TEACHING PLAN

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Running head: TEACHING PTITLE

NAME

INSTITUTION

Situation

Mr. Howard Bernese is a 77-year-old male that was admitted to the hospital by his wife after reporting an abnormal amount of swelling in his legs and ankles. Mr. Bernese’s wife reported that the patient has also has episodes of confusion. He was diagnosed with acute kidney failure upon assessment and will need to be monitored for a few days in the hospital prior to discharge.

Background

The patient is 6”4” and weighs 260 pounds, he lives at home with his wife who seems to manage well for her age. Due to the pandemic the patient has been to skeptical and afraid of leaving the house. Because of his fear he did not go to the urgent care when he first noticed the swelling in his lower extremities. He reports having a heart attack five years ago and a decrease in urine output. Mr. Bernese also reports taking 1000mg of ibuprofen a day for the pain in his legs. In the last few weeks, he reports feeling exhausted after standing for too long and shortness of breath from walking from one part of the house to the other. Mr. Bernese does not have the best nutrition as they order food every day due to their lack of motivation to cook. (MER, 2020)

Needs Assessment

Howard is surprised to find that the swelling in his leg is due to a very serious disease that if left untreated could result in death. The physician has ordered a dietician, strict intake and output, renal ultrasonography, and a lab on serum creatinine levels. A social worker has been assigned to Mr. Bernese to help with any difficulties the couple may experience one Mr. Bernese is discharged from the hospital. Patient will also be sent home with a health pamphlet on what foods to stay away from and what foods the patient should be eating instead. The patient will learn the severity of his condition and will be taught on the importance of immediately reporting any abnormal findings in the patient’s health.

The patient will be on a treatment to manage the amount of fluid in the client’s blood.And patient will be put on medications to control his potassium levels and medications to restore the client’s calcium levels. Dialysis treatment will be considered after several other treatments have been used. The education to the patient for the medications will be provided for both the potassium and the calcium medications. This patient has a bachelor’s in business administration and is able to speak both English and Spanish fluently which means the patient is able to understand and comprehend instructions well. Mr. Bernese concentrates best after a meal and when he is not feeling any anxiety. The patient relies on his wife’s support for comfort (MC, 2020).

Learning styles

Howard prefers to visually learn things rather than any other style. Says that he much rather watch television than to read a book. He enjoys instructions with photographs rather than having to read a set of instructions. He expresses the fact that he can become easily agitated if something is not easily understood and that his wife does not speak great English. The appropriate learning style for this client would be visual learning styles with minimal wording for the client to understand best.

Goal Development

This client should be provided education on his current illness and all the illnesses that could be caused if the patient does not take the right steps forward to a healthier life style. The patient will be taught the education on each medication he will be prescribed. Patient will be educated on how to take each medication, the frequency, the route, and the length of his medication (MER, 2020). And patient will be taught the importance of his diet and what type of diet he should follow. Due to the BMI of this patient he should be put on a high-fiber low sodium diet to prevent any other complications to occur.

Learning Outcomes

If the patient is compliant with the following standards and health practices that have been in put in place for him the patient should expect to feel less pain and less swelling to be prominent in his daily life. Through the encouragement of a routine exercise plan and a meal plan given by the dietitian the patient can help to prevent further complications with his health. To prevent the patient from fluid accumulating in his body the patient should follow the diet plan set for him, the patient is eager to do so. Based on a scholarly article a low sodium diet can help to prevent fluid from accumulating in the patients body (MC, 2020).

Teaching Content

Kidney Disease | Education | DaVita Kidney Care On World Kidney Day, Baxter Shows How You Can Live a Healthy Lifestyle for Healthy Kidneys | Baxter Download infographics about kidney disease - American Kidney Fund (AKF)

Instructional Methods

1. Make a diet plan with foods that are enjoyable for the client

2. Encourage the patient to stay away from food that are high in sodium

3. Encourage patient to follow a high-fiber diet

4. Find a CKD support group that the patient can attend to provide support for his new life change

5. Exercise at least 30 minutes daily

6. Follow directions given by the nurse regarding the medications

7. Increase movement throughout daily life

8. Follow up with PCP every month to check labs

9. Report any pain or any swelling to PCP right away

10. Report any adverse effect of medication to patient right away

11. Give proper education to both the patient and the spouse of the patient

Time and Resources

Howard Bernese needs to be evaluated regularly to assure that the care plan that was provided for the patient is effective for his health. The patient needs to be educated on medications and overdose. If the patient is experiencing pain the pain should be taught the cautions of overdosing and to not take more medication that what is prescribed to him. Within 5 months the patients levels will be stabilized if he follows the care plan that is set out for him. The patient will be given different support groups that are available to him that could help with his new life changes. A go fund me will be set up by his niece in order to compensate for this unexpected health situation. Mr. Bernese will follow his exercise routine. (MC, 2020) If the patient request further education the proper information should be provided to the patient.

Evaluation

Patient was evaluated by primary care physician every month but an entire assessment was done four months after the diagnosis of acute kidney disease. Lab results are normal and in range. The patient has done well with following medications, the right diet plan, and has exercised daily. The patient has lost 10lbs while on this new diet and the swelling is no longer visible. Pitting edema of +2. The wife has also taken part in the same diet plan and exercise routine in order to make the transition for the patient easier. He has been to support groups that have helped him with this new change in his life. The patient is currently taking kayexalate and calcitonin (MER, 2020)

 

References

Mayo Foundation for Medical Education and Research. (2020, July 23). Acute kidney failure. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/kidney-failure/diagnosis-treatment/drc-20369053.

Mayo Foundation for Medical Education and Research. (2020, March 31). Medications for Acute Kidney Disease. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/hypercalcemia/diagnosis-treatment/drc-20355528.

 

developmental realms

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Despite increased abilities across developmental realms, including the maturation of pain systems involving self-regulation and the coordination of affect and cognition, the transition to young adulthood is accompanied by higher rates of mortality, greater engagement in health-damaging behaviors, and an increase in chronic conditions.  Rates of motor vehicle fatality and homicide peak during young adulthood, as do mental health problems, substance abuse, unintentional pregnancies, and sexually transmitted infections.

Describe how the advanced practice nurse can play a role in improving the health of young adults through preventive screening and intervention.

Instructions: 

Word limit 500 words.  Support your answers with the literature and provide citations and references in APA format.

chronic care management

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    1. Content
      Scenario
      You are a nursing case manager working in a 100 bed community hospital in a rural setting. Many clients are elderly with chronic health conditions. And have several factors that impair their timeliness of follow-up appointments for chronic care management. Since they are remote, the hospital struggles to meet the needs of this community health population. Therefore, the hospital experiences a delay in client care and chronic care management due to a lack of provider access. Many clients also report having to align transportation needs for their nurse appointments which further limits their availability. Recently, client complaints have increased with regards to lack of reliable. Prompt service for client chronic care consults and lingering concerns for their overall health.

      Instructions

      A Clinical Standards and Innovations Committee has been created to look at leveraging technology to expand care for remote. Community health populations. The Chief Nursing Officer has assigned you to this committee. To examine strategies for best practice related to use of telehealth to support rural settings. And expand care to all community populations. As the lead RN on the committee you have been tasked with leading the telehealth initiative. And have one month to research, analyze. And propose the best evidence based strategy to implement telehealth services through telecommunications-ready tools. You will present your findings to the Chief Nursing Office. And CEO of the facility in a succinct one-page summary leveraging your committee’s recommendation. They have asked for the summary to include the following components:

    2. Discuss the defining characteristics of telehealth
    3. Include your own definition of telehealth
    4. How does telehealth impact the nursing role
    5. Examine how telehealth is currently integrated in healthcare
    6. Describe the evidence based practice that supports the use of telehealth in rural and community healthcare settings.
    7. Provide a detailed description of your recommended evidence based strategy to implement telehealth
    8. Provide rationale supporting your strategy
    9. Summary to include current evidence from the literature.

theory development in nursing.

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Deliverable 1 – Theory to Guide Nursing Practice Assignment

Assignment Content

  1. Competency
    Describe theory development in nursing.

    Student Success Criteria
    View the grading rubric for this deliverable by selecting the “This item is graded with a rubric” link, which is located in the Details & Information pane.

    Scenario
    As a BSN prepared nurse, it is an expectation that you incorporate theory into your daily practice. As a new graduate, you are interviewing for a position as a registered nurse in a large academic medical center. When scheduling the interview, the Human Resource department provided some possible interview topics and suggested that you be prepared to discuss these topics. One topic included, “Discuss one nursing theorist that will guide your clinical practice.”

    Instructions
    As a means of organizing the information, you decide to prepare an Infographic that includes the following information:

Writing A Sample

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Discussion Topic

Top of Form

Chapter 22: Presenting your research findings

Chapter 23: Publishing your research results

Read Chapter 22 & 23

Discussion # 7 Please see discussion grading rubric below.

 

NURSING RESEARCH Discussion Post Rubric.docx

 

 

Please read chapters 22 and 23 in your class textbook. Presenting your research findings and presenting your research results.

What are some suggestions that you would like to share regarding disseminating your research findings? How would you present them for presentation or defense? Additionally, discuss the rationale and responsibilities for publication of your research.

 

 

 

 

 

 

 

 

 

 

Discussion Post Rubric:

Each posting and Reading Reflection:

Criteria 1 Point 0.75 Point 0.50 Point 0.25 Point
Participation

Weight 25.00%

 100 %

3 Posts

 80 %

2 Posts

 60 %

1 Post

 0 %

0 Posts
Quality of information

Weight 25.00%

 100 %

Information is clear and relates to the topic

 80 %

Information is somewhat clear and might relate to the topic

 60 %

The information has little relation to the topic and is not clearly displayed

 0 %

Information is not clear, and it does not relate to the topic
Resources

Weight 25.00%

 100 %

Provides resources using APA guidelines

 80 %

Provides resources without APA guidelines

 60 %

Limited on the resources provided with major errors in APA

 0 %

Provides no resources
Critical Thinking

Weight 25.00%

 100 %

Enhances the critical thinking process through premise reflection

 80 %

Enhances the critical thinking process without premise reflection

 60 %

Does enhance the critical thinking process in a very limited manner

 0 %

Does not enhance the critical thinking process

DISEASE PREVENTION IN HOSPITALS

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Running head: DISEASE PREVENTION IN HOSPITALS 1

 

DISEASE PREVENTION IN HOSPITALS 2

 

 

 

 

 

 

 

 

 

Disease Prevention in Hospitals

Yoslaine Guevara

Miami Regional University

 

Disease Prevention in Hospitals

Theoretical Framework

There are several theories that are in place supporting the disease prevention and health promotion approach in healthcare. The theories and models explain how the planning to understand the people heath behavior would assist much in the identification, development and implementation of intervention. There are several factors that need to be considered when choosing a theory and this includes the specific health problem targeted, health promotion and the disease prevention. Social cognitive theory is one of the theories and is more about influencing individual health behaviors. The social cognitive theory (SCT) offers the possibility of giving an opportunity of social support to the patients and healthcare providers towards prevention from the disease infections (RHI, 2021). The nurses and doctors have the understanding and behavior capability of considering preventing themselves from contracting diseases by using the personal protective gear required before attending to patients.

Educating and promoting disease promotion by nurses to the patients under the SCT is an approach that helps towards disease prevention in the hospital setting. The second theory is the reasoned action/planned behavior theory that suggests that an individual health behavior is determined by their intention to perform the behavior. A person behavioral intention is based on their attitude and subjective norms regarding the behavior and this is what guides the patients, staff and the healthcare providers in the hospital setting in the approach in offering necessary disease prevention from spreading (RHI, 2021). The hospital management intention or the reasoned action of creating the best environment in the hospital that ensure that the staff are safe from disease infections and the patients have enough space to minimize possible infections within the facility.

Research Questions

Determine the possible ways in which disease infections are prevented in hospital?

Identify the best practices that will minimize hospital infections?

The five studies have discussed similar research questions have highlighted above but the differences are associated on the type of diseases that they are preventing from being infected in the hospital facility. The research study by (Schoppenthau et al, 2021) answers the research question about the best prevention ways against in-hospital Covid-19 infections targeting on protecting the patients and hospital staff. Lindsey et al (2016) study research question is about determining the ways of preventing the healthcare-associated antibiotic-resistant (AR) infections. The (Lindsey et al, 2016) study has dealt with 4000 short-term acute care hospitals, 501 long-term acute care hospitals and 1135 impatient rehabilitation facilities in all the 50 states. Gan et al (2020) study also targets on answering the question about the best practices that should be adopted in the hospitals in order to achieve zero occupational infections in the hospitals. The research study conducted by (Robin et al., 2018) is about answering about the newer approaches to preventive intervention against infectious diseases in older adults in long-term facilities, hospital and nursing facilities.

Data Collection Methods

The data collection methods highlighted in the articles were the use of questionnaires and survey methods where the participants were subjected to a monitoring program in checking the outcome of the prevention strategies.

Sampling and Sampling Size

The research conducted by (Robin et al., 2018) target the elderly population of the patients of 65 years and above and the process of sampling most was done through volunteering process where the target facilities are chosen. The volunteering approach is more necessary when handling a sensitive topic like the health status of a patient. The sampling technique adopted in the study (Schoppenthau et al, 2021) involves strategically targeting the hospital facility employee. The employees are the nurses, physicians and other staff and they are all of age range between 19 and 71 years. A sample size of 394 staff was subjecting to the SARS-CoV-2 testing and 589 tests were conducted on the patients. The study by Gan et al (2020) was more about assessing the general improvements and targets towards achieving a zero occupational infections in Singapore and make sure that the healthcare providers are protected from infections. Bearman et al (2019) implemented the cluster randomized method in choosing the participants of the study that comprised of healthcare providers of 20 medical and surgical ICUs in 20 US hospitals. The cluster randomized trial was used in gloving and gowning the medical staff in the ICU facilities and the impact on patient and healthcare interactions are monitored and recorded.

Research Designs

The highlighted articles employed distinct research designs based on the objective of the study. The study by (Schoppenthau et al, 2021) collected data through voluntary approach and this means that the administering of the treatment was not done randomly but there was the consent from the patient or healthcare provider. A quasi experimental design was adopted for the study where testing was conducted on the effectiveness of the preventive techniques against the SARS-CoV-2. A questionnaire was used to collect the participants’ feedback that was subjected to a periodical monitoring. A true experimental design was adopted in the study by (Bearman et al., 2019) and this was demonstrated by the cluster randomized design treatment on the universal gloving and gowning and the outcome of the prevention strategy monitored for the patients and healthcare workers in terms of infectious disease prevention. A correlation research study was adopted for the (Lindsey et al., 2016) study where different data for the 50 states about the infectious disease and the impact of the preventive approaches.

Goals and Health Outcome

The goal of the study is to define the appropriate ways in which disease infections are avoided in the hospital setting especially in protecting the patients and the healthcare providers. The findings of all the five articles indicates that the physicians, nurses and healthcare leaders are required to follow the required infectious disease prevention protocols and recommendation for a better outcome. According to (Bearman et al., 2019), hospital-acquired infections are associated with a significant increase in morbidity and mortality. The existing infectious disease prevention processes are known to prevent approximately 70% of the infectious diseases and the prevention protocols include gloving, gowning and implementing contact precautions. The study on (Schoppenthau et al, 2021) has illustrated about the massive testing conducted in the healthcare institutions about the highly infections Covid-19 and the adoption of the isolation strategies and masking has resulted to a decrease in the infection rate among the patients and the staff members. There is a high possibility of a zero occupational infections in the hospitals and this is achieved by adhering to all the prevention techniques and always being cautious on using the protective equipments and gear.

Research Findings and Implementing Strategy

The findings obtained by (Lindsey et al., 2016) demonstrate that there has been a tremendous progress in the approach towards preventing infectious diseases within the hospital facility. The many remaining infections that are experienced in the hospitals are mainly contributed by the failure of the healthcare providers by failing to implement the existing recommended practices that include masking, gloving and gowning. According to (Schoppenthau et al, 2021), a comprehensive testing of the patients and the hospital staff for the SARS-CoV-2 and the use of surgical face masks for both parties helps in the early detection of the infectious Covid-19.

Early detection of the COVID-19 play a major role in preventing the spread to the vulnerable hospital population (Schoppenthau et al, 2021). The other articles support the masking and gowning and the use of all the protective gear as the preventive strategies to the infectious diseases. The hospital management should consider offering the necessary resources needed to achieve a healthy work environment to achieve a zero occupational infections (Bearman et al., 2019). Based on the findings, there is the need to sensitize more about implementing the safety precaution of preventing the infectious diseases from spreading in the hospital to meet the requirement of the healthcare providers to avoid harming the already vulnerable population.

Interrelationship between Theory, EPB and research

The theories discussed include the social cognitive theory (SCT) and the reasoned action theory. The theories express more about the understanding and the intention of an individual’s to perform the prevention behavior like adhering to the provided guidelines. The theories relate with the evidence based practice (EBP) in a manner that there is the need of training and building a subjective behavior and norms of adhering to the safety protocols to minimize spreading the infectious disease in the hospital facility. Evidence based research works in a manner that the highlighted source of the problem is addressed through research to find the necessary solutions. An example is the issue that the healthcare professionals are not masking or gowning and the concern is directed towards researching the reasons that contribute to the non-adherence.

Credibility of the Sources

The five sources used in the research paper are credible and their findings and outcomes are true since they are resources that are scholarly and peer-reviewed. The chosen articles are credible in a manner that they were published in between the period of 3-5 years.

 

 

 

 

 

 

 

References

Bearman, G., Doll, M., Cooper, K., & Stevens, M. (2019). Hospital Infection Prevention: How Much Can We Prevent and How Hard Should We Try?. Current Infectious Disease Reports, 21(1). https://doi.org/10.1007/s11908-019-0660-2

Gan, W., Lim, J., & Koh, D. (2020). Preventing Intra-hospital Infection and Transmission of Coronavirus Disease 2019 in Health-care Workers. Safety And Health At Work, 11(2), 241-243. https://doi.org/10.1016/j.shaw.2020.03.001

Jump, R., Crnich, C., Mody, L., Bradley, S., Nicolle, L., & Yoshikawa, T. (2018). Infectious Diseases in Older Adults of Long-Term Care Facilities: Update on Approach to Diagnosis and Management. Journal Of The American Geriatrics Society, 66(4), 789-803. https://doi.org/10.1111/jgs.15248

RHI. (2021). Social Cognitive Theory Model – Rural Health Promotion and Disease Prevention Toolkit. Ruralhealthinfo.org. Retrieved 27 June 2021, from https://www.ruralhealthinfo.org/toolkits/health-promotion/2/theories-and-models/social-cognitive.

Schöppenthau, D., Weiß, K., Estepa-Martinez, M., Hommel, M., Miera, O., & Schoenrath, F. et al. (2021). Preventing SARS-CoV-2 In-Hospital Infections in Cardiovascular Patients and Medical Staff: An Observational Study From the German Heart Center Berlin. Frontiers In Medicine, 7. https://doi.org/10.3389/fmed.2020.616648

Weiner, L., Fridkin, S., Aponte-Torres, Z., Avery, L., Coffin, N., & Dudeck, M. et al. (2016). Vital Signs: Preventing Antibiotic-Resistant Infections in Hospitals – United States, 2014. American Journal Of Transplantation, 16(7), 2224-2230. https://doi.org/10.1111/ajt.13893

Community Health Distel

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NRS 450 Community Health Distel 2018

 

 

 

Community Assessment Worksheet

 

GUIDELINES FOR A WINDSHIELD SURVEY

 

· Use a map. Google Maps or similar services are an excellent resource

· Drive at a moderate speed, and avoid unexpected actions

· Drive both on major and minor streets, particularly in residential neighborhoods. You’ll want to get a sense of different parts of neighborhoods and different streets.

· Pull over at regular intervals to make notes. DO NOT WRITE OR TAKE PICTURES WHILE DRIVING. AVOID DISTRACTED DRIVING AT ALL TIMES.

· Try to be inconspicuous, but if asked what you are doing be honest.

GUIDELINES FOR A WALKING SURVEY

· Study a map beforehand

· For safety sake, we recommend that you do not perform any part of the windshield survey alone. Try not to take more than 2 people. Two or three people walking together are a normal group, but five or six is a crowd, and stands out. Plan to perform the windshield survey during daylight hours only.

· If you want to experience the community, take part in everyday activities. Take public transportation, eat in a local restaurant, buy something in a drugstore or supermarket or discount store. This will give you a chance to listen to people’s conversations and to get a sense of how they interact.

· Go inside public buildings and cultural institutions

If you have the time, combine the windshield and walking survey techniques over several trips in order to get a feel for the daily variations – try to alternate the time of day, if possible.

As always, please consider your safety in completing the survey. Chose a different day to go if there are poor driving conditions, and do not go into areas that feel unsafe.

 

 

You will note that the survey asks you to talk to residents: please do not leave this step out! The people in the community know more about it than you can learn from walking/driving through. Be sensible about whom you talk with and what is going on around you, and be respectful. You may find varying perspectives from different members of the community – this adds to the depth of your findings.

Common sources of data to supplement the windshield survey include: US Census data, Chamber of Commerce, community libraries, social service agencies, RTD, US Department of Labor, your state Department of Public Health and Department of Education, police and fire departments, local public health agencies, local stores.

You must address each required subsection of the survey, but the questions that are included on the worksheet are to be used as a guideline only. You might want to include additional information to address your specific location.

Adapted from Anderson & McFarlane (2011) Community as Partner: Theory and Practice in Nursing, 6th ed. Lippincott, Williams & Wilkins Use this tool to complete the windshield survey
Windshield Survey Worksheet    
  OBSERVATIONS/

DATA

I. Community Core

1. History–Is there any pertinent history for your location (e.g., old, established neighborhoods; new subdivision)? Is it a rural, suburban or urban community? What is your feel of the population density?

  
2. Demographics–What is the population of the community? Has the community experienced a recent increase or loss of population (in-migration versus out-migration)? What are the age, gender and racial distribution of the community? Can you find birth and death rates for the community?

 

  
3. Ethnicity–Do you note indicators of different ethnic groups (e.g., restaurants, festivals)? What signs do you see of different cultural groups, if any? Is there a predominant culture?

 

  
4. Religion–Are there churches, mosques, temples? Where are they located within the community? Any religious schools? Is there evidence of religious homogeneity or diversity?

 

  

II. Subsystems

1. Physical Environment–How does the community look? What is the age and condition of the majority of housing? Do housing conditions vary in different parts of the community? How is the land used (open space, residential, agricultural, commercial, industrial)? Is there any evidence of pollution (water, soil, air) or environmental concerns (rodents, trash)? What is the size (e.g., square miles, blocks)?

  
2. Health & Social Services–What are the major causes of morbidity and mortality? What is the infant mortality rate and teenage pregnancy rate? Are there any ’traditional” healers (e.g., curanderos, herbalists)? Are there clinics, ambulances, hospitals, practitioners’ offices, home health agencies, urgent or emergency care centers, nursing homes, social service facilities, mental health services?  

Economy and Safety

3. Economy and Safety–Do you see signs of economic growth such as real estate signs or new construction, remodeling or street repair? Do you see signs of community decline such as trash, abandoned cars, graffiti or rundown housing?

Are there industries, stores, places for employment? What occupations (retail, industrial, farming, service, government, tourism or unemployed) are represented in the community? Where do people grocery shop, inside or outside of the community?

Is there a difference in types of stores available in different neighborhoods or parts of the community?

What is the unemployment rate, types of protective services are there (e.g., fire, police)? What types of crimes are committed here? And is the geographic distribution of crimes? Are there any signs of neighborhood watch programs?

 

Transportation

  
4. Transportation –How do people get around? What type of private and public transportation is available? Do you see buses, bicycles, taxis? Are there sidewalks, bike trails? Is getting around in the community possible for people with disabilities?

 

  
5. Politics and Government–What is the local governmental jurisdiction of the community and how is it organized (e.g., elected mayor, city council with single member districts)? What services does the local government provide to residents?

 

  
6. Public Health–What is the local health department? How big is the agency and what population does it serve? What services are provided?

 

  
7. Education–Are there schools in the area? Do they look well-maintained and how are they rated academically? What are the drop-out rates? How far are the schools from the center of the community? Are there any school health services, there any higher-education schools available in the community? And there any libraries?

 

  

 

 

 

 

 

8. Recreation–Where do children play? What are the major forms of recreation? What facilities for recreation do you see? Are there any movie theatres, bowling alleys or amusement parks in the area? Are there any recreation programs aimed at specific groups such as seniors or preschoolers?

 

  

III. Interviews

The Residents–How do people feel about the community? What do they identify as its strengths? Do people feel safe? Any problems that they see in the community? Any changes they would like to see made? Ask several people from different groups (e.g., old, young, field worker, factory worker, professional, minister, housewife) and keep track of who gives what answer. DO NOT AGGREGATE YOUR INTERVIEWS. STATE WHO SAID WHAT. Attempt to gain interviews from people whom you believe might be “stakeholders”, if possible.

 

  
2. Your Perceptions–General statements about the “health” of this community. What are its strengths or assets? Upon completion of the windshield survey, what health- related problems can you identify for this community? (Be specific)

 

  
Note: Supplement your impressions with information from the census, police records, school statistics, chamber of commerce data, and health department reports, and so on to confirm or refute your conclusions. Tables, graphs, and maps are helpful and will aid in your analysis.

 

Cite all sources per APA guidelines

 

Syllabus – NRS450, updated: Jan. 2013 1

Windshield Survey Scoring Rubric Updated 03/2018 4

Nutritional Foundations and Clinical Applications

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Week 5: Elderly Case Study

Ebook attached below: Nutritional Foundations and Clinical Applications: A Nursing Approach 7th Edition

You are asked to see Mr. Basset, who is 80 years old, currently living alone, and has recently lost his wife. His children do not live nearby, but Mr. Basset sees them on holidays. Mr. Basset was recently diagnosed with lung cancer and has had an unexplained weight loss of 20 pounds in 3 months. He is getting chemotherapy as well as taking oral medication for hypertension and arthritis, and is showing signs of dehydration.

Mr. Basset reports that his wife did most of the cooking and he has limited cooking skills. He usually has cereal with milk and coffee for breakfast and soup for a second meal later in the day. He eats crackers throughout the day if he is hungry, but admits that he doesn’t have much of an appetite. In addition, Mr. Basset has ill-fitting dentures and claims that food just does not taste the same. He is also on a limited budget.

1. What physiological factors might contribute to Mr. Basset’s weight loss?

2.  What psychosocial factors might contribute to Mr. Basset’s weight loss?

3.   Give one likely explanation why Mr. Basset’s dentures do not fit.

4. What nursing actions need to be included in the plan of care to improve Mr. Basset’s nutritional status?

APA format (6th ed.) and is free of errors

Grammar and mechanics are free of errors free of Plagiarism

References: Use your book, the outside source must be within the last 5 yrs, Scholarly Article or Nurse journals within the last 5 yrs

Type out the questions and respond to the question in APA format with citation and very detailed responses

Acid-Base Imbalance

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Module 05 Written Assignment – Acid-Base Imbalance

  1. Competency
    Describe strategies for safe, effective multidimensional nursing care for clients with acid-base imbalances.

    Scenario
    Tony is a 56-year-old, Hispanic male that presented to the Emergency Room with complaints of shortness of breath, which he has been experiencing for the past two days. He states “I haven’t felt good for about a week, but couldn’t afford to miss work.” He complains of a cough, fever, and feeling exhausted. Past medical history includes asthma, chronic obstructive pulmonary disease, and diabetes. Upon physical examination, you notice that Tony is struggling to breathe, his respiratory rate is 36 breaths per minute and labored, his heart rate is 115 beats per minute, his blood pressure is 90/40 mm Hg, and his pulse oximetry is 84% on room air. You notify the MD. He orders oxygen at 2 L via NC and arterial blood gas.

    Tony’s ABG results:
    pH 7.28
    PaCO2 – 55 mm Hg
    PaO2 – 70 mm Hg
    HCO3 – 30 mEq/L

    Instructions
    In a 1-2 page Word document:

    1. Determine Tony’s acid-base imbalance
    2. Describe possible causes of the imbalance
    3. Identify the signs and symptoms that Tony is exhibiting as a result of the acid-base imbalance
    4. List the multidimensional care strategies that are appropriate for the care of Tony

Corrective Measurement Action Plan

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Need a corrective measurement action plan for the following topics please incorporated the list below on the plan. And it mostly has a way to measure the outcome in percentage

How to prevent adverse outcomes such as injuries or sentinel events at an ambulatory pain management surgery center.

The list below is the updated and new measurement taken to correct and prevent any unwanted adverse effects pre. And post-surgery procedures at the specific surgery center..

1- At all times there will be a registered nurse pre-procedure and post-procedure to evaluate the patient.

2-The RN will check the first set of vital signs before the procedure. And after the procedure before endorsing the patient to the medical assistance.

3-Any patient with an allergic reaction to a medication use at the surgery center. Or any material use for preparing the patient before surgery will have a red chart to indicated that there is a potential for harm.

4 Neon bright stickers will be applied to the red charts to use as a second line of preventing any adverse reactions.

5-New  advanced patient monitor with the capability to identify any issues during and after the procedure were installed.

6-Any patient post-surgery procedure who is not aroused spontaneously will be placed on a 3 lead EKG and any abnormality will be reported to the surgeon right away.

7- Two RN nurses will be present at all times during procedures.