Tag Archive for: nursing

Global health ethics

Required Reading
D’Abramo, F., Schildmann, J., & Vollmann, J. (2015). Research participants’ perceptions and views on consent for biobank research: A review of empirical data and ethical analysis. BMC Medical Ethics, 16(60). doi:10.1186/s12910-015-005305.

Retrieved from http://bmcmedethics.biomedcentral.com/articles/10.1186/s12910-015-0053-5

Duffy, J. D. (2016). Ethical aspects of palliative medicine. Oxford American Handbook of Hospice and Palliative Medicine and Supportive Care, 287.

DeCamp, M., Farber, N. J., Torke, A. M., George, M., Berger, Z., Keirns, C.C., & Kaldjian, L.C. (2014). Ethical challenges for Accountable Care Organizations: A structured review. Journal of General Internal Medicine. 29(10)

Latham, S. R., Kipnis, K., Martin, M. W., & Gabard, D. L. (2014). Health care. In M. Davis & A. Stack (Eds.) Conflict of interest in the professions. (pp. 279-335). Oxford, England: Oxford University Press.

Linder, D. (2018). Free exercise of religion;The issue: When may the government enforce a law that burdens an individual’s ability to exercise his or her religious beliefs? Retrieved from http://law2.umkc.edu/faculty/projects/ftrials/conlaw/freeexercise.htm

Marcus, B. S., Shank, G., Carlson, J. N., & Venkat, A. (2015). Qualitative analysis of healthcare professionals’ viewpoints on the role of ethics committees and hospitals in the resolution of clinical ethical dilemmas. HEC Forum, 27(1), 11-34. doi:http://dx.doi.org/10.1007/s10730-014-9258-0

Oyez. (n.d.). Cases – Free exercise of religion. Retrieved from https://www.oyez.org/issues/339

Perry, F. (2013). The tracks we leave: Ethical and management dilemmas in healthcare. Chapter 1: Understanding Your Ethical Responsibilities. Retrieved from https://www.ache.org/pdf/secure/gifts/Perrych1-final.pdf

Rossum, R. A. & Tarr, G. A. (2013). Chapter 6: Freedom of religion. American constitutional law, volume II: The Bill of Rights and subsequent amendments. New York: Westview Press.

Snyder, J. E., & Gauthier, C. C. (2008). Evidence-based medical ethics. Chapter 2: The Underlying Principles of Ethical Patient Care Retrieved from http://www.springer.com/cda/content/document/cda_downloaddocument/9781603272452-c1.pdf?SGWID=0-0-45-577128-p173746241

Summers, J. (2013) Principles of healthcare ethics. In E. E. Morrison and B. Furlong (Eds.) Health care ethics: Critical issues for the 21st century. (47-63). Burlington, MA: Jones and Barlett Learning, LLC. Retrieved from: http://samples.jbpub.com/9781449665357/Chapter2.pdf

Thomson Reuters. (2018). United States Supreme Court; ROE v. WADE, (1973); No. 70-18 Argued: December 13, 1971; Decided: January 22, 1973. Retrieved from http://caselaw.findlaw.com/us-supreme-court/410/113.html

University of Washington School of Medicine. (2013). Ethics in medicine: Clinical ethics and law. Accessed from https://depts.washington.edu/bioethx/topics/law.html

World Health Organization. (2016). Global health ethics. Accessed from http://www.who.int/ethics/en/

Required Video
U.S. Department of Health and Human Services. (2018, January 18). OCR new conscience and religious freedom division announcement [Video file]. Retrieved from https://www.youtube.com/watch?v=FHttk1t28t4

Optional Reading
Vidat, A., Lecturer. (2015). Issues legal and economic regarding amendments of the individual employment contract because the individual performance targets are not achieved by the employee. Juridical Tribune Journal = Tribuna Juridica, 5(2), 201-207.

HOMEWORK ASSIGNMENT:

Assignment Overview
As a healthcare professional, it is your responsibility to be ethically sound. You have an essential responsibility to effectively apply ethical reasoning to crucial decisions. One method of elevating your ethical reasoning abilities is through the practice, reading, and understanding of case studies. While every case is not identical, the review of ethical case studies prepares you for similar incidents that may arise.

Case Assignment
For the Module 1 Case Assignment, you are to review 2 cases from the AMA Journal of Ethics (http://journalofethics.ama-assn.org/site/cases.html).

In a 3-page paper complete the following:

Identify each case that you have selected.
Explain in detail the ethical issue of each case.
Identify the ethical principle(s) that have been violated in the cases.
Explain from a healthcare professional perspective, what you would have done differently in the case.
You are to support your analysis and views with at least 3 scholarly references (e.g., peer-reviewed journals).

Assignment Expectations
Conduct additional research to gather sufficient information to justify/support your analysis.
Limit your response to a maximum of 3 pages.
Support your proposal with peer-reviewed articles, with at least 3 references. Use the following link for additional information on how to recognize peer-reviewed journals: http://www.angelo.edu/services/library/handouts/peerrev.php
You may use the following source to assist in your formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/.

heart disease

…heart disease remains the No. 1 killer in America; nearly half of all Americans have high blood pressure, high cholesterol, or smoke—some of the leading risk factors for heart disease—Murphy et al., 2018. Despite the high mortality rates associated with cardiovascular disorders, improved treatment options do exist that can help address those risk factors that afflict the majority of the population today.

As an advanced practice nurse, it is your responsibility to recommend appropriate treatment options for patients with cardiovascular disorders. To ensure the safety and effectiveness of drug therapy, advanced practice nurses must consider aspects that might influence pharmacokinetic and pharmacodynamic processes such as medical history, other drugs currently prescribed, and individual patient factors.

Reference: Murphy, S. L., Xu, J., Kochanek, K. D., & Arias, E. (2018). Mortality in the United States, 2017. Retrieved from https://www.cdc.gov/nchs/products/databriefs/db328.htm

To Prepare

· Review the Resources for this module and consider the impact of potential pharmacotherapeutics for cardiovascular disorders introduced in the media piece.

· Review the case study assigned by your Instructor for this Assignment.

· Select one the following factors: genetics, gender, ethnicity, age, or behavior factors.

· Reflect on how the factor you selected might influence the patient’s pharmacokinetic and pharmacodynamic processes.

· Consider how changes in the pharmacokinetic and pharmacodynamic processes might impact the patient’s recommended drug therapy.

Think about how you might improve the patient’s drug therapy plan based on the pharmacokinetic and pharmacodynamic changes. Reflect on whether you would modify the current drug treatment or provide an alternative treatment option for the patient.

ASSIGNMENT: 

CASE STUDY: Patient HM has a history of atrial fibrillation and a transient ischemic attack (TIA). The patient has been diagnosed with type 2 diabetes, hypertension, hyperlipidemia and ischemic heart disease. Drugs currently prescribed include the following:
• Warfarin 5 mg daily MWF and 2.5 mg daily T, TH, Sat, Sun
• Aspirin 81 mg daily
• Metformin 1000 mg po bid
• Glyburide 10 mg bid
• Atenolol 100 mg po daily
• Motrin 200 mg 1–3 tablets every 6 hours as needed for pain

Write a 2- to 3-page paper that addresses the following:

Explain how the factor you selected might influence the pharmacokinetic and pharmacodynamic processes in the patient from the case study you were assigned.

Describe how changes in the processes might impact the patient’s recommended drug therapy. Be specific and provide examples.

Explain how you might improve the patient’s drug therapy plan and explain why you would make these recommended improvements.

REQUIRED READINGS

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier.

· Chapter 34, “Review of Hemodynamics” (pp. 335–340)

· Chapter 35, “Diuretics” (pp. 341–349)

· Chapter 36, “Drugs Acting on the Renin-Angiotensin-Aldosterone System” (pp. 351–362)

· Chapter 37, “Calcium Channel Blockers” (pp. 363–369)

· Chapter 38, “Vasodilators” (pp. 371–373)

· Chapter 39, “Drugs for Hypertension” (pp. 375–388)

· Chapter 40, “Drugs for Heart Failure” (pp. 389–402)

· Chapter 41, “Antidysrhythmic Drugs” (pp. 403–418)

· Chapter 42, “Prophylaxis of Atherosclerotic Cardiovascular Disease: Drugs That Help Normalize Cholesterol and Triglyceride Levels” (pp. 419–439)

· Chapter 43, “Drugs for Angina Pectoris” (pp. 441–450)

· Chapter 44, “Anticoagulant and Antiplatelet Drugs” (pp. 451–472)

Addison’s Disease

Project 7  –  Jane Austen: Addison’s Disease

Prompt
You will choose a well-known individual from history or current popular literature, with instructor approval, who has a known physiological—as opposed to psychiatric or psychological—disease or illness, and, using a systematic approach, you will analyze that disease or illness. You will also develop a plan of care for that disease or illness.
In your analysis, you will describe the pathophysiology for your selected disease or illness, propose historical explanations for variations in findings (when applicable), and demonstrate use of nursing conceptual models to frame your discussion of adaptation and stressors collectively for system analysis.
Your plan of care should utilize the PIE (planning, intervention, and evaluation) format. The planning (P) section should include at least two short-term and two long-term goals that are most appropriate for your chosen case, and each goal should have measurable criteria and have a hypothetical target date or time. The intervention (I) section should include interventions or nursing actions that directly relate to the selected case’s goals and that are specific in action and frequency. The number of interventions should be appropriate for helping to meet individual goals. Finally, the evaluation (E) section of the plan of care should include proposed measures for determining success of the plan and an evaluation of the potential success of the plan, based on those measures.

 

Specifically, the following critical elements must be addressed:

  1. Introduce your selected case
    1. a)  Identify the individual you selected and his or her disease or illness, and provide a brief explanation of why you selected this case.
    2. b)  Describe how normal physiology is changed by the disease state for your selected case.
    3. c)  Define the pathophysiology and clinical manifestations associated with your selected case and how they may be explained by altered physiology.
      Be sure to support your claims with scholarly evidence.
    4. d)  Assess the extent to which clinical manifestations of your selected case affect multiple body systems, using scholarly evidence to support your
      claims.
  2. History of selected case
    1. a)  Describe historical variations (that is, examples of individuals with the selected disease or illness) of your selected case, using evidence from
      literature.
    2. b)  Identify physiological stressors that may affect the course of the disease or illness, and explain their impact.
    3. c)  Identify adaptive physiological mechanisms that may affect the course of the disease for your selected case.
    4. d)  Assess the historical impact of patient care technologies on patient outcomes for your selected case. Be sure to justify your claims with scholarly
      evidence.
  3. Planning for care for your selected case
    1. a)  Write a goal statement that is patient-centered and contains at least one measurable criterion or target date/time. In order to address this
      element comprehensively, you should be sure to provide at least two short-term and two long-term goals for your selected case.
    2. b)  Analyze the critical nursing concerns associated with this disease state, and prioritize them from a treatment standpoint.
    3. c)  Identify patient care technologies that are appropriate for managing clinical manifestations of your selected case.
  4. Intervention
    1. a)  Outline appropriate nursing interventions for your selected case. Be sure to substantiate your claims with scholarly evidence.
    2. b)  Outline common classes of medications used to manage the disease. Be sure to provide examples from scholarly evidence to support your
      claims.
    3. c)  Assess the extent to which current patient care technologies improve health promotion for your selected case, using scholarly evidence to
      support your claims.
    4. d)  Assess the extent to which current patient care technologies assist in decreasing medication errors and improving patient safety with regard to
      your selected case.

V. Evaluation

  1. a)  Identify the most appropriate measures for determining the success of your plan of care. In other words, what data will you need to collect to
    determine if your plan worked? Be sure to substantiate your claims with scholarly evidence.
  2. b)  In terms of the outcome measures you identified, evaluate the potential success of your plan of care and proposed nursing interventions for
    your selected case. In other words, do you feel your proposed plan of care and interventions for your selected case will result in successful outcomes? Be sure to justify your rationale with evidence-based research.

Final Product Rubric
Guidelines for Submission: Your case analysis and plan of care paper should be between 6 and 10 pages, not including title page and reference list. It should be

formatted with 12-point Times New Roman font and one-inch margins; all citations should follow proper APA guidelines.

coding

QUESTION 1

1.    When coding for an established patient for a particular level of service you must have a minimum of 2 of the 3 key elements whereas with a new patient you must have 3 of 3 key elements.

[removed] True

[removed] False

QUESTION 2

1.    The 3 key components of Evaluation and Management coding are history, exam and medical decision making.

[removed] True

[removed] False

QUESTION 3

1.    Emergency department evaluation and management codes are broken out into new and established patients.

[removed] True

[removed] False

QUESTION 4

1.    Preventive Services codes are broken out by age but there is no distinction between new and established.

[removed] True

[removed] False

QUESTION 5

1.    There are 4 “contributing components” of an Evaluation and Management codes are 1) counseling, 2) coordination of care, 3) nature of presenting problem, and 4) time.

[removed] True

[removed] False

QUESTION 6

1.    Types of anesthesia used in surgical practice are 1) general, 2) local and 3) nerve blocks.

[removed] True

[removed] False

 

QUESTION 7

1.    An add-on code is a procedure commonly carried out in addition to the primary procedure performed.

[removed] True

[removed] False

QUESTION 8

1.    CPT modifiers are reported s two digit numeric codes added to the front of the 5 digit CPT code (e.g. 25-99213) .

[removed] True

[removed] False

QUESTION 9

1.    “Disqualifying circumstances” are additional codes to anesthesia such as 99100, 99140, 99116 and 99135.

[removed] True

[removed] False

QUESTION 10

1.    The CPT symbol “triangle” identifies a code description that has been revised.

[removed] True

[removed] False

QUESTION 11

1.    Code the excision of a complicated pilonidal cyst.

[removed] a. 10080
[removed] b. 10081
[removed] c. 11772
[removed] d. 11770

QUESTION 12

1.    Code electrolysis for 2 hours.

[removed] a. 17380
[removed] b. 17380 x 4
[removed] c. 17380 – 22
[removed] d. 17360 x 4

QUESTION 13

1.    Code the reduction mammoplasty bilateral.

[removed] a. 19318
[removed] b. 19020
[removed] c. 19318-50
[removed] d. 19325-50

QUESTION 14

1.    Code a diagnostic laryngotomy.

[removed] a. 31320
[removed] b. 31300
[removed] c. 31360
[removed] d. 31370

QUESTION 15

1.    Code a planned tracheostomy on a 47 year old.

[removed] a. 31603
[removed] b. 31605
[removed] c. 31601
[removed] d. 31600

QUESTION 16

1.    Select an anesthesia CPT code for a 35 year old man undergoing hernia repair of the lower abdomen.

[removed] a. 00832
[removed] b. 00830
[removed] c. 00800
[removed] d. 00834

QUESTION 17

1.    Select an anesthesia CPT code for bilateral corneal transplant.

[removed] a. 00140-50
[removed] b. 00140
[removed] c. 00144-50
[removed] d. 65710-50

QUESTION 18

1.    Select the anesthesia CPT code for a patient undergoing a vulvectomy.

[removed] a. 56625
[removed] b. 00906
[removed] c. 00902
[removed] d. 56620

QUESTION 19

1.    Select the anesthesia CPT code for a patient undergoing a cleft lip repair.

[removed] a. 00102
[removed] b. 00100
[removed] c. 00172
[removed] d. 40700

QUESTION 20

1.    Betsy is an established patient of Dr. Gus and sees the doctor today for acne of the face. Dr. Gus does a problem focused history and exam and the medical decision making is straightforward. Code the office visit.

[removed] a. 99214
[removed] b. 99202
[removed] c. 99213
[removed] d. 99212

QUESTION 21

1.    Dee is an established patient of Dr. Wong and is 3 months post transplant. She goes to Dr. Wong today with edema, increased blood pressure and fatigue. The doctor does a comprehensive history and exam and due to the nature of her problems, the medical decision making is high complexity. Code the office visit.

[removed] a. 99215
[removed] b. 99205
[removed] c. 99245
[removed] d. 99214

1.    A patient is seen in the Emergency Department after falling off his scooter. The ER physician does an expanded problem focused history and exam. He takes an x-ray and determines that the boy only has a sprain so the medical decision making is of low complexity. Code the ER visit.

[removed] a. 99283
[removed] b. 99282
[removed] c. 99281
[removed] d. 99231

QUESTION 23

1.    Michael goes to his family doctor that he’s been seeing for years for his yearly preventive physical. He’s 55 years of age. Code the preventive visit.

[removed] a. 99386
[removed] b. 99214
[removed] c. 99396
[removed] d. 99213

QUESTION 24

1.    Due to injuries sustained in a car accident, Jane is seen by Dr. Ricker for 1hour and 15 minutes for critical care services. Code the critical care evaluation and management.

[removed] a. 99291, 99292
[removed] b. 99291
[removed] c. 99292
[removed] d. 99215

QUESTION 25

1.    The CPT code for a total splenectomy is:

 

[removed] a. 38100
[removed] b. 38120
[removed] c. 38101
[removed] d. 38115

Hispanics/Mexicans –

Hispanics/Mexicans –

Conduct a literature search for varied types of credible, peer-reviewed scholarly publications which may include journal articles, book chapters, white papers; government publications or sources such as credible professional nursing and healthcare organizations. Prepare a powerpoint slide presentation which concisely addresses key points in items one through five below as they apply to your chosen cultural group. Include a title slide which names the chosen culture, and a reference slide with only selected key citations cited in the slide presentation.

Required Content for Powerpoint Presentation

  1. What are the appropriate interdisciplinary interventions for hereditary, genetic, and endemic diseases and high-risk health behaviors within this culture?
  2. What are the influences of value systems in this culture on childbearing and bereavement practices?
  3. What are the sources of strength, spirituality, and magico- religious beliefs associated with health and health care within this culture?
  4. What are the healthcare practices for this culture such as  acute versus preventive care, barriers to healthcare, the meaning of pain and the sick role; and traditional folk medicine practices?
  5. What are cultural issues related to learning styles, autonomy, and preparation of educational content for this culture?

Expectations

  • Format: APA 6th ed. citation format.
  • Research: A minimum of five scholarly reference citations is required.

 NURSING

NURSING

Formulate a PICOT statement for your capstone project.A PICOT starts with a designated patient population in a particular  clinical area and identifies clinical problems or issues that arise  from clinical care. The intervention should be an independent,  specified nursing change intervention. The intervention cannot require  a provider prescription. Include a comparison to a patient population  not currently receiving the intervention, and specify the time frame  needed to implement the change process.Formulate a PICOT statement using the PICOT format provided in the  assigned readings. The PICOT statement will provide a framework for  your capstone project.
In a paper of 500-750 words, clearly identify the clinical problem  and how it can result in a positive patient outcome.Make sure to address the following on the PICOT statement:

  1. Evidence-Based Solution
  2. Nursing Intervention
  3. Patient Care
  4. Health Care Agency
  5. Nursing   Practice

Use a minimum of 3 scholarly references and prepare this assignment according to APA guidelines. No Plagiarism

non-parametric and parametric tests.

Answer to this post. APA, citation and reference . I need an answer that support the text below .

Discuss the differences between non-parametric and parametric tests.

Parametric and nonparametric tests are terms used by statistics shins frequently when doing analysis. Parametric and nonparametric tests referred to hypothesis test of the mean and median. The mean being the parametric and the median being a non-parametric. Parametric test assumes that your date of follows a specific distribution whereas non-parametric test also known as distribution free test do not.

Provide an example of each and discuss when it is appropriate to use the test. Next, discuss the assumptions that must be met by the investigator to run the test.

An example of a parametric test is a 1-2 sample T Test. It is appropriate to use this type of analysis when the sample size is greater than 20. In order to run a parametric test a researcher must know and assume that the test can perform well with skewed and non normal distributions. Another assumption a researcher must have in order to run a parametric test is the knowledge of knowing that the parametric test can perform well when the spread of each group is different.

An example of a non-parametric test is a 1 sample sign. One reason to perform a study using a non-parametric test is because you can perform a parametric test with non normal data. Another reason to use a non-parametric test in a study is when you have a very small sample size,  original data, rank data or outliers which are not removable.  An assumption that must be met any nonparametric test is that the data for all groups must have the same dispersion.

Evidence-based Practice

NR 505 Advance Research Method: Evidence-based Practice

(Chamberlain College – Spring 2016)

 

  • NR 505 Week 3 Assignment; Research Summary Table – Injuries of Children with Non-Helmet Use
  • NR 505 Week 3 Assignment; Research Summary Table – Rodents and Associated Health Risks to Humans

Develop a research summary table on the issue you studied for the community committee. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 3 Dropbox

 

  • NR 505 Week 5 Assignment; Critique of a Systematic Research Review

Critique a systematic research review related to bicycle safety or one of the issues identified in Week 1. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 5 Dropbox.

 

  • NR 505 Week 7 Assignment; Analysis and Application of a Clinical Practice Guideline

Select (1) one of the issues identified in Week 1, (2) the bicycle safety issue, or (3) the surgical infection issue and find a very recent (no more than 5 years) clinical practice guideline related to that issue. Follow the guidelines for this assignment located in Course Resources and submit your finished product to the Week 7 Dropbox.

 

Spiritual and Emotional:

Spiritual and Emotional:

  1. Complete the “EHS Personal Assessment” from the Emotionally Healthy website.
  2. Reflect on your own results. Analyze the structure and assumptions behind the assessment.

Burnout:

  1. Refer to the “Are You Heading for Caregiver Burnout?” quiz.
  2. Complete the survey and reflect on your own results. Analyze the structure and assumptions behind the assessment.

Part II: Reflection

Using the results from the resources, write a 200-250 word reflection on your results and how you plan to combat compassion fatigue and burnout, and how you plan to promote your own spiritual growth.

Prepare this assignment according to the APA 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.

 

1.   Assessment of the Neurological System

1.   Assessment of the Neurological System

Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.

Based on the above please discuss the following.

  1. Pathophysiology of concussive injuries and treatment
  2. Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)
  3. Current best practices associated with post-traumatic stress disorder (PTSD)
  4. Nursing interventions you would include in this patient’s plan of care.