Posts

1- Knee Injury 

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Case Studies

1- Knee Injury 

A 15-year-old gymnast has noted knee pain that has become progressively worse during the past several months of intensive training for a statewide meet. Her physical examination indicated swelling in and around the left knee. She had some decreased range of motion and a clicking sound on flexion of the knee. The knee was otherwise stable.

Studies and Results:

Routine laboratory values: Within normal limits (WNL)

Long bone (femur, fibula, and tibia) X-ray: No fracture

Arthrocentesis with synovial fluid analysis

Appearance: Bloody (normal: clear and straw-colored)

Mucin clot: Good (normal: good)

Fibrin clot: Small (normal: none)

White blood cells (WBCs) <200 WBC/mm3 (normal: <200 WBC/mm3)

Neutrophils <25% (WNL)

Glucose 100 mg/dL (normal: within 10 mg/dL of serum glucose level)

Magnetic resonance imaging (MRI) of the knee Blood in the joint space. Tear in the posterior aspect of the medial meniscus. No cruciate or other ligament tears

Arthroscopy Tear in posterior aspect of medial meniscus

Diagnostic Analysis

The radiographic studies of the long bones eliminated any possibility of fracture. Arthrocentesis indicated a bloody effusion, which was probably a result of trauma. The fibrin clot was further evidence of bleeding within the joint. Arthrography indicated a tear of the medial meniscus of the knee, a common injury for gymnasts. Arthroscopy corroborated that finding. Transarthroscopic medial meniscectomy was performed. Her postoperative course was uneventful.

Critical Thinking Questions

1. One of the potential complications of arthroscopy is infection. What signs and symptoms of joint infection would you emphasize in your patient teaching?

2. Why is glucose evaluated in the synovial fluid analysis?

3. What are special tests used to differentiate type of Tendon tears in the knee ? Explain how they are performed (Always on boards)

2-Testicular Cancer 

A 21-year-old male noted pain in his right testicle while studying hard for his midterm college examinations. On self-examination, he noted a “grape sized” mass in the right testicle. This finding was corroborated by his healthcare provider. This young man had a history of delayed descent of his right testicle until the age of 1 year old.

Studies and Results

Routine laboratory studies: Within normal limits (WNL)

Ultrasound the testicle: Solid mass, right testicle associated with calcifications

HCG (human chorionic gonadotropin): 550mIU/mL (normal: <5)

CT scan of the abdomen: Enlarged retroperitoneal lymph nodes

CT scan of the chest: Multiple pulmonary nodules

Diagnostic Analysis

At semester break, this young man underwent right orchiectomy. Pathology was compatible with embryonal cell carcinoma. CT directed biopsy of the most prominent pulmonary nodule indicated embryonal cell carcinoma, compatible with metastatic testicular carcinoma. During a leave of absence from college, and after banking his sperm, this young man underwent aggressive chemotherapy. Repeat testing 12 weeks after chemotherapy showed complete resolution of the pulmonary nodules and enlarged retroperitoneal lymph nodes.

Critical Thinking Questions

1. What impact did an undescended testicle have on this young man’s risk for developing testicular cancer?

2. What might be the side effects of cytotoxic chemotherapy?

3. What was the purpose of preserving his sperm before chemotherapy?

4. Is this young man’s age typical for the development of testicular carcinoma?

 

Medicare’s readmission penalties

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Review the story at the link below

Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/

(Links to an external site.)

Links to an external site.

After you have finished, consider how you would respond to the following situation:

Your local hospital has received notice from CMS (Centers for Medicare and Medicaid) regarding their readmission rates.

As a BSN prepared nurse, you have been asked to serve as a consultant to suggest a new Quality (Performance) Improvement process for ONE of the areas of deficiency. Write some brief steps (suggestions) for improvement as you contemplate accepting the consulting opportunity.

Share practice improvements utilized from your own clinical nursing experiences that have led to enhanced patient outcomes.

Power, influence,

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This is a discussion post, ABOUT 250 WORDS, tittle page not require In- text citation is required original work please, scholarly references are required for this assignment, website source strongly preferred.

QUESTION 1: Power, influence,

Power, influence, advocacy, and authenticity are all functions of leadership. View the video: “Morale and Discipline: The Mind of a Leader” at:

https://lopes.idm.oclc.org/login?url=http://fod.infobase.com/PortalPlaylists.aspx?wID=96349&xtid=48949

Discuss how strong leaders apply power, influence, advocacy, and authenticity to motivate those they lead. Support your response with a minimum of 3 peer-reviewed article.

health policy

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Choose a health policy issue in the United States to create a timeline of evolution.

Research events related to the policy’s creation, development, implementation, and modification.

Create a 700- to 1,050-word timeline detailing the evolution of your chosen health policy. Include the following:

  • A summary of the chosen policy. In your summary, include the objective of the policy and a discussion of the role the policy has played in the evolution of the US health care system
  • At least five key events tracing the policy’s path from inception to its current status.
  • For each event, include a 75- to 150-word explanation of why the event was significant in the development of the chosen policy.

Include at least five references.

Format any citations consistent with APA guidelines.

Click the Assignment Files tab to submit your assignment.

“Psychotherapy with Older Adults”

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“Psychotherapy with Older Adults”

Assess clients presenting for psychotherapy

Evaluate effectiveness of therapeutic approaches for clients receiving psychotherapy

To prepare:

Review this week’s media and consider the insights provided.

1-Reflect on the clients you are currently counseling at your practicum site.

2-Describe an older client you are Counseling Whom you do not think is adequately Progressing according to expected Clinical Outcomes.

Note: Do not use the client’s actual name.

3-Explain your Therapeutic Approach with the client, Including the perceived effectiveness of your approach.

4-Identify any additional information about this client that May potentially impact Expected Outcomes.

Note: Nurse practitioners must have strong oral communication skills. This Discussion is designed to help you hone these skills.

clinical problem

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During your practicum, determine what clinical problem or issue the organization is facing. Discuss two implications for nursing.

Aging Adult Case Study

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Assignment Description

Aging Adult Case Study

A 68-year-old client lives alone and is independent with all ADLs, has no restrictions for mobility, and is competent, and oriented x4. The client is on a fixed income, but has enough to manage a modest lifestyle. The client has family and social supports but is very independent and is proud of her self-reliance. The client’s height is 5’ 6”, weight is 210 lb. / 95.25 kg.

Please answer the following:

  • What is the client’s BMI?
  • Identify what screening tools you would use to assess nutritional and exercise knowledge, and why?
  • Identify two client outcomes that are reasonable, measurable and realistic
  • Identify 3 nursing interventions for each client outcome and give rationales
  • Identify what weakness in the client’s life and supports may be impacting the client’s activity and diet?
  • What referrals would you make and why?
  • Identify your references in APA format. Use references not just opinion.

Assignment Expectations:

Length: 1500 to 1750 words in length

Structure: Include a title page and reference page in APA format.  These do not count towards the minimum word count for this assignment. Your essay must include an introduction and a conclusion.

References: Use appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

Nurse Daniel information

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Directions

Please do not use any of the Nurse Daniel information for your own topic, nursing intervention, or change project. Nurse Daniel serves as an example only to illustrate the change process.

A short tutorial with tips for completing this assignment may be viewed below or by reading the transcript (Links to an external site.).

EBP Change Process (form)

  1. Download the EBP Change Process form (Links to an external site.) during Week 1.
  2. The use of this specific form is REQUIRED and is due at the end of Week 6.
  3. A short tutorial with tips for completing this assignment may be viewed in the short video above.
  4. Identify a clinical topic and related nursing practice issue you think needs to be changed.
  5. Locate a systematic review on your topic from the CCN Library databases. Be sure this involves nursing actions.
  6. Work through each step of the ACE Star Model as outlined on the assignment form (Star Points 1-5: Discovery, Summary, Translation, Implementation, and Evaluation). Respond to the instructions provided on the form.
  7. Follow the activities and thinking of Nurse Daniel in Weeks 1-6 in the ‘Illustration’ part of each lesson. He will be working through a clinical topic and nursing practice issue to demonstrate a change (ACE Star Model and systematic review).
  8. Work on a portion of the process each week, as the illustration unfolds.
  9. Please reach out to your instructor for feedback or assistance with your PICOT question as needed.
  10. Required and Additional Background Reading in Weeks 1 and 2 under Readings is available for more information on the ACE Star Model and the use of systematic reviews.
  11. Please cite any references (in APA format) of your systematic review or other scholarly document (optional) as needed. Paraphrasing information, rather than quoting, is expected. No quotes for this assignment please!
  12. For questions about this assignment, please contact your instructor.
  13. Use the grading rubric as a final way to check that all components of the form have been completed. The rubric is the tool your instructor will use to assess your content.

Reminder

Before preparing your assignment, please review this “Crediting Sources Made Simple (Links to an external site.)“ resource. This tool is intended to help you understand scholarly writing, APA, referencing, and crediting. Please reach out to your instructor with any questions as you prepare your assignment.

**Academic Integrity**

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment. Please see the grading criteria and rubrics on this page.

NOTE: Please use your browser’s File setting to save or print this page.

Rubric

Public Health Program

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This is Master level, please read. I have a Public Health Program  FINAL PROJ.Proposal (15 pages) On High Blood Pressure (HTN) to fill in. The outlines are already created ( TOPIC is HTN, Objectives are determined, Community is chosen). I need someone with Health care experience what has done previous Assignments on HTN and it an exert on how to address the problem on different levels: INTRApersonal, INTERpersonal, COMMUNITY level, SOCIETY levels.

1)TOPIC:  High blood pressure (hypertension)

2)OBJECTIVES: My health promotion program proposal will focus on optimization of hypertension management in rural communities; 50% reduction in cases of HTN in West Virginia rural community

3)This project focuses on PROGRAM PLANNING MODELS: planning model I   have selected for my proposal is the Intervention Mapping Model.

My Health promotion program proposal will focus on optimization of delivery of rural health care through development of an INTERVENTION PROGRAM that increase hypertension awareness and self-management by using community volunteers as health coaches. YOU will fill in with more details in here.

THE INTERVENTION STRATEGIES are to be filled in, I have already chose a Behavioral theory to be applied.

I have uploaded a FINAL PROJ.EXAMPLE in an adobe, from a collegue, for you to use it as INSPIRATION, please do not COPY PASTE anything from that!

Ethical Dilemma

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Ethical Dilemma

After reviewing The Invisible Patients documentary, define/describe in detail an ethical dilemma that was experienced by the NP. Please note, there are several ethical issues, so there should be diversity in the responses.  Explain how you would have handled the situation.

· How is the NP in the documentary a Disruptive Innovator?

· Discuss if there is a relationship between your personal beliefs and values and this ethical dilemma/barrier.

· Describe at least one mechanism to overcome the barrier discussed.

· Examine the potential cost and benefits to this barrier.

Remember there is no right or wrong answer for this ethical question. Suggested reference Look at the Nuremburg Code (US Department of Health & Human Services, 2005; Washington, 2012) as it was the major start of ethics in research and that can carry over to nursing practice.

US Department of Health & Human Services. (2005). The Nuremberg code.

Retrieved from http://www.hhs.gov/ohrp/archive/nurcode.html