Discussion due in 12 hours

 Instructions – A Personal Reflection on Disasters or Mass Casualty Incidents

Course Objective met

1. Describe the human impact created by different types of disasters. 

Assignment Objectives met

-Describe possible effects on victims, families,   

     neighborhoods & communities

-Recognize societal factors that increase loss to

     life & property

-Describe possible effects on Healthcare

     providers & responders

-Recall nursing implications OVERVIEW

Reflection is a method of thinking deeply. It allows us to ponder not only that which is obvious to our senses, but all layers of the event, even to the possible intangibles. At least three (3) of the following aspects of the event, should be used for the best possible grade:  physical [injuries, death], emotional [fear, loneliness, helplessness, etc.], spiritual [corporate worship, individual], environmental [human diversity, structures, access, etc.], various obligations [school, work, family care, etc.], and financial

 (Bogo, etal., 2011).

Option 1: Recollect a disaster or mass casualty incident that personally affected you (ie: you, your family, or your friends). If this is too painful for you to revisit, you may choose option two.

Option 2: If this has never occurred in your life, please consider a disaster or mass casualty incident that you are aware of by way of significant media/news exposure.

The subject matter may be recent or in the past. To refresh your memory, feel free to read old newspaper or internet reports. You must respond to all six (6) points below, and you must include at least 3 of the aspects mentioned in the Overview.

1. Describe what happened.

2. What were your thoughts and feelings as you lived the situation? (actual or vicariously)

3. What three (3 or more) aspects emerged throughout the event? (refer to the Overview above)

4. What did you learn about yourself or the event? (or those directly affected)

5. Why was the experience important to you?

6. Choose one thing you think would be helpful to those involved in the experience.

DIRECTIONS: This Discussion Forum (DF) differs from what you are used to in the RN-BSN program. No references are ‘required’ (unless they apply), for this ‘one’ DF (see below). Something that has not changed is the skillful construction of your sentences, spelling, grammar, punctuation, and how well you spoke to the six (6) points above, and interjected at least three (3) of the possible aspects of the event (also shown above).  This is a personal reflection and therefore, citations and references are not required. (However, citations and references are required “if” you are actually referring to someone else’s ideas. Ie: If you “quote” someone or use their “thoughts” about the event even in a newspaper, it is their idea.) Your response must be typed or copied and pasted directly into the discussion thread.  The maximum word limit is 400 (this is also different from a regular Discussion Forum). Please double space between paragraphs but do NOT use double spacing or indentions throughout your writing. No file can be uploaded. APA format “will” be graded if it exists.       The same criteria concerning a personal reflection from the above paragraph, applies to the secondary posting. Your postings in response to your peers should be concise but facilitate a lively dialogue on the topic being discussed. Do NOT simply repeat information from your initial posting or your peer’s posting. The maximum word limit is 200. Please double space between paragraphs but do NOT use double spacing or indents throughout. APA format “will” be graded if it exists. This activity is worth 10% of your total grade.  You can expect individual feedback within a week of the due date/time. Reference: M. Bogo, C. Regehr, E. Katz, C. Logie & M. Mylopoulos (2011).  Developing a tool for assessing students’ reflections on their practice. Social Work Education. 30 (2), 186-194.  DOI: 10.1080/02615479.2011.540392

Order 1354644: Collaborative Teams

  Type of paperAssignment SubjectHealthcare Number of pages1 Format of citationAPA Number of cited resources1 Type of serviceWriting

Please use scholarly articles

030

how would you use the self-efficacy theory to empower your patient? What does the theory state?

a. Case Study Ankylosing Spondylitis

  

Part I : 

a. Soap Note Ankylosing Spondylitis

b. add questions from your case study 

Part II: Ankylosing Spondylitis

a. Pathophysiology

b. Clinical Presentation

c. Physical Examination

d. Diagnostic Testing 

e. Differential Diagnosis

f. Management

g. Education and Health Promotion 

Power point

< 20 % plagiarism

5 References

Sample Regular Soap Note Template

PATIENT INFORMATION

Name: Mr. W.S.

Age: 65-year-old

Sex: Male

Source: Patient

Allergies: None

Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime

PMH: Hypercholesterolemia

Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.

Surgical History: Appendectomy 47 years ago.

Family History: Father- died 81 does not report information

Mother-alive, 88 years old, Diabetes Mellitus, HTN

Daughter-alive, 34 years old, healthy

Social Hx:No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone.

SUBJECTIVE:

Chief complain: “headaches” that started two weeks ago

Symptom analysis/HPI:

The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness.He states that he has been under stress in his workplace for the last month.

Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.

ROS:

CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures. 

HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing.

Respiratory: Patient denies shortness of breath, cough or hemoptysis.

Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal

dyspnea.

Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or

diarrhea.

Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.

MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.

Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.

Objective Data

CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200lb, BMI 25. Report pain 0/10.

General appearance: The patient is alert and oriented x 3. No acute distress noted.NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.

HEENT:Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding.Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race.

Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses.

Cardiovascular: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec.

Respiratory: No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation.

Gastrointestinal:No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no rebound no distention or organomegaly noted on palpation

Musculoskeletal: No pain to palpation. Active and passive ROM within normal limits, no stiffness.

Integumentary: intact, no lesions or rashes, no cyanosis or jaundice.

Assessment

Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed.

Differential diagnosis:

Ø Renal artery stenosis (ICD10 I70.1)

Ø Chronic kidney disease (ICD10 I12.9)

Ø Hyperthyroidism(ICD10E05.90)

Plan

Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease.

These basic laboratory tests are:

· CMP

· Complete blood count

· Lipid profile

· Thyroid-stimulating hormone

· Urinalysis

· Electrocardiogram

Ø Pharmacological treatment: 

The treatment of choice in this case would be:

Thiazide-like diuretic and/or a CCB

· Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily. 

Ø Non-Pharmacologic treatment: 

· Weight loss

· Healthy diet(DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat

· Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults

· Enhanced intake of dietary potassium

· Regular physical activity (Aerobic): 90–150 min/wk

· Tobacco cessation

· Measures to release stress and effective coping mechanisms.

Education

· Provide with nutrition/dietary information.

· Daily blood pressure monitoringat home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP

· Instruction about medication intake compliance. 

· Education of possible complications such as stroke, heart attack, and other problems.

· Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all

Follow-ups/Referrals

· Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn.

· No referrals needed at this time.

References

Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017 (25th ed.). Print (The 5-Minute Consult Series).

CodinaLeik, M. T. (2014). Family Nurse Practitioner Certification Intensive Review (2nd ed.). ISBN 978-0-8261-3424-0

 

Assignment #3 HCL class

Instructions

Due 02/28/20 by 11pm

Select a healthcare leadership issue listed in the weekly module. Please explain why you selected this topic, the limitations of your research, advantages/disadvantages of the topic you researched.  Complete an annotated bibliography that addresses the topic of choice. The annotated bibliography must include 10 references (webinar, journal article, and text book must be included in your references). Each annotated reference must be 7-10 sentences.

Sample annotated bibliographies are located in the weekly module. 

References and style of writing must be in correct APA formatting. The link listed below is a resource for annotated bibliographies:

https://owl.english.purdue.edu/owl/resource/614/01/

Please review APA manual pages 87-97 for mechanics of style.

This accounts for 33% of your grade.

Week 4 reply (1)

Please reply to this discussion with one reference.  

  

-In my opinion, the middle range theory of Madeleine Leininger cultural care theory can be applied to nursing practice. In nursing practice, we come across patients who have different cultural backgrounds. It’s important as a nurse to respect those cultures and provide appropriate care. “Furthermore, cultural competency is operationalized as health care providers possessing the knowledge, attitudes, and skills that are necessary to work with diverse patient populations” (Donaldson, W. V., & Vacha-Haase, T., 2016, p. 391). The article I came across discussed long term care among LGBT community. The cultural care theory came about in the 1950’s. Leininger discovered that care is important in helping patients recover from illnesses. Leininger noticed that children of different cultures required different care. She realized that care and culture came hand in hand and came up with the cultural care theory. “The need for the new field of transcultural nursing to prepare nurses to function in a multicultural world become clear” (Madeleine M., L., 1988, p.153). Madeleine realized there is a lot to learn about many different cultures.  Due to the different cultures you can see within some nurses, cultural conflicts and those should be addressed. Assumptions underpinning this theory is that caring is essential for curing and healing. Also that there are cultural care differences between the patient and the nurse as well as similarities. 

References:

Donaldson, W. V., & Vacha-Haase, T. (2016). Exploring Staff Clinical Knowledge and Practice with LGBT Residents in Long-Term Care: A Grounded Theory of Cultural Competency and Training Needs. Clinical Gerontologist, 39(5), 389–409. https://doi-org.su.idm.oclc.org/10.1080/07317115.2016.1182956

Jennings K. M. (2017). The Roy Adaptation Model: A Theoretical Framework for Nurses Providing Care to Individuals With Anorexia Nervosa. ANS. Advances in nursing science, 40(4), 370–383. doi:10.1097/ANS.0000000000000175

Madeleine M., L. (1988). Leiningerʼs Theory of Nursing: Cultural Care Diversity and Universality. Nursing Science Quarterly, (4), 152. Retrieved from https://search-ebscohost-com.su.idm.oclc.org/login.aspx?direct=true&db=edsovi&AN=edsovi.00006236.198811000.00007&site=eds-live

Phoebe Pember

1.Why was Phoebe Pember considered an nurse leader?

2. What did Phoebe Pember contribute to the profession of nursing?

A3C7

See attachments.

Evidence-based care

Assignment: Why is it important to provide evidence-based care? Discuss some of the challenges nurse administrators face in creating an environment in which bedside nurses use evidence-based care. Discuss the use of run charts and control charts to improve quality. Discuss how Lean thinking and Six Sigma can be used together to improve healthcare quality. What are ways to promote employee safety? Describe how complexity theory applies to your practice. Explain reasons that chaos theory offers hope for the future of health care.

This PowerPoint® (Microsoft Office) or Impress® (Open Office) presentation should be a minimum of 20 slides, including a title and reference slide, with detailed speaker notes on content slides. Use at least four scholarly sources.

Community Discussion Board

 

Goals of Healthy People 2020

Review and discuss the goals identified by Healthy People 2020 that are related to reducing violence.