Tag Archive for: nursing

ABDOMINAL ASSESSMENT 

Assessment of the Abdomen and Gastrointestinal System 

ABDOMINAL ASSESSMENT 

case study

Subjective: 

• CC: “My stomach hurts, I have diarrhea and nothing seems to help.”

• HPI: JR, 47 yo WM, complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards.

• PMH: HTN, Diabetes, hx of GI bleed 4 years ago

• Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs

• Allergies: NKDA

• FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD

• Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective: 

• VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs

• Heart: RRR, no murmurs

• Lungs: CTA, chest wall symmetrical

• Skin: Intact without lesions, no urticaria

• Abd: soft, hyperactive bowel sounds, pos pain in the LLQ

• Diagnostics: None

Assessment: 

• Left lower quadrant pain

• Gastroenteritis

PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

 

  • With regard to the Episodic note case study provided:
    • Review this week’s Learning Resources, and consider the insights they provide about the case study.
    • Consider what history would be necessary to collect from the patient in the case study.
    • Consider what physical exams and diagnostic tests would be  appropriate to gather more information about the patient’s condition.  How would the results be used to make a diagnosis?
    • Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

The Assignment

  1. Analyze the subjective portion of the note. List additional information that should be included in the documentation.
  2. Analyze the objective portion of the note. List additional information that should be included in the documentation.
  3. Is the assessment supported by the subjective and objective information? Why or why not?
  4. What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis?
  5. Would you reject/accept the current diagnosis? Why or why not?  Identify three possible conditions that may be considered as a  differential diagnosis for this patient. Explain your reasoning using at  least three different references from current evidence-based  literature.

therapeutic approach

Clients with personality disorders often find it difficult to overcome their problems and function in daily life. Even when these clients are aware that they have a dysfunction with their personality and are open to counseling, treatment can be challenging for both the client and the therapist. For this Discussion, as you examine personality disorders, consider therapeutic approaches you might use with clients.

Analyze therapeutic approaches to treating clients with personality disorders Select one of the personality disorders from the DSM-5. Write a 2 page paper of the personality disorder you selected. Explain a therapeutic approach (including psychotropic medications if appropriate) you might use to treat a client presenting with this disorder, including how you would share your diagnosis of this disorder to the client in order to avoid damaging the therapeutic relationship. Support your approach with evidence-based literature. APA format at least three evidenced-based references.

 

taxation

Before completing this graded discussion. You should have a full understanding of the concepts below, if you don’t please use the textbook and review them first.

  • Opportunity Cost, Scarcity, Market Failures, Government Regulation, Taxes, Tax Revenues, Public Goods, Government Spending.

Instructions and Steps:

1. View the following TED Talk (video presentation). As you watch the video, take notes of any relevant information.

2. Answer the following question;

  • As you are aware from reading chapters 4 & 10, Governments intervene in markets to solve market failures like pollution, and to provide for public goods, but to achieve this, they need funding, which they accomplish by collecting taxes. Jean-Baptiste Colbert a French politician who served as the Minister of Finances of France from 1665 to 1683, once famously said: “The art of taxation consists in so plucking the goose as to obtain the largest [number] of feathers with the least possible amount of hissing.” Implying that taxes should be as high as people are willing to pay without complaining too much. Based on what you read in chapter 10, and the information from this TED Talk, should governments focus more on becoming more efficient with the use of tax revenues hence reducing the cost of delivering for their citizens, or should they focus more on trying to increase tax revenues? Explain why.

3. Produce a post of at least 300 words in which you explain your position. Your post must contain at least the following elements:

  • It must state your stance to the question posted
  • It must state the reason why
    • Your reason must be explicitly connected to one of the concepts listed above, which means that must use at least of the concepts in your explanation
  • It must use information, or data from the TED Talk to support your argument.

Your grade will be based on how clear, precise, accurate, relevant and logical your post is and if it was turned in on time. Things such as the name of the video, the name of the presenter, your name, the questions, citation, and date do not count towards the word count.

Central Venous Catheters

0 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project

Week Two Assignment Instructions DNP 820

Please read the instructions thoroughly there are strict requirements

I need at least 10 different articles/literature reviews added to the ones in the 815 attachment. I have also included the chart to be filled out All within 5 years and pertinent to the subject.

Tutor MUST have a good command of the English language

The Rubric must be followed, and all the requirements met

This is a thorough professor, and she has strict requirements

I have attached the PICOT and the first 10 points (DNP 815) assignment. This is a continuation of that assignment. Please read the attachments

The following needs to be addressed:

Please note the followings: The introduction and the literature review are complete and thorough. The problem statement is written clearly PICOT is clear and very good Sample: 

· How will you determine the sample size? 

· What are the inclusion/exclusion criteria of the subjects? Methodology: Why is the selected methodology is appropriate? Please justify! 

· Data collection approach needs to be clear. How will you collect your data? What is needed here is to describe the process of collecting data form signing the informed consent until completing the measuring.

· Data analysis-What test will you use to answer your research question? 

Clinical/PICOT Questions:  

“In adult patients with CVC at a Clear Lake Regional Medical Center, does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to standard care over a one-month period?”

P: Patients with Central Venous Catheters

I: Staff re-education related to Hygiene of the hub

C: Other hospitals

O: Reduce probability of CLABSIs

T: Two months

“In Patients > 65 years of age with central line catheters at a Clear Lake Regional Medical Center, how does staff training of key personnel and reinforcement of central line catheter hub hygiene after its insertion, along with the apt cleansing of the insertion site, before every approach compared with other area hospitals, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) over a one-month period?”

P: Patients > 65 years of age with a Central line

I: Staff training and reinforcement of Central Catheter, Hub Hygiene 

C: Other area hospitals 

O: Reduce probability of CLABSIs

“In adult patients, with define CVC (CVC), does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to pre and post-intervention assessments 

1. I used central Missouri as an example, replace with a description of your site. 

2. While you might be interested in CLASBI rates as a primary variable, there are other patient outcomes that would also be important to consider

3. Ensure you can find validity and reliability measures on CLASBI rates if you cannot, we need to determine another question to help

4. How are your two comparison groups different, as they are currently stated the groups seem very much the same, could you state, standard care instead of pre and post intervention assessments? 

5. One month is the longest time you can use for a prospective project

Please note the following regarding the instructors grading

IMPORTANT INFORMATION ABOUT MY GRADING STYLE

As you prepare for written papers and manuscripts I’d like to give you some details about my grading style. I provide significant feedback on your papers, this is because I believe you should be working towards improving your writing so that at the end of this program you are able to successfully write your DPI project. In order to write well, you need feedback and you need to review that feedback and make progress on the next written work. To that end I always grade accordingly. This means that if I provide feedback one an item (for example APA format of your reference page) I expect that this will be improved on the next written submission. Otherwise I will deduct additional points. In addition, some other criteria to get down pat now. References should always

1. Be current, no older than 5 years that means 5 years from your proposed graduation date (2014-2019). Otherwise you will have to redo everything in DNP 955.

2. Be primary sources. You can no longer cite Young declared literary war in 1956 (as cited by Brown 2006). You must cite Young 1956. That means go find that paper and read it and make sure that you agree with what Brown said. What if you don’t agree due to some very valid points? Then the literary war is not what occurred, but instead you have concerns regarding point ____, ____, and ____.

3. You may no longer cite textbooks, they are 1) secondary sources and 2) not current enough, and please use peer reviewed manuscripts.

One more item that is not a reference. You may not use direct quotes any longer. There is no need. This may be difficult at first, but you are moving towards a different type of writing. This is manuscript writing (scientific writing). Scientific writing is terse, clear, and concise. No frilly words. In order to avoid the use of direct quotes you will synthesize the literature. There is a great resource for synthesizing the literature under Resources – Add-ons. These are also some other great writing resources there.

Details:

In the prospectus, proposal, and scholarly project there are 10 strategic points that need to be clear, simple, correct, and aligned to ensure the research is doable, valuable, and credible. The 10 strategic points emerge from researching literature on a topic that is based on or aligned with the learner’s personal passion, future career purpose, and degree area. These 10 points provide a guiding vision for DPI Project. In this assignment, you will continue the work begun in DNP-815, working on your draft of a document addressing the 10 key strategic points that define your intended research focus and approach.

General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Locate      the “The 10 Strategic Points for the      Prospectus, Proposal, and Direct Practice Improvement Project” that      you completed in DNP-815.
  • Doctoral      learners are required to use APA style for their writing assignments. The      APA Style Guide is located in the      Student Success Center. An abstract is not required.
  • This      assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the      expectations for successful completion.
  • You      are required to submit this assignment to Turnitin. Please refer to the      directions in the Student Success Center.

Directions:

Use the “The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” resource to draft statements for each of the 10 points for your intended research study.

You worked on this last in DNP 815. Pick up from where you left off (if you transferred in and did not complete this, you will have to begin fresh). Please include a copy of your last instructor feedback when you submit this assignment. You can either copy and paste the instructor feedback into your current paper (as an appendix and clearly marked); or upload two separate papers. I expect significant improvement from your last submission.

Please review the 10 Strategic Points document for additional instructions and an example. Add references to this document, I suggest 5-10 at this point. You need to realize that your literature review chapter will need at least 50+ articles by the time you get to DNP 955, so work on expanding your literature search each week, to include more and more to this paper as you move through each course. If you cannot locate 50+ articles you can ask your faculty for assistance or chose a different topic.

For the methodology and design sections. Methodology should cover the broad methods you plan to use (qualitative, quantitative, or mixed methods). The design portion will then go into more detail and discuss the design (i.e. correlational, cross-sectional, pre/posttest, etc.). Describe each and explain why your chosen methodology and design are appropriate to your topic and project questions. You may NOT use qualitative, GCU leadership does not support a qualitative methodology.

Intervention. You must have an intervention that you implement. Since you cannot evaluate a project that has already been implemented, please write up a description of your intervention and what your role will be in implementing this intervention. This is not a section listed on your 10 Strategic Points document as of yet, so add it after the methodology and design sections. Describe step by step what the intervention consists of, how it is evidence based, how you will implement, and your role in implementation.

Data collection should go step by step (extremely over-detailed) on how you will collect the data. Tell me about all instruments, surveys, and/or questions you will ask of participants. One MUST be a valid and reliable tool.

Data Analysis. Tell me the specific statistics you will use. Start with descriptive statistics, which ones will you use, why (cite current primary sources). Then tell me how you will compare your data (which statistic), what your p value will be before you start your data collection.

Apply Rubrics

medical charts

Book Review #1- “The Spirit Catches You and You Fall Down”
Chapters 1-3

  1. Explain why Foua Yang’s birthdate may have been different in various locations in the medical charts?
  2. Describe how the history of the Hmong people as discussed in chapter two may have influenced Foua and Nao Kao’s perception of the physicians and nurses who appear to be in charge of their daughter’s care?
  3. How do you think having an interpreter might have improved the outcomes of Lia’s numerous emergency room visits up to this point?
  4. Discuss the differences in conceptual frameworks that may have led Foua and Nao Kao and the caregivers at Merced County hospital to misunderstand one another during Lia’s admissions?
  5. How may have Foua and Nao Kao experienced cultural pain during the experience of Lia’s birth in the United States?

Students will write a typed summary of questions that pertain to weekly readings assigned to Fadiman (1997) text.

Grading will focus primarily on demonstration of your understanding and reflection on the content of the questions with ease of reading/organization as a secondary focus. Remember to use APA formatting for each book report which means there will be a cover page and reference page included with each book review. In this case, it is ok to use the first person when responding to questions that ask for your personal values/input/reflection. Answers to questions must be at least 100 words and should be typed and double spaced with 12 point font. Please include the number of the question and then include a summary of the question in your response.

Example: 1. Foua Lee and Neil Ernst appeared to finally make peace with one another when they….

Building a Safer Health System

The 1999 landmark study titled “To Err Is Human: Building a Safer Health System” highlighted the unacceptably high incidence of U.S. medical errors and put forth recommendations to improve patient safety. Since its publication, the recommendations in “To Err Is Human’ have guided significant changes in nursing practice in the United States.

In this Discussion, you will review these recommendations and consider the role of health information technology in helping address concerns presented in the report.

To prepare:

  • Review the summary of “To Err Is Human” presented in      the Plawecki and Amrhein article found in this week’s Learning Resources.
  • Consider the following statement:

“The most significant barrier to improving patient safety identified in “To Err Is Human” is a “lack of awareness of the extent to which errors occur daily in all health care settings and organizations (Wakefield, 2008).”

  • Review “The Quality Chasm Series: Implications for      Nursing” focusing on Table 3: “Simple Rules for the 21st Century Health      Care System.” Consider your current organization or one with which you are      familiar. Reflect on one of the rules where the “current rule” is still in      operation in the organization and consider another instance in which the      organization has effectively transitioned to the new rule.

Post your thoughts on how the development of information technology has helped address the concerns about patient safety raised in the “To Err Is Human” report. Summarize how informatics has assisted in improving health care safety in your organization and areas where growth is still needed.

health status

Select an ethnic minority group that is represented in the United States (American Indian/Alaskan Native, Asian American, Black/African American, Hispanic/Latino, Native Hawaiian, or Pacific Islander). Using health information available from Healthy People, the CDC, and other relevant government websites, analyze the health status for this group.

In a paper of 1,000-1,250 words, compare and contrast the health status of your selected minority group to the national average. Include the following:

Describe the ethnic minority group selected. Describe the current health status of this group. How do race and ethnicity influence health for this group?
What are the health disparities that exist for this group? What are the nutritional challenges for this group?
Discuss the barriers to health for this group resulting from culture, socioeconomics, education, and sociopolitical factors.
What health promotion activities are often practiced by this group?
Describe at least one approach using the three levels of health promotion prevention (primary, secondary, and tertiary) that is likely to be the most effective in a care plan given the unique needs of the minority group you have selected. Provide an explanation of why it might be the most effective choice.
What cultural beliefs or practices must be considered when creating a care plan? What cultural theory or model would be best to support culturally competent health promotion for this population? Why?
Cite at least three peer-reviewed or scholarly sources to complete this assignment. Sources should be published within the last 5 years and appropriate for the assignment criteria and public health content.

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

Article Analysis and Evaluation of Research Ethics

Search the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook.

Article Analysis and Evaluation of Research EthicsComplete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance

Attachments

fundamental elements of research

A baccalaureate nurse understands, relates, and values the fundamental elements of research, process, and designs as a foundation for an evidence-based practice (AACN, 2008; QSEN, 2018).

Purpose:
This assignment provides a learning activity for students to demonstrate understanding of quantitative and qualitative research, the purpose and importance of designs, and how research is critical for creating a credible evidence-based nursing practice.

Course Outcomes:
This assignment enables the student to meet the following Course Outcomes.

CO 1: Examine the sources of evidence that contribute to professional nursing practice. (PO 7)

CO 2: Apply research principles to the interpretation of the content of published research studies. (PO 4 & 8)

CO 5: Recognize the role of research findings in evidence-based practice. (PO 7 & 8)

hospital organization

      THE ASSIGMENT HAS TO BE FREE OF PLAGIARISM..PLEASE FOLLOW ALL INSTRUCTIONS TO ANSWER THIS ASSIGMENT

 

 

 

 

 

Details:

This is a benchmark assessment.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline, and their local communities.

The learning activity and corresponding assignment in this topic requires students to perform a heritage assessment with families selected by the student from their local community.

 

Click on http://wps.prenhall.com/wps/media/objects/663/679611/box_6_1.pdf in order to access the “Heritage Assessment Tool.”

Interview three families from different cultures. One family should be from your own culture. Compare the differences in health traditions between these cultures.

Assess the three families using the “Heritage Assessment Tool.” In 1,000-1,500 words discuss the usefulness of applying a heritage assessment to evaluate the needs of families and develop plans for health maintenance, health protection, and health restoration. Include the following:

  1. Perform a heritage assessment on three families. One of these families should be from your own culture.
  2. Complete the “Heritage Assessment Tool” and submit to: [email protected] – one assessment for each of the three families interviewed. You are not required to include the tool in your LoudCloud submission.
  3. Identify common health traditions based on cultural heritage. Evaluate and discuss how the families subscribe to these traditions and practices. Address health maintenance, health protection, and health restoration as they relate to your assessment.

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 

                                                                USE THIS RUBRIC

 

Benchmark Assignment – Heritage Assessment

1
Unsatisfactory
0.00%
2
Less than Satisfactory
75.00%
3
Satisfactory
79.00%
4
Good
89.00%
5
Excellent
100.00%
80.0 %Content
20.0 % Discuss the Usefulness of Applying a Heritage Assessment in Evaluating the Needs of the Whole Person.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is not offered.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered, but incomplete, lacking relevant information, or does not meet criteria for word count.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person meets requirements of the assignment.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered in detail.
Discussion of the usefulness of applying a heritage assessment in evaluating the needs of the whole person is offered in detail, while offering insight and/or reflection.
20.0 % Family Interviews
Interview of three families from different cultures not offered.
Interview of three families from different cultures is offered, but incomplete, lacking relevant information regarding the comparison of the differences in health maintenance, health protection, and health restoration among the cultures.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures meets requirements of the assignment.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures is offered in detail.
Interview of three families from different cultures that provides comparison of the differences in health maintenance, health protection, and health restoration among the cultures is offered in detail, while offering insight and/or reflection.
20.0 % Identifying Common Health Traditions
Identification of common health traditions based on your cultural heritage is not offered.
Identification of common health traditions based on your cultural heritage is offered, but is incomplete, lacking relevant information.
Identification of common health traditions based on your cultural heritage meets requirements of the assignment.
Identification of common health traditions based on your cultural heritage is offered in detail.
Identification of common health traditions based on your cultural heritage is offered in detail, while offering insight and/or reflection.
20.0 % Evaluate How Families Subscribe to These Traditions and Practices
Evaluation of how family subscribes to these traditions and practices is not offered.
Evaluation of how family subscribes to these traditions and practices is offered, but is incomplete, lacking relevant information.
Evaluation of how family subscribes to these traditions and practices meets requirements of the assignment.
Evaluation of how family subscribes to these traditions and practices is offered in detail.
Evaluation of how family subscribes to these traditions and practices is offered in detail, while offering insight and/or reflection.
15.0 %Organizatioan and Effectiveness
5.0 % Thesis Development and Purpose
Paper lacks any discernible overall purpose or organizing claim.
Thesis and/or main claim are insufficiently developed and/or vague; purpose is not clear.
Thesis and/or main claim are apparent and appropriate to purpose.
Thesis and/or main claim are clear and forecast the development of the paper. It is descriptive and reflective of the arguments and appropriate to the purpose.
Thesis and/or main claim are comprehensive; contained within the thesis is the essence of the paper. Thesis statement makes the purpose of the paper clear.
15.0 %Organizatioan and Effectiveness
5.0 % Paragraph Development and Transitions
Paragraphs and transitions consistently lack unity and coherence. No apparent connections between paragraphs are established. Transitions are inappropriate to purpose and scope. Organization is disjointed.
Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, and/or cohesiveness. Some degree of organization is evident.
Paragraphs are generally competent, but ideas may show some inconsistency in organization and/or in their relationships to each other.
A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Topic sentences and concluding remarks are appropriate to purpose.
There is a sophisticated construction of paragraphs and transitions. Ideas progress and relate to each other. Paragraph and transition construction guide the reader. Paragraph structure is seamless.
15.0 %Organizatioan and Effectiveness
5.0 % Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice and/or sentence construction are used.
Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, and/or word choice are present.
Some mechanical errors or typos are present, but are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used.
Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used.
Writer is clearly in command of standard, written, academic English.
5.0 %Format
2.0 % Paper Format (use of appropriate style for the major and assignment)
Template is not used appropriately or documentation format is rarely followed correctly.
Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent.
Template is used, and formatting is correct, although some minor errors may be present.
Template is fully used; There are virtually no errors in formatting style.
All format elements are correct.
3.0 % Research Citations (In-text citations for paraphrasing and direct quotes, and reference page listing and formatting, as appropriate to assignment)
No reference page is included. No citations are used.
Reference page is present. Citations are inconsistently used.
Reference page is included and lists sources used in the paper. Sources are appropriately documented, although some errors may be present.
Reference page is present and fully inclusive of all cited sources. Documentation is appropriate and GCU style is usually correct.
In-text citations and a reference page are complete. The documentation of cited sources is free of error.
100 % Total Weightage