Real Due

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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.

informatics

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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). 

Reflection 1

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One  of the key points of learning from experience is to reflect on what you  did. Reflect on choosing an article. Answer the following questions in a  document of between 250 and 500 words. Save your response as a word  document and include a 7th edition APA cover page. Upload the document  to complete the assignment. Do not cut and paste from any document of  quote from any source. This is a reflection on your own experiences, so  you should not need to do this.

A. How did you choose the question?

B. What difference could the answer to the question make?

C. Who will be affected by the answer to the question?

D. Could anyone else be affected?

For this assessment, you will create a 2-4 page plan proposal for an interprofessional team to collaborate and work toward driving improvements in the organizational issue you identified in the second assessment.

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For this assessment, use the context of the organization where you conducted your interview to develop a viable plan for an interdisciplinary team to address the issue you identified. Define a specific patient or organizational outcome or objective based on the information gathered in your interview.

The goal of this assessment is to clearly lay out the improvement objective for your planned interdisciplinary intervention of the issue you identified. Additionally, be sure to further build on the leadership, change, and collaboration research you completed in the previous assessment. Look for specific, real-world ways in which those strategies and best practices could be applied to encourage buy-in for the plan or facilitate the implementation of the plan for the best possible outcome.

Using the Interdisciplinary Plan Proposal Template [DOCX] Download Interdisciplinary Plan Proposal Template [DOCX]will help you stay organized and concise. As you complete each section of the template, make sure you apply APA format to in-text citations for the evidence and best practices that inform your plan, as well as the reference list at the end.

Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.

  • Describe an objective and predictions for an evidence-based interdisciplinary plan to achieve a specific goal related to improving patient or organizational outcomes.
  • Explain a change theory and a leadership strategy, supported by relevant evidence, that is most likely to help an interdisciplinary team succeed in collaborating and implementing, or creating buy-in for, the project plan.
  • Explain the collaboration needed by an interdisciplinary team to improve the likelihood of achieving the plan’s objective. Include best practices of interdisciplinary collaboration from the literature.
  • Explain organizational resources, including a financial budget, needed for the plan to succeed and the impacts on those resources if the improvements described in the plan are not made.
  • Communicate the interdisciplinary plan, with writing that is clear, logically organized, and professional, with correct grammar and spelling, using current APA style.
  • Length of submission: Use the provided template. Remember that part of this assessment is to make the plan easy to understand and use, so it is critical that you are clear and concise. Most submissions will be 2–4 pages in length. Be sure to include a reference page at the end of the plan.
  • Number of references: Cite a minimum of 3 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than 5 years old.
  • APA formatting: Make sure that in-text citations and reference list follow current APA style.

WEEK 8 MSN 5300

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An important part of building evidence-based practice is the development, refinement, and use of quality diagnostic tests and measures in research and practice. Discuss the role of sensitivity and specificity in accuracy of a screening test?

Please include 400 words in your initial post with two scholarly references .

Attached you can find the rubric to following 

week 6 587

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With the consolidation of hospitals, clinics, and healthcare providers across the United States, leadership is delivered in many forms.  The importance of understanding and mastering online leadership (often referred to as virtual or E-leadership) is imperative.

How would you establish relationships with your team on-ground and from a distance? How would you create presence in a virtual team? Provide examples.

Expectations

Initial Post:

  • Due: Thursday, 11:59 pm PT
  • Length: 150 – 250 Words

Peer Responses:

DP for brilliant

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1

Week 6 Discussion Forum

A theoretical framework provides a rationale for predictions about the relationship
among variables. Discuss the variables you will use in your change project and the
specific steps that are necessary to implement your change project in your
organization.

  • Week 6 Discussion Forum

How to discuss

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How to discuss

informatics

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1. Interoperability can only be achieved when provider organizations do the work necessary to participate. Do provider organizations have the necessary incentives to do that work?

2. Private health information exchanges seem to be growing at a faster pace than public health information exchanges. Public exchanges should arguably offer more value to patients and lower costs to provider organizations. Why the discrepancy?

3. The INPC, originated as a research project, was initially funded by grants and one of the ongoing value propositions is research use of the data. Is research necessarily critical to success of a health information exchange?

4. Establishing and operating a health information exchange requires a variety of investments including computing and network infrastructure, software systems of various types, legal and operational costs. Would you agree that data capture and normalization is the largest investment required?

5. Computing infrastructure, networking technology, software and clinical information standards will continue to evolve rapidly and investments in the technology will depreciate relatively rapidly. What are the core assets of an HIE if not these things?