Discussion Post-Chronic Renal Failure

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Mr. Rojas is a 49-year-old patient with End Stage Renal Disease. He has a history of hypertension and uncontrolled type 1 diabetes (since he was 12 years old). His last Hemoglobin A1c was 12.8%. He is currently receiving hemodialysis three times per week for three hours. He is in the hospital because he went into DKA a few days ago when he had a stomach virus. He is asking you about renal transplantation.

  • What are the criteria to be placed in the transplant list?
  • What options for transplantation does Mr. Rojas have?
  • What recommendations can you give Mr. Rojas on treatment compliance?
  • What other renal replacement therapies could Mr. Rojas be educated about?
  • What are their advantages and disadvantages?

Must be at least 250 words. 

Please Reply to the following 2 Discussion Posts:

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Please see the attachment for the instructions

Module 4-Discussion

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Before taking on an assignment you will look over the content and only use the references and resources provided in the attachments. No plagiarism and original work to be done. NO OUTSIDE SOURCES ALLOWED!!

Discussion: Health Care For All Is A Nice Idea – But How Would We Pay For It?

Extending health care services to all persons is a popular topic of discussion, but the overall cost of paying the bill for the services is what seems to stop it from becoming a reality. Take some time to research the facts regarding what it would cost to extend basic medical services to all persons in the United States, and some of the proposed ideas of how it would/could be paid for. What are the likely effects for all stakeholders involved? Do you believe it is fair to expect “the haves” to pay additional personal and/or corporate taxes to provide medical services for the “have nots”? Should workers have to give up their current employer-sponsored private-pay insurance to move to one single-payer system, or should there be a choice, and why? Use peer-reviewed sources (not opinions) to respond to these questions in approximately 200 words.

** Kaiser Family Foundation. (2019). Paying a visit to the doctor: Current financial protections for Medicare patients when receiving physician services. Available at https://www.kff.org/medicare/issue-brief/paying-a-visit-to-the-doctor-current-financial-protections-for-medicare-patients-when-receiving-physician-services/

Medicare Payment Advisory Commission. (2016). Physician and other health professionals payment system. Available at https://www.medpac.gov/wp-content/uploads/2021/11/medpac_payment_basics_21_physician_final_sec.pdf

FEEDBACK

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PLEASE FOLLOW ALL DIRECTIONS 

nursing

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 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. 

public health

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Social determinants of health (SDOH). 

Name the 5 domains of Healthy People 2030. What is the objective of Healthy People?

Select 1-2 overarching goals and describe the impact on health, well-being and quality of life.

Describe the current status of the overarching goals you selected.

Evidence based practice and the quadruple aim

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Write a brief analysis (no longer than 2 pages) of the connection between EBP and the Quadruple Aim.

Your analysis should address how EBP might (or might not) help reach the Quadruple Aim, including each of the four measures of:

  • Patient experience
  • Population health
  • Costs
  • Work life of healthcare providers

To Prepare:

  • Read the articles by Sikka, Morath, & Leape (2015); Crabtree, Brennan, Davis, & Coyle (2016); and Kim et al. (2016) provided in the Resources.
  • Reflect on how EBP might impact (or not impact) the Quadruple Aim in healthcare.
  • Consider the impact that EBP may have on factors impacting these quadruple aim elements, such as preventable medical errors or healthcare delivery.

Required Readings

The Five R's

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Apply the framework of The Five R’s approach to ethical nursing practice from this week’s reading to answer the questions about values and choices.

What are values?

Q. What are your personal values?

Q. Why do you value them?

Q. What are the values in your society?

Q. How do you make choices?

Q. Are your choices based on your values?

Q. What values are useful in society?

What are the limits to personal choice?

Q. Who limits your choices?

Q. Are limits to choices good?

Q. Do you limit other people’s choices?

Q. Should the health care organization or the government limit people’s choices? If so, how, and under what circumstances?

In your responses to peers, feel free to agree, disagree, question, compare, and discuss each other’s responses in a way that fosters thoughtful and respectful dialog. You may also address the following: Did any responses surprise you? If so, how? Did reading your peers’ responses to the questions expand your own view of ways to answer questions?

Finally, consider this: A common idea in health care is that if you are drawn to health care as a profession, you are inherently guided by an inner compass that is composed of a strong moral framework. Why is this a dangerous assumption?

DB

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2

 Answer with at least 6 sentences, one scholarly reference ( discussion doesn’t have to be long just enough to get the question answered )  

  

Scenario 1: Myocardial Infarction

CC: “I woke up this morning at 6 a.m. with numbness in my left arm and pain in my chest. It feels tight right here (mid-sternal).” “My dad had a heart attack when he was 56-years-old and I am scared because I am 56-years-old.” 

HPI: Patient is a 56-year-old Caucasian male who presents to Express Hospital  Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states this started this morning and has been getting worse, pointing to the mid-sternal area, “it feels like an elephant is sitting on my chest and having a hard time breathing”. He rates the pain as 9/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, or lightheadedness. Nitroglycerin 0.4 mg tablet sublingual x 1 which decreased pain to 7/10.

Lipid panel reveals Total Cholesterol 424 mg/dl, high density lipoprotein (HDL) 26 mg/dl, Low Density Lipoprotein (LDL) 166 mg/dl, Triglycerides 702 mg/dl, Very Low-Density Lipoprotein (VLDL) 64 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

Question:

1. How does inflammation contribute to the development of atherosclerosis?

NURSING

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Present your approved intervention to the patient, family, or group and record a 10–15 minute video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

Baccalaureate-prepared nurses have many opportunities to reflect on their contributions to patient care outcomes during clinical experiences. Research suggests that creating and sharing video reflections may enhance learning (Speed, Lucarelli, & Macaulay, 2018).

For this assessment, you’ll present your approved intervention to the patient, family, or group and reflect on various aspects of your capstone practicum experience. Such reflection will give you a chance to discuss elements of the project of which you are most proud and aspects of the experience that will help you grow in your personal practice and nursing career.

Reference

Speed, C. J., Lucarelli, G. A., & Macaulay, J. O. (2018). Student produced videos—An innovative and creative approach to assessment. 
Sciedu International Journal of Higher Education, 7(4).

Complete this assessment in two parts: (a) present your approved intervention to the patient, family, or group and (b) record a video reflection on your practicum experience, the development of your capstone project, and your personal and professional growth over the course of your RN-to-BSN program.

Part 1

Present your approved intervention to the patient, family, or group. Plan to spend at least 3 practicum hours exploring these aspects of the problem with the patient, family, or group. During this time, you may also consult with subject matter and industry experts of your choice. Be sure you've logged all of your practicum hours in Capella Academic Portal.

The BSN Capstone Course (NURS-FPX4900 ) requires the completion and documentation of nine (9) practicum hours. All hours must be recorded in the Capella Academic Portal. Please review the
 BSN Practicum Campus page for more information and instructions on how to log your hours.

Use the 
Intervention Feedback Form: Assessment 5 [PDF]
 Download Intervention Feedback Form: Assessment 5 [PDF]as a guide to capturing patient, family, or group feedback about your intervention. You’ll include the feedback as part of your capstone reflection video.

Part 2

Record a 10–15 minute video reflection on your practicum experience, the development of

your capstone project, and your personal and professional growth over the course of your RN-to-BSN program. A transcript of your video is not required.

You’re welcome to use any tools and software with which you are comfortable, but make sure you're able to submit the deliverable to your faculty. Capella offers Kaltura, a program that records audio and video. Refer to 
Using Kaltura for more information about this courseroom tool.

Note: If you require the use of assistive technology or alternative communication methods to participate in these activities, please contact 
[email protected] to request accommodations. If you’re unable to record a video, please contact your faculty as soon as possible to explore options for completing the assessment.

The assessment requirements, outlined below, correspond to the scoring guide criteria, so address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for supporting evidence.

· Assess the contribution of your intervention to patient or family satisfaction and quality of life.

· Describe feedback received from the patient, family, or group on your intervention as a solution to the problem.

· Explain how your intervention enhances the patient, family, or group experience.

· Describe your use of evidence and peer-reviewed literature to plan and implement your capstone project.

· Explain how the principles of evidence-based practice informed this aspect of your project.

· Assess the degree to which you successfully leveraged health care technology in your capstone project to improve outcomes or communication with the patient, family, or group.

· Identify opportunities to improve health care technology use in future practice.

· Explain how health policy influenced the planning and implementation of your capstone project, as well as any contributions your project made to policy development.

· Note specific observations related to the baccalaureate-prepared nurse's role in policy implementation and development.

· Explain whether capstone project outcomes matched your initial predictions

·

· Discuss the aspects of the project that met, exceeded, or fell short of your expectations.

· Discuss whether your intervention can, or will be, adopted as a best practice.

· Describe the generalizability of your intervention outside this particular setting.

· Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.

· Assess your personal and professional growth throughout your capstone project and the RN-to-BSN program.

· Address your provision of ethical care and demonstration of professional standards.

· Identify specific growth areas of which you are most proud or in which you have taken particular satisfaction.

· Communicate professionally in a clear, audible, and well-organized video.

Additional Requirements

Cite at least three scholarly or authoritative sources to support your assertions. In addition to your reflection video, submit a separate APA-formatted reference list of your sources.

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

· Competency 2: Make clinical and operational decisions based upon the best available evidence.

· Describe one's use of evidence and peer-reviewed literature to plan and implement a capstone project.

· Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.

· Explain whether capstone project outcomes matched one's initial predictions and documents the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form. Document the completion of nine hours of practicum time.

· Competency 4: Apply health information and patient care technology to improve patient and systems outcomes.

· Assess the degree to which one successfully leveraged health care technology in a capstone project to improve outcomes or communication with a patient, family, or group.

· Competency 5: Analyze the impact of health policy on quality and cost of care.

· Explain how health policy influenced the planning and implementation of one’s

·

· capstone project, as well as any contributions the project made to policy development.

· Competency 7: Implement patient-centered care to improve quality of care and the patient experience.

· Assess the contribution of an intervention to patient, family, or group satisfaction and quality of life.

· Competency 8: Integrate professional standards and values into practice.

· Assess one’s personal and professional growth throughout a capstone project and the RN-to-BSN program.

· Communicate professionally in a clear and well-organized video.