DUE REAL 2

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Name: Cara Jett
Age: 34 years
Provider: R. Mcbride NP
Allergies: NKA
Admit weight: 102 Ibs (46.3kg)
BMI: 17.5
Code status: full code

I just can’t eat. Every time I do, I have horrible pain in my stomach. My family keeps
accusing me of having an eating disorder. It’s not that I don't want to eat. It's that I can’t
without pain and diarrhea!

4/12
1345

Nursing Note: Client presents for ongoing stomach pain after eating. Current BMI of
17.5. Last recorded BMI from 3 years ago was 22.2. States pain has been ongoing for
several years, more severe as of late yesterday. Client skipped lunch today. Current
abdominal pain is 2/10. States that she has tried using over-the-counter pain relievers to
help with the abdominal pain, but this has not been successful. Rates 2/10 RLQ
abdominal pain.

4/12
1355

Neuro/Cognitive: Alert and oriented x4.

Cardiovascular: Regular heartbeat with S1 and S2 heard. No edema present. Capillary
refill <3 seconds. Bilateral pedal and radial pulses +3.

Respiratory: Lungs clear bilaterally.

Gastrointestinal: Abdomen flat, firm, hyperactive bowel sounds x 4 quadrants. Tender
in RLQ. Denies nausea. Last bowel movement was 1045 today. Loose, brown, mucous
looking – per client. Three loose stools today so far.

Genitourinary: Continent. No pain or burning when urinating

Musculoskeletal: Muscle atrophy present. +5 strengths for all extremities. Tenting
present on arm and collarbone.

Psychosocial: Anxious. Becomes tearful several times during visit. States her family is
accusing her of having an eating disorder.

5/7
1435

Nursing Note: Follow-Up Appointment with Gastrointestinal Specialist

Diagnosis: New Crohn’s disease.

Follow-up appointment after colonoscopy and upper GI procedure. Had a CT scan of the
abdomen completed after the procedure. Rates 4/10 abdominal pain. Client is taking
prednisone and metronidazole as prescribed by primary care provider for Crohn's
disease.

Date Temp HR RR BP SpO2 O2

4/12 1345 96.8 °F

(36.0 °C)

78 18 102/54 100% RA

5/1 0945 97.2 °F

(36.2 °C)

64 12 94/45 89% RA

5/1 1000 97.2 °F

(36.2 °C)

69 12 104/50 92% RA

5/1 1015 97.2 °F

(36.2 °C)

72 14 110/52 94% RA

5/7 1430 98.6 °F

(37.0 °C)

88 18 138/78 99% RA

Date Diagnostic Test Findings

5/1
1015

Upper GI
Colonoscopy

No abnormal findings.

Small ulcer found in the transverse portion of the large intestine with
evidence of more in the small intestine. Further testing, including an
MRI, is highly suggested.

5/5
1500

CT Scan of
Abdomen

Impression: Thickening of the wall of the small intestine present.
Three small abscesses noted by entrance to the colon correlating with
recent gastric studies. No fistula apparent.

5/1
0945

Endoscopy Center Nursing Note:

Client has completed an upper GI study and a colonoscopy with no noticeable
complications. Vitals stable. Drowsy but easily woken. Oriented x4.

5/1
1000

Endoscopy Center Nursing Note:

Vitals remain stable. Client drank 60mL of clear soda and two bites of graham cracker.
Swallow and gag reflex present. Mild 2/10 throat discomfort present. Driver present and
atbedside.

5/1
1015

Endoscopy Center Nursing Note:

Client discharged to home in care of mother, Nancy. Follow-up appointment made.

Response

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PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:

2. Nursing‐sensitive indicators are the criteria for changes in health status that nursing care can directly affect. Nursing‐sensitive indicators have been increasingly adopted as valid and reliable tools due to their features such as objective assessment, improvement of clinical practice, evaluation of nursing care quality and performance, and informed decision‐making capability for patients in selecting a hospital to receive care. The use of nursing‐sensitive indicators affects the outcomes of nursing care by defining the structure and processes of nursing care. Indicators can be used for quality improvement purposes in applied settings to monitor performance and progress and to support evidence-based decision making, to support informed policy analysis related to regulatory or accreditation requirements, workforce development, and reimbursement, and to research the role of nursing care in determining patient safety outcomes by examining structure-outcome, process-outcome, and structure-process-outcome relationships. I believe that no one nursing sensitive indicator is sufficient on its own for measuring the profession’s impact on patient care and outcomes. Rather, several elements must be considered together to provide a comprehensive view of nursing practices and results, such as patient falls with and without injuries, RN satisfaction survey, nosocomial infections, nursing hours per patient day. Indicators not included in the database statistics, but which professional nurses should consider, nonetheless are patient satisfaction with pain management, patient satisfaction with nursing care. For example, assessment and treatment of pain is complex, and optimal pain care remains elusive. Only 63-74% of patients report that their pain was well-controlled. Personal biases may interfere with healthcare’s ability to accurately assess pain management needs, but nurses who keep in mind the ethical principles of autonomy, beneficence, non-maleficence, and justice will be better equipped to make sound judgments. 

Reference:

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing-sensitive indicators for nursing care: A systematic review (1997-2017). Nursing open, 8(3), 1005–1022. https://doi.org/10.1002/nop2.654

Response TO WEEK 8 DISC 2

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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.

PN1

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A picture containing text Description automatically generated

Module 02 – Written Assignment-Communication Techniques Worksheet

Name:

Date:

Complete all your lesson content and assigned readings. Make sure that you are focusing on:

· Communication techniques used to promote safety within the healthcare facility.

· Communication techniques used to provide optimal patient care.

Instructions:

· Answer the questions listed below using complete sentences.

· Use correct grammar, spelling and APA format.

· Support your answers using credible sources such as textbooks, course materials, and evidence-based articles (
1 Point)

Resources:

How do I know if a source is credible?

How do I find evidence-based practice articles? Or nursing best practices?

1. Identify and describe communication techniques that can be used to promote safety within the healthcare facility.
(2 Points)

2. Describe how communication is used to provide optimal patient care.
(2 Points)

11/16/2021

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Nursing Assignment 2

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The baccalaureate prepared nurse must have a good understanding of the quality 

management process as well as the programs that various governmental and professional 

organizations have in place to measure and improve patient safety and quality of care. In

addition to discussing the National Database of Nursing Quality Indicators, delineate the 

role any two of the following have in addressing safety and quality issues: the Joint 

Commission (JC), Centers for Medicare & Medicaid Services (CMS), Agency for

Healthcare Research and Quality (AHRQ), or National Quality Forum (NQF). 

SOAP note HTA

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Hypertension

Independent Variable: Presence of a buzzer sound or not. Dependent Variable: Number of times the hand sanitizer lever was pressed. Level of Measurement: Ratio

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Design an experiment with one independent variable (with at least two levels) and one dependent variable. Additionally, what levels of measurement would you use when collecting your data?

Example: XYZ hospital wanted to increase compliance of staff using hand sanitizer after every interaction with a patient. In order to gain compliance, they set up a buzzer when staff exited the patient’s room. For the treatment group, a buzzer would ring for 1 second after exiting the room unless staff had pressed the hand sanitizer lever. The control group did not have the buzzer activated, so no sound would emit when exiting the patient’s room.

Independent Variable: Presence of a buzzer sound or not.

Dependent Variable: Number of times the hand sanitizer lever was pressed.

Level of Measurement: Ratio

In your responses to other students, identify a strength or weakness of another student’s example design.

Initial discussion question posts should be a minimum of 200 words and include at least two references cited using APA format. Responses to peers or faculty should be 100-150 words and include one reference. Refer to “HLT-362V Discussion Question Rubric” and “HLT-362V Participation Rubric,” located in Class Resources, to understand the expectations for initial discussion question posts and participation posts, respectively

Reflexion about clinical rotations experiences

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Please see the attachment for instructions

551 uni 7

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Darlene, age 32 years, has been having back pain for a number of years, ever since suffering a compressed L2 disc as the result of a motor vehicle accident that led to surgery and extensive physiotherapy. Now she is missing time from work as a secretary because of constant pain. Darlene has been referred to you for chronic pain.

  1. As the nurse practitioner working with Darlene, what aspects of disorders of pain are important to understand?
  2. How would you effectively manage Darlene’s pain at this time?

Instructions: discussion post, 1 page is long enough. APA format. Has to have 3 references. 

Potential effectiveness resulting

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Analyze the potential effectiveness resulting from professional or nurse-provided social support versus enhancement of social support provided by personal relationship and social networks for parents of children with chronic mental illness.