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Case Study, Chapter 9, Chronic Illness and Disability

1. Mr. Edwards is 20-year-old male patient who is admitted for treatment of recurring pyelonephritis (kidney infection) and surgical treatment of a urinary stricture, which has decreased the urinary stream. Mr. Edwards has paraplegia; he is paralyzed from the waist down secondary to an automobile accident when he was 16. He came by ambulance to the hospital, leaving his wheelchair and wheelchair pressure-relieving cushion at home. According to the nursing history, the patient is a nonsmoker and he does not drink alcohol or take any illegal drugs.  What nursing considerations should be made for Mr. Edwards related to his disability? What health promotion and prevention education does Mr. Edwards need?

2. Ms. Fulton is a 38-year-old mother who was recently diagnosed with myasthenia gravis, a chronic disease of the neuromuscular system. Management of this disease process requires strict adherence to a medication regimen. The disease also affects ADLs for the patient and her family. Additionally, because myasthenia gravis is characterized by exacerbations that may require hospitalizations, Ms. Fulton has had to resign from her position as president of a marketing firm. She has remained as an employee of the same company, but now serves as a consultant with more flexible work hours.  In discussing management of her chronic disease, the nurse focuses on what types of strategies? Describe supportive nursing care that may be helpful to Ms. Fulton.

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 Hematology Case Study

1) This is an instruction sheet ONLY and should not be used to write the below paper. Open a new Word document to construct paper.

2) Must be APA formatting throughout.

3) Must have a title page.

4) Must have a reference page.

5) The body of your paper must be at least three full pages not including the title page and reference (those are separate pages).

6) All seven questions must be answered in its entirety.

7) Must cite at least two references in the body of your paper to support your work.

Nursing care management for a stroke patient

Presentation: You inherit a new patient F. L. who has a history of “recent stroke.” He was recently (approximately 3 months ago) hospitalized, but you don’t have his records at the moment. The patient’s wife wanted him “checked out,” and states that his “cat scan” showed a stroke. She claims, “They did a bunch of other tests but didn’t find anything.” She does not think he has hypertension but adds, “He does not like to go to doctors.” The past medical history is unknown. He does report taking aspirin 81mg daily and does not have any known drug allergies. Patient F. L. smoked one pack a day but quit five years ago, however he does drink socially. As for his family history, his mother died at the age of 79 from a stroke and his father died at the age of 64 from a myocardial infarction; he is the only child. He is 57 years old, married to his wife for 29 years and has three children. He works Monday through Friday as an accountant.

Medications: Aspirin 81mg daily

Review of systems: Subtle left hemiparesis; increased tone and hyperactive reflexes; very mild neglect of his left side.

Physical exam: Vitals: height = 72″, weight = 225, body mass index = 30.5, blood pressure = 150/99 mm Hg; heart rate = 93 beats per minute at rest. Describe the pathophysiology of a stroke. What would your nursing assessment consist of? What should you be cognitive of with stroke patients? What are three short-term goals for this patient? What are three nursing interventions for this patient? What are three things you would discuss with the patient and his family during your discharge teaching? What are two medications (other than aspirin) that could be provided for this patient and why? What is the mechanism of action of each?  What are some of the possible side effects associated with these medications? How would the patient benefit from taking these medications? What are three recommendations for follow-up care?

  Baker, J. J., Baker, R. W., & Dworkin, N. R.  (2018). Health care finance: Basic  tools for nonfinancial managers (5th ed.). Burlington, MA: Jones and  Bartlett Learning.
Chapter 12, “Financial and Operating Ratios as Performance Measures” (pp. 127-134)
This chapter introduces a number of different tools that can be used to measure the performance of an organization. These include liquidity ratios, solvency ratios, and profitability ratios. Kleinpell, R. M. (2009). Analyzing economic outcomes in advanced practice learning. In Outcome assessment in advanced practice nursing (2nd ed.). New York, NY: Springer Publishing Company.
Outcome Assessment in Advanced Practice Nursing, 1st Edition by Kleinpell, R. M. Copyright 2009 by Springer Publishing Company. Reprinted by permission of Springer Publishing Company via the Copyright Clearance Center.

This chapter outlines five different types of economic outcomes that can be used by advanced practice nurses for assessing costs and determining performance benefits within a health care organization. Serb, C. (2011). Effective dashboards: What to measure and how to show it. Hospitals & Health Networks, 85(6), 40. 
Retrieved from the Walden Library databases.

In this article, the authors discuss automated systems known as executive dashboards, which are designed to highlight key data. Additionally, the article describes the components most experts agree should be included on an executive dashboard. Nash, M., Pestrue, J., Geier, P., Sharp, K., Helder, A., & McAlearney, A. (2010). Leveraging information technology to drive improvement in patient satisfaction. Journal for Healthcare Quality: Promoting Excellence in Health care, 32(5), 30–40.
Retrieved from the Walden Library databases.

This article explores how senior leaders can facilitate improvement in patient experience and satisfaction by strategic improvement and setting goals. This article presents a case detailing how the Ohio State University Medical Center (OSUMC) used information technology to formulate a strategy to improve patient experience. Barta, A. (2010). Dashboards: A required business management tool. Biomedical Instrumentation & Technology, 44(3), 228–30.
Retrieved from the Walden Library databases.

This article describes how dashboards became an integral financial and management tool for Trinity Health Clinical Engineering when it centralized the clinical engineering functions of five hospitals. National Database of Nursing Quality Indicators. (2014). National Database of Nursing Quality Indicators. Retrieved from NDNQI :http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.html
This website is a repository for nursing quality indicators. Wadsworth, T., Graves, B., Glass, S., Harrison, A., Donovan, C., & Proctor, A. (2009). Using business intelligence to improve performance. Healthcare Financial Management, 63(10), 68–72.
Retrieved from the Walden Library databases.

In this article, the authors describe a case study involving the Cleveland Clinic Foundation’s management supervision and how they kept track of its key performance indicators (KPIs) to aid in reducing operational costs and improving quality of care. Required Media Laureate Education (Producer). (2012). Dashboards. Baltimore, MD: Author.

Note:  The approximate length of this media piece is 6 minutes.

In this video, William Ward discusses the use of dashboards as a tool for tracking organizational performance. He compares different types of dashboards and describes how to select the most relevant data to include on a dashboard.

Accessible player –Downloads–Download Video w/CCDownload AudioDownload Transcript Discussion: Performance Reports/Dashboards Performance reports are a valuable tool for gauging the financial well-being and progress of a health care organization. When properly designed, these reports can provide data on key measures, quality indicators, performance of operations, patient satisfaction, personnel, and facility capacity.

Have you ever seen the cockpit of an airplane? The dashboard is covered with a variety of knobs and gauges. Having a pilot who understands the meaning of the data contained on the dashboard is essential for passenger safety and for reaching the correct destination in a timely fashion. Similarly, a dashboard for your organization can supply a wide variety of performance information to assist in the financial decision making process.

In this Discussion, you will describe a dashboard that would be useful for you in your current position and organization (or one with which you are familiar).

To prepare: Review this week’s Media program, Dashboards. Consider your own organization (or one with which you are familiar) and the key information that would be useful for decision making. Develop a list of key performance indicators in the following categories that would be useful for your situation. Include: 2–3 financial indicators 2–3 operational indicators 2–3 satisfaction indicators 2–3 quality indicators By Day 3

Post describe the specific indicators you selected for each category and explain why you chose those particular ones. Describe whether each indicator is a leading or trailing indicator and how this particular combination would provide the best overall view of