Case StudyRosie, 76 year old female, is being admitted to your ward from emergency department with acopia and falls for investigation following a fall at home.Vital signs on admission: blood pressure 150/95, heart rate 110 beats per minute, respirations 20 breaths per minute, SpO2 90% on room airOn examination in emergency department Rosie was found to have haematomas to her left eye and bilaterally on her knees and a small superficial laceration to her left eye that was sutured in emergency department. A CT of her head and x-rays shows no apparent fractures or abnormalities.Prior to admission Rosie has been having an increasing number of falls at home over the past few months. She denies dizziness, pain or loss of consciousness contributing to the falls. She states she “just goes weak and falls down”. She reports she sometimes feels quite anxious and breathless post fall.Rosie has a medical history of hypertension and hypercholesteremia. Rosie, however, is a poor historian claiming “my memory is not quite as good as it once was”.Rosie lives with her supportive husband, Joe who assists her as needed. Joe states “we have always looked after each other” since coming to Australia from Poland forty years ago. They have never had children and have very few friends or social supports preferring to rely on each other. They try to cook healthy meals a few times a week but are increasingly relying on heating frozen meals or snack foods for convenience.Joe states he has to assist Rosie a bit more than usual as she seems to be “slowing down” and is becoming increasingly tired and fatigued. He is finding it especially difficult when she falls and is having to rely on the ambulance service to assist to get her up.
Assessment 1:Based on the handover you received at the beginning of your shift today, other information included below and current reliable evidence for practice, address the following 5 tasks.Do not make up or assume information in relation to or about Rosie. Only use what you know from the information you received today.
Task 1: Patient assessmentAssessment is one of the major roles of the registered nurse and is the first step in the nursing process to assist in planning and to facilitate mutually established goals and evaluate outcomes. In reality the nurse is continually assessing and re-assessing the patient throughout the continuity of care.In grammatically correct sentences and topic paragraphs and using current, reliable evidence for practice•Identify 3 specific nursing assessments that you would conduct as a priority for Rosie’s nursing care that you will undertake on Rosie’s admission to your ward.ANDFor each assessment you have identified explain:• •Why the assessment is relevant to Rosie’s care.• •What consequences may occur if this assessment is not completed accurately?(300 words 10 marks)
1. Task 2: Care planningYou recognise that Rosie may require assistance addressing her fundamental care needs.Based solely on the handover you have received and using the template provided, select five (5) fundamentals of care from Week 1 learning materials and develop a plan of care for each one identifying:o •The related nursing problemo •The underlying cause or reason that the nursing problem is related too •Goal of careo •Specific bedside nursing interventions you will doo •The rationales for your nursing interventions and actionso •Indicators that your plan is workingNotes for Task 2 only•Read beyond the set texts to prepare the nursing care plan. Appropriate resources students might find useful for the care plan ONLY is information on the JBI databaseo •Dot points may be used in the care plan templateo •Rationales must be appropriately referenced (900 words 40 marks)
Task 3: Medication managementThree important aspects of medication management by registered nurses is for the nurse to understand why a patient has been prescribed specific medications, understanding the nursing responsibilities and how to monitor the patient to ensure they are responding to prescribed medications as they should.In grammatically correct sentences and topic paragraphs and using current, reliable evidence for practice,•Briefly explain why Rosie has been prescribed: o Atorvastatin 20mg dailyo Ramipril 10mg daily o Aspirin 100mg dailyAND•Identify and explaino The specific nursing responsibilities associated with administering each medicationo How you will monitor Rosie for expected, side and adverse effects of each medication.(300 words, 10 marks)
Task 4: Patient teachingNurses are in a prime role to support and encourage healthy lifestyle changes and educate patients on healthy living to reduce the risk of morbidity and mortality of hypertension and hypercholesteremia.You recognise part of your nursing role is to provide Rosie with education on the modifiable risk factors for hypertension and hypercholesteremia during her hospital stay.Select one (1) of the diagnoses above and, in grammatically correct sentences and topic paragraphs, •Identify the specific information you will need to explain to Rosie about the topicAND•Explaino Why the topic is an important aspect of Rosie’s careo How you will ensure that Rosie knows and understands why it is important and, if appropriate to the topic, what she needs to do(200 words, 10 marks)
Task 5: Clinical judgement and handoverThere are two (2) parts to Task 5.Part A:When removing Rosie’s breakfast tray this morning you notice she has not eaten and ask her why. She states she slept badly overnight as she could not get comfortable lying down and she is feeling anxious about Joe being on his own. As a result she is now feeling nauseous and unwell. She denies pain apart from slight indigestion which she often gets lately but it usually goes away on its own. She is feeling irritable so you leave her to rest.On your return you find Rosie extremely agitated and trying to get out of bed stating she has to call Joe. Visually assessing Rosie as you assist her back into bed you notice Rosie’s skin appears very pale and slightly bluish grey. She appears dyspnoeic and slightly breathless with shallow, rapid respirations. Her skin feels cool and moist and her ankles appear swollen.On further assessment you find:• •Respiratory rate is 28 – 32 breaths/minute• •Oxygen saturations are 84% on room air• •Heart rate 140 beats/minute.• •Radial pulse is weak and thready and difficult to palpate.• •Blood pressure is 90/80 mmHg but faint and difficult to detect clear margins.In grammatically correct sentences and topic paragraphs,•Identifyo What you think is happeningo Your immediate nursing actions and interventions o The reason for your actions and interventionsPart B:An important legal requirement of nursing practice is to effectively and succinctly communicate relevant information, actions and outcomes related to patient care and provide an accurate reflection of the health status of the patient, their responses to care and the patient’s perspective.Once Rosie’s condition has been stabilised, the doctors arrange to transfer Rosie to the Coronary Care Unit for closer monitoring and management.Using the ISBAR format, information from the handover you initially received and the additional information above:•Write a written handover that clearly and succinctly outlines the important information the coronary care unit needs to know about Rosie

Your initial discussion thread is due on Day 3 (Thursday) and you have until Day 7 (Monday) to respond to your classmates. Your grade will reflect both the quality of your initial post and the depth of your responses. Refer to the Discussion Forum Grading Rubric under the Settings icon above for guidance on how your discussion will be evaluated.
Prior to beginning work on this discussion, read the Splett, Fowler, Weist, McDaniel, & Dvorsky (2013), Stinnett, Bui, & Capaccioli, (2013), and  Kosher, Jiang, Ben-Arieh, & Huebner, (2014) articles,  and review Chapters 10 through 13 in your textbook.
For this discussion, you will be taking on the role of the school psychologist in a public middle school. In this role, you will facilitate the evaluation of a student based on psychoeducational personality assessments, mental status exam, and observations of the student to make recommendations to the education team consisting of yourself, school counselors, and teachers who work with the student. Carefully review the PSY615: Week Three School Psychologist-Based Personality and Behavior Assessment Scenario .
In your initial post: 

Examine the personality assessment instrument used in the scenario and research a peer-reviewed article in the Ashford University Library on this personality assessment.
Using the required articles as well as your researched article to support your statements, describe the standard use of this personality assessment.
Based on the scenario, evaluate the reliability, validity, and cultural considerations inherent to the personality assessment used and comment on the relevance of these elements within the scenario.
Analyze and describe some of the potential ethical issues which might arise from the use of this personality assessment in the given scenario. 
Provide information from your research regarding the use of the personality measure, and assess the value of other possible instruments that could be added to create a more complete assessment of the student in the scenario.

Guided Response:  Review several of your colleagues’ posts and respond to at least two of your peers by 11:59 p.m. on Day 7 of the week. You are encouraged to post your required replies earlier in the week to promote more meaningful interactive discourse in this discussion. 

Was your colleague’s researched article appropriate for the personality measure being considered?
Assess the personality instrument(s) suggested by your colleague. Would these measures provide reliable, valid, and culturally conscious results for the given scenario? Use your research to support your assertions.
What other measure(s) would you suggest your colleague use in this situation?

C

Codes of Conduct
Various associations including APA and AP-LS have their own legal and ethical guidelines. In addition, states have their specific codes of conduct for counselors and other mental health professionals. In this Discussion, you will examine the guidelines in your own state and consider how they align with those put forth by associations.
To prepare:

Review your state’s(Michigan) legal and ethical guidelines for psychologists.
Compare these guidelines to the codes of ethics set forth by the APA and the AP-LS.
Consider which specific guidelines within the codes of conduct seem most important or encompassing to you.
Think about which guidelines might present the most challenge in your practice.

With these thoughts in mind:
Post by Day 4 a description of a specific guideline within a code of conduct that you regard as crucial in relating to clients, and a description of a guideline that you think might present the biggest challenge in conducting assessment, diagnosis, or treatment. Explain why you selected each of the guidelines. Select one guideline from your state and one from AP-LS, or two guidelines from the APA Code of Conduct.
Be sure to support your postings and responses with specific references to the Learning Resources.
Read a sampling of your colleagues’ postings. Consider how your colleagues’ postings match or differ from your ownThe post private first appeared on Nursing School Essays.

    I need 3 or 4 slides exploring the effects Changes to family structure; and lesbian, gay, bisexual, and transgender issues have on the field of psychology.
Include speaker notes with your presentation.
Incorporate information from at least 2 peer-reviewed publications.
Cite each outside source on a slide titled References.
Format your presentation consistent with APA guidelines