Health Assessment Discussion 3

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Health Promotion Discussion 3

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writing

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NUR – 502 Module 5 Discussion

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 Discussion 5 

 

Gastrointestinal Function:
R.H. is a 74-year-old black woman, who presents to the family practice clinic for a scheduled appointment. She complains of feeling bloated and constipated for the past month, some-times going an entire week with only one bowel movement. Until this episode, she has been very regular all of her life, having a bowel movement every day or every other day. She reports straining most of the time and it often takes her 10 minutes at a minimum to initiate a bowel movement. Stools have been extremely hard. She denies pain during straining. A recent colonoscopy was negative for tumors or other lesions. She has not yet taken any medications to provide relief for her constipation. Furthermore, she reports frequent heartburn (3–4 times each week), most often occur-ring soon after retiring to bed. She uses three pillows to keep herself in a more upright position during sleep. On a friend’s advice, she purchased a package of over-the-counter aluminum hydroxide tablets to help relieve the heartburn. She has had some improvement since she began taking the medicine. She reports using naproxen as needed for arthritic pain her hands and knees. She states that her hands and knees are extremely stiff when she rises in the morning. Because her arthritis has been getting worse, she has stopped taking her daily walks and now gets very little exercise.

Case Study Questions

  1. In your own words define constipation and name the risk factors that might lead to develop constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.
  2. Based on the clinical manifestations on R.H. case study, name and explain signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present on the case study.
  3. Sometimes as an associate diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided on the case study?

Endocrine Function:
C.B. is a significantly overweight, 48-year-old woman from the Winnebago Indian tribe who had high blood sugar and cholesterol levels three years ago but did not follow up with a clinical diagnostic work-up. She had participated in the state’s annual health screening program and noticed that her fasting blood sugar was 141 and her cholesterol was 225. However, she felt “perfectly fine at the time” and could not afford any more medications. Except for a number of “female infections,” she has felt fine until recently. Today, she presents to the Indian Hospital general practitioner complaining that her left foot has been weak and numb for nearly three weeks and that the foot is difficult to flex. She denies any other weakness or numbness at this time. However, she reports that she has been very thirsty lately and gets up more often at night to urinate. She has attributed these symptoms to the extremely warm weather and drinking more water to keep hydrated. She has gained a total of 65 pounds since her last pregnancy 14 years ago, 15 pounds in the last 6 months alone.

Case Study Questions

  1. In which race and ethnic groups is DM more prevalent? Based on C.B. clinical manifestations, please compile the signs and symptoms that she is exhibiting that are compatible with the Diabetes Mellitus Type 2 diagnosis.
  2. If C.B. develop a bacterial pneumonia on her right lower lobe, how would you expect her Glycemia values to be? Explain and support your answer.
  3. What would be the best initial therapy non-pharmacologic and pharmacologic to be recommended to C.B?

Submission Instructions:

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

NUR 502 Module 6 Discussion

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 Discussion 6

 

Musculoskeletal Function:
G.J. is a 71-year-old overweight woman who presents to the Family Practice Clinic for the first time complaining of a long history of bilateral knee discomfort that becomes worse when it rains and usually feels better when the weather is warm and dry. “My arthritis hasn’t improved a bit this summer though,” she states. Discomfort in the left knee is greater than in the right knee. She has also suffered from low back pain for many years, but recently it has become worse. She is having difficulty using the stairs in her home. The patient had recently visited a rheumatologist who tried a variety of NSAIDs to help her with pain control. The medications gave her mild relief but also caused significant and intolerable stomach discomfort. Her pain was alleviated with oxycodone. However, when she showed increasing tolerance and began insisting on higher doses of the medication, the physician told her that she may need surgery and that he could not prescribe more oxycodone for her. She is now seeking medical care at the Family Practice Clinic. Her knees started to get significantly more painful after she gained 20 pounds during the past nine months. Her joints are most stiff when she has been sitting or lying for some time and they tend to “loosen up” with activity. The patient has always been worried about osteoporosis because several family members have been diagnosed with the disease. However, nonclinical manifestations of osteoporosis have developed.

Case Study Questions

  1. Define osteoarthritis and explain the differences with osteoarthrosis. List and analyze the risk factors that are presented on the case that contribute to the diagnosis of osteoarthritis.
  2. Specify the main differences between osteoarthritis and rheumatoid arthritis, make sure to include clinical manifestations, major characteristics, joints usually affected and diagnostic methods.
  3. Describe the different treatment alternatives available, including non-pharmacological and pharmacological that you consider are appropriate for this patient and why.
  4. How would you handle the patient concern about osteoporosis? Describe your interventions and education you would provide to her regarding osteoporosis.

Neurological Function:
H.M is a 67-year-old female, who recently retired from being a school teacher for the last 40 years. Her husband died 2 years ago due to complications of a CVA. Past medical history: hypertension controlled with Olmesartan 20 mg by mouth once a day. Family history no contributory. Last annual visits with PCP with normal results. She lives by herself but her children live close to her and usually visit her two or three times a week.
Her daughter start noticing that her mother is having problems focusing when talking to her, she is not keeping things at home as she used to, often is repeating and asking the same question several times and yesterday she has issues remembering her way back home from the grocery store.

Case Study Questions

  1. Name the most common risks factors for Alzheimer’s disease
  2. Name and describe the similarities and the differences between Alzheimer’s disease, Vascular Dementia, Dementia with Lewy bodies, Frontotemporal dementia.
  3. Define and describe explicit and implicit memory.
  4. Describe the diagnosis criteria developed for the Alzheimer’s disease by the National Institute of Aging and the Alzheimer’s Association
  5. What would be the best therapeutic approach on C.J.

Submission Instructions:

  • You must complete both case studies.
  • Your initial post should be at least 500 words per case study, formatted and cited in current APA style with support from at least 2 academic sources.

WK 6 DIS DATA

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NUR 512 Module 5 Discussion

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Discussion 5 

 

Describe a situation of ethical dilemma that you have experienced as a psych nurse  and how it was resolved. (Saunders, 2014)

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.

NUR 512 Module 6 Discussion

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Discussion 6 

 

APN Business Planning

Based on your textbook reading, discuss the process of Advanced Practice Nurse (APN) business planning from a system approach.

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.

Week 5

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Nursing practice and health outcomes are typically influenced by fiscal management practices within a healthcare system. Decisions related to cost of supplies, rate of pay, and staffing are often considered based on location, organizational size, and healthcare policy and legislation.

Consider a scenario where due to staffing shortages, a hospital unit is exploring either bringing in contract travel staff or reorganizing staffing teams to help support the staffing demands of a unit.

  • In your discussion response, describe the benefits of using travel nurses to increase staffing and improve nurse to patient ratios. Also, describe the disadvantages of using travel nurses to fulfill staffing needs.
  • Besides a direct impact to salary budget, what other financial impacts can travel nurses have on unit and healthcare organization budgets?
  • What are some alternative ways to improve staffing and retention of full-time nurses within an organization? Describe how these solutions can improve budgetary considerations.

Week 5assig

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Assignment Overview 

As a healthcare provider, it is essential to understand the relationship between economics, resources, budgeting, and staffing, and how these issues affect the ability to provide safe, quality care to patients. Two basic types of health care budgets affect nursing: capital and operating budgets. Capital budgets are used to plan investments and upgrades to physical assets that lose or gain value over time.  Operating budgets include personnel costs and annual facility operating costs. In this assignment, you will select a healthcare budget to analyze and present your findings to stakeholders. 

Assignment Instructions:  

Analyze a healthcare organization’s capital or operating budget and create a slide presentation of your findings and recommendations for stakeholders. The presentation should include the following content: 

Budget Analysis (2-3 slides) 

Obtain a current or previous capital or operating budget or annual report that exists within your healthcare organization from your supervisor or research a healthcare organization budget that is publicly available. Include background information and some context about the healthcare organization. Include a copy of the budget as one of the slides in the presentation. 

  • Identify the components of the budget and describe which categories within the budget are impacted by patient outcomes (e.g.,  patient satisfaction, HCAHAP scores length of stay, readmissions) and which categories may impact patient care. 

Organizational Budget Procedures/Processes (4-5 slides) 

Interview a leader in your organization or research online to find details on your chosen organization budget procedures and processes. 

  • Describe the role of the budget within the specific healthcare organization or unit and how it impacts patient outcomes.  
  • Identify titles/roles of people in the organization who help create and manage budgets for this organization. 
  • Outline the process for reviewing and revising budgets and/or submitting budget requests within this unit, department, or organization.  
  • Discuss the process for communication of budgetary decisions within the organization.  

Recommendations for Improvement (5-7 slides) 

  • Review the budget and identify expected or unexpected items or outliers. Describe whether that issue, opportunity, or concern is capital vs. unit and what implications this has on patient care and healthcare practice. 
  • Make general recommendations to the (unit, department, or organizational) appropriate leader about areas that should be cut, reappropriated, or realigned to improve the issue, opportunity, or concern identified.   
  • Reflecting on this budget and your current practice, develop specific recommendations for the (unit, department, or organization) appropriate leader about one area of focus within the budget for the upcoming fiscal year.   

Application of Analysis (1 slide)

  • Consider the following scenario:
    • The organization you obtained the sample budget from has directed all managers to either cut 5%, increase revenue, or reprioritize spending to meet the budget for the next fiscal year. Based on the budget, justify your choice to cut spending, increase revenue or reprioritize spending.  
      • Describe which areas you would make cuts or adjustments or how you would increase revenue or reprioritize spending. 
      • Which lines in the budget are priorities to keep?  
      • If you make cuts, explain how the remaining budget items are reasonable for the organization and department given the size of the organization and the population served.