Internal Code: MAS3280 Nursing Assignment :
Scenario:
Patient states he is usually well at home. He swims a couple of laps in the pool every morning. He has a history of hypertension and is on medication control. His normal blood pressure (BP) is 120/70mmHg (on medical treatment). Yesterday, he forgot whether he had taken his antihypertensive drug and he didn’t want to miss a dose. So, he took the tablet around 2200 hours, just before he went to bed. At 0400 hours, he felt the urge to use the bathroom. He said he felt generally unwell and giddy as soon as he got out of bed. He reported he saw everything were splinting around in the room, then he lost his balance and fell on the floor in the bedroom. His wife called 000 and took him to the emergency department.
Question:
1. Provide a brief summary of your assigned patient scenario.
2. List the objective and subjective data that you have collected from reviewing the patient scenario information provided.
3. Analyse and interpret your patient’s vital signs data and explain the significance of the information in this patient’s context.
4. Critically reflect on your clinical skills to gather vital signs data 24 total views, 2 views today

Research of Best Practice and Application to Nursing Care
•Research best practice nursing related to a trend/issue in medical-surgical nursing.
•Apply research of best practice to a nursing care plan to promote health for a medical-surgical client.
•Demonstrate critical thinking applicable to care of medical/surgical client. Through this assignment, you will write a scholarly paper on a procedure or trend/issue that impacts the health of a medical-surgical client. You will apply your research by describing how the evidence best supports the change of nursing procedure or changing trend/issue and the impact of the change on the health outcomes of the medical-surgical. This evidence will be applied in a nursing care plan for a medical-surgical client. Include health teaching that is promotes the health of the medical-surgical client.
1.This assignment must be typewritten (word-processed) and follow APA 6th edition format.
2.Part A: Research. The research portion of this assignment should identify the impact of the procedure or trend/issue on the medical-surgical client and how the evidence supports best practice of nursing care. Reference at least three (3) sources published within the last threeyears – current journal articles, reputable medical websites or textbooks. This section of theassignment should not be more than three (3) pages long.
3.Part B: Care Plan. Develop a care plan that incorporates your research and best practice nursing. The care plan may be completed using the forms provided or in a scholarly paper format (maximum 3 pages). If you choose to submit your plan in a scholarly paper, use APA 6th edition format.
4.Submit the marking guide with your assignment. Instructions PART A: RESEARCH Select one of the topics below, or select a topic that interests you. Ensure your topic addresses a procedure or a trend/ issue that impacts the medical-surgical client. If you choose a topic that is not listed below, you are strongly encouraged to discuss the topic with your instructor/tutor prior to starting this assignment. Research the topic of your choice. Compare previous and current practice and include evidence based practice (“best practice”) that promotes the health of the medical-surgical client in hospital or following discharge home. Finally, consider teaching information that is important for the medical-surgical client to learn.
Potential Topics •Care and use of different types of chest tubes (e.g., wet/dry/Heimlich valves) •Different types of wound dressings (Adaptic, VAC wound care, All Dress, etc.) and their impact on wound healing •Increasing incidents of super-infections ( ESBL, VRE, MRSA, etc.) in the acute-care setting and how these can be avoided •Types and trends of post-op infections in the acute-care setting in Alberta •Clean vs. sterile techniques for tracheostomy care, bladder irrigation, or intermittent catheterization •Preventing complications such as DVTs, respiratory complications, and skin breakdown in the immobilized client (skeletal traction, external fixators, strict bed rest, etc.)
•Issues of early discharge of the post-op client from the acute-care setting PART B: CARE PLAN Apply the evidenced-based practice research to a care plan for a medical-surgical client. •Write three (3) nursing diagnoses •One addressing a priority •One addressing a potential complication •One addressing an educational need •Write one goal for each nursing diagnosis, and one expected outcome for each goal using the SMART criteria •Write three (3) nursing interventions for each goal. Support each intervention with evidence from the literature. •Include interventions applicable to the care of the client, and health promotion teaching that is applicable to the acute-care setting as well as the home setting after discharge. •Write one evaluative statement for each goal to indicate how each goal could be met.

Nursing 1)Identify local health services in the following areas: health promotion, illness prevention, diagnosis and treatment, rehabilitation, and long-term care. Judging from the number of agencies for each service, where does the health care emphasis seem to be? What implications does this have for citizens of your community?(we live in charleston, South Carolina) 2) What process should be used to determine how health care resources are allocated? List criteria you would suggest to determine whether a person should receive a kidney transplant, a hip replacement, or a bone marrow transplant. Should ability to pay play a role in the decision? Why or why not? student responses
1) Lauren Conley RE: DQ2_CH 14RE: DQ2_CH 14 Over the last several years, the United States healthcare system, has been working on allowing all citizens of the U.S. to be available to healthcare. (Black 303). Although the U.S. favors a free-market economy, the federal government has taken steps to ensure certain groups have access to health care through publicly funded programs including: Medicare and Medicaid (Black 304). Multiple steps should be considered when allocating health care services. Decisions should include normal societal values, and there should be no biased or discriminative opionions among people. The public, insurers, and physicians should be allowed input of health care resources. An effective plan to conserve and distribute health care will help to elimate inequalities and enable proper health care to all Americans. Whether an individual is covered by insurance, Medicare, Medicaid, or other sources of payment, individuals should recieve the same care. In regards to if a patient needs a kidney tansplant and they can not afford it, they still get on the list. If a kidney becomes available, they will recieve that kidney. As a nurse, it does not matter if a patient can afford their medical bills. It doesnt effect the care in which the patient will recieve. The patient should be treated the same reguardless of their income, and should be provided with the same medical treatment as patient who was able to afford their medical bills. Black, B.P. Professional Nursing: Concepts and Challanges (7th ed.). St. Louis, Missouri: Elsevier Saunders.
2)Summer Elliott RE: DQ2_CH 14RE: DQ2_CH 14 How should health care resources be allocated is a difficult question to answer. I think that more of the resources should focus on health promotion and maintenance, and prevention. These offer ways to keep the patient healthy and prevent problems, identify risk factors, or detect illnesses in the early stages when there is a better chance for treatment or survival (Black, 2014, p. 286). Maybe we wouldn’t have to deal with so many kidney transplants, hip replacements and bone marrow transplants if we put our resources in those categories of health care service. A more difficult question is what criteria should be used to determine whether a patient receives certain care or not. Where do you draw the line? If the issue is not enough resources, then I guess patient compliance has to be factored in. You can’t waste an organ on someone who is not compliant. If we spend hundreds of thousands of dollars to transplant a kidney for a patient and deny someone else the benefit of it, then the patient should be counted on take all his medicine, go to appointments, and follow his plan of care so he doesn’t need another one in a few years. I believe that currently there is a procedure that ranks those who need organs by criteria such as how sick they are, whether they use drugs, their age, etc. I think if someone could benefit from a bone marrow transplant or hip replacement the same sort of criteria could apply. Of course, it’s easy to say that until it’s you or your family member that is the one being denied that life saving procedure because you don’t fit the criteria. I don’t think that the ability to pay should be a factor. I don’t believe that the wealthy should have more right to health care than the poor. You are not a better person or more worthy just because you are rich. Black (2014), points out that “an illness or injury severe enough to require hospitalization can quickly exhaust a family’s financial reserves, forcing them into bankruptcy” (p. 307). According to Black (2014), “the United States and South Africa are the only two industrialized nations that do not provide universal access to health care to all their citizens” (p. 308). Health care expenditures are higher in the United states than any other country (Black, 2014, p.308). Since everyone is so concerned about bringing down health care costs, maybe going to universal coverage will help rein in the soaring costs. If people had the right to basic care, maybe they would quit using the emergency rooms as doctor’s offices, catch problems before they become severe and more expensive to treat, and participate in health promotion and maintenance, all which would bring down health care costs. People who wanted more than basic coverage could still obtain coverage through private insurers. I know universal coverage won’t fix all the problems, but the system seems broken the way it is. References Black,B. P. (2014). Professional nursing: concepts and challenges (7th ed.). St. Louis, Missouri: Elsivier Saunders.
3) April Gilliard RE: DQ1_CH14RE: DQ1_CH14 In my search to find local services for health promotion and illness prevention I found it to be very unsuccessful. The only thing that I do know and that is from working in the hospital is that there are different classes as well as different health fairs that do take place in the community that you can sign up for or attend. These events and classes are what we use to help promote health and bring awareness to illness prevention. Also my church has health fairs along with health screenings that aid in making the community aware of any health issues or how to prevent those issues by having those free screenings. I do believe that would be the only way you could get health promotion or illness prevention services. They do not have a free standing building or agency you can go to and get information. Another way to get awareness would be to sign up for any of the websites that they offer online. The online services will provide you with free information on the health topic of your concern and they usually will send you a monthly letter that has lots of tips and tricks and what to look for as far as signs and symptoms are concerned. While doing my search for rehabs and long-term care services that search turned out more successful. There were over 31 long-term care facilities that I found in Charleston alon and with the rehab services it was about the same, over 15. Judging by the overwhelming number of local facilities that are made available it seems as though we put our money and emphasis on after the fact. After the fact of you contracting an illness that could have been prevented or a disease that can be reversed you have all of these services available to you, and that is sad but it speaks for how that United States views health care. Health care is seen as a money maker and not a service used for its citizens to assist them when health care is needed. Black (2014)teaches us that the United States is one of the two industrialized nations that do not provide universal access to health care to all of their citizens. The majority of the health care dollar is spent on hospital care (Black,2014). We spend little to no money providing services for heath promotion and illness prevention and our numbers when it comes to death rates and infant death rates speaks for itself. In order to stay on top of your health you have to be pro active. You have to do your own research and find out what you can do stay out of those numbers if it can be prevented in any way. If you don’t do it, no one else will. References Black, B.P (2014).Professional nursing:concepts and challenges (7th ed).St. Louis, Missouri:Elsevier
4) Summer Elliott RE: DQ1_CH14RE: DQ1_CH14 Looking at local services on the internet revealed that most of the services available were in the diagnosis and treatment category of health care services. There are 7 local hospitals numerous emergent care centers, many free standing outpatient surgery centers, several medical imaging centers and countless doctors. Diagnosis and treatment of diseases has been the focus in the United States and advances in diagnosis and treatment has led to shorter hospital stays and quicker recovery times (Black, 2014). Rehabilitation was next with 3 centers for rehab and over 40 long term nursing care facilities found. These provide assisted living homes, residential facilities for the elderly or impaired, as well as rehabilitation centers or hospitals where the goal is to “restore the patient to fullest possible level of function and independence after injury or illness” (Black, 2014, p. 287). Illness prevention and health promotion and maintenance were hard to find. MUSC has a Wellness Center that it states is for the promotion of good health. According to Black (2014), “health promotion and maintenance services are based on the assumption that patients who adopt a healthy lifestyle are likely to avoid lifestyle-related diseases, such as heart attacks, lung cancers and certain infections “(p. 286). Illness prevention services in the area include AA meetings, and county health clinics which can give out information to people who have known risk factors to assist “in reducing the impact of those risk factors on their health and well being” (Black, 2014, p.286). The citizens in our area have great resources if they need diagnosis and treatment or rehabilitation and long-term care. However, when it comes to health promotion it is hard to find any resources. I think there needs to be more emphasis on this area of health care so that they can prevent diseases and health care issues that arise from poor lifestyle choices. Resources Black, B.P. (2014). Professional nursing: concepts and challenges(7th ed.). St. Louis, Missouri: Elsevier Saunders

Internal Code: MAS161 Literature Review Assignment: Question: Topics are:
1.Handover a.What is nurses’ preferred handover method?
2. Vitals signs a. Why are vital signs not routinely measured in the acute setting? b. Why is respiratory rate the neglected vital sign? c. Do nurses in acute settings value METs? d.Why don’t nurses routinely call METs when needed?
3. Hand washing/infection control a. Why don’t nurses/clinicians routinely wash their hands?
4. Pulse oximetry a. Do nurses know how to use pulse oximetry?
5. What are nurses’ experiences of unexpected patient deaths?
6. Pain a. What is acute pain poorly managed in the hospital setting? b. Is aromatherapy/acupuncture effective in controlling chronic pain?
7. Research utilisation a. Why don’t nurses routinely utilize research in their clinical practice?
8. Do nurse/patient ratios affect outcomes in the acute setting?
9. Are hip protectors effective in reducing the severity of falls in elderly patients?
10. Medications a. What are the drug calculations skills of RNs? b. What factors contribute to medication errors in specific clinical settings? Just letting you know that my assignment is based on research and those topics I have sent you above were just examples we need to search an another unique clinical issue like that and write a literature review on it. 13 total views, 2 views today