Transcultural Perspectives in the care of Older Adults. x 2 (due: 24 hours)

 You must answer the 4 questions twice. You must submit two documents, in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

1) **********minimum 3 full pages per each document = Total 6 pages ( not words)**************************** (cover or reference page not included) 

2)¨**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences)

3)********** It will be verified by Turnitin and SafeAssign 

4) **********References from the last 5 years  

5) The points don’t be must copied in the work. It must be identified by numbers. 

For example

1) It is important that nurses learn about this culture …….

2) It is important to focus the diabetic patient on ………………..

3) It is important to assess the feeding habits of the patient with

4) ………………………………..

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Read well:

You must answer the 4 questions twice. You must submit two documents, in each one you must answer the 4 questions. Copy and paste will not be admitted. You should address the questions with different wording, different references, but always, objectively answering the questions.

_______________________________________________________________

Question:

 

Diabetes has been emerging as a major public health concern among Native American communities in the United States for the past 40 years. The Pima Indians in Arizona currently have the highest recorded prevalence of diabetes in the world. On average, American Indian and Alaska Native adults are 2.6 times more likely to have diabetes than non-Hispanic Whites of similar age. Diet is a key factor in controlling blood glucose levels and preventing serious cardiac, renal, peripheral vascular, and retinal complications such as heart attacks, renal failure, limb amputations, and blindness.

An Indian Health Service (IHS) nurse visits a patient in her mobile home, located on an Arizona Indian reservation. The patient is a 72-year-old, obese, female Pima Indian with a blood glucose level of 280. She is at risk for serious complications of type 2, or non–insulin-dependent, diabetes mellitus. With type 2 diabetes, the body either resists the effects of insulin or doesn’t produce enough insulin to maintain a normal blood glucose level. The patient lives with her adult daughter, two grandchildren, and five great-grandchildren. The nurse’s goals are to use culturally appropriate diet education to repattern the patient’s eating habits for the purpose of reducing the blood glucose level to normal (between 70 and 110 mg/dL); promoting steady sustained weight loss (5 pounds per week); encouraging increased exercise and activity. The nurse also asks the patient to participate in group sessions at the Pima Community Center focused on healthy food preparation and eating a balanced meal. If you were a nurse who just began doing home health care on the Pima Reservation, how would you learn about the specific cultural beliefs and practices related to nutrition and diet for this patient as a member of the Pima Indian Nation, versus stereotypes about the diet of Native Americans in general? Given that the patient’s family doesn’t own a vehicle, how will you encourage her to shop for healthy foods, prepare them, and actively participate in weight loss and exercise programs held free of charge at the Pima Community Center? How would you assess the patient’s eating habits, for example, type of food, method of preparation, amount eaten, etc.? Each of the patient’s children, grandchildren, and great-grandchildren is obese. How would you involve the patient’s family in the plan of care and motive them to lose weight as well?

Health History Report Document Help

Hello:

I need someone who throughly understands health assessments and can help me preparing a report. Attached are the guidelines including all the questions that need to be answered.

NUR-630-D1R1

MINIMUM OF 250 WORDS WITH PEER REVIEW

You are assigned to a quality team on a rehabilitation floor where patient falls are on the rise. What strategy would be best to approach this issue—quality improvement, evidence-based practice, or research? Support your choice with one or two examples and one or two references. 

Paper–Evaluation of Health Information on the Internet

Evaluation of Health Information on the Internet 

****Follow Instructions. Remember At Least 250 Words. Reference Between (2013-2018)Thanks

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the topic material “Nursing and Health Reform.” Discuss how these two provisions have impacted, or will impact, your current practice of nursing.

What are the principles of scholarly discussion in an online environment? How does this differ from a social network? Please cite the sources used to support your response.

What are the principles of scholarly discussion in an online environment? How does this differ from a social network? Please cite the sources used to support your response.for mehreen gul

Death and Dying

DUE DATE MARCH  07, 2018

The purpose of this paper is to complete a comparative ethical analysis of George’s situation and decision from the perspective of two worldviews or religions: Christianity and a second religion of your choosing. For the second faith, choose a faith that is unfamiliar to you. Examples of faiths to choose from include Sikh, Baha’i, Buddhism, Shintoism, etc.

In your comparative analysis, address all of the worldview questions in detail for Christianity and your selected faith. Refer to Chapter 2 of Called to Care for the list of questions. Once you have outlined the worldview of each religion, begin your ethical analysis from each perspective.

In a minimum of 1,500-2,000 words, provide an ethical analysis based upon the different belief systems, reinforcing major themes with insights gained from your research, and answering the following questions based on the research:

How      would each religion interpret the nature of George’s malady and suffering?      Is there a “why” to his disease and suffering? (i.e., is there a reason      for why George is ill, beyond the reality of physical malady?) In      George’s analysis of his own life, how would each religion think about the      value of his life as a person, and value of his life with ALS? What      sorts of values and considerations would each religion focus on in      deliberating about whether or not George should opt for euthanasia? Given      the above, what options would be morally justified under each religion for      George and why? Finally,      present and defend your own view.

Support your position by referencing at least three academic resources (preferably from the GCU Library) in addition to the course readings, lectures, the Bible, and the textbooks for each religion. Each religion must have a primary source included. A total of six references are required according to the specifications listed above. Incorporate the research into your writing in an appropriate, scholarly manner.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 

Please layout your paper with the following headings:

   Introduction

   Seven Worldview Questions – Christianity

   Seven Worldview Questions – (religion of your choice)

   Case Study: A Christian Interpretion

   Case Study A (the other religion) Interpretation

  My Interpretation

[Within each of the the case study interpretations, please address each of the following questions.] How would each religion interpret the nature of George’s malady and suffering? Is there a “why” to his disease and suffering? (i.e., is there a reason for why George is ill, beyond the reality of physical malady?) In George’s analysis of his own life, how would each religion think about the value of his life as a person, and value of his life with ALS? What sorts of values and considerations would each religion focus on in deliberating about whether or not George should opt for euthanasia? Given the above, what options would be morally justified under each religion for George and why?

dq response

Understanding the health care system is very important for EBP research.  And knowing your stakeholders is also important.  However, In the health care system and in health care research, stakeholders are more than financial supporters.  Stakeholders are customers, the general public, suppliers, and any other group that might be affected by the decisions being made.  Stakeholder engagement is a process where input and ideas from those who are named as stakeholders are incorporated into the decision making process.  The attitude is that when organizations involve these stakeholders, the overall effectiveness of their change process will be enhanced.  Stakeholder engagement helps to drive long-term sustainability of change a align research with societal needs and expectations (Pandi-Perumal, et al., 2015). 

References:

Pandi-Perumal, S. R., Akhter, S., Zizi, F., Jean-Louis, G., Ramasubramanian, C., Freeman, R. E., & Narasimhan,

M. (2015). Project Stakeholder Management in the Clinical Research Environment: How to Do it Right.

Frontiers in Psychiatry, 6.Retrieved from 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4434843/#__ffn_sectitle

Discussion Response APA 180-200 WORDS

THIS IS A RESPONSE TO DISCUSSION BELOW, PLEASE USE APA & IN-TEXT CITATIONS. NO MORE THAN 200 WORDS.

  I was always taught in nursing school that pain is what the patient says that it is. We cannot feel what the patient is feeling, so we have to believe the patient and what they are telling us. “McCaffery defined pain as ‘whatever the experiencing person says it is, existing whenever he says it does’” (Huether &McCance, 2017, p.336). Pain effects each and every person differently. There are many different types of pain caused by many different diagnoses and issues. “Acute pain is transient, usually lasting seconds to days, sometimes up to 3 months. It begins suddenly and is relieved after the chemical mediators that stimulate pain receptors are removed” (Huether & McCance, 2017, p.340). When I think of acute pain, I think of getting a shot. A shot hurts while we are receiving the shot but is quickly relieved once the shot is over. “Visceral pain often radiates (spreads away from the actual site of the pain) or is referred. Referred pain is felt in an area removed or distant from its point of origin- the area of referred pain is supplied by the same spinal segment as the actual site of pain” (Huether & McCance, 2017, p.340). An example of referred pain would be left arm pain during a heart attack. Pain that is radiating away from the actual site of where the hurt is. “Chronic or persistent pain has been defined as lasting for more than 3 to 6 months and is pain lasting well beyond the expected healing time”(Huether & McCance, 2017, p.340). We hear of a lot of people struggling with chronic back pain. 

Pain can feel throbbing, stabbing, aching, burning, cramping, squeezing, etc. There are different factors that affect pain as well. “There are important age and sex differences in the clinical presentations of chronic pain patients. Some older patients present with unique clinical profiles that may reflect cohort differences, and/or physiological or psychological adjustment processes. There appears to be a greater number of distinct chronic pain presentations among females” (Cook & Chastain, 2001, para.5). Age and gender are just 2 factors that can affect pain and the way it is perceived. “In general, the prevalence of chronic pain has been found to be 50% or more among people aged 65 years or older” (Karjalainen, Saltevo, Tiihonen, Haanpää, Kautiainen, & Mäntyselkä, 2018, p.6). Different diseases that patients have can cause patients to have pain. Ethnicity can also be a factor of pain. If we think about sickle cell patients, it occurs more in African Americans and can cause pain during a sickle cell crisis. Age does not affect who can get sickle cell but can affect pain. Sickle cell presents at birth but usually patients do not have any issues until the age of 5 or 6. Another example would be having a tonsillectomy. Everyone states that the pain and recovery is so much easier on young children than in adults. These examples just go to show that everyone perceives pain differently depending on different factors like age, gender, ethnicity, and diseases. 

References

Cook, A. J., & Chastain, D. C. (2001). The Classification of Patients with Chronic Pain: Age and 

Sex Differences. Pain Research and Management, (3), 142. https://doi-org.ezp.waldenulibrary.org/10.1155/2001/376352

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, 

MO: Mosby.

Karjalainen, M., Saltevo, J., Tiihonen, M., Haanpää, M., Kautiainen, H., & Mäntyselkä, P. 

(2018). Frequent pain in older people with and without diabetes – Finnish community-based study. BMC Geriatrics, 18(1), 73. https://doi-org.ezp.waldenulibrary.org/10.1186/s12877-018-0762-y

Nebraska Medicaid Memo- 1 1/2 pages using article attached – must have by 2pm tomorrow

Putting a Band-Aid on Nebraska Medicaid

 

You are the assistant director for the Medicaid program in the state of Nebraska.  The director has decided that it is time to review why the managed care and public policy objectives of implementing the program are not producing the results originally contemplated.  Nebraska’s Medicaid staff is limited.  Its administrative functions are generally dispersed across the state, rather than centralized.  Its database related to care patterns is practically nonexistent.  State law prohibits the program from extensive health care marketing.  In order to simplify enrollment processes, Nebraska only considers one month’s income as a part of its eligibility process.  In addition, Nebraska requires a $30 co-pay for all services from recipients who have income above the poverty guidelines.  Nebraska has very few providers per capita.

 

 

The director asks you to draft a memo for discussion at the next Medicaid committee meeting that identifies seven (7) problem areas in the Nebraska Medicaid Managed Care Program and explains how each problem could arise.  In addition, the Director would like you to write a brief conclusion to the memo explaining how the Program could improve.