The ACA was meant to provide quality health care coverage for all yet a coverage gap. For some populations especially in states that oppose Medicaid expansion. Based on what you have learned so far in this course, create a PowerPoint presentation that addresses the coverage gap problem. Who is impacted by the coverage gap, the role the ACA plays in the coverage gap. Why the coverage gap should be closed, and solutions/ recommendations for closing the gap. Address the following in your PowerPoint:

• Select one state opposed to Medicaid expansion and describe why. Then, consider your own state. What are the benefits and drawbacks to Medicaid expansion in your state?
• Define what the coverage gap is (problem/issue)
• Discuss how the coverage gap impact low income healthcare consumers population.
• What role does the ACA have in widening or closing the coverage gap?
• Why is it important to close the gap (implications for positive social change)?
• What are some solutions to closing the coverage gap and how can healthcare equity help close the gap? Include recommendations and/or solutions.

Your PowerPoint presentation should include/address:

• Title Slide (1 slide)
• Objectives Slide (1 slide)
• Medicaid expansion (1-2 slides)
• Coverage gap – define/problem/issue (1-2 slides)
• Coverage gap impact on low income healthcare consumers (2-3 slides)
• Role ACA has in widening or closing the coverage gap (1-2 slides)
• Close the gap (1-2 slides)
• Solutions to closing the coverage gap and how can healthcare equity help close the gap? (2-3 slides)
• Reference slide (1-2 slides).

Assignment Expectations

Length: 9-14 slides (in addition to the title slide and reference slides)

Structure: Include a title slide and reference slide in APA format.   Be sure to fully explain all slides in the Speaker Notes.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of three (3) scholarly sources are required for this assignment.

A PARAGRAP IS NEEDED FOR EACH TOPIC LISTED BELOW:

Students are required to submit weekly reflective narratives throughout the course. That will culminate in a final,ourse-long reflective journal due in Topic 10. The narratives help students integrate leadership and inquiry into current practice.

This reflection journal also allows students to outline what they have discovered about their professional practice. Personal strengths and weaknesses. And additional resources that could be introduced in a given situation to influence optimal outcomes. Each week students should also explain how they met a course competency or course objective(s).

In each week’s entry, students should reflect on the personal knowledge. And skills gained throughout the course. Journal entries should address one or more of the areas stated below.  In the Topic 10 graded submission. Each of the areas below should be addressed as part of the summary submission.

1. New practice approaches

2. Interprofessional collaboration

3. Health care delivery and clinical systems

4. Ethical considerations in health care

5. Practices of culturally sensitive care

6. Ensuring the integrity of human dignity in the care of all patients

7. Population health concerns

8. The role of technology in improving health care outcomes

9. Health policy

10. Leadership and economic models

11. Health disparities

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking the information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg

2. BP: 172/98, HR 88, RR 26

3. 3+ pitting edema bilateral feet and ankles

4. Fasting blood glucose: 146 mg/dL

5. Total cholesterol: 250 mg/dL

6. Triglycerides: 312 mg/dL

7. HDL: 30 mg/dL

8. Serum creatinine 1.8 mg/dL

9. BUN 32 mg/dl

Critical Thinking write up

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.

2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.

3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)

4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.

5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.

6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

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

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

Case Study for SOAPIER Note.

Read the case study. Write a progress note using the SOAPIER format.

SJ came to the ER you are working at with complaint of severe pain in his left leg. When you asked him what happened, he said “I was sled riding in the snow with some friends. I lost control and went over the hill and hit a tree. My leg is killing me.”

You do an assessment. SJ is alert and oriented to person, place and time. He has no known allergies (NKA).Skin is warm and dry. Color appropriate for ethnicity. Neuro checks are normal. Denies hitting his head. Has full range of motion in both arm and right leg. EMS has a stabilizing splint on his right leg. Bilateral toes are pink and capillary refill is quick to return. Distal extremities pulses are strong and bounding. Bowel sounds are positive in all four quadrants.

Vital signs are 97.8 orally. Heart rate is 110 and regular. Heart sounds S1 and S2 heard. Respirations are 24 and unlabored. Lung sounds are clear. Blood pressure is 172/96. He asks “Please can you give me something for pain?” Rates his pain a “10” on the 0 -10 numeric scale. You give him 4 milligrams of morphine IV as prescribed by the physician.

The xray results come back and he has a complete fractured tibia. He is admitted to the medical/surgical unit and scheduled for surgery tomorrow. Report given to RN “Mary” on the medical/surgical unit.