Develop an individual Case profile, and integrated review of the case from your own individual perspective, using the following response rubric (next page) as a framework for structuring, and completing,

/in /by

Internal Code : MAS994 Nursing Assignment Scenario:
You are on duty at 9pm as a Medical Radiation Technologist (MRT) in the Emergency Department and your partner who is an Emergency Department Registrar and who is coincidently also on duty that night. You are working with Dr W an Intern in the Emergency Department. You are helping her to review images to develop her recognition skills. She is called by the Triage Nurse to attend to Ms Z who has presented with a six -hour history of severe abdominal pain. ‘I hope she doesn’t require surgery,’ says Dr W. ‘Your partner will probably scream. The theatres have been going flat out all night. Maybe she’s just drug seeking.’ ‘I’m not sure we should say it like that at this stage,’ you reply tersely. Ms Z is 22-year-old fashion sale assistant. She has experienced severe abdominal pain for the last six hours. ‘I haven’t felt all that good for the last few days,’ she says. ‘I put it down to a big weekend and pressure at work.
Today I woke up with a bit of pain in my stomach. I was doing the late night shopping shift and it got worse after I came back from my break, really quite unbearable. I was sick then too. I had to leave work. It left us short at the shop but my boss ordered me a taxi to come here.’ Dr W obtains the following initial history from Ms Z to present to the Emergency Registrar. Question: Case study report, which is to be based on your individual analysis, and interpretation, of One of the PBL case study scenario’s. Drawing on the experience and content themes that you have assimilated from PBL case discussions in your PBL Group – Develop an individual Case profile, and integrated review of the case from your own individual perspective, using the following response rubric (next page) as a framework for structuring, and completing, your report: Description of what is expected for each section of your case report on a PBL case 6 total views, 6 views today

 

Critically evaluate the impact of government policies in the context of modern health and social care delivery when critiquing how the critical incident would be managed now.

/in /by

Ethica and legal issues in public health Report and Policy/Protocol Assessment Task Critically review the case you presented in your seminar, identifying either/or both the moral, ethical, and legal constructs involved (2,000 words), and then develop a policy/protocol regarding the situation which if it occurred again would enable it to be managed more effectively (1,000 words) Guidelines for this Assessment You should critically review the case you presented for your presentation. The aim of this review is to expand upon the few, concise points that were made about the ethical or legal (or both) issues of the case by exploring them in more depth and including other, relevant issues in order to develop your conclusion. Your Report provides the opportunity to develop your critical analysis and evaluation of the case that was presented. In addition, you should provide a separate policy or protocol responding to the issues discussed in the Report outlining what would constitute an appropriate response, such as the measures that might be put in place, were such a situation to arise again.
The Assessment should: ? be well structured, with an appropriate introduction and conclusion; ? be clear and well argued; ? provide critical analysis and evaluation of the issues, and not simply describe them; ? demonstrate background reading, drawing on the literature to support your critique; ? be fully referenced using the Harvard system Word Allowance for this Assessment The word allowance for this Report and Policy/Protocol is 2,000 and 1,000 words respectively.  a margin of 10% more or less than the word allowance is allowed without penalty. Therefore for this assessment, 1,800 to 2,200 words for the Report and 900 and 1,100 words for the Policy/Protocol will be acceptable.  all words used in the assignment (Introduction, Body and Conclusion) are included in the word count. It is normal for the computer to ?count? all words including tables, diagrams, references in the text and direct quotes.  the word limit does not include the reference list, bibliography or appendices.  you should state the word count at the end of the assignment after the conclusion If an assignment presented for marking falls outside these guidelines, the marking team may downgrade the assignment Guidelines for Presenting Written Assignments The following guidelines should be followed: ? all written assignments must be word processed / typed ? the recommended font style is Arial 11 or 12. ? use line spacing of 1.5 or double spacing throughout. ?
use A4 size white paper ? number each page clearly ? the unit title and Student ID must be included as either a header or footer on every page (except front page) ? create margins of at least 2.5 cms on all sides of each page. ? the title page should contain your name and ID, the name of the University, the name of your course, the unit code / title and the title of the assessment ? provide a contents page and use section headings if appropriate. ? state the number of words written at the end of the assignment after the conclusion. ? start the reference list on a new page and adhere to Harvard referencing guidelines ? number any appendices for ease of cross referencing and ensure that they are referred to in the text by the relevant number ? a high standard of presentation is expected and this include accurate referencing, attention to layout, grammar and spelling.
Learning Outcomes: On completion of this unit you should be able to: Critically analyse the relationship between ethical and legal requirements and adhering to professional codes of practice. Demonstrate a critical appreciation of the implications of such concept as autonomy and the right to self-determination, paternalism ,beneficence, and non-malificience Identify and critically evaluate the workings of the Data Protection Act and the Human Rights Acts, and to have an understanding of advanced directives and living wills. Assessment Criteria: To achieve the learning outcome you must demonstrate the ability to: Critically evaluate the dynamics between professional codes of practice, ethical and legal principles using a case-study of critical incident you have been involved with or are aware of. Identify a critical situation from your own practice (or a situation that you are aware of) then using problem based learning analyse the situation by considering the ethical and/or legal aspects involved. Critique how the incident was handled at the time and how you would manage the matter now. Critically evaluate the impact of government policies in the context of modern health and social care delivery when critiquing how the critical incident would be managed now.

 

Explain the pathology test that is required for a patient who is prescribed Warfarin. 5. Identify what nursing observations you would perform on Mrs Carr during admission, providing a rationale for your response.

/in /by

Internal Code: TV691 Nursing Assignment Case Study Mrs Carr is a 49 year old woman with early onset Alzheimer’s disease, bilateral knee osteoarthritis, Type 1 Diabetes, Asthma and a past medical history of Deep Vein Thrombosis. Mrs Carr uses a three-prongwalking stick to assist her with mobilisation. Mrs Carr has arrived by wheel chair in the ward for admission. Mrs Carr is being admitted to the ward for further investigation for an increased abdominalgirth and jaundice. Prior to admission Mrs Carr has been prescribed oral Corticosteroids (Prednisolone) for her Asthma for 6 months and is on Flixotide 250mcg Inhalation TDS as a preventative, as outlined within her Asthma Management Plan provided by her General Practitioner. Mrs Carr is also prescribed Warfarin and is required to undertake regular blood tests to monitor and regulate this medication dosage. Mrs Carr’s husband administers his wife’s SC insulin, NovoRapid and Humulin 30/70, BD. Questions:
1. Discuss the clinical manifestations (signs and symptoms) of Mrs Carr’s diagnoses.
2. Outline the appropriate nursing assessments and interventions for Mrs Carr, taking into consideration her physical, emotional and psycho social needs providing a rationale for your nursing interventions.
3. Discuss Mrs Carr’s medication management, outlining their mode of action and what reactions, adverse reactions and contraindications, you would observe or expect while providing nursing care.
4. Explain the pathology test that is required for a patient who is prescribed Warfarin.
5. Identify what nursing observations you would perform on Mrs Carr during admission, providing a rationale for your response.
6. Document your nursing observations in the progress notes attached, providing an example of each finding and identify who to report the abnormalities to.
7. Describe how the Enrolled Nurse can provide respect for the client’s individual rights and maintain their dignity throughout their admission within a health care facility. 18 total views, 2 views today

 

How do patients view health care providers who are able to let go of their own beliefs in the interest of the beliefs and practices of the patient?

/in /by

Health care providers at all levels Paper instructions: The practice of health care providers at all levels brings you into contact with people of a variety of faiths. This calls for acceptance of a diversity of faith expressions. Research three diverse faiths. Choose faiths that are less well-known than mainstream faiths or are less known to you, such as Sikh, Bahai, Buddhism, Shintoism, Native American spirituality, etc. Compare the philosophy of providing care from the perspective of each of these three faiths with that of the Christian perspective and your own personal perspective.
In 1,250 -1500 words, summarize your findings, and compare and contrast the different belief systems, reinforcing major themes with insights gained from your research. Some of the questions to consider when researching the chosen religions are:
1. What is the spiritual perspective on healing?
2. What are the critical components of healing, such as prayer, meditation, belief, etc.?
3. What is important to people of a particular faith when cared for by health care providers whose spiritual beliefs differ from their own?
4. How do patients view health care providers who are able to let go of their own beliefs in the interest of the beliefs and practices of the patient? Compare these beliefs to the Christian philosophy of faith and healing. In your conclusion, describe what you have learned from your research and how this learning can be applied to a health care provider practice. This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

 

Describe a professional and clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.

/in /by

Write a 2- to 3-page paper in which you do the following:
• Describe the PMHNP practice environment for your home state, highlighting restrictions or limitations for practice.
• Compare the PMHNP practice environment in your home state with a neighboring state or a state in which you would like to practice ).
• Describe a professional and clinical practice issue a new PMHNP will need to consider and address with the certification, licensure, credentialing, or relocation process.
• Develop a checklist for passing the national certification exam, including a detailed timeline that includes academic preparation (study plan), registration, financial preparation, etc.

 

Evaluate nursing care o Describe how you would evaluate the effectiveness of the intervention to address whether it met the planned goal of care

/in /by

Written assignment: “Nursing Process applied to a Family” 2,000 words Weighting: 40 % Aim: The aim of this written assessment item is to apply the nursing process in providing family centred care. When an infant, young child or adolescent experiences a health or social issue, the issue can impact upon all family members. Nurses working in acute care and community settings need to understand the functioning of the family unit so they can care for and assist the whole family. This written assignment addresses course learning outcomes 2 and 3: 2. Demonstrate an understanding of the functioning of the family unit using family assessment models that enable families to make health decisions; 3. Plan and evaluate evidence-based nursing for families across the lifespan. Instructions: This 2000 word written assignment has two distinct parts that you should address separately. Please use headings for each part. You do not need to provide an introduction or a conclusion for the written assignment or any of the parts. There are two family scenarios for you to choose from; select ONE scenario and use this for your entire assignment.
Part 1 – Nursing Care of the Family: Assessment (500 words) • Create a genogram to visually depict the family’s structure. You must use the PowerPoint slide which will be supplied to you within the Assessment Folder on Learning@Griffith course site to create your genogram. Save the slide as a picture file (*.jpeg), and insert the picture into your document. • Below the genogram, summarise the structure of the family to demonstrate your understanding of the family assessment findings. • Use the Australian Family Strengths Nursing Assessment Guide (AFSNAG) to identify and briefly describe two (2) strengths of the family you are assessing. 2
Part 2 – Nursing Care of the Family: Planning, Implementing and Evaluating (1,500 words) • Select two (2) issues/challenges for the family or a member of the family you have selected. These issues may be identified by the nurse, family or both. These can be health, social, or developmental family issues/challenges e.g., breastfeeding, social isolation, transition to parenting; they should not be ‘medical’ issues e.g., diabetes, high blood pressure. • For each issue/challenge identified in the family assessment (allow approximately 750 words per issue): a) Describe the issue o Use appropriate evidence from scholarly literature to describe the issue and discuss what is known about the issue/challenge. b) Plan nursing care o Provide a relevant nursing goal and justify the goal (explain why it is relevant to the issue) using appropriate evidence or policies. c) Implement nursing care o Outline one nursing intervention that supports the family to achieve the goal. Each nursing intervention should be supplemented by the recommendation of an existing online resource for the family and an appropriate referral. d) Evaluate nursing care o Describe how you would evaluate the effectiveness of the intervention to address whether it met the planned goal of care

 

How does the Gate Control Theory of Pain inform treatment Why is in the interdisciplinary model important for pain conceptualization and treatment?

/in /by

How does the Gate Control Theory of Pain inform treatment Why is in the interdisciplinary model important for pain conceptualization and treatment? What approaches to pain treatment seem the most beneficial? The most problematic? What factors are most likely to lead to pain-related disability? How do we treat pain for individuals who experience “phantom” pain? According to our case example, is CBT helpful in reducing pain and improving quality of life? What are the strengths and weaknesses of CBT? You do not have to answer all of the questions. Go into depth on a few ideas, but make sure to include all of the readings in the paper. You can use outside ideas as well to help with the paper. Sources: Chronic Pain Overview Koestler, A. J., & Myers, A. (2002). Understanding chronic pain. Jackson: University Press of Mississippi.
Read chapters 1 – 4 TED Talk on Chronic Pain (8 minutes) Krane, E. (2011 May). The mystery of chronic pain [Video file]. Retrieved from http://www.ted.com/talks/elliot_krane_the_mystery_of_chronic_pain.html How Pain Relates to Disability Åsenlöf, P., & Söderlund, A. (2010). A further investigation of the importance of pain cognition and behaviour in pain rehabilitation: Longitudinal data suggest disability and fear of movement are most important. Clinical Rehabilitation, 24(5), 422-430. doi:10.1177/0269215509353264 Clinical Experience & Application: Case Example of Treatment of Amputation Pain: Young, S. (2008, March 19). For amputees, an unlikely painkiller: Mirrors. CNN. Retrieved from http://www.cnn.com/2008/HEALTH/03/19/mirror.therapy/index.html?iref=allsearch Case Example of Treatment of Chronic Lower Back Pain: Heapy, A. A., Stroud, M. W., Higgins, D. M., & Sellinger, J. J. (2006). Tailoring Cognitive-Behavioral Therapy for Chronic Pain: A Case Example. Journal Of Clinical Psychology, 62(11), 1345-1354. doi:10.1002/jclp.20314

 

What were the top 5 ranked genes by p-value and what were the p-values and the corresponding fold changes (FC)

/in /by

(Based on Pevsner Problems/Computer Lab 10-5 page 471)
Perform differential gene expression analysis using the digital differential display (DDD) tool:
Go to UniGene at NCBIFamiliarize yourself with DDD by reading the DDD tutorial, then select the link to use DDDUse homo sapiens as species Then:Perform an analysis between two different normal tissues and identify the differentially expressed genes. Discuss your results. Are then any genes that are expressed in only one of the tissues? Are the results expected, surprising, etc.? Suggestion: you can learn more about a gene by using genecards.org, NCBI, wikigenes, etc.
Perform an analysis between two different tumors and identify the differentially expressed genes. Discuss your results, as above. Hint: search for “cancer” or “tumor” in the cDNA library page to find cancer-related data sets.Formulate a hypothesis to test, based on your knowledge of gene expression. (E.g., what genes would one expect to see differentially expressed in pancreatic tumor samples vs. normal pancreatic samples). Select the appropriate libraries and test your hypothesis. Were your expectations confirmed or not?2. GEO2R (Based on Pevsner Problems/Computer Lab 11.1 page 532)
Visit NCBI GEO and select a gene expression dataset to analyze (e.g., search for a type of cancer). Copy its GEO accession number (usually a GSE number, e.g., GSE64670). Feel free to do the exercise using GSE64670, or use another accession number of your choice.Then analyze this data set using GEO2R. Begin by reading the GEO2R tutorial at https://www.ncbi.nlm.nih.gov/geo/info/geo2r.html. First, you will need to define the (usually) 2 analysis groups. E.g., for GSE64670, 6 samples are NeuT and 6 samples are NeuN. Assign the samples to the 2 groups and run the test. Explore the “Options” tab and include various “columns”, such as Gene Ontology (GO) annotations. Discuss your results. What were the top 5 ranked genes by p-value and what were the p-values and the corresponding fold changes (FC). Were there any interesting genes, such as tumor-related genes, etc.?

 

Discuss why it is important to create a truly unbiased sample and survey questions.

/in /by

sing survey data to calculate statistics can be extremely valuable, but you must also make sure that the sample and questions are unbiased. Design a pair of questions that are related to the same healthcare issue: one that is unbiased and another that would result in a bias in one direction or the other.
Examples:
Do you think that the rate of type II diabetes diagnoses will increase over the next 10 years?
Given the large increase in childhood obesity in the United States, do you think that type II diabetes diagnoses will increase over the next 10 years?
Discuss why it is important to create a truly unbiased sample and survey questions.

 

Discuss a process improvement plan that would decrease the likelihood of a reoccurrence of the outcome of the scenario

/in /by

Introduction:
Healthcare organizations accredited by the Joint Commission are required to conduct a root cause analysis (RCA) in response to any sentinel event such as the one described below. Once the cause is identified and a plan of action established it is useful to conduct a failure mode and effects analysis (FMEA) to reduce the likelihood that a process would fail. As a member of the healthcare team in the hospital described in this scenario you have been selected as a member of the team investigating the incident.
Scenario:
It is 3:30 p.m. on a Thursday and Mr. B a 67-year-old patient arrives at the six-room emergency department (ED) of a sixty-bed rural hospital. He has been brought to the hospital by his son and neighbor. At this time Mr. B is moaning and complaining of severe pain to his (L) leg and hip area. He states he lost his balance and fell after tripping over his dog.Mr. B was admitted to the triage room where his vital signs were B/P 120/80 HR-88 (regular) T-98.6 R-32 and his weight was recorded at 175 pounds. Mr. B. states that he has no known allergies and no previous falls. He states My hip area and leg hurt really bad. I have never had anything like this before. Patient rates pain at ten out of ten on the numerical verbal pain scale. He appears to be in moderate distress. His (L) leg appears shortened with swelling (edema in the calf) ecchymosis and limited range of motion (ROM). Mr. Bs leg is stabilized and then he is further evaluated and discharged from triage to the emergency department (ED) patient room. He is admitted by Nurse J. The admitting nurse finds that Mr. B has a history of impaired glucose tolerance and prostate cancer. At Mr. Bs last visit with his primary care physician laboratory data revealed elevated cholesterol and lipids. Mr. Bs current medications are atorvastatin and oxycodone for chronic back pain. After the nurse completes Mr. Bs assessment Nurse J informs the ED physician of admission findings and the ED physician proceeds to examine Mr. B.
Staffing on this day consists of two nurses (one RN and one LPN) one secretary and one emergency department physician. Respiratory therapy is in-house and available as needed. At the time of Mr. Bs arrival the ED staff is caring for two other patients. One patient is a 43-year-old female complaining of a throbbing headache. The patient rates current pain at four out of ten on numerical verbal pain scale. The patient states that she has a history of migraines. She received treatment remains stable and discharge is pending. The second patient is an eight-year-old boy being evaluated for possible appendicitis. Laboratory results are pending for this patient. Both of these patients were examined evaluated and cared for by the ED physician and are awaiting further treatment or orders.After evaluation of Mr. B Dr. T the ED physician writes the order for Nurse J to administer diazepam 5 mg IVP to Mr. B. The medication diazepam is administered IVP at 4:05 p.m. After five minutes the diazepam appears to have had no effect on Mr. B and Dr. T instructs Nurse J to administer hydromorphone 2 mg IVP. The medication (hydromorphone) is administered IVP at 4:15 p.m. After five minutes Dr. T is still not satisfied with the level of sedation Mr. B has achieved and instructs Nurse J to administer another 2 mg of hydromorphone IVP and an additional 5 mg of diazepam IVP. The physicians goal is for the patient to achieve skeletal muscle relaxation from the diazepam which will aid in the manual manipulation relocation and alignment of Mr. Bs hip. The hydromorphone IVP was administered to achieve pain control and sedation. After reviewing the patients medical history Dr. T notes that the patients weight and current regular use of oxycodone appear to be making it more difficult to sedate Mr. B.
Finally at 4:25 the patient appears to be sedated and the successful reduction of his (L) hip takes place. The patient appears to have tolerated the procedure and remains sedated. He is not currently on any supplemental oxygen. The procedure concludes at 4:30 p.m. and Mr. B is resting without indications of discomfort and distress. At this time the ED receives an emergency dispatch call alerting the emergency department that the emergency rescue unit paramedics are en route with a 75-year-old patient in acute respiratory distress. Nurse J places Mr. B on an automatic blood pressure machine programmed to monitor his B/P every five minutes and a pulse oximeter. At this time Nurse J leaves his room. The nurse allows Mr. Bs son to sit with him as he is being monitored via the blood pressure monitor. At 4:35 Mr. Bs B/P is 110/62 and his O2 sat is 92%. He remains without supplemental oxygen and his ECG and respirations are not monitored.Nurse J and the LPN on duty have received the emergency transport patient. They are also in the process of discharging the other two patients. Meanwhile the ED lobby has become congested with new incoming patients. At this time Mr. Bs O2 saturation alarm is heard and shows low O2 saturation (currently showing a sat of 85%). The LPN enters Mr. Bs room briefly and resets the alarm and repeats the B/P reading.
Nurse J is now fully engaged with the emergency care of the respiratory distress patient which includes assessments evaluation and the ordering respiratory treatments CXR labs etc.At 4:43 Mr. Bs son comes out of the room and informs the nurse that the monitor is alarming. When Nurse J enters the room the blood pressure machine shows Mr. Bs B/P reading is 58/30 and the O2 sat is 79%. The patient is not breathing and no palpable pulse can be detected.
A STAT CODE is called and the son is escorted to the waiting room. The code team arrives and begins resuscitative efforts. When connected to the cardiac monitor Mr. B is found to be in ventricular fibrillation. CPR begins immediately by the RN and Mr. B is intubated. He is defibrillated and reversal agents IV fluids and vasopressors are administered. After 30 minutes of interventions the ECG returns to a normal sinus rhythm with a pulse and a B/P of 110/70. The patient is not breathing on his own and is fully dependent on the ventilator. The patients pupils are fixed and dilated. He has no spontaneous movements and does not respond to noxious stimuli. Air transport is called and upon the familys wishes the patient is transferred to a tertiary facility for advanced care.Seven days later the receiving hospital informed the rural hospital that EEGs had determined brain death in Mr. B. The family had requested life-support be removed and Mr. B subsequently died.
Additional information: The hospital where Mr. B. was originally seen and treated had a moderate sedation/analgesia (conscious sedation) policy that requires that the patient remains on continuous B/P ECG and pulse oximeter throughout the procedure and until the patient meets specific discharge criteria (i.e. fully awake VSS no N/V and able to void). All practitioners who perform moderate sedation must first successfully complete the hospitals moderate sedation training module. The training module includes drug selection as well as acceptable dose ranges. Additional (backup) staff was available on the day of the incident. Nurse J had completed the moderate sedation module. Nurse J had current ACLS certification and was an experienced critical care nurse. Nurse Js prior annual clinical evaluations by the manager demonstrated that the nurse was meeting requirements. Nurse J did not have a history of negligent patient care. Sufficient equipment was available and in working order in the ED on this day.
Task:
A. Complete a root cause analysis (RCA) that takes into consideration causative factors errors and/or hazards that led to the sentinel event (this patients outcome).B. Discuss a process improvement plan that would decrease the likelihood of a reoccurrence of the outcome of the scenario.1. Discuss a change theory that could be used to implement the process improvement plan developed in B.C. Use a failure mode and effects analysis (FMEA) to project the likelihood that the process improvement plan you suggest would not fail.1. Identify the members of the interdisciplinary team who will be included in the FMEA.2. Discuss steps for preparing for the FMEA.3. Apply the three steps of the FMEA (severity occurrence and detection) to the process improvement plan created in part B.4. Explain how you would test the interventions from the process improvement plan from part B to improve care in a similar situation.Note:You are not expected to carry out the full FMEA but you should explain each step and how you would apply it to your process improvement plan.D. Discuss how the professional nurse may function as a leader in promoting quality care and influencing quality improvement activities.E. When you use sources to support ideas and elements in a paper or project provide acknowledgement of source information for any content that is quoted paraphrased or summarized. Acknowledgement of source information includes in-text citation noting specifically where in the submission the source is used and a corresponding reference which includes:AuthorDateTitleLocation of information (e.g. publisher journal or website URL)