This week, you will select Lewin’s change theory or the PDCA that would work best for your proposed quality improvement project. you will need to summarize the main theoretical notions and concepts of the selected theory. You will then need to discuss in detail the various stages of implementation of the proposed project based on the selected theory.
After studying Module 2: Lecture Materials & Resources, submit the following:
Submission Instructions:
RUBRIC FOR GRADING
Subjective Documentation in Provider Note Template: Subjective narrative documentation in Provider Note Template is detailed and organized and includes: Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS)ROS: covers all body systems that may help you formulate a list of differential diagnoses. You should list each system as follows: General: Head: EENT: etc. You should list these in bullet format and document the systems in order from head to toe. = Documentation is detailed and organized with all pertinent information noted in professional language….Documentation includes all pertinent documentation to include Chief Complaint (CC), HPI, Current Medications, Allergies, Past Medical History, Family History, Social History and Review of Systems (ROS).
Objective Documentation in Provider Notes – this is to be completed using the documentation template that is provided. Document in a systematic order starting from head-to-toe, include what you see, hear, and feel when doing your physical exam using medical terminology/jargon. Document all normal and abnormal exam findings. Do not use “WNL” or “normal”. You only need to examine the systems that are pertinent to the CC, HPI, and History. Diagnostic result – Include any pertinent labs, x-rays, or diagnostic test that would be appropriate to support the differential diagnoses mentioned. Differential Diagnoses (list a minimum of 3 differential diagnoses). Your primary or presumptive diagnosis should be at the top of the list (#1). = Documentation detailed and organized with all abnormal and pertinent normal assessment information described in professional language….Each system assessed is clearly documented with measurable details of the exam.
. Analyze the subjective portion of the note. List additional information that should be included in the documentation.Analyze the objective portion of the note. List additional information that should be included in the documentation.Is the assessment supported by the subjective and objective information? Why or why not. Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis. Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature.
How can healthcare providers account for the age-related changes in pharmacokinetics and pharmacodynamics that impact medication absorption, distribution, metabolism, and excretion, and what strategies can be used to adjust medication regimens for older adult patients to minimize the risk of adverse drug reactions and medication errors?
The case study I was presented was “An 83-year-old resident of a skilled nursing facility presents to the emergency department with generalized edema of extremities and abdomen. History obtained from staff reveals the patient has a history of malabsorption syndrome and difficulty eating due to lack of dentures. The patient has been diagnosed with protein malnutrition”.
When looking into protein malnutrition, protein energy-malnutrition is the most commonly seen terminology, or PEM, that is the result of starvation (with or without catabolic stress). PEM is considered a disease and is the result of chronic inadequate protein or energy intake not meeting the body’s needed intake of nutrients. In some cases, the loss of fat is reduced due to a slowed energy use accomplished by decreasing the metabolism and instead using the body’s storage of lean protein. Typically, the majority of the protein is released from muscle tissues and the kidneys, blood, immune cells, GI tract and liver are spared for the most part. In cases where the ration of energy and protein are not obsolete, the body can adapt to the environment by decreasing the energy and protein needed to sustain homeostasis. PEM results in “a lowered metabolic rate and reduced muscle mass (including reduced cardiac and respiratory muscle mass); its clinical consequences include muscle weakness and functional disability, reduced cardiac and respiratory capacity, mild hypothermia and a reduced body protein reserve” (Hoffer, 2001). In PEM, the extracellular fluid also shifts and can cause generalized edema.
In consideration of protein malnutrition, there are two conditions that come up in various articles, Kwashiorkor and marasmus. “Kwashiorkor is predominantly a protein deficiency, while marasmus is a deficiency of all macronutrients — protein, carbohydrates and fats. People with marasmus are deprived of calories in general, either because they’re eating too little or expending too many, or both. People with kwashiorkor may not be deprived of calories in general but are deprived of protein-rich foods” (C.C. Medical, n.d.). In this case study, though the primary diagnoses is protein malnutrition, marasmus may be more fitting and in align with the physiologic problems this patient is facing. “For older adults, adverse health outcomes associated with malnutrition can often be more complex and disproportionally worse than outcomes associated with overweight or obesity. Malnutrition in older adults can lead to weight loss. Functional recovery from this weight loss is unlikely to occur due to the loss of skeletal muscle mass, even with full nutritional support” (Dent et. al, 2023). “Marasmus is equally distributed between the genders, however, as a result of cultural differences in some parts of the world women may be at an increased risk of marasmus” (NCBI, 2023).
After studying Module 2: Lecture Materials & Resources, submit the following:
Submission Instructions:
Patient: 17-year-old male with a diagnosis of testicular torsion
******Please use OLDCARTS for the history of the present illness*****
answer everything and remove all instructions on the template
Discuss the role of sensitivity and specificity in accuracy of a screening test?
Generate 400 words 3 citations APA format since 2018 to present
please provide plagiarism report
PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:
Since Week 1, I have learned a lot. My perspective on the concepts of trends in nursing has changed to say the least. This class has helped me build and evolve the way of thinking that nurses have to deal with low pay, lateral violence, long hours, not being heard etc, just because it’s part of our job. There are ways for us to use our voice and join different groups to help us be heard in the healthcare field. Discussion 6 I thought was especially important because it shows different ways for nurses to get involve and advocate for nurses. Trends and issues in nursing is something we can overcome with time and effort. Providing the right care and education in all aspects of nursing will help change the view people have of nursing and the believe that nursing is a just a job and not a profession.
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