Evaluate the Health History and Medical Information for Mrs. J., presented below

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It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

  1. Is very anxious and asks whether she is going to die.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5kg.
  2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
  3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1 ; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
  5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

  1. IV furosemide (Lasix)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. IV morphine sulphate (Morphine)
  5. Inhaled short-acting bronchodilator (ProAir HFA)
  6. Inhaled corticosteroid (Flovent HFA)
  7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

  1. Describe the clinical manifestations present in Mrs. J.
  2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
  3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
  4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
  5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
  6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
  7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

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Clinicians traditionally incorporate history taking and physical examination as an integral component in the evaluation, assessment, diagnosis, planning, and implementation of care. With the advent of ever-more sophisticated diagnostic tools, some individuals propose that these new tools and innovations ultimately can replace the history and examination. Is that a good idea? Why or why not? Support your position with a minimum of two references.

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Part 1

Question 1

Clinicians traditionally incorporate history taking and physical examination as an integral component in the evaluation, assessment, diagnosis, planning, and implementation of care. With the advent of ever-more sophisticated diagnostic tools, some individuals propose that these new tools and innovations ultimately can replace the history and examination. Is that a good idea? Why or why not? Support your position with a minimum of two references.

Question 2

Reflect back on the course content and on the various diagnostic and screening tools and procedures that have been recommended or incorporated as best practices for the differing body systems or special populations. Which of these do you perceive as having the greatest value and benefit and why? Which of these do you perceive as having the least value or benefit and why? How could you improve a tool or procedure to achieve better information in order to provide better or realize better results?

Sexually Transmitted Diseases among African American Population

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RUA PROJECT TOPIC: Sexually Transmitted Diseases among African American Population

Specifically, among elderly population (65years and older)

he Health Promotion Project (RUA) is due this week. Your paper should be completed and ready for one last review. Download the assignment guidelines(Links to an external site.) and compare your paper to the grading rubric, making last-minute adjustments as needed. If you have any questions about the assignment, please speak to your instructor.

ALL STUDENTS must submitthe assignment by the posted deadline.

Rubric

NR222 RUA: Health Promotion Project (New MAY20)NR222 RUA: Health Promotion Project (New MAY20)CriteriaRatingsPtsThis criterion is linked to a Learning OutcomeIntroduction and ConclusionRequired criteria1. Introduction establishes the purpose of the paper and describes why topic is important to health promotion in the target population in your area. 2. Introduction stimulates the reader’s interest. 3.Conclusion includes the main ideas from the body of the paper.4.Conclusion includes the major support points from the body of the paper.15.0 ptsHighest PerformanceIncludes no fewer than 4 requirements for section.13.0 ptsHigh PerformanceIncludes no fewer than 3 requirements for section.12.0 ptsSatisfactoryIncludes no fewer than 2 requirements for section.8.0 ptsUnsatisfactoryIncludes 1 or fewer requirements for section.0.0 ptsSection not PresentNo requirements for this section presented.15.0 ptsThis criterion is linked to a Learning OutcomeRelate Topic to Target PopulationRequired criteria1.Describes the topic and target cultural population.2.Includes statistics to support significance of the topic.3.Explains how the project relates to the selected Healthy People 2020 topic area. 4.Applies health promotion concepts.25.0 ptsHighest PerformanceIncludes no fewer than 4 requirements for section.20.0 ptsHigh PerformanceIncludes no fewer than 3 requirements for section.15.0 ptsSatisfactoryIncludes no fewer than 2 requirements for section.10.0 ptsUnsatisfactoryIncludes 1 or fewer requirements for section.0.0 ptsSection not PresentNo requirements for this section presented.25.0 ptsThis criterion is linked to a Learning OutcomeSummary of ArticlesRequired criteria1.A minimum of three (3) scholarly articles, from the last 5 years, are used as sources. 2.Articles meet criteria of being from scholarly journals and include health promotion and wellness content.3.At least one article is related to the chosen cultural group. 4.Summaries all key points and findings from the articles.5.Includes statistics to support significance of the topic.6.Discusses how information from the articles is used in the Health Promotion Project, including specific examples.25.0 ptsHighest PerformanceIncludes no fewer than 4 requirements for section.23.0 ptsHigh PerformanceIncludes no fewer than 3 requirements for section.21.0 ptsSatisfactoryIncludes no fewer than 2 requirements for section.10.0 ptsUnsatisfactoryIncludes 1 or fewer requirements for section.0.0 ptsSection not PresentNo requirements for this section presented.25.0 ptsThis criterion is linked to a Learning OutcomeHealth Promotion DiscussionRequired criteria1.Describes approaches to educate the target population about the topic. 2.The approaches are appropriate for the cultural target population.3.Identifies specific ways to promote lifestyle changes within the target population.4.Applies health promotion strategies.25.0 ptsHighest PerformanceIncludes no fewer than 4 requirements for section.23.0 ptsHigh PerformanceIncludes no fewer than 3 requirements for section.21.0 ptsSatisfactoryIncludes no fewer than 2 requirements for section.10.0 ptsUnsatisfactoryIncludes 1 or fewer requirements for section.0.0 ptsSection not PresentNo requirements for this section presented.25.0 ptsThis criterion is linked to a Learning OutcomeAPA Style and OrganizationRequired criteria1.TurnItIn is used prior to submitting paper for grading. 2.Revisions are made based on TurnItIn originality report.3.References are submitted with assignment.4.Uses current APA format and is free of errors.5.Grammar and mechanics are free of errors.6.Paper is 3-4 pages, excluding title and reference pages.7.Information is organized around required components and flows in a logical sequence.10.0 ptsHighest PerformanceIncludes no fewer than 7 requirements for section.9.0 ptsHigh PerformanceIncludes no fewer than 6 requirements for section.8.0 ptsSatisfactoryIncludes no fewer than 5 requirements for section.4.0 ptsUnsatisfactoryIncludes 1 -4 requirements for section.0.0 ptsSection not PresentNo requirements for this section presented.10.0 ptsTotal Points: 100.0

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application of statistics in health care. Specifically discuss its significance to quality, safety, health promotion, and leadership.

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Statistical application and the interpretation of data is important in health care. Review the statistical concepts covered in this topic. In a 750-1,000 word paper, discuss the significance of statistical application in health care. Include the following:

  1. Describe the application of statistics in health care. Specifically discuss its significance to quality, safety, health promotion, and leadership.
  2. Consider your organization or specialty area and how you utilize statistical knowledge. Discuss how you obtain statistical data, how statistical knowledge is used in day-to-day operations and how you apply it or use it in decision making.

Three peer-reviewed, scholarly or professional references are required.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not 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 LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

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a model of cultural competence to personal practice beliefs

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Apply a model of cultural competence to personal practice beliefs. For this assignment: Reflect on the 5 constructs of Campinha-Bacote’s model of The Process of Cultural Competence in the Delivery of Healthcare Services: Cultural desire, Cultural Awareness, Cultural Knowledge, Cultural Skill, and Cultural Encounters. (See Chapter 2) Ritter, L.A., Graham, D.H. (2017). Multicultural Health (2nd ed.). Burlington, MA: Jones and Bartlett Learning.ISBN: 9781284021028 Review the Mission statements and values of St. Thomas University and its Nursing programs. Reflect on your learning during this course. Evidence of reflection on Campinha-Bacote’s cultural competency model and/or STU mission and values. Your personal beliefs. Your philosophy statement(s) related to culturally competent nursing care. Implementing your beliefs. Continuing your journey towards cultural competence.Submission Instructions: Your paper should be formatted per current APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling. The paper is to be no shorter than 1 pages; nor longer than 2 pages in length, excluding the title, abstract and references page. Incorporate a minimum of 2 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work. Journal articles and books should be referenced according to current APA style (the library has a copy of the APA Manual).

Billing and Collections

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Billing and Collections

Each week, you will be asked to respond to the prompt or prompts in the discussion forum. Your initial post should be 75-150 words in length and is due on Sunday. By Tuesday, you should respond to two additional posts from your peers.

Most insurance contracts require providers to bill insurance companies before billing patients, with the exception of co-payments.

What process can you implement as the billing and collections specialist to ensure payment is a collection from patients? Explain how you would implement the process.

View your discussion rubric.

The death often reflect about spiritual beliefs, the importance of spirituality, and how it influences their view of death.

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Step 1: Read about Death and Dying

The death often reflect about spiritual beliefs, the importance of spirituality, and how it influences their view of death.

Step 2: In a two page paper:

  • Define Euthanasia.
  • Discuss the two types of euthanasia.
  • Discuss whether or not you believe that euthanasia is acceptable in some situations
  • How do you feel about other forms of assisted suicide?
  • Support your opinions with 3-5 references.

Which of the following situations is most likely a significant change in status as defined by the OBRA regulations?

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1.Which of the following situations is most likely a significant change in status as defined by

the OBRA regulations?

Mrs. M. is having an adverse reaction to the over-the-counter cold medication she started taking

yesterday. The resulting delirium has caused incontinence of urine, mental confusion, and she is not

able to feed herself independently as she was yesterday.

Mrs. P. has had the flu for the past week. She is feeling weak and requires much more assistance with

toileting and personal hygiene than she did before she became ill.

Mr. S. has been exhibiting increasing signs of sadness in the weeks since his wife died, despite taking

antidepressant medication. It is now noted that he has had a significant weight loss.

Mrs. Q has been on hospice for six months for terminal cancer and now has stopped transferring

altogether and is being spoon fed by staff and family all the time.

2. After completing the Quarterly MDS, when must it be transmitted to the national QIES

ASAP system?

Within 7 days

Within 14 days

Within 21 days

Within 31 days

3. While reviewing a resident’s medical record, it is discovered that the resident’s race was

incorrectly coded at A1000 on the most recent comprehensive assessment. What is the

correct course of action?

Complete an SCPA within 14 days of identifying the error

Complete a modification utilizing the section X Correction Request

Complete an SCSA within 14 days of identifying the error

Complete an inactivation utilizing the section X Correction Request.

4. When a significant, uncorrected error has been identified, what qualifies the error as

significant requiring a significant correction of a prior comprehensive or quarterly

assessment?

The resident had two uncorrected errors identified

The resident’s birthdate was coded as January 1, 1936, but the correct birthdate is January 19, 1936

The clinical status was misrepresented and a subsequent assessment with the correct information was

not submitted

The resident was admitted to Hospice after the assessment’s ARD, but before the assessment was

completed

5. The interdisciplinary team is in the process of completing a Quarterly assessment for a

resident.  The ARD was yesterday.  The dietitian reports to the MDS coordinator that she just

realized the resident’s weight on the quarterly three months ago was incorrect. The weight

that was coded and care planned was 102 lbs. and the actual weight was 120 lbs.  What is the

correct course of action now?

Modify the previous Quarterly to correct the weight and continue to complete the regularly scheduled

Quarterly that is already in progress when the error was found

Modify the previous Quarterly to correct the weight

Modify the previous Quarterly to correct the weight and follow up with a significant correction to prior

Quarterly within 14 days

Modify the previous Quarterly to correct the weight.  Change the reason for assessment on the current

Quarterly to a significant correction of prior Quarterly

6. A long term resident fell, fractured her femur, had a three-day stay in the hospital, and

returned on a Medicare A stay.  In the initial evaluation of the resident after hospitalization,

the interdisciplinary team noted that the fall with major injury was not coded on the OBRA

Discharge assessment.  What is the correct course of action now?

Modify the OBRA Discharge assessment to add the fall.  Follow the PPS schedule of assessments.  Code

the first one as a combination Significant Correction of Prior Discharge/PPS 5-Day assessment

Modify the OBRA Discharge assessment to add the fall.  Follow the PPS schedule of assessments, and

continue the OBRA schedule where it left off, considering significant change in status, if appropriate

Inactivate the OBRA Discharge assessment and perform a Significant Change in Status Assessment to

capture the fall prior to admission.  Begin the PPS schedule of assessments

Begin the PPS schedule of assessments.  Code the fall that happened prior to hospitalization in J1800

and J1900c on the current assessment

7. When the RNAC was reviewing an Annual assessment prior to attesting to completion in

Z0500, he noticed that two pressure ulcers were not coded on the Annual assessment.  What

is the correct action now?

No action is required.  The RNAC’s signature verifies completion only.  The RNAC has no role in whether

an accurate assessment is transmitted to the national repository.  The RNAC should sign and lock the

assessment

The RNAC must ensure the error is corrected in the seven-day editing period prior to transmitting the

assessment and follow up with a Significant Correction to prior annual within 14 days

The RNAC must ensure the error is correct in the seven-day editing period prior to transmitting.  If this is

done, no Significant Correction to prior comprehensive is required

The RNAC must attest to completion, lock and transmit the assessment and follow up within 14 days

with a Significant Change in status assessment

8. Which of the following usually describes when an OBRA Discharge assessment-return

anticipated form is used?

Is admitted to the hospital.

Goes with family home on a leave of absence.

Is discharged to Assisted Living.

Is discharged home.

9. Which of the following describes when an OBRA Discharge assessment is required for a

resident?

The resident leaves the facility for a temporary home visit.

The resident goes out for a temporary therapeutic leave.

The resident goes to the hospital for an observational stay of less than 24 hours when the hospital does

not admit the resident to an inpatient bed.

The resident goes to the hospital for an observational stay of more than 24 hours when the hospital

does not admit the resident to an inpatient bed.

10. For which situation is an OBRA Discharge assessment not required?

Transfer to acute hospital for admission.

Discharge to the assisted living facility on the same campus as the nursing home.

Discharge to another long-term care facility.

Leave of absence to emergency room less than 24 hours.

11. When should a Death in Facility tracking record be completed for a resident in a skilled

nursing facility?

When the resident dies within two hours of being admitted to the hospital

When the resident dies while in the ambulance on the way to the ER from the SNF

When the resident dies 26 hours after being sent to the hospital for observation

When the resident dies one hour after discharge from facility

12. Which of the following does not require a Death in Facility tracking record to be

completed for a resident in a skilled nursing facility?

When the resident discharges to home and dies the next day

When the resident dies 23 hours after being sent to the hospital for observation

When the resident dies after three hours in the emergency room

13. When the resident dies while on a Leave of Absence to home for a holiday visit

Which of the following is true regarding the Entry Tracking Record?

The transmission date must no later than the entry date plus seven days

The completion date must be no later than the entry date plus 14 calendar days

The transmission date must be no later than the completion date plus 14 days

14. The completion date must be no later than the entry date plus seven calendar days

When must an OBRA Discharge assessment be completed?

When the resident left the facility by ambulance and is admitted to acute care

When the resident dies in the ER less than 24 hours from leaving the facility

When the resident leaves the facility for an overnight temporary home visit

When the resident dies during a leave of absence from the facility

Explore conflict management principles and professional integrity through review of healthcare personnel conflict management review

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Purpose:

  • Explore conflict management principles and professional integrity through review of healthcare personnel conflict management review.
  • This conflict management assignment gives you the opportunity to review common conflict scenarios in clinical practice, and reflect on appropriate resolution strategies. This gives you a review of an evidence based approach to a training conflict management in healthcare settings.
  • Critically access conflict management as it relates to team building in clinical practice

Description:

Students will reference the conflict case management study from the nursing literature. Students will develop a summary and reflection consensus of strategies used to resolve the case review. Support your summary using a minimum of three academically credible sources in addition to the source provided.

Please retrieve and read the following Journal article from the Library.

Forbat, L., Simons, J., Sayer, C., Davies, M., Barclay, S (2017). Training pediatric healthcare staff in recognizing, understanding and managing conflict with patients and families: findings from a survey on immediate 6-month impact. Archives of Disease in Childhood, 102 (3): 250.

Directions:

Students are expected to:

  1. Create a 5-10, 6-8, (etc.) slide PowerPoint presentation not including the title slide or reference slide addressing the following:
  2. Create a brief and concise overview of the case study within the PowerPoint slides;
  3. Reference a minimum of three academically credible sources in addition to the source provided;
  4. As a team, develop a Poster Project using PowerPoint, like an executive summary, critically assessing conflict management principles used in the case for clinical practice;
  5. Submit the Summary and Poster Slide to the Unit 8 Dropbox

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements:

Before finalizing your work, you should:

  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
  • conduct a spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.);
  • be well ordered, logical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th Edition format.
  • Please see the Writing Center located in the Academic Success Center in the student portal for assistance with writing, APA, and online communication. https://campus2.purdueglobal.edu/page/writing-center

How to Submit:

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit.

When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Make sure to save a copy of the Assignment you submit.

Public policy— Private policy— Health policy— Social policy— Organizational policy?

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1- What is Policy?

2-Explain each of them: Public policy— Private policy— Health policy— Social policy— Organizational policy?

3- Who was F lorence Nightingale, and what was her contribution to the Nursing Field?

4- Who wasLillian Wald?

5- Who was Margaret Sanger, and in what way she helped to thedevelopments of Nursing Field?6_ what is (ICN), and what they do?

7- What is s (NLCA) and they do?

8-Which stage of the policy model does this scenario represent? ■

Jeanne Blum, RN, is a nurse on a LDRP unit. Recently, the policy and procedures manual for Jeanne’s unit included the premature rupturing of membranes of a laboring patient as a practice acceptable for nurses to perform. Jeanne and some of her coworkers shared their concern over lunch about this new responsibility.They felt uncomfortable with the possibility of cord prolapse and other potential medical complications resulting from this practice. Jeanne gathered data from her state and many others states and noted that her hospital was not in compliance with her professional organizationpractice standards. Jeanne shared this information with her coworkers. She volunteered to contact the state board of nursing on their behalf to request a declaratory statement on the nurse’s role in the initiation of premature rupturing of uterine membranes. Her state board’s clinical practice committee reviewed her request for a declaratory statement and gathered information from other states. A formal declaratory statement was drafted by the board and made it available on its Web site. A letter from the board was sent to Jeanne’s institution, informing it of the declaratory statement, which stated that the task nurses were requested to perform was beyond their scope of practice based on the Nurse Practice Act.

APA style (intext citations and references)

Plagiarism FREE

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