Iron Deficiency Anemia Diseases Assignment

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Iron Deficiency Anemia Diseases Assignment

Student’s Name
Miami Regional University
Date of Encounter: Mo/day/year
Preceptor/Clinical Site: MSN5600L Class
Clinical Instructor: Patricio Bidart MSN, APRN-IP, FNP-C
Soap Note # _____ Main Diagnosis: Dx: Herpes Zoster
PATIENT INFORMATION
Name: Ms. GP
Age: 78
Gender at Birth: Female
Gender Identity: Female
Source: Patient
Allergies: Peanut. Iodine
Current Medications:
 Insulin Lantus 100 u/ml 15 unit in the morning and at bedtime
 Metformin 500 mg 1 tablet PO once a day
 Atorvastatin 20 mg 1 tablet PO at bedtime. Iron Deficiency Anemia Diseases Assignment
PMH:
 Diabetes mellitus type II
 Hyperlipidemia
 Varicella (Chickenpox) at the age of 20 year-old
Immunizations: Flu vaccine in 2020, Covid -19 (Pfizer) in 2021
Preventive Care: Wellness exam on 03/2021
Surgical History: appendicectomy 20 years ago
Family History: daughter 48 years old / hyperlipidemia
Social History: Patient is widow, lives with her daughter. Catholic religion. No alcohol. No
smoker. No history of drug used, sedentary lifestyle. Does not work.
Sexual Orientation: Straight
Nutrition History: Regular diet, low in carbohydrates and fat.
Subjective Data:
Chief Complaint: I have been feeling itching and pain on my right lower back” started 3 day
ago.

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Symptom analysis/HPI: The patient is Ms. GP is 78-year-old Hispanic woman, who is
complaining about itching, pain or tingling on her right lower back. Patient stated that 3 days ago
she started to feel an increase in burning sensation on the area taking all right lower back and
don’t relieve the pain with analgesic, she stated that wear any clothes that touch the area is very
uncomfortable. Denies any episodes of fever but she feels fatigue and chills and mild headache.
She stated that today in the morning she feel worse and noted some redness in the area and
decided to come to the clinic to PCP evaluation.
Review of Systems (ROS)
CONSTITUTIONAL: fatigue, chills, denies weakness, no thirsty, no loss of weight. No fever.
NEUROLOGIC: mild headache, no dizziness, no changes in LOC, no loss of strength or
weakness/paresis/paralysis on extremities, no Hx of tremors or seizures.
HEENT: denies any head injury, denies any pain
 Eyes: patient denies blurred vision, no diplopia, no wear glasses for reading
 Ears: patient denies tinnitus, ear pain, no ear drainage through ear canal.
 Nose: no presence of nasal obstruction, no nasal discharge, denies nasal bleeding. (No
epistaxis)
 Throat: no sore throat, no hoarse voice, no difficult to swallow
RESPIRATORY: patient denies shortness of breath, cough, expectoration, or hemoptysis.
CARDIOVASCULAR: patient denies chest pain, tachycardia. No orthopnea or paroxysmal
nocturnal dyspnea.
GASTROINTESTINAL: patient denies abdominal pain or discomfort. Denies flatulence,
nausea, vomiting or diarrhea. (BM pattern) every other day, last BM: today, no rectal bleeding
visible for her. Iron Deficiency Anemia Diseases Assignment
GENITOURINARY: patient denies polyuria, no dysuria, no burning urination, no hematuria, no
lumbar pain, no urinary incontinence.
MUSCULOSKELETAL: denies falls or pain. Denies hearing a clicking or snapping sound
SKIN: patient states itching, pain, or tingling sensation on her right lower back.
HEMO/LYMPH/ENDOCRINE: glands swelling on groin, denies bruising or abnormal
bleeding.
PSYCHIATRIST: patient denies anxiety, depression, denies hallucinations or delusions, no
mood changes
Objective Data:
VITAL SIGNS:
Temperature: 98.4 °F, Pulse: 82x ‘, BP: 122/71 mm hg, RR 19, PO2-97% on room air, Ht- 5’3”,
Wt 164 lb, BMI 30.2. Report pain 6/10.
GENERAL APPREARANCE: Adult, female. Alert and oriented x 3.
NEUROLOGIC: Alert, oriented to person, place, and time. Cranial nerves from I to XII intact.
Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5. Pupil
normal in size and equal. Deep tendon reflex presents.
HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no
tenderness. Iron Deficiency Anemia Diseases Assignment
 Eyes: No conjunctival injection, no icterus, visual acuity, and extraocular eye movements
intact. No nystagmus noted. Wear glasses.
 Ears: BL external canal pattern, permeable, no redness, no drainage, tympanic membrane
intact, pearly gray with sharp cone of light. No pain or edema noted.
 Nose: Nasal mucosa normal. No irritations.
 Mouth: oral mucosa pink, tongue central, papillaes normal distributed, no lesions
detected, present of upper and lower denture, fitting properly. Lips with no lesions.
 Neck: No lymphadenopathy noted. No jugular vein distention. No thyroid swelling or
masses, no thrills on auscultation.
CARDIOVASCULAR: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary
refill < 2 sec. Peripheral pulses present and symmetric. No edema on BLE.
RESPIRATORY: Lungs sounds clear. Chest wall symmetric and no deformities, no intercostal
retractions, patient no noticed dyspnea, no orthopnea. No egophony, no pectoriloquy, no fremitus
or sign of condensation tissue on palpation. Resonance equal in both hemithorax. Lungs: breath
sounds present and clear on auscultation, no rales, no wheezing, no rhonchi.
GASTROINTESTINAL: Abdomen soft and non-tender. Continent to BB. Bowel sounds
present in all four quadrants; no bruits present over aortic or renal arteries. Last BM today.
GENITOURINARY: Costovertebral angles non-tenders, kidneys no palpable. External
genitalia present, no enlargement, no tumors palpable. Groins area noted with redness.
MUSKULOSKELETAL: No pain to palpation. Active and passive ROM within normal limits,
no stiffness. Iron Deficiency Anemia Diseases Assignment
INTEGUMENTARY: painful redness rash, with crops of vesicles on an erythematous base
with a few satellite lesions in linear distribution, do not cross midline, some of the blisters are
filled with purulent fluids and other are crusted. Area is swollen and redness.
ASSESSMENT:
Patient Ms. GP is 78-year-old Hispanic woman with Hx of DM Type II and Hyperlipidemia,
came into our clinic today complaining about itching, pain and tingling on her right lower back
starting 3 days ago. During the physical exam was noted painful redness rash, with crops of
vesicles on an erythematous base with a few satellite lesions in linear distribution, which do not
cross midline. Diagnosis is based on the clinical evaluation through history and physical
examination. According to patient presentation, signs and symptoms patient is diagnosed with
herpes zoster. Patients falls into the high risk group based on Buttaro (2017). Herpes zoster is
viral infection that occurs with reactivation of the varicella-zoster virus and the patient referred
has history of Chickenpox when she was 20 years old. Iron Deficiency Anemia Diseases Assignment
Main Diagnosis
Herpes Zoster (ICD10 B02.9): Herpes zoster is infection that results when varicella-zoster virus
reactivates from its latent state in a posterior dorsal root ganglion. Symptoms usually begin with
pain along the affected dermatome, followed within 2 to 3 days by a vesicular eruption that is
usually diagnostic. (Domino, Baldor, Golding, &Stephens,2017).
Other diagnosis:
Diabetes mellitus type II. (ICD-10 E11.9)
Hyperlipidemia. (ICD-10 E78.5)
Differential diagnosis
 Irritant contact dermatitis (ICD10 L24)
 Impetigo. (ICD10 L01.0)
 Varicella. (ICD 10 B01)
 Dermatitis herpetiformis. (ICD10 L13.0)
PLAN:
Labs and Diagnostic Test to be ordered (if applicable)
 Viral culture, polymerase chain reaction for VZV
Pharmacological treatment:
 Valtrex 1 gm TID x 7 days ideally during the prodrome, and is less likely to be effective if
given > 72 hours after skin lesions appear, Iron Deficiency Anemia Diseases Assignment
 VZV vaccine
 Pain-reliever NSAIDs
 Management of post herpetic neuralgia (Treatments include gabapentin, pregabalin)
Continue with current medication for chronic condition:
 Insulin Lantus 100 u/ml 15 unit in the morning and at bedtime
 Metformin 500 mg 1 tablet PO once a day
 Atorvastatin 20 mg 1 tablet PO at bedtime
Non-Pharmacologic treatment:
 Do not scratch the area with dirty hands. Use lotion like calamine to refresh the area.
 Keep the area clean and dry.

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Education
 Isolation precaution – Type Contact
 Avoid contact with susceptible person like pregnancy woman, kids and
Immunocompromised patient.
 Education about hand washing. Iron Deficiency Anemia Diseases Assignment
 Avoid ABT cream.
Follow-ups/Referrals
Follow up appointment 2 weeks / No referral needed at this time
Call if the symptoms are worse or you noticed any adverse reaction.
References
Buttaro, T. M., Trybulski, J. A., Polgar-Bailey, P., & Sandberg-Cook, J. (2017). Primary care: a
collaborative practice. St. Louis, MO: Elsevier.
Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017
(25th ed.). Print (The 5-Minute Consult Series).
McCance, K. L., & Huether, S. E. (2019). Pathophysiology: the biologic basis for disease in
adults and children. St. Louis, MO: Elsevi. Iron Deficiency Anemia Diseases Assignment

 

Case Application Imagine Self In The Role As Counselor And Apply Techniques Commonly Used In CBT To A Specific Case. (Application)

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Case Application Imagine Self In The Role As Counselor And Apply Techniques Commonly Used In CBT To A Specific Case. (Application)

Directions: Assume the perspective of a CBT therapist, and show how you would proceed with Carol by answering the questions that follow the case description.

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CAROL: “I’m to blame for all the problems in my family”

As the oldest of three children, Carol (who is 29) berates herself for her family’s tension and dissension. Her father is depressed most of the time (which Carol feels responsible for); her mother feels overburdened and ineffectual (Carol feels she contributes to this); and both her sisters are doing poorly in school and having other personal problems (Carol also assumes responsibility for this). Somehow she is convinced that if she were different and did what she should do, most of these problems would greatly diminish. Assume, as you listen to her, that you hear her saying some of the following things: Case Application Imagine Self In The Role As Counselor And Apply Techniques Commonly Used In CBT To A Specific Case. (Application)

“My father looks to me to be the strong one in the family. I must be strong if I’m to gain his approval, which I feel I must ”
“Since my mother is overworked, I should take on more of the responsibility for taking care of my younger sisters. I ought to be able to talk with them and help them with their problems.”
“My sisters both expect me to do their chores for them, to help them at school, and to live up to the image they have of me. I ought to meet their ideals, and it would be absolutely horrible of me to fail in this regard. Then if they grow up with problems, I’ll have only myself to blame for the rest of my life.”
Answer the following questions related to the case study:

(1) What are the ABCs in this case?

Activating Events:

Beliefs:

Consequences:

(2) One of the things a rational emotive behavior therapist would do is teach Carol that her thinking and her evaluation of events are causing her problems (feelings of inadequacy, anxiety, and insecurity). What do you hear her saying to herself that is irrational? Case Application Imagine Self In The Role As Counselor And Apply Techniques Commonly Used In CBT To A Specific Case. (Application)

(3) List some other procedures you would be inclined to use in her case and explain why you would use them.

Source: Corey, G., & Muratori, M. (2017). Instructor’s Resource Manual to accompany Theory and Practice of Counseling and Psychotherapy (10th ed.). Boston, MA: Cengage Learning.

 

 

number responses make it personal

Margins – 1 Inch
Font – Times New Roman, Arial or (12pt)
Spacing – Double
Length – No Page Length (Questions must be answered thoroughly)
Number your responses
Include Separate Title Page – Name, PID, Title of Essay. Case Application Imagine Self In The Role As Counselor And Apply Techniques Commonly Used In CBT To A Specific Case. (Application)

Nursing homework help

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Do you believe you have the traits to be an effective leader? Perhaps you are already in a supervisory role, but as has been discussed previously, appointment does not guarantee leadership skills. Nursing homework help

How can you evaluate your own leadership skills and behaviors? You can start by analyzing your performance in specific areas of leadership. In this Discussion, you will complete Gallup’s StrengthsFinder assessment. This assessment will identify your personal strengths, which have been shown to improve motivation, engagement, and academic self-conference. Through this assessment, you will discover your top five themes—which you can reflect upon and use to leverage your talents for optimal success and examine how the results relate to your leadership traits.

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To Prepare:

Complete the StrengthsFinder assessment instrument, per the instructions found in this Module’s Learning Resources.

Please Note: This Assessment will take roughly 30 minutes to complete.

  • Once you have completed your assessment, you will receive your “Top 5 Signature Themes of Talent” on your screen.
  • Click the Download button below Signature Theme Report, and then print and save the report. We also encourage you to select the Apply tab to review action items.

Post a brief description of your results from the StrengthsFinder assessment. Then, briefly describe two core values, two strengths, and two characteristics that you would like to strengthen based on the results of your StrengthsFinder assessment. Be specific. Note: Be sure to attach your Signature Theme Report to your Discussion post. Nursing homework help

 

Health History Plan of Care Form Assignment

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Health History Plan of Care Form Assignment

Health History Plan of Care Form

Using data gathered in your health history, develop a plan of care.

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1: Analyze Assessment Data:

Based on the health history information, identify the following:

  1. Areas for focused assessment

Provide a brief overview of those areas of strength and weakness noted from health history.

 

  1. Client’s strengths

Expand on areas identified as strengths related to the person’s overall health. Support your conclusions with data from the credible evidence (peer reviewed journal or credible website).

 

  1. Areas of concern

Expand on areas previously identified as abnormal and those that place the person at a health risk. Support your observations with data from the evidence. Health History Plan of Care Form Assignment

 

  1. Health teaching topics

Identify health education needs. Support your statements with facts from the Health History and information from your credible evidence.

 

2: Nursing Plan of Care

Next, plan your care based on your analysis of your assessment data:

  1. Diagnosis

Write two nursing diagnosis that reflects a priority need for this person. Remember a wellness diagnosis is a possibility.

 

  1. Plan

Write one goal and one measurable expected outcome related to each of your nursing diagnoses.  Explain why this goal and outcome is a priority. Include cultural considerations for this client.

 

  1. Intervention

Write as many nursing interventions that you need in order to achieve the outcome.  Provide the rationale for each intervention listed.

 

  1. Evaluation

You will not carry out your care plan so you cannot evaluate the effectiveness of your nursing interventions. Instead, comment on what you would look for in order to evaluate your effectiveness. Health History Plan of Care Form Assignment

 

 

References

 

 

 

 

 

 

Week 4: Strategies To Promote Student Engagement, Active Learning, And Academic Integrity

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Week 4: Strategies To Promote Student Engagement, Active Learning, And Academic Integrity

Focus on promoting student engagement and active learning to promote interpersonal and academic integrity.

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From a student perspective, faculty are central to the learning experience. Many of our students spend the greatest amount of time in class interacting with faculty. As such, faculty have the opportunity to cultivate relationships with students and are often in the best position to become aware of violations of academic integrity. Examine how nursing faculty can collectively cultivate an environment that positively contributes to active learning and proactively prevents/responds to student misconduct and cheating?  Consider legal and ethical implications in your response.

Sources: You may use your text books and other reading material, but you must also include at least two additional articles from peer reviewed nursing journals. Week 4: Strategies To Promote Student Engagement, Active Learning, And Academic Integrity

A discussion based on the YMH Boston Vignette 5 video

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A discussion based on the YMH Boston Vignette 5 video

Discussion post reply

APA format with intext citation

3 scholarly references for each reply with in the last 5 years

Plagiarism free with Turnitin report

300- 350 minimum word count

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Discussion post reply # 1

Amy S

A discussion based on the YMH Boston Vignette 5 video

What did the practitioner do well? In what areas can the practitioner improve?

The practitioner established a rapport with the client and ensured he was comfortable before asking him questions. Because of that, the patient felt more at ease being genuine and upfront during the examination. Before offering comments, the practitioner also provided questions encouraging the subject to articulate their perspective of the underlying issue. Throughout the examination, the practitioner effectively prompted the subject to reveal their perspective on the current situation, including his break up with his girlfriend and how he does not find a reason to live. The practitioner did not ask more questions about his family relations at home (YMH Boston, 2013,May 22). She can improve on that by concentrating on asking questions about his close associates at home and in school.

Do you have any compelling concerns at this point in the clinical interview? If so, what are they?

No, there are no compelling concerns at this point because the information provided was enough to come up with the right diagnosis for the patient

What would be your next question?

The next question would be if his parents are aware of what is going on in his life. Parents tend to be more concerned about their children, which would help recommend medications. A discussion based on the YMH Boston Vignette 5 video

Why is it important to do a thorough psychiatric assessment of a child/adolescent

A complete psychiatric examination for children and adolescents is critical since it assists in the early diagnosis and intervention of mental health concerns. Such examinations take into account psychological, emotional, and social factors, allowing for more precise diagnosis and tailored treatment planning. Early intervention can avert long-term consequences and increase general well-being. Understanding developmental complexities also provides targeted care, promoting healthy growth and a higher quality of life throughout these critical years.

Appropriate symptom rating scales for a child/adolescent during psychiatric assessment

The two appropriate symptom rating scales include the Child Behavior Checklist (CBCL), a parent-reported measure used to assess various emotional and behavioral disorders in children and adolescents. The other one is the Children’s Depression Inventory (CDI), a self-report questionnaire used to assess depressed symptoms in children of this age (Park et al., 2022). Both scales give useful information about a child’s mental health, assisting professionals in correct assessment and therapy planning.

Two psychiatric treatment options for children and adolescents

The two treatment options for children and adolescents include play therapy, a technique tailored for children that uses play to help them express feelings and handle psychological difficulties, as they may not speak as successfully in traditional talk therapy (Lebowitz et al., 2020). The other is Family-Based Treatment (FBT), mostly among teenagers with teenage eating disorders. FBT engages the entire family in therapy to address familial dynamics contributing to the disorder’s genesis and maintenance. Adult-focused therapies sometimes do not include as much family participation (Lebowitz et al., 2020).

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The role of parents/guardians during the assessment

Parents/guardians play an important part in child and adolescent evaluations by offering vital information about the individual’s behavior, emotions, and development. Their feedback assists physicians in gaining a thorough grasp of the children’s everyday lives, obstacles, and abilities. Collaboration with parents/guardians improves diagnostic accuracy, treatment plan development, and overall therapy success since they are major sources of information and crucial collaborators in the evaluation process (MacMullin et al., 2021). A discussion based on the YMH Boston Vignette 5 video

 

Discussion post reply # 2

Rachael T

Studies have shown that the prevalence of depression in children is low, however as I have seen in clinicals it seems to be becoming a worsening problem. It does appear that the most affected is adolescents. “Depression in adolescents is a major risk factor for suicide, the second-to-third leading cause of death in this age group,4 with more than half of adolescent suicide victims reported to have a depressive disorder at time of death” (Thapar et al., 2012).

Depression can also cause an adolescent to preform poorly at school and they may withdrawal from friends, or even being to use alcohol or drugs. “Individuals who are currently depressed have diminished academic achievement and occupational functioning, experience more interpersonal conflict, and are more likely to be afflicted with comorbid conditions” (Chang & Kuhlman, 2022).

YMH Vignette 5 Questions

In this video the practitioner actively listened and interacted with Tony. The practitioner did not introduce herself or let the patient introduce himself. She seemed rehearsed. The rapport did not feel genuine between them.  She should have talked with him about privacy and what information would need to be shared.  I have several concerns that were not addressed appropriately. She asked Tony if he knew why he was there and he stated that his doctor referred him. At this point she should ask; can you tell me what you told your doctor that made him concerned?  She also asked open-ended questions but then made suggestions for the answers. Asking a male if he has been crying would probably not get an honest answer. Asking if he has been irritable or angry would probably be a better option.  When he said that he felt angry and felt like fighting someone, she should have explored this instead of saying that she would get back to that. Also, when he stated that he didn’t want to live, she should have asked if he had a plan. She asked if he thought about hurting himself but did not talk about the specifics of his suicidal thoughts. “Early identification of depression represents an important opportunity to prevent the morbidity and mortality associated with depression and suicide” (Fallucco et al., 2015).

Remaining Questions

            Explain why a thorough psychiatric assessment of a child/adolescent is important.

According to Stanford Medicine a comprehensive psychiatric evaluation may help diagnose any number of emotional, behavioral, or developmental disorders (2023). The psychiatric interview is the most crucial element in the evaluation of adolescents. A comprehensive assessment of children and adolescents allows providers to gather the necessary information to seek interprofessional collaboration and develop a patient (Sadock et al. , 2015 ) . A discussion based on the YMH Boston Vignette 5 video

Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.

One scale that I would use is the PHQ-9, this scale is a 9-item questionnaire based directly on the nine diagnostic criteria for major depressive disorder in the DSM-IV. This can be used in adolescents 12 and older. This scale can be completed in a few minutes by the patient and is scored by the psychiatrist in the office. Scores of 15 or greater usually indicated major depression (APA, 2011). Another scale I would use would be The Child Behavior Checklist (CBCL) it is a component of the Achenbach System of Empirically Based Assessment (ASEBA). The ASEBA is used to detect behavioral and emotional problems in children and adolescents (APA, 2015).

 

Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.

            Two types of therapy that can be used in children and adolescents is art therapy and play therapy.  Art therapy is “a form of psychotherapy that uses art media as its primary mode of expression and communication” (Hu et al., 2021). Art therapy can help the patient to communicate their feelings without putting them into words. Play therapy is used primarily in children but can be used in adolescents. Play therapy helps the child to express feelings with toys instead of words. “Play therapy is an alternative proposal of intervention on important issues related to children” (Koukourikos et al., 2021).  “Play therapy is widely used to treat emotional problems and behavioral disorders of children because it fully meets their unique developmental needs” (Koukourikos et al., 2021).

Explain the role parents/guardians play in assessment.

Parents/guardians are usually the first point of contact. Obtaining the history and what behaviors they have noticed comes from the parents/guardians. An initial consultation also allows the therapist to explain the process of play therapy and how it works. One method I like is meeting with parents 10 min before session starts and then play therapy for 45 minutes. This allows the therapist to address concerns the parents may have or any new behaviors. This also allows for “helping parents recognize the child’s goals of misbehavior and teach the parents how they can “(Homeyer & Bennett, 2023) A discussion based on the YMH Boston Vignette 5 video

 

Policy Summary: (I)SBAR Summary Template Assignment

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Policy Summary: (I)SBAR Summary Template Assignment

Policy Summary: (I)SBAR Summary Template

When advocating for a policy change, often a policy maker will read a summary to determine if they would like to move forward in supporting a proposal.

This (I)SBAR is a summary of the policy proposal described in your paper.

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Policymaker’s Name__________________

Policymaker’s Title___________________

[Name of the Policymaker who will move your policy proposal forward]

(I) Identify Self

[Introduce yourself by briefly stating your title and professional experience.]

(S) Situation

[State your concern about the situation regarding the health issue.] Policy Summary: (I)SBAR Summary Template Assignment

(B) Background 

[Provide a brief background summary of the health issue. Include a statement about the current policy or program(s) and why they are insufficient in addressing the social determinant of health (SDOH) contributing to the health issue.]

(A) Assessment

[State what you are asking the policymaker to do to address the situation.]

(R) Recommendation

[Describe your recommended policy proposal to address the SDOH contributing to the health issue.]

 

 

 

Title of Work

 

Author Name (First, Middle Initial, Last)

College of Health Professions, Western Governors University

D025: Essentials of Advanced Nursing Roles & Interpersonal Practice

Instructor Name

Date

 

Title of Work 

Advanced Professional Nurse as Advocate

 Interprofessional Collaboration 

Data Driven Health Issue

 Characteristics of At-Risk Population 

Social Determinant of Health 

Current Policy 

Policy Proposal 

Health Issue Impact 

Equitable Distribution of Resources           

Ethical Provisions           

Barriers

 

Policy Maker

 

Rationale

 

Strategic Next Steps

 

Policy Summary (See Attached) 

 References

Week 5 Peer Replies NSG 3050 Trans To Baccalaureate

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Week 5 Peer Replies NSG 3050 Trans To Baccalaureate

NSG 3050 – Trans to Baccalaureate Nsg

Week 5 – Peer Response Instructions

  • Substantially respond to at least two other student posts in a way that prompts further input or provides another viewpoint.  Describe a situation from your nursing professional experience that backs up your viewpoint and discuss the social, moral, political and economic factors impacting your position.
    • Please respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites.
    • Provide a rationale for your response with at least one scholarly source using an APA in-text citation and full reference. Week 5 Peer Replies NSG 3050 Trans To Baccalaureate

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Valerie Smith

Monday Aug 7 at 2:46pm

The theory/model I chose is Betty Neuman’s healthcare systems model. When reading about the different theorists, Neuman’s theory I identified with the most. I appreciate Neuman’s respect for holistic patient care. Neuman defines nursing as “action which assists individuals, families and groups to maintain a maximum level of wellness, and the primary aim is stability of the patient/client system, through nursing interventions to reduce stressors’’ (Current Nursing, 2020). Neuman’s model focuses on the reduction of stressors to maximize patient wellness.

Critically ill patients require peace, quiet, and rest to help them heal. There is a ton of medical staff coming in and out of these patients’ rooms all day, resulting in no peace or rest whatsoever. I work the night shift, so whenever I can, I cluster as much as I can earlier on in the evening. This allows my patients to rest for longer, more consistent periods of time. Proper rest is one of the best ways to help let the body heal, and without this, patients are looking at longer and more difficult recovery times. Neuman developed her nursing lens to encompass caring for her clients as persons situated in their environments and taking into consideration not only their physical well-being but also their mental well-being (Montano, 2020).

I often see “ICU delirium” develop in our patients. This happens from a large mixture of things, such as being NPO for extended periods of time, medications that can cause insomnia and confusion, and lack of rest, quiet, and peace can all lead to “ICU delirium.” It is important for us as nurses to identify the development of delirium early and prevent it. One of the best ways of prevention I have found so far is proper rest in a peaceful environment.

Current Nursing. (2020, March 12). Nursing Theories. Betty Neuman’s System Model. https://currentnursing.com/nursing_theory/Neuman.html#:~:text=Neuman%20defines%20nursing%20as%20%E2%80%9Caction,nursing%20interventions%20to%20reduce%20stressors Links to an external site.

Montano, A.-R. (2020). Neuman Systems Model with Nurse-Led Interprofessional Collaborative Practice. Nursing Science Quarterly, 34(1), 45–53. https://doi.org/10.1177/0894318420965219 Links to an external site. Week 5 Peer Replies NSG 3050 Trans To Baccalaureate

 

 

Kerrie Miller

Aug 9 at 1:04pm

 

Jean Waston, a nursing theorist, focused her theory on human caring. Over time, her approach developed into Watson’s Caring Science and Human Caring Theory. This theory focuses on a philosophical foundation that embraces the whole person, which includes the unity of mind, body, and spirit as one in relation to the individual environment (Watson, 2023). This theory fits my values in my nursing practice since I like to build relationships and rapport with each of my patients. I think that it is essential to communicate with your patients about things outside of the medical world. I often ask about their family or hobbies. It’s a way to get their mind off what’s going on medically. By doing this, patients open up and trust me more when I share my hobbies or information about myself. Many of my patients have pets like I do, so I take the extra time to talk about their pets. This not only builds trust but offers a window into their home life.

 

An example was when I was treating an older patient; I could tell they were deep in thought and very frustrated. The patient was rude to the care tech assigned to them, so I wanted to understand what the patient was going through. Through communicating, I understood that the patient’s brother had passed away, and their hospital stay interfered with plans to attend the funeral. With the help of the dayshift nurse and social worker, we set up a Zoom call from a laptop so the patient could still participate in their brother’s funeral while in the hospital. The patient’s gratitude for this was immense, and their trust in the staff grew. My job is about helping wherever I can to help my patients achieve better health. Week 5 Peer Replies NSG 3050 Trans To Baccalaureate

 

Another example would be when a patient had an extended hospital stay and couldn’t find anyone to care for their dog. Again, with our social worker’s help, it was arranged for animal control to pick up the dog and hold it at their facility until the patient was discharged. This relieved the stress placed on the patient, knowing that their pet would be well cared after. By eliminating that extra stress, the patient could focus on achieving better health so they could be discharged and reunited with their pet. Again helping others is the role of a nurse, and it’s also in HCA’s mission statement. Above all else, we are committed to the care and improvement of human life. Having a trustworthy relationship with your patients is part of improving human life, and communication with them can give the nurse so much information and insight into their patient’s life, allowing us to tailor their care.

 

Watson’s Caring Science & Theory. Watson Caring Science Institute. (2023, April 27). https://www.watsoncaringscience.org/jean-bio/caring-science-theory/. Week 5 Peer Replies NSG 3050 Trans To Baccalaureate

 

Week 5 Peers Replies NSG 3150 HC Informatics

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Week 5 Peers Replies NSG 3150 HC Informatics

NSG 3150 – Healthcare Informatics

Week 5 – Peer Response Instructions

  • Substantially respond to at least two other student posts in a way that prompts further input or provides another viewpoint.  Describe a situation from your nursing professional experience that backs up your viewpoint and discuss the social, moral, political, and economic factors impacting your position.
    • Please respond to peers thoughtfully, add value to the discussion, and apply ideas, insights, or concepts from scholarly sources, such as: journal articles, assigned readings, textbook material, lectures, course materials, or authoritative websites.
    • Provide a rationale for your response with at least one scholarly source using an APA in-text citation and full reference.

 

Mandy Cross

Aug 10 at 2:51pm

Describe how technology and informatics are used to support the interventions used in practice?

During bedside shift report, both day and night nurse gives a report on the patient’s medical diagnosis and history at the bedside. Technology can help track the staff to ensure they’re doing report at the bedside. Some facilities have the ability to track when a nurse goes in and out of a room or every time, they use hand sanitizer. Week 5 Peers Replies NSG 3150 HC Informatics

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Describe how employing evidence-based practice guidelines improve patient outcomes?

Evidenced-based practice proves that processes work by already being implemented into practice. Utilizing bedside shift reports involves the patient in their care and decreases mistakes. Facts show that the patient has caught mistakes during bedside shift report and nursing has also caught mistakes by during report or checking all lines and drains.

What benefits and challenges have you experienced with (the integration of) information technology in your practice?

The benefit we’ve experienced is a decrease in mistakes made, which is a huge patient safety issue so that helps keep patients safe. This also helps nursing staff set eyes on their patient in case anything is off. Patients enjoy being a part of their care and can request not to have bedside shift report if not. Some challenges we’ve had are getting the buy-in from nurses. Nursing is so task-oriented, and shortcuts are more prominent with staffing being extremely thin. Week 5 Peers Replies NSG 3150 HC Informatics

What strategies did you, or could you, use to overcome these challenges?

Explaining the why is a huge thing for me. I also know that nurses often don’t understand why something changes, so explaining the why will give them the reason and meaning behind it. Getting your charge nurses behind and helping navigate the change helps get more buy-in from the nursing staff as well.

 

Elines Torres-Cedeno

Aug 9 at 9:39pm

One evidence-based practice that my facility uses to improve patient outcomes is the sepsis protocol. We use a web-based algorithm called SPOT-Sepsis Prevention and Optimization of Therapy to detect patients at risk for sepsis. The SPOT system is triggered by a combination of factors including the patient’s vital signs and lab values. If a patient flags as meeting the algorithms SPOT criteria a notification is sent to the patient’s care team and the patient is to be assessed for potential intervention. Upon notification, the patient’s nurse or provider has up to 27 minutes to input data regarding organ function status, mental status, and whether the patient is on antibiotics (which indicates that at some point someone thought this patient may have an infection). That combination of data-some technology-based, some human assessment based-is used to determine if a patient is sepsis positive. If so they should receive intervention in the form of fluid resuscitation and antibiotics within one hour of identification.

The benefits of having an actionable sepsis monitoring system and protocol for intervention are evident in patient outcomes, as mortality increases with each hour without intervention. The adaptation of machine-based algorithms such as SPOT monitoring aid in timely treatment, which is important in preventing mortality and improving recovery among affected patients (Shadid et al, 2023). Week 5 Peers Replies NSG 3150 HC Informatics

The challenges we have faced with this system are few, except for the occasional annoyance of nursing staff, which occurs when a patient is either admitted for sepsis and receiving treatment and yet continues to flag for screening, or when those flags are explained by a reason other than sepsis, yet they continue to flag for reassessment as often as every six hours. This can cause some “alarm fatigue”, where nurses miss signs that the system is picking up accurately related to sepsis or worsening sepsis which would require intervention. We overcome this by having a sepsis coordinator, who is assigned to independently reassess these patients and determine their status. This coordinator also assures that those flagging positive for sepsis are indeed receiving all necessary parts of the protocols implementation bundle in a timely manner.

Reference:

Shahid, M.U., Furqan. M., Fatima, S., (2023). Machine-based algorithm: a revolution we need for early sepsis diagnosis in hospitals. The Journal of the Pakistan Medical Association. 73(8). https://10.47391/JPMA.8318 . Week 5 Peers Replies NSG 3150 HC Informatics

 

 

Rasmussen College Nursing Discussion Paper

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Rasmussen College Nursing Discussion Paper

Scenario
As a nurse on a general medical floor, the RN has received a new admit. Review the client data provided.
Richard Henderson
58 years old
Male
Admit diagnosis: GI bleed
History: no surgical history
Medical history: Gastritis & GERD
Medications: Prilosec 40 mg PO daily, Atenolol 25 mg PO BID, Fiber daily, Alka Seltzer PO – states he takes this at least daily.

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Report from physician’s office: Mr. Henderson arrived to the physician’s office today for a complaint of increasing abdominal pain. He states that he is now throwing up coffee-ground emesis. He states that he didn’t take his BP medication this morning because he was dizzy. The physician is admitting him with a diagnosis of GI bleed with an EGD scheduled for tomorrow. He is NPO, and has a 22G IV lock in the left forearm. Last set of vital signs BP 106/60 mm Hg, HR 98 beats/min, RR 20 breaths/min, Temp. 98.8 degrees F, P.O. 90% on room air. He last vomited about 45 minutes ago with a small amount of dark coffee-ground emesis. His pain is 4/10 at present. No pain medication is ordered at this time. Rasmussen College Nursing Discussion Paper
Lab assessments ordered: CBC and chemistry panel
CT of the abdomen shows no signs of free air (no perforation)
When he arrives to the floor, he is pale, nauseous, and his skin is cool and clammy. When he is transferred to the bed from the stretcher, he vomits a large amount of coffee-ground emesis and loses consciousness.

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Instructions
In the discussion post, address the following:
While receiving report, what concerns do you have regarding the client report?
What type of shock is occurring?
What stage of shock is the client experiencing?
What is your next intervention and why?
What additional lab assessments would you anticipate?
Provide additional thoughts and insights.
In the initial posting provide one additional resource other than the required reading.
When responding to the initial posting, provide an evidence-based article in support of your response.
References
Jones, D., DeVita, M., & Bellomo , R. (2011). Rapid-Response Teams. English Journal of Medicine, 365, 139-146. Retrieved from Client Safety Network.
Please make your initial post by midweek, and respond to at least two other students’ posts by the end of the week. Please check the Course Calendar for specific due dates. Rasmussen College Nursing Discussion Paper