Consider the following factors that affect chronic illness when responding to your selected topic — pain, stigma, social isolation, altered mobility, or fatigue. 

Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress.

Consider the following factors that affect chronic illness when responding to your selected topic — pain, stigma, social isolation, altered mobility, or fatigue. 

Topic 1

  • Based on the research, which of the factors above have the greatest impact on a patient? Why? 
  • Contrast at least two ways the factors would affect a twelve-year-old with the way they would affect a seventy-five-year-old.

Peer 1

Diabetes is a chronic disease that can affect a twelve-year-old and a seventy-five-year-old in which the trajectory of the illness will differ for each age group. While the treatment of diabetes is relatively the same for all ages regarding the need for insulin, diet management, and blood sugar control a big difference here is the part in which the twelve year old may need more assistance with care while the seventy five year old has more than likely been dealing with this disease their whole life and has their management covered. I have previously worked with children and those affected with diabetes tend to struggle more with body image if they have to wear an insulin pump, feelings of not fitting in, and being at an age in which they are not able to care for themselves independently and require assistance from others. The trajectory for the seventy five year old may look different considering they may experience more of the long term side effects that come with diabetes such as neuropathy, wounds due to altered mobility, visual impairments, high blood pressure and cholesterol in which would have to be treated as well. Diabetes is a disease than can drastically affect the whole body if not managed properly, but with compliance, education, and encouragement both a twelve year old and seventy five year old can live well. 

American Diabetes Association (2010). Diagnosis and classification of diabetes mellitus. Diabetes care33 Suppl 1(Suppl 1), S62–S69. https://doi.org/10.2337/dc10-S062

Peer 2

Numerous factors will affect chronic illness, with each factor having a different impact on the patients. Based on scholarly research, the factors that will have the greatest impact on the patients thus include pain, social isolation, and altered mobility. Pain is highlighted as one of the factors that cause a lot of discomfort on patients. Uncontrolled pain causes a lot of discomfort on the patients and may even contribute greatly to adverse outcomes. In most healthcare environments, healthcare practitioners have to take up a lot of mitigation measures to try and control the pain, which gives patients experience (Maresova, Javanmardi, Barakovic, et al., 2019). Social isolation will also have a huge impact on patients and will also affect their ability to recover. Isolation may thus cause mental health issues on patients, which may interfere with their ability to recover. Healthcare facilities take up numerous measures to avoid helping the patients not to be isolated, such as allowing family members to visit the patients. Finally, altered mobility has a great impact on patients and their recovery. Patients whose mobility is affected are thus not able to perform their activities of daily living, which can result in being stressed. Such patients can also experience outcomes, such as developing pressure ulcers (Maresova, Javanmardi, Barakovic, et al., 2019).

For both twelve years old and 75-year-old patients, the issues of pain would affect them the same way with each of the patients requiring adequate measures to alleviate pain. On the other hand, altered mobility would seem to affect the 12-year-old patient more than a 75-year-old patient. This is because a 12-year-old patient is naturally more active and would feel more restricted than a 75-year-old patient who is less active.

References

Maresova, P., Javanmardi, E., Barakovic, S. et al. (2019). Consequences of chronic diseases and other limitations associated with old age – a scoping review. BMC Public Health, 19(1), 1431. https://doi-org.su.idm.oclc.org/10.1186/s12889-019-77625

 

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Why is it important that nurses implement health promotion interventions based on evidence-based practice?

Discuss how the concept of “health” has changed overtime. Discuss how the concept has evolved to include wellness, illness, and overall well-being. How has health promotion changed over time? Why is it important that nurses implement health promotion interventions based on evidence-based practice?

Due Date: Tuesday 21

 

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PICOT Question Paper and Literature Evaluation Table

While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone project change proposal, the literature review enables students to map out and move into the active planning and development stages of the project.

A literature review analyzes how current research supports the PICOT, as well as identifies what is known and what is not known in the evidence. Students will use the information from the earlier PICOT Question Paper and Literature Evaluation Table assignments to develop a 750-1,000 word review that includes the following sections:

  1. Title page
  2. Introduction section
  3. A comparison of research questions
  4. A comparison of sample populations
  5. A comparison of the limitations of the study
  6. A conclusion section, incorporating recommendations for further research

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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Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented.

Work with your preceptor to assess the organization for required resources needed for the strategic plan if the change proposal were to be implemented. Review your strategic plan and determine what resources would be needed if the change proposal were to be implemented. Write a list of at least four resources you will need in order to implement your change proposal.

The assignment will be used to develop a written implementation plan.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are not required to submit this assignment to LopesWrite.

 

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Describe three political actions nurses could take to strengthen their role in policy-making as it relates to advocacy for improving LGBTQ health.

Describe three political actions nurses could take to strengthen their role in policymaking as it relates to advocacy for improving LGBTQ health. Correlate your discussion to the AACN MSN Essentials, identify one that most pertains to this topic and elaborate on your selection.

Attached below is additional information regarding providing adequate care for the LGBTQ community as outlined by Joint Commission and the CDC: 

Joint Commission Model for Improving LGBTQ Health

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Lesbian, Gay, Bisexual and Transgender Health: https://www.cdc.gov/lgbthealth/

APA style. 250-300 words 

 

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Analyze legal and ethical implications of counseling clients with psychiatric disorders

Assignment: Practicum – Week 5 Journal Entry (Due Week 7)

Learning Objectives
Students will:
  • Develop diagnoses for clients receiving psychotherapy*
  • Evaluate the efficacy of therapeutic approaches for clients*
  • Analyze legal and ethical implications of counseling clients with psychiatric disorders*

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 7.

Select a client whom you observed or counseled that suffers from a disorder related to trauma. Then, address the following in your Practicum Journal:

  • Describe the client (without violating HIPAA regulations) and identify any pertinent history or medical information, including prescribed medications.
  • Using the DSM-5, explain and justify your diagnosis for this client.
  • Explain whether any of the therapeutic approaches in this week’s Learning Resources would be effective with this client. Include expected outcomes based on these therapeutic approaches. Support your approach with evidence-based literature.
  • Explain any legal and/or ethical implications related to counseling this client.
 

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Why are databases important in the implementation of an electronic health record?

Part One

Given the knowledge you have gained about data dictionaries and metadata, put yourself in the role of an electronic health record designer. Specify the attributes that should be included in the database to correctly identify and track patients. Attributes are the individual data types that can be represented as “columns” in the data table.

Your database attributes and the specifications of the attribute should be listed in a table format–Excel spreadsheet or a Word table. The content in your spreadsheet or table should include:

  • Data attribute or element
  • Definition
  • How many characters long should this data attribute or element be
  • What type is the data attribute (text, numeric, etc.)
  • Any other specifications you think would be important to the attribute or element

Example:

Data Attribute

Definition

Characters

Type

Other Specifications

Patient First Name

Patient First Name

30

Text

None

Part Two

The second part of this assignment is a one-to-two page written essay answering the following questions regarding databases:

  1. What is a database?
  2. What kinds of functions and uses do databases perform?
  3. Why are databases important in the implementation of an electronic health record?
  4. What is a data dictionary, and what is its purpose? How can data dictionaries help with your day-to-day work?
  5. Explain why developing a data dictionary so important?
  6. Explain data sets, and what they are used for in healthcare information.
  7. You must include a reference page with at least two references.

You should have two documents for this assignment.

Submit your completed assignments to the drop box below. Please check the Course Calendar for specific due dates.

Save your assignments as a Microsoft Word or Excel Document for Part One, and a Microsoft Word Document for Part Two. (Mac users, please remember to append the “.docx” extension to the filename.) The name of the file should be your first initial and last name, followed by an underscore and the name of the assignment, and an underscore and the date. An example is shown below:

Jstudent_exampleproblem_101504

Need Help? Click here for complete drop box instructions.

 

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Evaluate the Health History and Medical Information for Mrs. J.

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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Discussion: Patient Preferences And Decision Making

Changes in culture and technology have resulted in patient populations that are often well informed and educated, even before consulting or considering a healthcare need delivered by a health professional. Fueled by this, health professionals are increasingly involving patients in treatment decisions. However, this often comes with challenges, as illnesses and treatments can become complex.

What has your experience been with patient involvement in treatment or healthcare decisions?

In this Discussion, you will share your experiences and consider the impact of patient involvement (or lack of involvement). You will also consider the use of a patient decision aid to inform best practices for patient care and healthcare decision making.

To Prepare:

  • Review the Resources and reflect on a time when you experienced a patient being brought into (or not being brought into) a decision regarding their treatment plan.
  • Review the Ottawa Hospital Research Institute’s Decision Aids Inventory at https://decisionaid.ohri.ca/.
    • Choose “For Specific Conditions,” then Browse an alphabetical listing of decision aids by health topic.

NOTE: To ensure compliance with HIPAA rules, please DO NOT use the patient’s real name or any information that might identify the patient or organization/practice.

Post a brief description of the situation you experienced and explain how incorporating or not incorporating patient preferences and values impacted the outcome of their treatment plan. Be specific and provide examples. Then, explain how including patient preferences and values might impact the trajectory of the situation and how these were reflected in the treatment plan. Finally, explain the value of the patient decision aid you selected and how it might contribute to effective decision making, both in general and in the experience you described. Describe how you might use this decision aid inventory in your professional practice or personal life.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

  • Chapter 7, “Patient Concerns, Choices and Clinical Judgement in Evidence-Based Practice” (pp. 219–232)

Hoffman, T. C., Montori, V. M., & Del Mar, C. (2014). The connection between evidence-based medicine and shared decision making. Journal of the American Medical Association, 312(13), 1295–1296. doi:10.1001/jama.2014.10186

Note: You will access this article from the Walden Library databases.

 

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