Tag: patient

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Improving patient care and outcomes is paramount to the practice of nursing

Improving patient care and outcomes is paramount to the practice of nursing. As we conclude our learning journey through our world of research and evidence-based practice, it is important to reflect upon your time spent in the course:

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Writers Solution

Impact on Patient Care (What happens to patient care?)

Remember word count for all posts and to have 1 outside source cited and referenced in correct APA for full credit.

When discussing stress and burnout in nursing, the nursing shortage is a concern that comes to the top of the list (for legal and ethical reasons), both for working nurses and educational faculty.

  • Find an article that explores the nursing shortage and how it relates to stress and burnout
    • First, summarize the article’s findings (remember to cite and reference this article. This can be your one outside source requirement)
    • Next, add a possible solution to the problem. Discuss what could be a solution to nursing shortage in detail.

Assignment This week’s assignment is an APA paper of 1000 words with a required 3 sources used throughout the paper – cited and referenced correctly in APA. Rubric is for an APA Essay is found in the Assignment Upload link in the lower right corner– please review. It is important to learn how to use Level 1 and Level 2 headings in a paper and organize the paper correctly for professionalism. The below instruction will help you gain this skill 🙂

This week we talk about Role Strain and Burnout in Nursing. When setting up the paper your first Level 1 heading after the introduction is set would be:

Role Strain and Burnout in Nursing

Then to answer the question prompts in the assignment with properly organizing them into an APA paper using the level 2 headings – bold and flush left – below. Each question prompt and section should be at least 5 sentences in length.

Impact on the Nurse (What happens to the nurse when role stress or strain becomes too overwhelming?)

Impact on Patient Care (What happens to patient care?)

Possible Ethical and Legal Issues (How is this related to possible ethic and legal issues?)

Management (Discuss how nurses can manage or reduce role stress and role strain.)

Issues and Solutions (Explain two issues that lead to nurse burnout and discuss a solution for each issue)

Personal Experience (Think of an experience in your nursing profession where you either felt strain or burnout and how you overcame this event. (Since this is personal experience, you can use first person narration for this portion of your essay.))

End the paper with a Conclusion (heading is centered and in bold font)

Be sure to follow all the APA rules for an APA paper which includes title page, running head, page #s, introduction, level headings to organize the different sections of the paper as given above, conclusion, citations throughout, and a reference page.

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Writers Solution

YOU BE THE JUDGE The patient, on the first day postoperative for a transurethral prostate resection, received a unit of packed cells early in the morning on the supposition that he was bleeding internally.

Case Study Chapter 9

YOU BE THE JUDGE The patient, on the first day postoperative for a transurethral prostate resection, received a unit of packed cells early in the morning on the supposition that he was bleeding internally. That afternoon at 3:22 p.m., the patient’s wife informed the nurse that her husband was breathing “heavily” and requested that the nurse assess him. The nurse, according to the testimony of the wife, informed her that the doctor was aware of the patient’s breathing pattern and that there was nothing about which she should worry. The nurse did not leave the nursing station. The patient subsequently died related to a shock from the internal bleeding complicated by a reaction to the blood transfusion. In court some years later, this same nurse testified that she had called the surgeon immediately to report that the patient’s respirations were 50, that she had taken vital signs that were within the normal limits for this patient, and that she had obtained a pulse oximeter reading that was acceptable. She also testified that she kept calling the physician’s office to report these findings.

None of this nursing care was documented in the progress notes that the patient’s nurse placed in the patient’s chart the next day. The nurse testified that she had compiled the progress notes from scratch notes she had written during the previous afternoon. The nurse further testified that it was her practice to make handwritten notes during the time that she worked and then to type her progress notes on the hospital system the next day. Additionally, this nurse never documented taking vital signs during the critical 2 hours between the spike in the patient’s respirations and the time he was pronounced. The surgeon’s office nurse testified that a call was received from the hospital at 4:00 p.m. and that the surgeon immediately left the office for the hospital. The surgeon testified that he called the hospital from his car phone and that he immediately called a code as soon as he reached the patient’s room.

1. Did the lack of documentation affect the ultimate outcome of this case? 2. Was there negligence on the part of the nursing staff in the care of this patient? 3. How does the obvious contradiction in the testimony between the patient’s hospital nurse and the office nurse’s and physician’s account of what happened affect your decision in this case? 4. What standards for documentation did the patient’s nurse breach? 5. How would you decide this case?

Using the sample professional liability insurance policy (Guido, p. 193-194), locate the various provisions:

· Limits of liability

· Declarations

· Deductibles

· Exclusions

· Reservation of rights

· Covered injuries

· Defense costs

· Coverage conditions and supplementary payments

· Did you have difficulty finding some of the sections? Would this be a policy that you would consider purchasing for your own liability coverage? Why or why not?

YOU BE THE JUDGE During an unexpected heat wave, the administrator of a nursing home decided against turning on the air conditioner, which resulted in the death of four of the residents of the home. One of the deceased resident’s daughters brought a lawsuit against the home for a wrongful death suit. She was awarded a judgment of $275,000. She then filed a second lawsuit against the nursing home’s insurance company to collect payment on the judgment. The insurance company refused to pay, stating that the judgment underlying the lawsuit was professional liability and the insurance company did not cover the nursing home for professional judgment. The nursing home then filed a lawsuit against the insurance company for payment of this judgment. QUESTIONS 1. What provisions of an insurance policy would you consult to determine whether an insurance company should pay such a claim and what would the limits of the liability be? 2. Is the nursing home insurance company correct in saying that this is a professional judgment issue? 3. Which insurance company (the nursing home’s or the administrator of the nursing home, assuming she has coverage) should pay the court-ordered judgment? 4. How would you decide the case?

Guido, Ginny Wacker, JD, MSN, RN. Legal and Ethical Issues in Nursing (Legal Issues in Nursing ( Guido)) (p. 198). Pearson Education. Kindle Edition.

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Writers Solution

practice setting and the typical patient population.

Discussion

The nursing process is utilized in a variety of nursing roles and health care settings. Whether you are working in direct patient care, telehealth, or in a leadership role – the basic model is the same! Take this opportunity to share how the nursing process is utilized in your own practice settings! Hint: Your assigned readings will be helpful in formulating your answers.

Please answer the following question in your initial post:

Describe how you apply the first step (assessment) of the nursing process in your current practice setting. If you are not currently practicing as an RN, you may use an example from a prior clinical or work experience. Include the following information:

  • Briefly describe your practice setting and the typical patient population.
  • Provide examples of key subjective and objective data points you collect.
  • Describe how you document your findings. Is there technology involved?
  • Describe your process of data analysis. What is the end result of this process? (i.e., Do you formulate nursing diagnoses and care plans, collaborate with others and/or make referrals?)
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Writers Solution

Metabolic alkalosis is a concern for this patient. Which lab findings would you expect with metabolic alkalosis?

Metabolic alkalosis is a concern for this patient. Which lab findings would you expect with metabolic alkalosis? 

Everyone is on the same page for the most part, so here is the additional information/questions that I posted to everyone’s “Part 2”. Please answer these questions and add everything as ONE DOCUMENT and post in this drop box.

Now I’m going to add a few things: you have ordered a CBC, CMP, UA, blood pH, and x-rays. You have stated that you are concerned with hydration status and pyloric stenosis. So, here are your questions for the remainder of your case study:

1. Metabolic alkalosis is a concern for this patient. Which lab findings would you expect with metabolic alkalosis?
a. Na: 128 mEq/L, K: 2.6 mEq/L, Cl: 90mEq/L, HCO3: 28 mEq/L
b. Na: 130 mEq/L, K: 5.7 mEq/L, Cl: 94mEq/L, HCO3: 22 mEq/L
c. Na: 130 mEq/L, K: 3.9 mEq/L, Cl: 98 mEq/L, HCO3: 17 mEq/L
d. Na: 148 mEq/L, K: 4.1 mEq/L, Cl: 108 mEq/L, HCO3: 13 mEq/L

2. What is the underlying cause of S.B.’s diagnosis of metabolic alkalosis?

3. Which of these clinical manifestations might you find with metabolic alkalosis? Select all that apply.
a. Increased respiratory rate
b. Tetany
c. Increased risk for seizures
d. Hyperthermia
e. Neuromuscular irritability

4. What additional assessment findings might reflect the consequences of prolonged vomiting in the infant?

5. The abdominal x-ray reveals a distended stomach with minimal distal intestinal bowel gas. You decide to order an ultrasound, which reveals a thickened pyloric muscle. What is your final diagnosis, as well as 5 other differential diagnoses?

6. You admit S.B. to the pediatric unit with a surgical consult. What are some socioeconomic/familial concerns that you may have in regard to his hospitalization, procedure, recovery, and overall health?
I have included week 1 & 2 to add to the paper please email if you have questions

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Writers Solution

Value Proposition in Patient Care

Value Proposition in Patient Care

Paradise Hospital, Inc., is a for-profit hospital. As the facility’s new hospital administrator, you have been tasked with improving the service value of the hospital. The administration has not done this process since the hospital began operating in the year 1995. The investors are not familiar with the value proposition strategies of hospitals in current-day America.

Note: You may create or make all necessary assumptions needed for the completion of this assignment.

Write a 4–6 page paper in which you:

Articulate the meaning of value-added service as it pertains to patient care services, and argue the major reasons why it matters to add value to patient services. Justify your response.

Outline a system for identifying the functional areas in which changes might be necessary in order to improve the hospital’s service value. Recommend the key methods that you would use to acquire the information necessary to identify the specified functional areas.

Specify four specific areas where you believe the administration can add value in Paradise Hospital, and argue the most significant reasons why such a value proposition would improve the value of services to the patients.

Go to Basic Search: Strayer University Online Library to find four recent (within the last five years) quality academic resources for this assignment. Note: Wikipedia and other websites do not qualify as quality academic resources.

Your assignment must follow these formatting requirements:

Be typed, double-spaced, using Times New Roman font (size 12), with 1-inch margins on all sides.

Follow APA or school-specific format for citations and references. Check with your professor for any additional instructions.

Include a cover page containing the title of the assignment, your name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required page length.

The specific course learning outcome associated with this assignment is:

Propose areas where a hospital can add value to patient services.

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Writers Solution

Chest Pain 1. How do you evaluate a patient with a history of chest discomfort and risk factors for heart disease?

Please follow the soap note template provided:
Title page – including the identified case study name and number
 
1. Learning Issues – what do you need more information in order to develop a plan? If so, what information do you need or want? (Can be bullet points)
    1. Example – Chest Pain
        1. How do you evaluate a patient with a history of chest discomfort and risk factors for heart disease?
        2. What are the laboratory findings that are important to look for with someone with chest discomfort?
* How do you manage abnormal lipids?
1. What lifestyle changes are important to recommend to reduce cardiac risk
2. Interpretation of Cues, Patterns, and Information – symptoms analysis and identification of any missing data that would helpful in making a plan for care (Can be bullet points)
    1. Example – Chest pain
        1. Chest discomfort – musculoskeletal vs gastrointestinal vs cardiac vs respiratory?
        2. What labs are missing that would assist in the planning process for this patient?
* Family history that could increase risk of cardiovascular disease
1. Psychosocial issues – caffeine intake, smoking, ETOH use, or working history
2. Differential Diagnoses – include 3 differential diagnoses including ICD-10 codes (Can be bullet points)
    1. Example – Chest pain
        7. Precordial Pain – R07.2
        8. Acute Myocardial Infarction – I21.9
* Gastroesophageal Reflux Disease without esophagitis– K21.9
4. Diagnostic Options – what additional laboratory work, diagnostic testing, or possible referrals may be required? (Can be bullet points)
5. Final Diagnosis – what is the most probable cause of the patient problem?
6. Therapeutic Options – this is related to your final diagnosis (Paragraph Form or Bullet Points)
    1. Pharmacological
    2. Nonpharmacological
    3. Educational
    4. Social Determinants of Health
7. Follow up – when should this patient return to the office? What conditions would need earlier follow up? (Paragraph Form)
8. References page (APA Format)

Case 16

1:30 PM
Jerome Wilson
Age 47 years
Opening Scenario
Jerome Wilson is a 47-year-old man on your schedule for a follow-up visit. He had an annual examination six months ago with elevated lipid levels. At that time, you recommended that he start lipid-lowering medication. Rather than using medication, Mr. Wilson preferred to try to improve his lipids by working on lifestyle changes for six months. He was started on a heart-healthy diet and an exercise and stress management plan. The results of his lipid profile drawn six months ago, as well as other tests ordered, are shown in Table 16-1 and Table 16-2.
Notes of Jerome Wilson’s Visit Six Months Ago
Reason for Visit
Jerome Wilson is a 47-year-old man scheduled for a complete physical examination. It has been three years since his last physical with you.
History of Present Illness
“I am planning to increase my exercise level by joining a local fitness club. I thought it would be a good idea to schedule a physical before doing this. I feel fine and have not had any change in my health.”
Medical History
No hospitalizations or surgery. Seen twice in the past for bursitis of the left shoulder, which required steroid injections. No hypertension, coronary artery disease (CAD), or diabetes mellitus.
Family Medical History
Mother: 71 years old (hypercholesterolemia, surgery at age 65 for vascular occlusion in the leg)
61
Father: 71 years old (Alzheimer’s disease for three years)
Sister: 47 years old (current diagnosis of breast cancer)
Grandparents: All died many years ago; he does not know causes of death
Social History
Lives with wife and three children, ages 3, 8, and 12. Works as a certified public accountant in a large accounting firm. Nonsmoker for 15 years. Four drinks of alcohol per week. Three cups of coffee per day. Golfs two to three times a week in good weather.
Medications
None
Allergies
NKDA
Review of Systems
General: States energy level is good; sleeps well; feels healthy but stressed keeping up with family and work responsibilities
Integumentary: Dry, itchy areas on scalp
HEENT: Denies problems with hearing; recently began to use reading glasses; sees dentist regularly
Respiratory: Denies any chest pain, shortness of breath, cough, or dyspnea on exertion
Gastrointestinal: No heartburn, nausea, abdominal pain; occasional constipation with occasional painful hemorrhoid; no rectal bleeding
Genitourinary: No dysuria, frequency, hesitancy, nocturia
Musculoskeletal: No current joint pain, but occasionally (every few months) notes transient joint pain in knees, wrists, and fingers; uses aspirin or acetaminophen when needed with good relief of symptoms
Neurological: No headaches; denies depression, memory changes
Physical Examination
Vital signs: Temperature 98.0° F; pulse 72 bpm; respirations 16/min; BP 136/74 mm Hg
Height: 5 ft 8 in; weight: 160 lb; BMI: 24
Ge