module 5

 

Jackie is a 31-year-old pregnant patient (2nd child, two different fathers) single mother of a 6-year-old who is coming for prenatal care since she suspects she is pregnant. She is no longer with the father of Robby, her firstborn. She indicates “pretty serious partying” with the likely father of the baby. By pretty serious partying she means 10-12 drinks per occasion, one to two times per week, plus intermittent methamphetamine use.Which clinical information would be most critical for you to collect in the first visit?What are the greatest risk factors for substance use disorder for this patient?Which harm reduction strategies would you recommend?Identify your city. Then refer this patient to three agencies near you that would support positive health outcomes for this patient.   (These agencies must not have been used in past discussion posts). What was your rationale for choosing these three agencies? 

Renal

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

Renal Failure

Patient Profile:

J.M. is a 37-year-old woman transferred to a large medical center from a small rural hospital for further evaluation of lower abdominal pain, nausea, vomiting, and progressive deterioration of urinary output.

Subjective Data:

-Long history of ETOH Abuse with a drinking binge two days ago

-Arthritis with heavy use of ibuprofen

-HTN for three years, treated with hydrochlorothiazide and a calcium channel blocker

-Borderline NIDDM for three years, does not want to take medications and has been trying

to lose weight and “watch her sugar intake.”

Objective Data:

B/P: 160/110 K: 6.3 mEq/L Urinary output: <15ml/hr Na: 149 mEq/L Lethargic Hgb A1C: 9.2%

Creatinine: 9.6 mg/dL BUN: 121 mg/dL

CRITICAL THINKING QUESTIONS…

1. Address how the various factors in her past medical history could have contributed to her present renal problem.

2. Is her acute renal failure likely to be prerenal, intrarenal, postrenal, or a combination? Why?

3. Discuss each of the laboratory values and how they reflect the pathophysiology that occurs in renal failure. What is the significance of her Hgb A1C level?

4. What are the specific priorities of treatment for J.M.?

5. Explain the types of dialysis available, their indications, and their advantages/ disadvantages. What type of dialysis will most likely be used for J.M?

6. After two weeks of intensive support and dialysis, J.M’s urinary output returns. Explain the diuretic phase of recovery in Acute Renal Failure, and what complications can occur.

7. Do you think she needs intervention for her diabetes? What guidelines did you consult? How would you start in treating a patient with newly diagnosed Type 2 diabetes? Which medication(s) might you want to start first? What patient education issues would you emphasize in the initial period?

weekly discussion

STRATEGIES FOR ACADEMIC PORTFOLIOS

In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. A solid branding strategy can help add visibility and credibility to a company’s products.

Similarly, nurse-scholars can build a personal brand to add visibility and credibility to their work. You can begin building your brand by developing and maintaining an academic portfolio. Such an activity can help share the results of your efforts and contribute to your success. This Module’s Discussion asks you to consider and share strategies for building your portfolio.


Note

: Unless otherwise noted, initial postings to Discussions are due on or before Day 3, and response postings are due on or before Day 6. You are required to participate in the Discussion on at least three different days (a different day for main post and each response). It is important to adhere to the weekly time frame to allow others ample time to respond to your posting. In addition, you are expected to respond to questions directed toward your own initial posting in a timely manner.

 

RESOURCES

Required readings

Required Readings

· Burns, M. K. (2018). 
Creating a nursing portfolio
Links to an external site.
. Ohio Nurses Review, 93(3), 16-17.

· Casey, D. & Egan, D. (2013). 
The use of professional portfolios for career enhancement
Links to an external site.
. British Journal of Nursing, 15(11), 547–552.

· East, R. (2015). 
Developing a nurse practitioner portfolio
Links to an external site.
. ACORN: The Journal of Perioperative Nursing in Australia, 28(4), 35.

· Hannans, J. & Olivo, Y. (2017). 
Craft a positive nursing digital identity with an ePortfolio
Links to an external site.
. American Nurse Today, 12(11), 48–49. Retrieved November 14, 2018, from https://www.americannursetoday.com/wp-content/uploads/2017/11/ant11-Digital-Identity-1017a-1.pdf

· Leahy, R., & Filiatrault, A. (2017). 
Employers’ perceptions of the benefits of employment electronic portfolios
Links to an external site.
. International Journal of ePortfolio, 7(2), 217-223.

· McMillan, L. R., Parker, F., & Sport, A. (2014). 
Decisions, decisions! E-portfolio as an effective hiring assessment tool
Links to an external site.
. Nursing Management, 45(4), 52-54.

· Walden University. (n.d.). 
Walden University catalog
Links to an external site.
. Retrieved October 4, 2019, from https://catalog.waldenu.edu

Select College of Nursing, then Master of Science in Nursing (MSN). Review the MSN Learning Outcomes on this page.

· Walden University. (n.d.). 
Field experience: College of Nursing: Student resources – Graduate courses
Links to an external site.
. Retrieved from https://academicguides.waldenu.edu/fieldexperience/son/applicationprocess?preview=628dc4af1964e1228ef523827b9733ab#s-lg-box-3870501

· Walden University Writing Center. (n.d.). 
Walden templates: Overview
Links to an external site.
. Retrieved from https://academicguides.waldenu.edu/writingcenter/templates

Note: Download and review the College of Nursing Template by navigating to “Program-Specific Templates” and then “College of Nursing,” and selecting “College of Nursing Writing Template With Instructions.”

· Document:
 APA Basics Checklist: Citations, Reference List, and Style
 Download APA Basics Checklist: Citations, Reference List, and Style(PDF)

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 



WEEKLY RESOURCES

To Prepare:

· Reflect on strategies that you can pursue in developing portfolios or portfolio elements that focus on academic achievements.

· Review one or more samples from your own research of resources focused on portfolio development.

BY DAY 3 OF WEEK 8

Post an explanation of at least two strategies for including academic activities and accomplishments into your professional development goals. Then, explain how those goals may align with the University’s emphasis on social change. Be specific and provide examples.

BY DAY 6 OF WEEK 8

Respond to at least 
two of your colleagues' posts by offering additional ideas regarding academic achievements to include or offering alternative ways of presenting the current achievements.

FOCUSED SOAP NOTE AND PATIENT CASE PRESENTATION,

  

· State 3–4 objectives for the presentation that are targeted, clear, use appropriate verbs from Bloom’s taxonomy, and address what the audience will know or be able to do after viewing.

·

Work Environment in Nursing Practice

 

  • Discuss the strategies for maintaining a healthy work environment; the legal implications of workplace violence and the responsibilities from organizations in providing a healthy work environment
  • Review the ANA Bill of Rights (Box 14-1 from your textbook) and discuss how it protects nurses.

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.

informatics

please focus on the following question:

 Based on your understanding of concepts of health and US values and the history of health care services, why do you think concepts like Social Determinants of Health have not been used as much in the health care industry? In your answer. you can consider the prevailing medical model (p. 53), anthro-cultural beliefs and values (pp. 84-86), and the history of health care services (132-134). 

data analytics

 Scenario:  

Your organization is planning to purchase a tool for data analytics. You have been asked to make a recommendation for two tools. 

Your organization is also researching the application of data warehousing, big data, and data mining. You have also been asked to make an evaluation of how data warehousing, big data, and data mining can be beneficial to a healthcare system. Some members of your audience may be unfamiliar with these concepts, so part of your goal is to provide background information.

 

  • Research two data analytics tools that you would recommend in response to the scenario above.  
  • Thoroughly investigate the specifications of each tool and consider the pros, cons, and hardware requirements of each tool. 
  • Using supporting evidence from the articles you researched, create a PowerPoint presentation with the following information:
    • Recommend two tools for data analytics and explain why they would be beneficial to your organization.
    • Provide a description of big data, data mining, and data warehousing.
    • Provide an analysis of how data mining can be beneficial to a healthcare system.
    • Explain the purpose, characteristics, and components of a data warehouse.
    • Explain how the type of data warehousing used can impact the ability to mine data.
    • Describe examples of the successful use of guided data mining and automated data mining within healthcare.
    • Support your work with references from this week’s Learning Resources and the three articles you found in the Walden Library.
  • Provide references in APA style at the end of your presentation—the reference slide or slides do not count toward your assignment total.

NURSSING

ethical decision

Eleanor Thompson, a 72-year-old woman, has been battling an aggressive form of ovarian cancer for the past three years. Despite undergoing multiple rounds of chemotherapy and radiation, her condition has deteriorated, and she is now experiencing severe pain and suffering. Eleanor’s oncologist, Dr. Samuel Martinez, has presented the family with the option of another experimental treatment, but he has also suggested considering transitioning to palliative care. Eleanor’s family is deeply divided on the decision. Her eldest daughter, Maria, believes that every possible treatment should be pursued, holding onto hope for a miracle. She argues that her mother has always been a fighter and would want to continue the battle against her illness. On the other hand, Eleanor’s son, Michael, feels that his mother has suffered enough. He believes that transitioning to palliative care would allow her to spend her remaining days in comfort and peace. Caught in the middle is Eleanor’s husband of 50 years, Robert. He is torn between wanting to honor his wife’s fighting spirit, desiring to ease her pain, and the painful finality of either decision. The healthcare team must navigate a complex ethical landscape. Beneficence, the principle of doing good, pushes the team to consider what would truly benefit Eleanor in terms of quality of life. Non-maleficence, or “do no harm,” raises questions about the potential suffering Eleanor might endure with further aggressive treatments. Lastly, the principle of justice requires the team to treat Eleanor fairly and equitably, ensuring her needs are met regardless of family disagreements.
Using the case study above, answer the questions below.

  1. Summarize the facts in the selected case study and use the three components of an ethical decision-making model to analyze an ethical problem or issue and the factors that contributed to it.
    • Identify which case study you selected and briefly summarize the facts surrounding it. Identify the problem or issue that presents an ethical dilemma or challenge and describe that dilemma or challenge.
    • Identify who is involved or affected by the ethical problem or issue.
    • Access the Ethical Decision-Making Model media piece and use the three components of the ethical decision-making model (moral awareness, moral judgment, and ethical behavior) to analyze the ethical issues.
      • Apply the three components outlined in the Ethical Decision-Making Model media.
    • Analyze the factors that contributed to the ethical problem or issue identified in the case study.
      • Describe the factors that contributed to the problem or issue and explain how they contributed.
  2. Apply academic peer-reviewed journal articles relevant to an ethical problem or issue as evidence to support an analysis of the case.
    • In addition to the readings provided, use the Capella library to locate at least one academic peer-reviewed journal article relevant to the problem or issue that you can use to support your analysis of the situation. The NHS-FPX4000: Developing a Health Care Perspective Library Guide will help you locate appropriate references.
      • Cite and apply key principles from the journal article as evidence to support your critical thinking and analysis of the ethical problem or issue.
      • Review the Think Critically About Source Quality resource.
        • Assess the credibility of the information source.
        • Assess the relevance of the information source.
  3. Discuss the effectiveness of the communication approaches present in a case study.
    • Describe how the health care professional in the case study communicated with others.
    • Assess instances where the professional communicated effectively or ineffectively.
    • Explain which communication approaches should be used and which ones should be avoided.
    • Describe the consequences of using effective and non-effective communication approaches.
  4. Discuss the effectiveness of the approach used by a professional to deal with problems or issues involving ethical practice in a case study.
    • Describe the actions taken in response to the ethical dilemma or issue presented in the case study.
    • Summarize how well the professional managed professional responsibilities and priorities to resolve the problem or issue in the case.
    • Discuss the key lessons this case provides for health care professionals.
  5. Apply ethical principles to a possible solution to an ethical problem or issue described in a case study.
    • Describe the proposed solution.
    • Discuss how the approach makes this professional more effective or less effective in building relationships across disciplines within his or her organization.
    • Discuss how likely it is the proposed solution will foster professional collaboration.
  6. Write clearly and logically, with correct use of spelling, grammar, punctuation, and mechanics.
    • Apply the principles of effective composition.
    • Determine the proper application of the rules of grammar and mechanics.
  7. Write using APA style for in-text citations, quotes, and references.
    • Determine the proper application of APA formatting requirements and scholarly writing standards.
    • Integrate information from outside sources into academic writing by appropriately quoting, paraphrasing, and summarizing, following APA style.

Outline

After fully exploring the CMS website, review in detail the Hospital-Acquired Condition Reduction Program. Choose one of the CMS PSI 90 conditions below and using the Six Sigma DMAIC model, outline how you would create a process improvement plan by separately using the outline:

Define:

Measure:

Analyze:

Improve:

Control:

  • PSI 06 — Iatrogenic Pneumothorax Rate
  • PSI 08 — In Hospital Fall with Hip Fracture Rate
  • PSI 09 — Perioperative Hemorrhage or Hematoma Rate
  • PSI 10 — Postoperative Acute Kidney Injury Requiring Dialysis Rate
  • PSI 11 — Postoperative Respiratory Failure Rate
  • PSI 12 — Perioperative Pulmonary Embolism or Deep Vein Thrombosis Rate
  • PSI 14 — Postoperative Wound Dehiscence Rate
  • PSI 15 — Abdominopelvic Accidental Puncture/Laceration Rate