Tag Archive for: nursing

Policy/Regulation Fact Sheet

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Assignment: Policy/Regulation Fact Sheet

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

· Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.

· Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).

· Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

· Briefly and generally explain the policy or regulation you selected.

· Address the impact of the policy or regulation you selected on system implementation.

· Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.

· Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

Use the below resources for references;

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 8, “Legislative Aspects of Nursing      Informatics: HITECH and HIPAA” (pp. 145–166)

American Association of Nurse Practitioners. (2018). MACRA/MIPS: The transition from fee-for-service to quality-based reimbursement. Retrieved from https://www.aanp.org/legislation-regulation/federal-legislation/macra-s-quality-payment-program 

Centers for Medicare and Medicaid Services. (n.d.). MACRA. Retrieved January 18, 2019, from https://www.cms.gov/medicare/quality-initiatives-patient-assessment-instruments/value-based-programs/macra-mips-and-apms/macra-mips-and-apms.html

HealthIT.gov. (2018a). Health IT legislation. Retrieved from https://www.healthit.gov/topic/laws-regulation-and-policy/health-it-legislation

HealthIT.gov. (2018b). Meaningful use and MACRA. Retrieved from https://www.healthit.gov/topic/meaningful-use-and-macra/meaningful-use-and-macra

U.S. Department of Health and Human Services. (n.d.). Laws & regulations. Retrieved September 27, 2018, from https://www.hhs.gov/regulations/index.html

Required Media

Laureate Education (Producer). (2018). Health Informatics & Population Health Analytics: Privacy, Security, and Ethics [Video file]. Baltimore, MD: Author.

Case Study in Primary care

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4. Bioethics Case Study: This assignment asks you to examine a current ethical controversy case study. The paper is informal, but should be in APA style, and does not need an abstract or cover page. With a

minimum of two pages and a maximum of four pages A reference page is needed. In-text citations should

be in APA format. Papers will be graded on a 0 to 25-point scale.

EXAMPLE OF Case Study in Primary care:

One hypothetical case study involves Jim a 54, year old patient who has recently diagnose with hypertension and his Creatinine and BUN laboratory results are elevated, if left untreated, will result in kidney failure. The patient refuses to take the medication because he said it will affect his sex life The NP must work with the patient to respect the fact that he doesn’t want the medication (autonomy), and needs to find a solution that would prevent him from going into kidney failure and other complications, which is in his best interest (beneficence). Although medications are the best choice, forcing the patient to accept the medication will result in probably patient leaving the care (non-maleficence). Finally, the NP needs to consider the impact that the patient’s choices might have on others if he starts to go into preventable kidney failure, he’ll need dialysis, which affects other people who need the same treatment (justice). So before making the final decision the NP must consider all four principles of health care ethics, which will

help the NP make the choice that will have the best possible benefits for both the patient and society.

ANSWER THESE Questions?

1. What are the skills necessary for the provider to identify, address, and assess this clinical ethical

issue?

2. What are the provider’s obligations when a patient discloses does he not intent to follow the

treatment?

3. What are the ethical considerations in evaluating a patient’s failure to adhere to a prescribed

therapy?

4. Will you terminate care for this patient? What are the implications?

Marketing and the Health Care System

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Assignment 1: Marketing and the Health Care System

Due Week 4 and worth 300 points

Select a health care provided with which you are familiar and write a four to six (4-6) page paper in which you:

Determine the direct impact of marketing for the health care provider you selected.
Outline a strategy for the health care provider you selected to determine the utilization of its products or services.
Outline a marketing strategy for the health care provider you selected.
Recommend at least three (3) separate ways the health care provider you selected could shape the buying decisions of its customers.
Provide at least three (3) qualified sources, e.g., peer-reviewed journals, professional organization Website, or health care provider Websites.
Your assignment must follow these formatting requirements:

This course requires use of new Strayer Writing Standards (SWS). The format is different than other Strayer University courses. Please take a moment to review the SWS documentation for details.
Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow SWS or school-specific format. Check with your professor for any additional instructions.
Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.
The specific course learning outcomes associated with this assignment are:

Describe the health care system and the role of marketing.
Analyze the competitive environment of a health services organization and identify a course of action that will allow for strategic marketing success.
Use technology and information resources to research issues in health services marketing.
Write clearly and concisely about health services marketing using proper writing mechanics.
Grading for this assignment will be based on answer quality, logic/organization of the paper, and language and writing skills.

Click here to view the grading rubric.

advantages of using EHR

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Imagine you are working at a doctor’s office. You are approached by the office manager, who asks you to develop an effective way of storing patient information.

Write a 350- to 700-word summary to your office manager informing her of the advantages of using electronic health records (EHRs) to store patient information. Be clear and concise, use complete sentences, and use examples to support your responses.

Include the following in your response:

  • Discuss the functions and advantages of using EHRs.
  • Discuss three to four forms used to keep patient information in EHRs.
    • What is the purpose of each form?

pediatric clinical rotation,

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No plagiarism please.

Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and Include: (3 references within years 2015-2018) with intext citations.

This week’s Discussion will focus on sharing experiences that you have encountered so far in your pediatric clinical rotation, specifically with mental health disorders. Please post your initial response and respond to your classmates for a rich conversation.

(Please use example of 13 y/o child with signs of depression, mention that the child is not suicidal and that referral to psychologist was made before patient discharge. You can mention that there is family history of depression.)

treatment plans

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In clinical settings, some of the most common questions that patients ask are Why do I have this? What caused this disorder? Will it ever go away? These emotional questions can be difficult to ask and to answer. However, for patients to come to terms with their diagnoses and adhere to treatment plans, they must have an understanding of factors that might have caused, or continue to impact, their disorders. As an advanced practice nurse, it is important that you are able to explain disorders, associated alterations and symptoms, and changes that might occur within your patients’ bodies.

To Prepare

  • Review this week’s media presentation with Dr. Terry Buttaro. Reflect on the importance of developing an in-depth understanding of pathophysiology.
  • Select a disorder from the following list:
    • Adrenal insufficiency (Addison’s disease)
    • Atherosclerosis
    • Cholelithiasis (gallstones)
    • Colon cancer
    • Cystic fibrosis
    • Hemophilia
    • Nephrolithiasis (kidney stones)
    • Osteoporosis
    • Parkinson’s disease
    • Tuberculosis
  • Select one of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how that factor might impact your selected disorder, as well as potential associated alterations and symptoms.
  • Identify the pathophysiology of the associated alterations, including the normal and altered cellular function. Consider both intra- and extra-cellular changes that occur.

By Day 3

Post a brief description of a patient scenario involving the disorder and the factor you selected. Explain how the factor might impact your selected disorder, as well as potential associated alterations and symptoms. Finally, explain the pathophysiology of the associated alterations, including changes in cellular function.

Critical Appraisal of Research

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ART 1: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected and analyzed by completing the Critical Appraisal Tools document. Be sure to include:

1. Evaluation Table

2. Level of Evidence Table

3. Outcome Synthesis Table

PART 2: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research. 

CRITICAL APPRAISAL TOOL IS INCLUDED UNDER FILES 

Healing and Autonomy

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In addition to the topic study materials, use the chart you completed and questions you answered in the Topic 3 about “Case Study: Healing and Autonomy” as the basis for your responses in this assignment.

Answer the following questions about a patient’s spiritual needs in light of the Christian worldview.

  1. In 200-250 words, respond to the following: Should the physician allow Mike to continue making decisions that seem to him to be irrational and harmful to James, or would that mean a disrespect of a patient’s autonomy? Explain your rationale.
  2. In 400-500 words, respond to the following: How ought the Christian think about sickness and health? How should a Christian think about medical intervention? What should Mike as a Christian do? How should he reason about trusting God and treating James in relation to what is truly honoring the principles of beneficence and nonmaleficence in James’s care?
  3. In 200-250 words, respond to the following: How would a spiritual needs assessment help the physician assist Mike determine appropriate interventions for James and for his family or others involved in his care?

Remember to support your responses with the topic study materials.

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.

This benchmark assignment assesses the following competencies:

BS Nursing (RN to BSN)

5.2: Assess for the spiritual needs and provide appropriate interventions for individuals, families, and groups.

professional and academic goals

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Post a brief introduction of yourself to your colleagues. Include an explanation as to how Walden’s vision, mission, goals, and social change initiatives relate to your professional and academic goals and to your becoming a scholar-practitioner. Also include an explanation for how the Walden MSN Program Outcomes and perspectives relate to your professional and academic goals and to your becoming a scholar-practitioner. APA, Citation, Reference

crucial element

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NR 511 Week 4 Midterm Exam Version 1

Question 1:  Which of the following is a crucial element of developing a guideline?

a. Creating a physician expert panel
b. Reviewing the literature with ratings of available evidence
c. Conducting an external review of a guideline
d. Developing evidence-based tables

Question 2:  African American patients seem to have a negative reaction to which of the following asthma medications?

a. Inhaled corticosteroids

b. Long-term beta-agonist bronchodilators

c. Leukotriene receptor agonist
d. Oral corticosteroid

Question 3:  Jolene has breast cancer that has been staged as T1, N0, M0. What might this mean?

a. The tumor size cannot be evaluated, the cancer has not spread to the lymph nodes, and the distant spread cannot be evaluated.
b. The cancer is in situ, it is spreading into the lymph nodes, but the spread otherwise cannot be evaluated.
c. The cancer is less than 2 cm in size and has not spread to the lymph nodes or other parts of the body.
d. The cancer is about 5 cm in size, nearby lymph nodes cannot be evaluated, and there is no evidence of distant spreading.

Question 4:  Sondra’s peripheral vestibular disease causes dizziness and vertigo. Which of the following medications will help to decrease edema in the labyrinth of the ear?

a. Meclizine
b. Diphenhydramine
c. Diamox
d. Promethazine

Question 5:  Mandy presents with a cauliflower-like wart that is in her anogenital region. You suspect it was sexually transmitted and document this as a:
a. Filiform/digitate wart.

b. Dysplastic cervical lesion.

c. Condyloma accuminata.
d. Koilocytosis.

Question 6:  Inattention and a sleep-wake cycle disturbance are the hallmark symptoms of?

a. Dementia

b. Alzheimer’s disease

c. Parkinson’s disease

d. Delirium

Question 7:  You have taught Jennifer, age 15, about using a flow meter to assess how to manage her asthma exacerbations. She calls you today because her peak expiratory flow rate is 65%. What would you tell her?

a. “Take your short-acting beta-2 agonist, remain quiet, and call back tomorrow.”
b. “Use your rescue inhaler, begin the prescription of oral glucocorticoids you have, and call back tomorrow.”
c. “Drive to the emergency room (ER) now.”
d. “Call 911.”

Question 8:  A patient is seen in the clinic with hematuria confirmed on microscopic examination. The clinician should inquire about the ingestion of which of these substances that might be the cause of hematuria?
a. NSAIDs

b. Beets

c. Vitamin A
d. Red meat

Question 9:  Which of the following is an example of tertiary prevention in a patient with chronic renal failure?

a. Fluid restriction
b. Hemodialysis 4 days a week
c. High-protein diet
d. Maintain blood pressure at 120/80

Question 10:  Which of the following conditions is associated with cigarette smoking?

a. Glaucoma

b. Increased sperm quality

c. Bladder cancer

d. Eczema

Question 11: A chronic cough lasts longer than:

a. 3 weeks

b. 1 month

c. 6 months
d. 1 year

Question 12: The ‘freezing phenomenon’ is a cardinal feature of?

a.Parkinson’s disease

b. Alzheimer’s disease

c. A CVA

d. Bell’s palsy

Question 13: When administered at the beginning of an attack, oxygen therapy may help this kind of headache?

a. Tension

b. Migraine

c. Cluster

d. Stress

Question 14: Which ethnic group has the highest lung cancer incidence and mortality rates?

a. African American men

b. Scandinavian men and women

c. Caucasian women

d. Asian men

Question 15: The most significant precipitating event leading to otitis media with effusion is:

a. Pharyngitis

b. Allergies

c. Viral upper respiratory infection (URI)

d. Perforation of the eardrum

Question 16:  Samuel is going to the dentist for some work and must take endocarditis prophylaxis because of his history of:

a. Severe asthma.
b. A common valvular lesion.
c. Severe hypertension.
d. A previous coronary artery bypass graft (CABG).

Question 17: A 34-year-old patient was treated for a urinary tract infection (UTI) and has not responded to antibiotic therapy. Which of the following actions should be taken next?
a. Send a urine specimen for microscopy looking for fungal colonies.
b. Increase the dose of antibiotic.
c. Order a cytoscopy.
d. Order a different antibiotic.

Question 18: Which statement best describes a carotid bruit?

a. It is felt with the middle three fingers over the carotid artery.
b. A bruit becomes audible when the lumen is narrowed to 1 mm or less.
c. A low-pitched bruit is a medical emergency.
d. The higher the pitch of the bruit, the higher the degree of stenosis.

Question 19: Which statement is true regarding chloasma, the ‘mask of pregnancy’?

a. It is caused by a decrease in the melanocyte-stimulating hormone duringpregnancy.

b. This condition only occurs on the face.

c. Exposure to sunlight will even out the discoloration.

d. It is caused by increased levels of estrogen and progesterone.

Question 20: Simon presents with alopecia areata with well-circumscribed patches of hair loss on the crown of his head. How do you respond when he asks you the cause?

a. “You must be under a lot of stress lately.”
b. “It is hereditary. Did your father experience this also?”
c. “The cause is unknown, but we suspect it is due to an immunologic mechanism.”
d. “We’ll have to do some tests.”

Question 21: A blood pressure (BP) of 150/90 is considered:

a. Stage 2 hypertension

b. Hypertensive

c. Normal in healthy older adults

d. Acceptable if the patient has DM

Question 22: When teaching post MI patients about their NTG tablets, theclinician should stress that the tablets should remain in thelight-resistant bottle in which they are packaged and shouldnot be put in another pill box or remain in areas that are orcould become warm and humid. Once opened, the bottlemust be dated and discarded after how many months?

a. 1 month

b. 3 months

c. 6 months

d. As long as the tablets are kept in this special bottle, they will last forever

Question 23: Your patient has decided to try to quit smoking with Chantix. You are discussing his quit date, and he will begin taking the medicine tomorrow. When should he plan to quit smoking?

a. He should stop smoking today.

b. He should stop smoking tomorrow.

c. His quit date should be in 1 week.

d. He will be ready to quit after the Frst 30 days

Question 24: When looking under the microscope to diagnose an intravaginal infection, you see a cluster of small and oval to round shapes. What do you suspect they are?

a. Spores

c. Pseudohyphae
b. Leukocytes

d. Epithelial cells

Question 25: The hallmark of an absence seizure is:

a. No activity at all.
b. A blank stare.
c. Urine is usually voided involuntarily.
d. The attack usually lasts several minutes.

Question 26: Which medication used for scabies is safe for children 2 months and older?

a. Permethrin cream

b. Lindane

c. Crotamiton lotion and cream

d. Ivermectin

Question 27: The clinician is seeing a patient complaining of red eye. The clinician suspects conjunctivitis. The presence of mucopurulent discharge suggests which type of conjunctivitis?

a. Viral conjunctivitis

b. Keratoconjunctivitis

c. Bacterial conjunctivitis
d. Allergic conjunctivitis

Question 28: Gabby, aged 22, has Bell’s palsy on the right side of her face. Her mouth is distorted, and she is concerned about permanent paralysis and pain. What do you tell her?

a. “Most patients have complete recovery in a few weeks to a few months.”
b. “Unfortunately, you’ll probably have a small amount of residual damage.”
c. “Don’t worry, I’ll take care of everything.”
d. “You may have a few more episodes over the course of your lifetime but no permanent damage.”

Question 29: How often should drug levels be monitored when a seizure medication has controlled the seizures and the drug level is adequate

a. Every 3 months
b. Every 6 months
c. Annually
d. Whenever there is a problem

Question 30:  Immunizations are an example of which type of prevention?

a. Primary
b. Secondary
c. Tertiary

Question 31: The result of the patient’s 24-hour urine for protein was 4.2 g/day. The clinician should take which of the following actions?

a. Repeat the test.
b. Refer to a nephrologist.
c. Measure the serum protein.
d. Obtain a blood urea nitrogen (BUN) and creatinine.

Question 32:  Which cranial nerve is afected in a patient with acerebrovascular accident who has difficulty chewing?

a. CN V

b. CN VII

c. CN IX

d. CN X

Question 33: Which of the following diagnostic tests should be ordered for a patient suspected of having bladder cancer?
a. KUB (kidneys, ureter, bladder) x-ray

b. Cystoscopy with biopsy

c. Magnetic resonance imaging (MRI)
d. Urine tumor marker (NMP22)

Question 34: The “B” in the ABCDEs of assessing skin cancer represents:

a. Biopsy.

b. Best practice.

c. Boundary.
d. Border irregularity.

Question 35: Which statement is true regarding driving and patients with a seizure disorder?

a. Once diagnosed with a seizure disorder, patients mustnever drive again.

b. After being seizure free for 6 months, patients may drive.

c. Each state has diferent laws governing driving forindividuals with a seizure disorder.

d. These persons may drive but never alone.

Question 36: Which high-density lipoprotein (HDL) level is considered cardioprotective?

a. Greater than 30

b. Greater than 40

c. Greater than 50
d. Greater than 60

Question 37: The most common etiologic organism for community-acquired pneumonia is:
A. Streptococcus pneumoniae
B. Beta hemolytic streptococcus
C. Mycoplasma
D. Methicillin resistant staphylococcus 

Question 38: Sandra has palpitations that occur with muscle twitching, paresthesia, and fatigue. What specific diagnostic test might help determine the cause?

a. Serum calcium

b. Electrocardiogram (ECG)

c. Thyroid-stimulating hormone test

d. Complete blood cell count

Question 39: A patient presents to the clinician with a sore throat, fever of 100.7?F, and tender anterior cervical lymphadenopathy. The clinician suspects strep throat and performs a rapid strep test that is negative. What would the next step be?

a. The patient should be instructed to rest and increase fluid intake as the infection is most likely viral and will resolve without antibiotic treatment.
b. Because the patient does not have strep throat, the clinician should start broad spectrum antibiotics in order to cover the offending pathogen.
c. A throat culture should be performed to confirm the results of the rapid strep test.
d. The patient should be treated with antibiotics for strep throat as the rapid strep test is not very sensitive.

Question 40: Patients with acute otitis media should be referred to a specialist in which of the following situations?
a. Concurrent vertigo or ataxia
b. Failed closure of a ruptured tympanic membrane
c. If symptoms worsen after 3 or 4 days of treatment
d. All of the above

Question 41: Which of the following tests is most useful in determining renal function in a patient suspected of chronic renal failure (CRF)?
a. Blood urea nitrogen (BUN) and creatinine
b. Electrolytes
c. Creatinine clearance
d. Urinalysis

Question 42: Marci has a wart on her hand. She says she  heard something about “silver duct tape therapy.” What do you tell her about his?

a. It is an old wives’ tale.
b. It is used as a last resort.
c. Salicylic acid is more effective.
d. It is a simple treatment that should be tried first.

Question 43: What is the first-line recommended treatment against Group A b-hemolytic streptococci (GABHS), the most common cause of bacterial pharyngitis?
a. Penicillin

b. Quinolone

c. Cephalosporin
d. Macrolide

Question 44: Which of the following is an example of sensorineural hearing loss?

a. Perforation of the tympanic membrane

b. Otosclerosis

c. Cholesteatoma
d. Presbycusis

Question 45: Which of the following is “a linear crack extending from the epidermis to the dermis?”

a. An ulcer

b. A fissure

c. Lichenification
d. An excoriation

Question 46: A 65-year-old man presents to the clinician with complaints of increasing bilateral peripheral vision loss, poor night visio0n, and frequent prescription changes that started 6 months previously. Recently, he has also been seeing halos around lights. The clinician suspects chronic open-angle glaucoma. Which of the following statements is true concerning the diagnosis of chronic open-angle glaucoma?

a. The presence of increased intraocular pressure measured by tonometry is definitive for the diagnosis of open-angle glaucoma.
b. The clinician can definitively diagnosis open-angle glaucoma based on the subjective complaints of the patient.
c. Physical diagnosis relies on goniscopic evaluation of the angle by an ophthalmologist.
d. Early diagnosis is essential in order to reverse any damage that has occurred to the optic nerve.

Question 47: The majority of HSV-1 and HSV-2 infections are asymptomatic so that only which elevated antibody titer shows evidence of previous infection?

a. IgA

b. IgE

c. IgG
d. IgM

Question 48: A patient is seen with a sudden onset of ±ank painaccompanied by nausea, vomiting, and diaphoresis. Inaddition to nephrolithiasis, which of the following should beadded to the list of diferential diagnoses?

a. Pancreatitis

b. Peptic ulcer disease

c. Diverticulitis

d. All of the above

Question 49: Which of the following is abundant in the heart and rapidly rises in the bloodstream in the presence of heart failure, making it a good diagnostic test?

a. B-type natriuretic peptide

b. C-reactive protein

c. Serum albumin

d. Erythrocyte sedimentation rate

Question 50: You are doing a cerumen extraction and touch the external meatus of your patient’s ear. He winces and starts coughing. What is the name of this reflex?

a. Baker phenomenon

b. Arnold reflex

c. cough reflex

d. Tragus reflex