Integumentary Function Case Study

/in /by

Instructions: Respond by extending, refuting/correcting. Or adding additional nuance. Must be in current 7th edition APA format with academic references cited. Must be gramatically correct.

Integumentary Function Case Study

Psoriasis is a skin disorder caused by an immune-mediated chronic inflammation of the skin cells resulting in a build-up. Genetics play a role in the development of the disease. However, some environmental triggers can induce an exacerbation. Triggers include stress, infections, trauma, systemic drugs, alcohol, gluten. And obesity (Tirant et al., 2020).

Manifestations will be on various parts of the body. The symptoms are categorized into several clinical types: Plaque (chronic), erythrodermic (acute. Or chronic), guttate, inverse, and pustular. According to Dlugasch & Story (2021), the plaque type is the most common. And it consists of thick, red plaques covered by silver-white scales on the skin that may cause bleeding if lifted. The plaques are found on the scalp, elbow, and knees. The erythrodermic type has intense erythema, itching. And painful scaling within large body areas that are at most risk for infections. Guttate type has small, pink-red papules on the trunk and extremities. The inverse type entails erythema. And irritation without scaling on the armpits, groin, and skin folds. The pustular type includes papules. And plaque with pus, erythema, malaise, and fever. Other manifestations included with psoriasis are dryness, flaking, pain. And psychological concerns.

types of treatment strategies to decrease the cell buildup

Although there is no cure for psoriasis. There are three main types of treatment strategies to decrease the cell buildup: 1) topical treatments (e.g., corticosteroids, retinoids, salicylic acid, and moisturizers); 2) phototherapy (e.g., sunlight, ultraviolet A&B, and excimer laser); 3) oral or injected systemic medications (e.g., retinoids, methotrexate, hydroxyurea) (Dlugasch & Story, 2021). The patient may take a systemic medication due to the exacerbation in many areas of her body (but only for a limited time because of extreme side effects). And sunlight phototherapy to slow the growth of the cells. And decrease inflammation. Non-pharmacological treatment is to avoid triggers. Keep hydrated with moisturizers, natural sunlight. And daily baths.

Certain medications can cause an exacerbation of psoriasis. So it is essential to take a thorough review of current medications. Patient K.B. has been diagnosed with psoriasis for five years. With a relapse of three times since diagnosis. And remission for the last 18 months. The flare-up caused an increase in body surface area. So the appropriate review would be to ask about current medications. Beta-blockers, lithium. Anti-malarial drugs. And interferons strongly affect psoriasis exacerbation (Balak & Hajdarbegovic, 2017).

                                      Sensory Function Case Study

The patient of this case study presents with crusty yellow discharge on bilateral eyes. That developed within twenty-four hours. In addition, his conjunctiva is red. And vision is blurry in the mornings despite washing of the eyes. His visual acuity returns to normal once the discharge is gone. His left ear is painful with a red, bulging. And opaque tympanic membrane upon examination. My diagnosis for the patient would be bacterial conjunctivitis. This type of conjunctivitis produces mucopurulent yellow-green discharge. In one or both eyes. It can accompany otitis media. Which displays as tympanic membrane inflammation as red. And bulging (Dlugasch & Story, 2021).

The symptom manifestations, frequency of occurrence. And level of severity determine the diagnosis. Labs and cultures are not used to confirm conjunctivitis. Unless suspected of gonococcal infections (Dlugasch & Story, 2021). However, a rapid viral test for adenovirus can differentiate viral. And bacterial etiology (Dlugasch & Story, 2021). The best therapeutic approach for the patient is warm compresses. And eye drop or topical antibiotics.

Qualitative Research In Nursing Practice

/in /by

Which method of research provides the best evidence for nursing practice? Is there a place for both quantitative and qualitative research in evidence-based practice? How do these research methods improve patient outcomes?

Return to and reflect on your thoughts and postings from Week 1’s Discussion on the respective characteristics, strengths, and limitations of quantitative and qualitative research. Consider the uses of each type of research in the health care field. Also reflect on the amount of quantitative versus qualitative research that exists in the health care field in particular. There is an impression among some researchers that qualitative research is inferior to, easier than, or not as rigorous as quantitative research.

In this Discussion, you consider the idea of rigor, or thoroughness and scope of study, with regard to qualitative research. You examine the methods of qualitative research outlined and recommended in this week’s Learning Resources and how they aim to create standards of rigor by which to assess qualitative studies. You also have the opportunity to assess an article of your choice in terms of rigor and recommended methods of qualitative data collection.

To prepare:

  • Consider your readings about and understanding of quantitative and qualitative research. If you had to choose, which type of research (quantitative or qualitative) do you think is more rigorous and why? Do you think it is useful to make such generalizations and comparisons?
  • Locate an article describing a qualitative research study related to a health care topic.
  • Formulate a research question to address the problem and that would lead you to employ correlational statistics.
  • With information from the Learning Resources in mind, critically analyze your selected study. Ask yourself: How rigorous was the study in terms of the researchers’ efforts, the data collected, and the conclusions drawn? What might the researchers have done to improve the rigor?

By Day 3

Post a cohesive response that addresses the following:

  • Do you think there is one type of research (quantitative or qualitative) that is inherently more rigorous than the other? If so, identify which one and why. If not, discuss your reasoning.
  • Post a brief summary of your research article analysis and the correct APA citation for the article.
  • Outline how the study’s qualitative data collection and analysis did, or did not, promote rigor, provide scientific or systematic scaffolding, and/or generate a more thorough analysis of the research topic.

U.S. health care system

/in /by

The Affordable Care Act In The US

1. Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.

2.The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

  1. “About the Affordable Care Act”
  2. “Health Care Transformation: The Affordable Care Act and More”

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

using real-time data

/in /by

Class question for consideration:

Class,

According to Nelson and Staggers (2018). Organizations manage data is changing over time. The initial approach in using data is typically retrospective in nature. With the organization progressing toward using real-time data.  For example. Instead of getting QI reports the next month reporting on the prior month. Dashboards can show catheters still in place. That need to be removed. IVs that need to be changed. Or data associated with other nurse-sensitive outcomes. These real-time data analytics allow timely care to be delivered. And positively Wk 5impacts patient outcomes.  In the very near future. Predictive analytics will be anticipating care. Needing to be delivered (Nelson & Staggers, 2018).

How do you use data in real time?  Do you use any predictive analytics?  How do you see technology assist. With knowledge management. Retrieval, and communication to aid. In creating a culture of safety for our patients?

Reference

Nelson, R., & Staggers, N. (2018). Health informatics: An interprofessional approach (2nd ed.). Missouri: Elsevier

 

Instructions:

Use an APA 7 style and a minimum of 200 words. Provide support from a minimum of at least three (3) scholarly sources. The scholarly source needs to be: 1) evidence-based, 2) scholarly in nature, 3). Sources should be no more than five years old (published within the last 5 years), and 4) an in-text citation. citations. And references are included when information is summarized/synthesized. And/or direct quotes are used. In which APA style standards apply. Include the Doi or URL link.

• Textbooks are not considered scholarly sources. 

• Wikipedia, Wikis, .com website or blogs should not be used.

the shamanic worldview of health and illness

/in /by

Discuss the shamanic worldview of health and illness and how it pertains to the practice of nursing.  

PLEASE USE YOUR BOOK AS AT LEAST ONE OF YOUR REFERENCES.

 

Complementary and Alternative Therapies for Nursing Practice (4th Edition)

ISBN-13:9780133346503

ISBN-10:0133346501

Author:Karen Lee Fontaine RN MSN

Edition:4

Publisher: Pearson Education, Inc

Published:January 2015

3paragraph of at least 5 sentences.3 references. APA

  • 11

Measuring and Monitoring Quality of Care

/in /by

Instructions: Respond by extending, refuting/correcting, or adding additional nuance. Must be in current 7th edition APA format with academic references cite. Must be grammatically correct.
Measuring and Monitoring Quality of Care

Part of the job of the advanced nurses is to measure and monitor performance. The practice is essential in determining the efficacy of the approach used in caring. It provides feedback that helps in the promotion of the quality of care for the AP nurses. It is also a social responsibility to assess the impact of the care offered on the outcomes of the patients (Pantaleon, 2019). The activity promotes evidence-based practice as it leads to an improved quality of care. The discussion will suggest the various approaches of monitoring and measuring the quality of care and patient outcomes.

Most of the responsibilities and variables that nurses measure are those outlined I the definition of nursing. They include health promotion, protection, prevention, alleviation of suffering, and health optimization. The new regulations are shifting the focus towards outcome-based practice. The shift is in response to the economic and quality concerns and the reimbursement policies formulated. The fee paid is determined by the NP’s value, and measuring it helps determine the reimbursement and quality of care. Organizations also use the same model in appraising the NPs. It helps to know the NPs who are saving hospital costs and improving the outcomes of patients (Jones, 2016). It assists in retaining excellent NPs and letting go or training the others.

measuring and monitoring of patient outcomes.

There are various components that NPs can use in the measuring and monitoring of patient outcomes. One of the approaches is to focus on patient experience. Patient experience plays an essential role as it determines the quality of care. Nurses can use the parameter to assess the progress of the care and measure the outcomes (Pantaleon, 2019). Elements of patient experience include the quality of communication with the nurses, patients, and other stakeholders involved in care provision. The communication has to be clear, precise, and use the right channel. Communication improves understanding between the care provider and the nurses. Pain management is the other measurement indicator as patients whose pain gets managed well experience positive outcomes. The nurse can also ensure the patients stay in a clean and quiet environment that facilitates healing.

important parameter to measure for nurses

The other important parameter to measure for nurses includes the process. The process is critical as it examines the actual activities that promote the quality of care, such as diagnosis, screening, and surgical care. The nurse can measure it by calculating the time taken to diagnose patients and assess them. The process needs to be effective to reduce time wastage and improve the accuracy of diagnosis (Jones, 2016). Patient outcomes are another element to monitor and measure. It is the aspect that can get seen and measured by the public. Mortality is the initial variable as it measures the number of deaths that the nurses have experienced in caring for patients.

When the deaths are high, it calls for analysis to determine the reason for it. Hospital-acquired infections are another indicator of quality and safe care. Effective nurses have minimal numbers of patients who develop hospital infections (Pantaleon, 2019). Such cases lead to an increased cost of care as patients incur additional expenses in treatment, length of stay in hospitals, and quality of life. Efficiency is another way of measuring NP performance. NPs should make sure that the care provided is cost-effective. The focus on preventive care is critical as it reduces medical costs that the hospital and the patient would incur.

 

Chronic Stable Angina

/in /by
  1. Chronic Stable Angina

    E.H. is a 45-year-old African American man who recently moved to the community from another state. He requests renewal of a prescription for a calcium channel blocker, prescribed by a physician in the former state. He is unemployed and lives with a woman, their son, and the woman’s 2 children. His past medical history is remarkable for asthma and six “heart attacks” that he claims occurred because of a 25-year history of drug use (primarily cocaine). He states that he used drugs as recently as 2 weeks ago, does not have any prior medical records with him.

  2. And claims that he has been having occasional periods of chest pain. He is unable to report the duration or pattern of the pain. Before proceeding, explore the following questions: What further information would you need to diagnose angina (substantiate your answer)? What is the connection between cocaine use and angina? Identify at least three tests that you would order to diagnose angina.

    Diagnosis: Angina

    1. List specific goals of treatment for E.H.
    2. What dietary and lifestyle changes should be recommended for this patient?
    3. What drug therapy would you prescribe for E.H. and why?
    4. How would you monitor for success in E.H.?
    5. Describe one or two drug–drug or drug–food interactions for the selected agent.
    6. List one or two adverse reactions for the selected agent that would cause you to change therapy.
    7. What would be the choice for the second-line therapy?
    8. Discuss specific patient education based on the prescribed first-line therapy.
    9. What over-the-counter and/or alternative medications would be appropriate for E.H.?

general medicine unit

/in /by

PICOT Question:

For hospitalized patients on a general medicine unit with Foley catheters (P), does implementation of nursing Foley bundles. Accompanied with continual education on Foley bundles (I). Compared to using no nursing Foley bundles/continual education (C), decrease the incidence of hospital-acquired catheter-associated urinary tract infections (O), over one year (T)?

Institute of Medicine has set a goal to have 90% of practice decisions to be based on Evidence by 2020 with the goal to improve care.

 The intent of the dissemination of EBP results is that the information and intervention is aimed at a specific clinical practice audience.  The main objective of dissemination is to increase and advance knowledge regarding evidence-based interventions for greater application and patient outcomes.

In determining the best mode of EBP dissemination you must answer these questions:

  1. Who will benefit from receipt of this evidence?
  2. Where will this evidence have the greatest impact?
  3. What resources are needed?
  4. Who is the most appropriate audience?
  5. What are the;
  6. benefits of this evidence to your selected audience?
  7.  potential risks of failing to disseminate this evidence?
  8.  barriers to dissemination of evidence?

Choose one of the following modes of dissemination and discuss why it was chosen.  Assure you have attended to questions 1-7 above.

  1. Power point presentation

Compare Independent Variables, Dependent Variables, And Extraneous Variables

/in /by

1 postsRe: Topic 4 DQ 1
Independent variables are the ones that are manipulated by a researcher. Whereas dependent variables are those that are impacted by the manipulation of the independent variables. Extraneous variables are those variables that have an undesirable impact in an experiment. Under ideal circumstances, manipulating the independent variable will cause a change in the dependent variable. All the other variables should not be effected. This, in turn, helps establish a causal relationship. However, sometimes other factors can have an impact on the dependent variables, in addition to the independent variable (Pourhoseingholi et al., 2016).

Therefore, the extraneous variables lower the credibility of the experiment results by providing an alternative explanation, which in turn can make it difficult to establish a causal relationship which is often the goal of the researchers. It becomes even more problematic if the extraneous variables change along with the dependent variable, therefore becoming confounding variables. The major ways that researchers try to restrict the impact of extraneous variables are randomizing, restricting and matching. In randomizing, the subjects involved are all exposed to the extraneous variables, therefore creating consistent groups. In restricting, the variations in the extraneous variables are eliminated to prevent changes, and in matching, the subjects are selected in a way the extraneous factors are matched and they no longer remain extraneous factors (Kahlert et al., 2017)

Using 200-300 APA format with at least two references to support the discussion

 

Developed theory to be used in Metaparadigm of Nursing

/in /by

Link the theory you developed with the Metaparadigm of Nursing.  Each of the elements of the Metaparadigm should be represented in your theory. Revise your theory if necessary to include each of the components of the Metaparadigm.

Developed theory to be used

Concept

Observation is an important aspect of nursing that creates a quest for knowledge leading to the creation of theories. These theories help in ensuring patient safety and quality care. Also, they help in explaining or predicting phenomenon for observation. One important theory is the theory of beta-blockers agent. The use of beta-blockers agent has been underused because of adverse events, negative effects on short term, or complex management (Klapholz, 2009). However, there is proof that beta-blocker agent are beneficial to CHF patients leading to increased life expectancy.

Theory

My theory is significant because it has been proven effective in treating CHF patients in various stages. For example, the use of ACE inhibitors in treatment of hypertension and diabetes patients who are at high risk of developing HF. Further, blockers are used on asymptomatic patients with abnormal cardiac structure or function, and symptomatic patients with HF. My theory remains relevant because beta-blockers prevent progression, improve outcomes and reverse remodeling on patients (Klapholz, 2009). Therefore, the concept I have identified may be sued to support nurse use of this theory on CHF patients.

Empirical

There are successful practical applications of my theory. A study by the US Carvedilol Heart Failure Program with placebo on a 35% or less LVEF showed a 65% decrease in all-cause mortality, and reduced hospitalization for cardiovascular cause (Klapholz, 2009). There is also evidence that supports the use of beta-blockers in patients with mild to moderate HF. Therefore, if beta-blockers are important in treating HF patients because they reduce the likelihood of progression.

Expectations

Initial Post:

Due: Thursday, 11:59 pm PT
Length: A minimum of 250 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years