Tag Archive for: nursing

Preoperative Diagnosis

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Part A: Answer each of the following questions in one or two paragraphs.

1. Code the following operative report.

Preoperative Diagnosis: Left flank soft tissue mass

Postoperative Diagnosis: Left flank soft tissues mass

Surgeon: John Doe, DO

Operations: Excision of left flank soft tissue mass with layered closure measuring 4 cm , with margins, prior to excision

Anesthesia: sedation with 1% lidocaine with epinephrine and sodium bicarbonate

Operative Indications: this is a pleasant female who come in with soft tissue lesion in the left

flank over what appeared to be a Spigelian Hernia site as well. However, it was not reducible and did not appear to be consistent with a hernia. Consequently, the procedure, risk, benefits, and alternative of excision of this lesion were discussed with the patient, and she understood and wished to proceed with the excision.

Operative Findings: Large soft tissue lesion measuring about 6 cm in greatest dimension

Operative procedure: The patient was brought into the operation room after informed consent was obtained. The patient then underwent sedation with a sterile prep and drape. We then anesthetized with 1% lidocaine with epinephrine and sodium bicarbonate, made a 4-cm incision, and used sharp dissection to dissect circumferentially around this soft tissue lesion, being careful to make sure that we were not entering any kind of hernia sac secondary to Spigelian hernia. As we continued to dissect circumferentially around it without sharp dissection, it was noted that it did go down to a muscle, but no evidence of hernia was identified. The lesion was excised in its entirety and electrocautery was used to control hemostasis. We then irrigated with saline solution and closed the subcutaneous tissue with 3-0 Vicryl interrupted and sutures. We then used 4-0 Vicryl sutures to close the skin in a subcuticular fashion. Benzoin and Steri-Strips were then applied. Blood loss was minimal. The patient tolerated the procedure well and remained in stable condition throughout the procedure.

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communications with children

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CRITICAL QUESTIONS AND REFLECTIONS 

1- Consider your own everyday communications with children – how you approach them and the language you use. How do you include children as active participants in discussions about care choices and planning?

2- After reading this chapter you are ready to undertake a family strengths assessment to apply the principles described to practice. Utilising the AFS Nursing Assessment Guide, engage in a conversation with a family as a group about their strengths and how their family functions across the eight qualities. Explore what goals the family are currently striving towards. Remember, not every strength needs to be explored with every family. What benefits do you think a family strengths assessment can have for clinical practice and promoting family health? What were the challenges to conducting your family strengths assessment?

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Strengths-Based Leadership   

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Strengths-Based Leadership

The task of leadership is not to put greatness into people, but to elicit it, for the greatness is there already.  —John Buchan  It can be demoralizing when managers focus primarily on the deficiencies of employees, yet it can sometimes be difficult to see beyond the negatives. Strengths-based leadership is a management approach that not only recognizes an individual’s strengths, but also draws upon these strengths to enhance the dynamics of the workplace. Strengths-based leadership can be applied to employees performing at their personal best or to those who may need redirection. In addition, the principles of strengths-based leadership can be carried over to managers themselves. When nurse managers are aware of their own strengths, they can better leverage them to effectively manage difficult situations.

•Review the article “Know Your Own Strength.” How can strengths-based leadership improve the skills and attitudes of employees? •Reflect on your own personal and professional leadership strengths. Consider how you might use these strengths to manage staff members who seem to be disengaged or problematic. In addition, determine how you might use these strengths to resolve difficult situations between employees. •Recall a time when you either observed a disengaged or problematic employee(s) at work or observed a difficult or conflict situation between employees. •Imagine that you were the nurse manager in the above situation. How might you have used your strengths to effectively manage this employee or situation? Also, give some thought to the strengths of those posing the problem. How might you have used their strengths to resolve the situation?

Post an explanation of what you consider to be your top two strengths as a leader. Then, briefly describe the situation you selected and explain how you could leverage your own strengths (applying strengths-based leadership) to successfully manage that situation. Explain at least two ways you might also capitalize on the strengths of the employee(s) involved to successfully resolve the situation.

Required Readings  Lussier, R. N., & Hendon, J. R. (2016). Human resource management: Functions, applications, & skill development (2nd ed.). Thousand Oaks, CA: Sage Publications.  •Chapter 7, “Training, Learning, Talent Management, and Development” (pp. 234–274) Chapter 7 explores many types of training that organizations can offer new employees, such as on-the-job training, classroom training, and e-learning. It also highlights career development opportunities for existing employees.    Manion, J. (2011). From management to leadership: Strategies for transforming health care (3rd ed.). San Francisco, CA: Jossey-Bass.  •Chapter 7, “Coaching and Developing Others” (pp. 283–349) This chapter compares the roles of leader and coach and explains why some leaders fail to employ effective coaching strategies. The author discusses coaching best practices and reviews in depth one practice, the six-step coaching model.    Kanefield, A. (2011). Know your own strength. Smart Business St. Louis, 4(2), 6. Retrieved from the Walden Library databases.     This article provides simple rationale for employing strengths-based leadership in clinical settings.   Tyra, S. (2008). Coaching nurses: A real example of a real difference. Creative Nursing, 14(3), 111–115. Retrieved from the Walden Library databases.      The author of this article uses an authentic coaching example to explain the stages of the coaching process. The author identifies coaching strategies as well as general feelings both the coach and the nurse might experience.

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local Children’s Miracle Network.

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Provide a response at least 50 words to the answer in apa format with in-text citations:

A servant leader that I have had that was internally consistent with their words and actions is my current leader. She is consistent with her words and her service to her direct reports. She makes all of us feel valued and respected. She gives us autonomy to be our own leaders and make decisions without feeling that we need to run everything by her. Her motto is to serve the patients first. If we act on patient service first the rest will work itself out. She is continually asking for our ideas and feedback. We are very active in the decision making in our areas. As a servant leader she continuously mentors’ others and encourages furthering education. Although she is supportive and serves next to us, we are also held accountable for our actions and decisions. The biggest characteristic of this leader is that she serves the community first. She encourages service programs that require volunteering and that result in services to the community. Her biggest event that she does every year is coming up next weekend. This is a 5K walk/run for women and children. All proceeds go to our local Children’s Miracle Network. This is a great community event and we all work the event to make this happen. As you can see this leader is not focused on power or authority as a secular leader. She is not focused on herself nor in power of her role. (DelHousaye & Brewer, 2004).

DelHousaye, D., & Brewer, B. (2004). Servant Leadership—Seven Distinctive Characteristics. Scottsdale: SBC Press.

Original Question:

Servant leaders must be internally consistent with their words and actions. Describe a mentor that you have had that displayed this kind of credibility. Share an example of what you witnessed from this person. Based on the text, contrast your response to the secular view of power.

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Collaborative Learning Community

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Details:

This is a Collaborative Learning Community (CLC) assignment.

Select a Nursing Conceptual Model from Topic 2, and prepare a 12-slide PowerPoint presentation about the model. Include:

  1. A brief overview of the nursing conceptual model selected.
  2. Explanation of how the nursing conceptual model incorporates the four metaparadigm concepts.
  3. Explain at least three specific ways in which the nursing conceptual model could be used to improve nursing practice. Elaborate, explain, or defend each point mentioned.
  4. Provide current reliable sources to establish credibility for the presentation.

Requirements for PowerPoint are as follows:

  1. 10 slides for content.
  2. 1 slide for references.
  3. 1 slide for the title, which includes: (a) title of the presentation, (b) names of the CLC group members, and (c) date
  4. Accompanying speaker notes elaborating on the information contained in each slide.
  5. One member of the CLC group will submit the presentation, speaker notes, and the completed “CLC Group Project Agreement” to the instructor.

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

This assignment uses a rubric. Students should review the rubric prior to beginning the assignment to become familiar with the criteria and expectations for successful completion.

NRS430V.v10R.CLCGroupProjectAgreement_Student.docx

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Home Visit With Sallie Mae Fishe

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As a group, observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).

Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.

Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:

Essay Portion

After viewing the home visit, write an essay of 500-750-words in which you do the following:

  1. Identify, prioritize, and describe at least four problems.
  2. Provide substantiating evidence (assessment data) for each problem identified.
  3. Identify and describe at least four medical and/or nursing interventions.
  4. Discuss your rationale for the interventions identified.

Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

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characteristics of the patient

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Formulating the Research Question, Problem Statement, Research Purpose

In the Week 1 discussion forum you had an opportunity to present a potential problem and an innovative solution specific to your role specialization. In addition, you have reviewed the literature to identify qualitative and quantitative research articles and submitted annotated bibliographies to provide evidence supporting the problem.

Considering the feedback provided to you by the faculty member it is now time to prepare your problem statement, research purpose, and research question.

First share your refined problem and proposed solution (given your review of literature this may have changed depending on the evidence you were able to provide). Next, follow the steps to help define your research question.

  1. Craft the problem statement and research purpose.
  2. Design your research question aimed at solving (a part of) the problem and include the following components which will focus the literature review.

PICOT Question:

Patient, Population or Problem

  1. What are the characteristics of the patient or population?
  2. What is the condition or disease you are interested in?

Intervention or exposure

  1. What do you want to do with this patient (e.g. treat, diagnose, observe)?

Comparison

  1. What is the alternative to the intervention (e.g. placebo, different drug, surgery)?

Outcome

  1. What are the relevant outcomes (e.g. morbidity, death, complications)?
  2. Ensure that the research question is answerable, feasible and clinically relevant

The next step in Submissions Area will be to develop a research hypothesis from the research question.

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, nonmaleficence,

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This week, students will be completing a paper to address the following two case studies.

Greg Case Study:

Peggy and Gary had been married for five years, and had been trying to have a child. They had undergone artificial insemination and in vitro fertilization, but each pregnancy had resulted in a miscarriage. Peggy and Gary decide that surrogacy was their best option and placed an advertisement in the local college newspaper.

Josephine, a 21-year-old college student, answered the advertisement. At the time, she was dating a man named Jerry who she loved very much and hoped to marry. But Jerry had recently broken up with Josephine. Hoping to trick Jerry into marrying her, Josephine agreed to be the surrogate for Peggy and Gary. Using Peggy and Gary’s zygote, Josephine underwent in vitro fertilization and became pregnant. During the pregnancy Josephine underwent routine medical examinations, as required by the surrogacy contract. During one of the examinations, a genetic screening test was performed and it was discovered that the child had Down Syndrome. Peggy and Gary did not desire to have a child with Down Syndrome and in accordance with the surrogacy contract paid Josephine to undergo an abortion. In addition, Josephine contacted Jerry, telling him that she was carrying his child. Not wanting to be a husband or father at a young age, Jerry paid Josephine for an abortion as well. He then transferred to another school in a different state.

As a college student who could use the cash, Josephine gladly took the money for the abortion. But because of religious reasons she did not have an abortion and carried the child to term. She never told Peggy, Gary, or Jerry that she delivered a child. Unfortunately, being a single mother and college student was too much for Josephine. At three months, she took the child, whom she called Greg, to the local hospital and surrendered him under the state’s Safe Haven law.

Address the following questions:

  1. Shortly after the child was surrendered, Jerry found out that Josephine had delivered a child, which he thought was his. Jerry’s parents completed the paperwork necessary to adopt Greg, because they could not fathom the idea of someone else raising their grandchild. Should Jerry’s parents be allowed to adopt Greg? Explain and support your answer.
  2. Shortly after the child’s second birthday, Greg needed to have minor surgery to correct an intestinal problem. Part of the pre-surgery laboratory work involved determining the child’s blood type. The blood typing indicated that it was biologically impossible for Jerry to have fathered Greg. Jerry and Jerry’s parents are now suing Josephine. Should Josephine have to pay the amount of money it cost to raise and support Greg? Explain and support your answer.
  3. As part of her testimony in the lawsuit, Josephine discloses the truth about Greg and the surrogacy pregnancy. Although enraged, Jerry’s parents felt it necessary to contact Peggy and Gary. When Peggy and Gary learn that their biological child had actually been born, they petitioned the court to have their child returned to them and to award them custody. How should the court decide? Should the child remain with Jerry’s parents or be given to Peggy and Gary? Explain and support your answer.

Baby Fae Case Study

On October 14, 1984, Baby Fae was born two weeks premature, with hypoplastic left heart syndrome (a condition that at the time was 100 percent fatal). Baby Fae’s mother, Teresa Beauclair, was presented with two options; keep the child in the hospital or take the child home. Teresa opted to take the child home, and was preparing to go through the dying process until Dr. Leonard Bailey presented her with a third option. The highly experimental surgery involved replacing Baby Fae’s heart with that of a baboon. Dr. Bailey had been investigating the possibility of cross-species transplantation and discussed his research with Teresa, gaining her consent to the operation. As you can image, the medical procedure was publicized across the United States and animal rights activists were outraged and protested.

While initially, the operation appeared to be successful, Baby Fae’s organs started to fail, leading to her death 21 days after the transplant surgery was performed. In announcing her death at a press conference, Dr. Bailey stated, “Infants with heart disease yet to be born will someday soon have the opportunity to live, thanks to the courage of this infant and her parents.” One year later, the first human to human heart transplant was performed in a child. Dr. Bailey credits the success, in part, to the information and experience that was gained by performing the xenotransplant (Cross-species) procedure.

Address the following questions:

  1. What is your initial reaction to this case? What ethical concerns does this case bring up in relation to: autonomy, nonmaleficence, beneficence, fidelity, and justice? Explain and give specific examples.
  2. The study of animal research has led to many advances in diabetes, cancer, neurological conditions, and cardiac. Currently, pig and bovine valves are still used in heart surgeries. Do you feel research on animals is necessary in the medical field? Explain your answer.
  3. If you were caring for baby Fae, how could the following information effect your interaction with the parents, and possible care of the child? Do you feel information about the family: their past, current status, and criminal record, should be publicized or shared? Explain your answers.

After the transplant, NBC news released this information:

“NBC News has learned the identity of the child’s parents. We will respect their wishes and not name them. However, certain aspects of their past might be relevant to some of the medical controversies in this case. According to relative and court records, the couple was never married. They had separated by the time the infant was born. Both have had trouble with the law in the state they came from, the father for disorderly conduct, and the mother for passing bad checks. They had little money when the baby was born.”

  • For each of these cases an APA formatted paper must be used, and should include a title page, level headings, references and citations.
  • This assignment should include at least 3 references and
  • Should be at least three pages in length for each case (six pages, not including title page and references).
  • Students should address the proposed questions providing ample detail, examples, and additional support.

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CORE Competency

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CORE Competency

Objective

Use effective verbal and nonverbal communication when delivering a speech

Assignment Overview

In this practice exercise, you will explore four styles that effective speakers use when delivering speeches.

Deliverables

A one-page (250-word) paper

Step 1 Research a speech.

Using your course materials and the internet, research a speech that you feel is particularly effective, then analyze each speaker’s style and language strategies.

Step 2 Answer the questions.

In a one-page (250-word) paper, address the following:

  • Who was the speaker, and what was that speaker’s main topic?
  • What CORE style(s) does the speaker use in his or her speech? Cite the choice of word phrases and other clues from the speech to justify your answer.
  • What you believe is the speech’s specific purpose?
  • What strategies did the speaker use to achieve the specific purpose of the speech?
  • Do you believe the speaker was successful in achieving the specific purpose of the speech?
  • How does style and word choice in this speech impact the effectiveness of the message?
  • How can you incorporate some of these techniques into your own speeches?

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diagnosis of cancer

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Case #1- The patient was admitted 2 days ago with a diagnosis of cancer.  She was informed by her doctor that a course of radiation and chemotherapy was her best option.  She became very upset and frightened about the proposed treatment and stated that she wasn’t sure if she would go through with it.  The nurse approaches her to discuss how she is feeling today.

Nurse:  “How are you doing today, Miss Smith.  I was wondering how you were feeling about undergoing radiation and chemotherapy?” Patient:  “I don’t know.  I’m not as scared as I was when I got here, but I have a lot of questions about it.”

Nurse:  “It sounds like you have given it some thought.  I’m sure Dr. Jones could talk with you and answer some of your questions.  Would you like to do that?”

Patient: “I guess so.

What do you think?” Think of a few ways the nurse could respond. Provide references to support your statements. Please use your textbook.

Case #2 An elderly patient is sitting in bed taking a nap. A tray of uneaten food is on the bedside table.  The nurse comes into the room.

Think of a few ideas of what the nurse could say to start a therapeutic conversation with this patient. Provide references to support your statements. Please use your textbook.

Nurse:  “…………”

Patient: “Oh, don’t bother with me.  I don’t have much time left in this world. And I don’t have much to live for anyway.”

Nurse:  Think of a few therapeutic responses. Provide references to support your statements. Please use your textbook.

Link: https://drive.google.com/drive/folders/1_9UxiSRjP4NjIKj5kYD40LnenRbDIRok?usp=sharing

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