provide rationale for your selection which includes discussion of the concepts of the selected model 

 

For this assignment develop criteria 5-8 as detailed below: 

You will submit just this section 5-8 as essay. Please do not resubmit Part 1. 

Use a presentation page. Start the body of content with topic 5.

· 5. Propose a health promotion program using an evidence-based intervention found in your literature search to address the problem in the selected population/setting. Include a thorough discussion of the specifics of this intervention which include resources necessary, those involved, and feasibility for a nurse in an advanced role. 

· Be certain to include a timeline. (2 to 4 paragraphs- you may use bullets if appropriate). 

· 6. Thoroughly describe the intended outcomes. Describe the outcomes in detail concurrent with the SMART goal approach. 
The SMART goal statement should be no more than one sentence (1 paragraph). 

· 7. Provide a detailed plan for evaluation for each outcome. (1 paragraph). 

· 8. Thoroughly describe possible barriers/challenges to implementing the proposed project as well as strategies to address these barriers/challenges. (1 paragraph). 

· Finish the paper with a conclusion paragraph (1 paragraph) without typing the word “conclusion” before the paragraph. 

Paper Requirements 

Your assignment should be up to 3-5 pages (excluding title page and references). 

Remember, your Proposal must be a scholarly paper demonstrating graduate school level writing and critical analysis of existing nursing knowledge about health promotion. 

Finish the essay with a your reference page.

Please review the Grading Rubric for this Assignment.

 

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