[ANSWERED 2023] Suppose you have been tasked with purchasing health insurance for your organization that has fifty (50) full-time employees.
Suppose you have been tasked with purchasing health insurance for your organization Health Insurance Assignment 4: Health Insurance and the Affordable Care Act Due Week 8 and worth 150 points Suppose you have been tasked with purchasing health insurance for your organization that has fifty full-time employees. Use the Internet or Strayer databases to research different types of health insurance. Write a 2-3 page paper in which you: Suggest one (1) plan that you would use to purchase health insurance for your organization. Determine the extent to which employee lifestyle choices and health economics would factor in to your chosen plan. Provide a rationale for your response. Analyze the implication of the Affordable Care Act on your decision to purchase insurance. Debate two (2) advantages and two (2) disadvantages of purchasing health insurance for your employees, as opposed to having your employees receive governmental insurance. Use at least two (2) quality references. Note: Wikipedia and other Websites do not qualify as academic resources. Your assignment must follow these formatting requirements: This course requires use of new Strayer Writing Standards (SWS). The format is different than other Strayer University courses. Please take a moment to review the SWS documentation for details. Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow SWS or school-specific format. Check with your professor for any additional instructions. Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. The specific course learning outcomes associated with this assignment are: Analyze the impact of healthcare financing and health insurance on healthcare access, quality, and cost. Analyze the influence of health policy and health reform on healthcare access, quality, and cost in the U.S. Use technology and information resources to research issues in healthcare policy, law, and ethics. Write clearly and concisely about healthcare policy and law using proper writing mechanics. Expert Answer and Explanation Health Insurance and the Affordable Care Act The choice of an insurance plan depends on whether one is looking for a family plan or an individual plan. The two types of health insurance plans include group health insurance and individual health insurance. The main factor that one needs to consider in choosing the insurance plan that is suited best for them is their income and the monthly cost of the specific insurance policy if the deductible will get met if the cost of the drugs for prescriptions that are needed for the treatment. Some plans do not cover services that involve emergencies like blood work and x-rays. This paper seeks to suggest a plan for insurance that will be most suitable for an organization that has fifty employees that work on a full-time basis and the implications of the ACA on the insurance purchasing decision. Plan The plan that I will use in purchasing health insurance for the organization is the group insurance plan, which can get purchased by an employee or employer of the organization and are typically cheaper compared to purchasing coverage for each employee in the company. The group health insurance is usually at a cost that is lower because the risk of the insurer gets spread across a group of holders of the policy (Glied et al., 2020).The insurance plan covers liability that is statutory for an employer for bodily injuries or death that may be suffered by the employee because of the accidents that arise out of and in the course of performing his employment duties in the organization. A group insurance plan is the most effective for the employees as they will all be covered for the same amount of medical insurance and it will also be more affordable for the organization, unlike the individual health insurance plan which will be more expensive as it will be based on the individual needs of each employee. With the group insurance plan, the organization will have to pay equal premiums for every employee, and the injury type to be covered will be specified. Health economics and the lifestyle choices of the employees factor into the plan I have chosen in the sense that the coverage gets limited to specific injuries. The employees will not have to have a different insurance plan for their healthcare needs as they will be covered as provided by the group plan. However, the plan does not cover for injuries sustained due to their own negligence or other events that take place outside the place of work. The plan covers what happens in the course of performing duties for the organization. Affordable Care Act Implication The Affordable Care Act has a significant implication on my decision to purchase insurance for the organization. The implication of the ACA on this decision is that the premium revenues for health insurers increased by 6.2%, including the enrolment made in groups of people (Siemons et al., 2017). The ACA makes a provision that an employer that does not provide coverage for its employees may face penalties. This ensures that employees at all levels of the organization have access to affordable care. There are several advantages and disadvantages of purchasing insurance for health for one’s employees. The various advantages include using it as a way of rewarding and attracting talent, it boosts the morale and dedication of the employees to their work and shaping a company culture that is positive (Kumar et al., 2019). Providing health insurance for the employees helps keep them happy and healthy, showing that the employer cares about them. Also, productivity gets enhanced when the employees are healthy as they will perform their duties efficiently. This is unlike letting them have governmental insurance with which they will be less motivated. Some of the disadvantages of purchasing health insurance for the employees include the fact that costs of healthcare have significantly increased over the years making it difficult for employers that are small to plan their finances as they find it to be an affair that is costly (Cooper & Gardner, 2016). If the employees get governmental insurance, the small businesses will not have to worry about the costs. Conclusion Providing health insurance is an essential part of every organization that seeks to achieve
[ANSWERED 2023] Conduct a cultural self-assessment In order to understand culture and cultural diversity, it is important that you understand your own culture and heritage
Conduct a cultural self-assessment In order to understand culture and cultural diversity Conduct a cultural self-assessment In order to understand culture and cultural diversity, it is important that you understand your own culture and heritage. Using the tables that are located throughout Chapter 2 of your textbook (one for each domain of the Purnell Model for Cultural Competence, Table 2-1 to Table 2-12), answer these questions as they relate to you. Remember, you are answering these questions from your personal perspective, so there is no right or wrong response. Explain why you do or do not adhere to the dominant cultural practices and beliefs of the ethnic group(s) with which you primarily identify. Although the information on this self-assessment paper is strictly confidential, if you do not wish to self-disclose a specific area from the Organizing Framework, indicate so instead of just not addressing it. You are not required to provide citations/references in this paper. Attention should be paid to grammar, spelling, and punctuation. Write a 3-4 page APA essay. Expert Answer and Explanation Purnell Model for Cultural Competence Purnell’s model of cultural competence provides twelve main elements that can be used to understand an individual’s cultural identity. This paper will use the twelve tools as described in Purnell‘s model to carry out a personal cultural assessment to help describe my culture and heritage. The following information describes my personal heritage and culture Overview, Inhabited Localities, and Topography Currently, I live in the United States of America, in California. I am originally from Sierra Leone a port city and the capital of Sierra Leone. It is also the same town where I was born. I have lived in the US for more than 8 years with both of my parents being born in Sierra Leone. I came to the US to continue with my academics and pursue my profession as a nurse. I have not lived in any other place in the US other than the state of California. However, I have relatives and friends in other states within the U.S. For now, I would rather not disclose my income level but it is enough to allow me to afford the basic essentials of life. I have a health insurance cover which I am able to afford with my current income. I have a Bachelor of Science in Nursing (BSN) and am currently pursuing Master of Science in Nursing (MSN). Some of the health hazards of working as a nurse include exposure to infections and toxic substances. I have never been in the military. I have been blessed with a wonderful family. Communication My full names are Jess Green. My legal name is Jess Green but calling me Jay will do just fine. My primary language is English but my dialect is Krio. I also know a little bit of French. I am a fairly open person and I rarely shy off to share my feelings with family, friends or healthcare providers. I don’t mind being touched by family or friends. I am however reserved when it comes to being touched by strangers. In terms of greeting, I don’t mind a handshake. I am a time-conscious person and strictly keep time for appointments but not so much when it comes to social engagements. Family Roles and Organization My parents take the center stage when it comes to decision-making, but mainly my father. In my family we don’t have any specific decisions meant for either men or women, all are at liberty to air their opinions. Most of the house chores are taken care of by succeed in their studies to make a good impression of themselves and the family while the women while men usually provide for the family. Children are required to be obedient and respectful, anything short of that will bring a bad image to the family. Young adults are supposed to are not supposed to engage in negative behaviors like drug and alcohol use. The older adults usually provide direction for the family and they are occasionally sought after for advice. There are currently no extended members living with my family. Our family is known for its humility; I think that is what gives us status. I don’t think it is wrong to get children in wedlock but getting them in marriage is a better option. I don’t think it’s a big issue for people to live together and not be married, but personally, I prefer people to live together after getting married. I don’t mind gay, lesbians or transgendered people but personally, I am straight. Workforce Issues Do you usually report to work on time? I am never late at work unless of an emergency and I am never late for meetings. I don’t think I have any concerns about working with someone of the opposite gender. I consider myself a loyal employee. I am very inquisitive especially in what I don’t know. I think I am assertive enough in my job. When a patient does not speak in fluent English or has a different accent, I at times find it hard to understand at times. Biocultural Ecology I am not allergic to any medication and don’t have any issues when taking OTC medication. There is no major illness I am aware of in my family nor any genetic diseases. Given that Sierra Leone is a coastal country, Malaria is one of the major health challenges in terms of diseases but access to medical facilities is an overall healthcare challenge for the country. My racial identity is a native African. High-risk Behaviors I don’t drink alcohol use tobacco or any other illicit or recreational drug. I occasionally jog in the morning but walk daily in the evenings for thirty minutes to an hour. I use seat belts when driving. I prefer abstinence as the best way of dealing with STIs and HIV Nutrition I am currently satisfied with my health and I normally make sure to eat a balanced diet. I avoid foodstuffs with excess fats given the negative health implications the pose. I don’t have any specific food I eat when ill
[ANSWERED 2023] A 50 year old Caucasian female presents to the clinic with complaints of cough for almost 2 weeks. Positive productive green sputum with associated chills, sweating, and fever up to 101.5
A 50 year old Caucasian female presents to the clinic with complaints Examining Chest X-Rays Chest x-rays are an invaluable diagnostic tool as they can help identify common respiratory disorders such as pneumonia, pleural effusion, and tumors, as well as cardiovascular disorders such as an enlarged heart and heart failure. As an advanced practice nurse, it is important that you are able to differentiate a normal x-ray from an abnormal x-ray in order to identify these disorders. The ability to articulate the results of a chest x-ray with the physician, radiologist, and patient is an essential skill when facilitating care in a clinical setting. In this Discussion, you practice your interprofessional collaboration skills as you interpret chest x-rays and exchange feedback with your colleagues. Consider the three patient case studies and x-rays Case Study 1 35-year–old Asian male presents to your clinic complaining of productive cough for two weeks. Stated he has had mild intermittent fever with myalgia, malaise and occasional nausea. SH: works as a law clerk PE: NP noted low grade fever (99 degrees), with very mild wheezing and scattered rhonchi. Case Study 2 This is a 44-year–old Caucasian male being seen at your clinics with complaints of complaints of cough for 4 days and worsening. Stated he has had high grade fever. States he feels weak and has been in bed most of the last two days. Complains of exertional dyspnea, followed by dyspnea at rest, non-productive cough and pleuritic chest pain MEDS: Zovirax, Diflucan, magic mouth wash, Zofran, mycostatin, filgrastin PMH: HTN, Hep C, HIV/AIDS, thrush SH: Past IV Drug abuse; lives in a group home; PE: VS: Ht: 5’7, Wt: 150#, BMI 23, Anorexic male, febrile, tachypneic, tachycardic, with rales and rhonchi. You note decreased in breath sounds, dullness, and egophony Case Study 3 A 50 year old Caucasian female presents to the clinic with complaints of cough for almost 2 weeks. Positive productive green sputum with associated chills, sweating, and fever up to 101.5. She manages a daycare and states that many of the children have had upper respiratory symptoms in the last two weeks. PMH: DM diagnosed 7 years ago, controlled on medications. MEDS: Glyburide 10mg qd PE: She looks ill with continuous coughing and chills. BP 100/80, T: 102, HR: 110; O2Sat 97% on RA. Lungs: +Crackles, increased fremitus Labs: CBC 17,000 cells/mm3 , blood sugar is 120 To prepare: Review Part 10 of the Buttaro et al. text in this week’s Resources, as well as the provided x-rays. Reflect on what you see in the x-ray assigned to you by the Course Instructor. Consider whether the patient in your assigned x-ray has an enlarged heart, enlarged blood vessels, fluid in the lungs, and/or pneumonia in the lungs. Post an explanation of the primary diagnosis, as well as 3 differential diagnoses, for the patient in the case study you were selected or were assigned. Describe the role the patient history and physical exam played in the diagnosis. Then, suggest potential treatment options based on your patient diagnosis. Expert Answer and Explanation Examining Chest X-Rays The Primary Diagnosis The primary diagnosis for this case is pneumonia. Pneumonia is either a bacterial or viral infection that affects one or all parts of the lungs. According to Zhu et al. (2020), pneumonia infection is often spread through droplets from an infected person. This disease has been selected as the primary diagnosis because the patient reports that she has bee interacting with children showing upper respiratory signs for the last two weeks. Some of the signs of pneumonia include fever, chills, a cough that produces mucus, and shortness of breath. The patient has reported almost all the signs highlighted above. The X-ray test showed that the patient has fluids in the alveoli, and according to Lapinsky, Leen, Mak, and Shafiee (2019), this is a sign of pneumonia. Differential Diagnosis 1. Asthma According to Chahin & Opal (2017), asthma is a chronic respiratory condition that causes a person’s airways to be inflamed, swollen, and narrow, making the individual experience difficulty breathing. Some of the symptoms of the disease include coughing that worsens, difficulty breathing, ad chest pain. This disease has been included in the diagnosis because it causes a cough that produces a lot of mucus as experienced by the patient. 2. Chronic Obstructive pulmonary disease COPD is a group of medical conditions that block a person’s breathing system and thus make it hard for the individual to breathe. Some of the diseases’ signs include lack of energy that can cause fainting, frequent respiratory infections, swelling of legs and ankles, and a cough that produces mucus (Zhou et al., 2020). This disease has been included in the diagnosis because one of its signs is a cough that produces mucus like the one reported by the patient. 3. Lung cancer Lung cancer is the growth of abnormal cells in the lung region. The disease symptoms include a new cough that does not fade, hoarseness, shortness of breath, bone pain, and losing weight (Yoon, Kim, Yang, & Ham, 2028). The disease has been included in the diagnosis because one of its symptoms is a prolonged cough, like the one experienced by the patient for two weeks. Role of Patient History in the Diagnosis The personal and medical history provided by the patient was so helpful when diagnosis the individual. The history was used to determine the causes of the ailment. Most of the respiratory problems are often caused by allergies. Therefore, information about allergies could help the medical doctor determine whether the patient’s condition is an allergic reaction (Zhou et al., 2020). By stating where she works, it was concluded that she contracted the disease from the children or the one who infected the kids. Another important history in the diagnosis is that it helped the medical professional risk factors that could have increased the patient’s chances of being infected by the germ. Patient history also provided the medical professional with information about the diagnostic tests the patient can afford. Potential Treatment Options The treatment of the patient will depend on the type of pneumonia the individual has. If the patient has bacterial pneumonia, she should be prescribed
[ANSWERED 2023] Discuss what resources are often necessary for nonacute care for cardiorespiratory issues. Explain how they support patient independence and decrease readmission
Discuss what resources are often necessary for nonacute care for cardiorespiratory issues DQ 1 Identify a cardiac or respiratory issue and outline the key steps necessary to include for prevention and health promotion. DQ 2 Discuss what resources are often necessary for nonacute care for cardiorespiratory issues. Explain how they support patient independence and decrease readmission. Expert Answer and Explanation: DQ 1 Heart Disease The primary purpose of the heart is to facilitate the flow of blood around the different body organs, but it first has to pump blood to the lungs to facilitate oxygenation. Heart disease has a direct impact on the respiratory system as it causes irregularities in the manner in which blood is transported to and from the lungs (DeFilippis et al., 2017). The interconnectedness of the heard and the lungs make them work together in ensuring that all cells within the body are provided with sufficient oxygen required for survival. Heart disease has become one of the leading causative agents for death and disability within the United States. Numerous causative agents can be considered risk factors for heart disease. While these risk factors (age, gender, and family history) cannot change, nor can they be controlled, there are others that can be controlled to prevent heart disease occurrence. The control measures can be evaluated in the form of steps that an individual can perform for the prevention and health promotion of heart disease. The first step for the prevention of heart disease is to control one’s blood pressure as it is a high risk of heart disease. Secondly, there is a need to control the levels of triglyceride and cholesterol as they can clog the blood vessels (Ammouri et al., 2016). Regular exercise is also a step to ensure that a person maintains a healthy weight as a preventive mechanism. Other essential steps include healthy dieting, limit alcohol or smoking, stress management, and also managing diabetes. These steps are essential in ensuring that a person is prevented from the controllable risk of acquiring heart disease. The steps are also a great measure to facilitate health promotion within society. Reference Ammouri, A. A., Tailakh, A., Isac, C., Kamanyire, J. K., Muliira, J., & Balachandran, S. (2016). Knowledge of coronary heart disease risk factors among a community sample in Oman: Pilot study. Sultan Qaboos University Medical Journal, 16(2), e189. DeFilippis, A. P., Young, R., McEvoy, J. W., Michos, E. D., Sandfort, V., Kronmal, R. A., … & Blaha, M. J. (2017). Risk score overestimation: the impact of individual cardiovascular risk factors and preventive therapies on the performance of the American Heart Association-American College of Cardiology-Atherosclerotic Cardiovascular Disease risk score in a modern multi-ethnic cohort. European heart journal, 38(8), 598-608. Expert Answer and Explanation: DQ 2 Resources for Cardiorespiratory Issues Both the lungs and the heart work jointly to ensure there is sufficient and constant supply of oxygenated blood within the body and the removal of carbon dioxide from the system. These cycles facilitate the importance of sustaining life as it is. Issues related to either the heart or the lungs may have a negative influence on the other organ and potentially result in both organs demonstrating nonacute cardiorespiratory issues (Canada et al., 2018). These issues are termed as those that concern both the lungs and heart but do not require urgent or emergency intervention. These patients can also be within hospitals in waiting for discharge to the healthcare facility necessary for their condition. The resources needed for the care of nonacute cardiorespiratory issues entail palliative care, long-term care, nursing and life support services, counseling, physiotherapy, and rehabilitation services. These services provide additional assistance with regards to care and management of the issues that the patient is facing through recovery. For instance, palliative care focuses on the measures that can improve the overall quality of life for both the patient and their families who ace the problems that are associated with the illness (Imboden et al., 2018). These resources are critical in support of patient readmission due to various reasons. To begin with, they offer relief to distressing symptoms and pain that a patient might be experiencing. While nonacute cardiorespiratory issues do not necessitate emergency care, the symptoms can be severe and in need of relief. These resources also help with affirming life by integrating spiritual and psychological elements of care. In the event of readmission, the resources help the patients with spiritual care and regard death as a normal process. They also facilitate quality of life, which positively influences the nature of the illness. References Canada, J. M., Weiss, E., Evans, R. K., Van Tassell, B. W., Garten, R., & Abbate, A. (2018). Determinants of Cardiorespiratory Fitness Following Thoracic Radiotherapy. Circulation, 138(Suppl_1), A14282-A14282. Imboden, M., Harber, M. P., Whaley, M. H., Finch, W. H., Bishop, D. A., & Kaminsky, L. A. (2018). The Association Between Long-Term Changes in Cardiorespiratory Fitness and Mortality Risk. Circulation, 138(Suppl_1), A16590-A16590. Place your order now for a similar assignment and get fast, cheap and best quality work written by our expert level assignment writers.Use Coupon: NEW30 to Get 30% OFF Your First Order FAQs Prevention and control of cardiovascular disease Cardiovascular disease (CVD) refers to a group of conditions that affect the heart and blood vessels, including heart disease, stroke, and high blood pressure. CVD is a leading cause of death globally, but there are steps that individuals can take to prevent and control the disease. Here are some strategies for prevention and control of CVD: Eat a healthy diet: Eating a diet that is low in saturated and trans fats, salt, and added sugars, and high in fruits, vegetables, whole grains, lean protein, and healthy fats can help reduce the risk of CVD. Get regular exercise: Regular physical activity can help lower blood pressure, improve cholesterol levels, and reduce the risk of CVD. Aim for at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity aerobic exercise per week. Maintain a healthy weight: Being overweight or obese can increase the risk of CVD, so maintaining a healthy
[ANSWERED 2023] Health care planners could be more effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest
Health care planners could be more effective and efficient if they used the concept of the Healthcare Systems Assignment Description: Complete ALL of the bullet points below: Health care planners could be more effective and efficient if they used the concept of the natural history of disease and the levels of prevention to design services that intervene at the weakest link in the chain of progression of specific diseases. Instead, most focus on high-technology solutions to preventable problems. Assess the characteristics of the medical care culture that encourage the latter approach. Hospitals and other health care institutions, whether voluntary or for-profit, need to be financially solvent to survive growing market pressures. Describe how this “bottom line” focus has changed the nature of the US health care system. The insurance industry plays a huge role in the American health care system and absorbs a significant portion of the health care dollar. A single payer system, whether it is a private company or the US government, would eliminate the complex insurance paperwork burden and free substantial funds that could be diverted to support care for the under-served. Why do you believe that so much resistance to a concept used in every other developed country has continued in the U.S.? Include the time management Weekly Planner to show when you will make room for your school work. Please submit one APA formatted paper between 1000 – 1500 words, not including the title and reference page. The assignment should have a minimum of two scholarly sources, in addition to the textbook. They want it in APA with the beginning of the paper stating what it is about and conclusion at the end Required Source: Sultz, H. A., & Young, K. A. (2017). Health care USA: Understanding its organization and delivery (9th ed.). Jones & Bartlett. Read chapters 1 & 2. Expert Answer and Explanation US Healthcare System The US healthcare system has experienced a lot of changes in terms of medical care methods and treatment protocols and financing. In terms of treatment, the US health system has been positively impacted by technologies such as electronic health records among other healthcare technologies (Sultz & Young, 2017). These technologies have allowed healthcare professionals to provide quality and safe care. In terms of financing, the US health system has experienced huge reimbursement changes. Some of the policies that have changed US health financing include Medicare, Medicaid, and Affordable Care programs (Sultz & Young, 2017). The purpose of this assignment is to explain characteristics of the medical care culture that have encouraged US care professionals to focus on high-technology solutions to preventable problems, how the “bottom line” focus has changed the nature of the US health care system, and why universal health care is resisted in the US. Question 1 Certain characteristics are common in a medical culture which encourages healthcare professionals to use high-technology solutions to preventable problems. The characteristics become visible during patient examination and provision of other care services concerning the technologies. It is vital to identify the players in healthcare culture to accurately determine their characteristics and motives. In the US healthcare culture, two main players are the patients and healthcare professionals (doctors, nurses, and other specialists) (Sultz & Young, 2017). Other players include the hospital system and third-party payers (private and government insurance plans). One of the medical care cultures that encourage the latter approach is instant gratification. According to Sultz and Young (2017), most healthcare planers focus on high-technology solutions to preventable problems because of the medical culture of instant gratification. Instant gratification means instant cure (Deo et al., 2020). Most patients in the US need an instant cure for acute illness, chronic disease, and pain which cannot be provided by the former. High-technology solutions can provide instant care while the former cannot. When high technologies are used, the patient is cured almost instantly. The second characteristic is work satisfaction. Sultz and Young (2017) noted that work satisfaction is highly associated with the use of high technology to provide cures and promote disease prevention. The main objective of healthcare professionals is to provide patient care using standardized interventions. Healthcare professionals prefer to use high technology to attain healthcare goals because it prevents them from fewer difficulties as compared to the conventional approach which relies on identifying the history of the illness to create a treatment protocol (Harerimana et al., 2019). In other words, healthcare professionals use high technology to help their patients because it achieves their care goals faster than conventional methods and thus improves their satisfaction. The last characteristic is improved coordination of responsibilities and communication. Healthcare professionals prefer care methods that allow them to effectively coordinate and communicate when providing care to their patients. High-technology methods provide them with the opportunity to coordinate and effectively communicate making it a preferred method of care provision among the players in the US care system. Sultz and Young (2017) noted that US care providers have recently shown interest in Electrotonic Health Records as a tool to be used in providing care. The authors argued that the tool has helped healthcare providers easily and effectively coordinate and communicate with patients and other stakeholders to provide care. EHR technology provided healthcare professionals with a single platform where they can access patient data and communicate with peers, making the high-technology care provision method the preferred approach. Question 2 All healthcare organizations across the US strive to be financially solvent in the process of providing quality and safe care to their patients and this has greatly affected the nation’s healthcare system. One of the ways the “bottom line” focus has changed the healthcare system in the US is increasing the cost of care services. Dieleman et al. (2020) noted that Americans are paying more for their care today than in the last decade due to healthcare organizations’ focus on the bottom line. Healthcare organizations are forced to increase the cost of care services to be able to pay for their human workforce and procure necessary products needed for care providers such as
[ANSWERED 2023] JR 47 yo WM complains of having generalized abdominal pain that started 3 days ago. He has no
JR 47 yo WM complains of having generalized abdominal pain that started 3 days ago. He has no ABDOMINAL ASSESSMENT Subjective: CC: “My stomach hurts, I have diarrhea and nothing seems to help.” HPI: JR 47 yo WM complains of having generalized abdominal pain that started 3 days ago. He has not taken any medications because he did not know what to take. He states the pain is a 5/10 today but has been as much as 9/10 when it first started. He has been able to eat, with some nausea afterwards. PMH: HTN, Diabetes, hx of GI bleed 4 years ago Medications: Lisinopril 10mg, Amlodipine 5 mg, Metformin 1000mg, Lantus 10 units qhs Allergies: NKDA FH: No hx of colon cancer, Father hx DMT2, HTN, Mother hx HTN, Hyperlipidemia, GERD Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys) Objective: VS: Temp 99.8; BP 160/86; RR 16; P 92; HT 5’10”; WT 248lbs Heart: RRR, no murmurs Lungs: CTA, chest wall symmetrical Skin: Intact without lesions, no urticaria Abd: soft, hyperactive bowel sounds, pos pain in the LLQ Diagnostics: None Assessment: Left lower quadrant pain Gastroenteritis PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses. The Assignment Analyze the subjective portion of the note. List additional information that should be included in the documentation. Analyze the objective portion of the note. List additional information that should be included in the documentation. Is the assessment supported by the subjective and objective information? Why or why not? What diagnostic tests would be appropriate for this case, and how would the results be used to make a diagnosis? Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. REQUIRED READINGS: Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Chapter 6, “Vital Signs and Pain Assessment ”This chapter describes the experience of pain and its causes. The authors also describe the process of pain assessment. Chapter 18, “Abdomen” In this chapter, the authors summarize the anatomy and physiology of the abdomen. The authors also explain how to conduct an assessment of the abdomen. Dains, J. E., Baumann, L. C., & Scheibel, P. (2019). Advanced health assessment and clinical diagnosis in primary care (6th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Advanced Health Assessment and Clinical Diagnosis in Primary Care, 6th Edition by Dains, J.E., Baumann, L. C., & Scheibel, P. Copyright 2019 by Mosby. Reprinted by permission of Mosby via the Copyright Clearance Center. Chapter 3, “Abdominal Pain” This chapter outlines how to collect a focused history on abdominal pain. This is followed by what to look for in a physical examination in order to make an accurate diagnosis. Chapter 10, “Constipation” The focus of this chapter is on identifying the causes of constipation through taking a focused history, conducting physical examinations, and performing laboratory tests. Chapter 12, “Diarrhea” In this chapter, the authors focus on diagnosing the cause of diarrhea. The chapter includes questions to ask patients about the condition, things to look for in a physical exam, and suggested laboratory or diagnostic studies to perform. Chapter 29, “Rectal Pain, Itching, and Bleeding” This chapter focuses on how to diagnose rectal bleeding and pain. It includes a table containing possible diagnoses, the accompanying physical signs, and suggested diagnostic studies. Colyar, M. R. (2015). Advanced practice nursing procedures. Philadelphia, PA: F. A. Davis. Credit Line: Advanced practice nursing procedures, 1st Edition by Colyar, M. R. Copyright 2015 by F. A. Davis Company. Reprinted by permission of F. A. Davis Company via the Copyright Clearance Center. These sections below explain the procedural knowledge needed to perform gastrointestinal procedures. Chapter 107, “X-Ray Interpretation: Chest (pp. 480–487) Chapter 115, “X-Ray Interpretation of Abdomen” (pp. 514–520) Note: Download this Student Checklist and Abdomen Key Points to use during your practice abdominal examination. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Student checklist. In Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel\’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2019). Abdomen: Key points. In Seidel\’s guide to physical examination: An interprofessional approach (9th ed.). St. Louis, MO: Elsevier Mosby. Credit Line: Seidel\’s Guide to Physical Examination, 9th Edition by Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. Copyright 2019 by Elsevier Health Sciences. Reprinted by permission of Elsevier Health Sciences via the Copyright Clearance Center. Expert Answer and Explanation Abdominal Assessment Assessment is a critical practice in nursing. Nursing assessment can be used to determine the current and future care needs of a patient (Ball, Dains, Flynn, Solomon & Stewart, 2019). Nursing assessment includes the recognition of abnormal versus normal physiology. The purpose of this assignment is to analyze the provided Episodic Note case study that describes abnormal findings in patients seen in a clinical setting and answer the provided questions. Additional Subjective Data to be included in the Documentation A lot of information was included in a subjective portion of the note. However, I feel that some critical data that can improve the assessment process are missing. For instance, the patient’s ethnic group was not mentioned. Some diseases are more prone in certain ethnic groups compared to others. Hence, identifying the race of the patient can help a nurse identify whether the client’s ethnicity is a risk factor for specific diseases. Another important data that should be added in the subjective portion of the note is the review of systems. The review of systems is the process of reviewing
[ANSWERED 2023] Search the GCU Library and find one new health care article that uses quantitative research
Search the GCU Library and find one new health care article that uses quantitative research. Search the GCU Library and find one new health care article that uses quantitative research. Do not use an article from a previous assignment, or that appears in the Topic Materials or textbook. Complete an article analysis and ethics evaluation of the research using the “Article Analysis and Evaluation of Research Ethics” template. See Chapter 5 of your textbook as needed, for assistance. While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Expert Answer and Explanation Article Analysis and Evaluation of Research Ethics Article Citation and Permalink (APA format) Article 1 Espeland, M. A., Lipska, K., Miller, M. E., Rushing, J., Cohen, R. A., Verghese, J., … & Pahor, M. (2017). Effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes. The Journals of Gerontology: Series A, 72(6), 861-866. https://doi.org/10.1093/gerona/glw179 Point Description Broad Topic Area/Title Effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes Problem Statement (What is the problem research is addressing?) More than a quarter of the US aging population suffer from diabetes mellitus. This condition has increased their chances of developing geriatric syndromes. Medication alone have not entirely reduced the effects of the condition. That said, this study has addressed physical activity and its effects on diabetic patients. Purpose Statement (What is the purpose of the study?) The purpose of this study was to explore the “effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes.” Research Questions (What questions does the research seek to answer?) The researchers used one primary research question to guide the study. The research question was “what are the effects of physical activity intervention on physical and cognitive function in sedentary adults with and without diabetes?” Define Hypothesis (Or state the correct hypothesis based upon variables used) Apart from the research question, a hypothesis was created to guide the study. The hypothesis for this study was that “the intervention may have different effects on physical and cognitive function, depending on individuals’ diabetes status.” Identify Dependent and Independent Variables and Type of Data for the Variables Two main variables were included in the study. The first variable is independent variable. This variable was represented by physical activity intervention. This variable belongs to quantitative data type. The second variable is dependent variable. It is represented by sedentary adults with and without diabetes. Its data type is categorical. Population of Interest for Study Researchers must identify the people or other populations targeted by their study. In this research, the target or population of interest were 65 years and above sedentary adults with and without diabetes. Sample The respondents in the research were 1,476 70–89 years old sedentary individuals who could walk for about 400 meters in 15 minutes regardless of their extreme inability to conduct daily function. Sampling Method Researchers must indicate how they conducted their sampling method to validate if the study was fair or not. In this research, random sampling approach was used to sample and select the participants for the study. Identify Data Collection Identify how data were collected Identifying a data collection instrument is vital because it can help in analyzing the research to determine its reliability and validity. Researchers in this study collected data using interviews as their main data collection instrument. Summarize Data Collection Approach The researchers collected data by administering three computer-based cognitive tests at either 18 or 30 months and at baseline, depending on when the respondents were included in the study. The interviewer-administered tests included the Wechsler Adult Intelligence Scale-III Digit Symbol Coding test (DSC), the Modified MiniMental State Exam (3MSE), and the Hopkins Verbal Learning Test-Revised (HVLT-D). Discuss Data Analysis Include what types of statistical tests were used for the variables. Descriptive analysis was used as the method to analyze data in the study. The authors analyzed data by comparing measures of cognitive and physical functions and baseline risk factors with diabetes groups and intervention based on the analyses of logistic regression and variance. Summarize Results of Study 90.3% of the participants successfully completed the study making it results reliable. The Lifestyle Interventions and Independence for Elders (LIFE) reduced the participants’ risk of developing major mobility conditions by increasing their physical activities. Physical activity alone was found to be beneficial because it increased the participants’ mobility speed but did not have effects on their cognitive health. However, LIFE has both cognitive and physical impacts. Summary of Assumptions and Limitations Identify the assumptions and limitations from the article. Report other potential assumptions and limitations of your review not listed by the author. The first limitation of the study is that it cannot be used to represent general population because few participants volunteered to participate. The second limitation is that the timeframe assigned the project was limited and could not be used to provide maximum results. The last limitation is that diabetes was underdiagnosed in the study. Ethical Considerations The first ethical consideration that may have occurred when sampling was informed consent. Informed consent is an ethical consideration that ensures that the researchers have not forced the participants to participate (Moore, Munguia Gomez & Levine, 2019). In other words, the element ensures that participants have voluntarily participated in the study. In the informed consent form, the researchers are ethically required to tell the respondents the purpose of the study, its importance, and how it will be used to improve healthcare. Another ethical consideration that might have occurred in the study was approved. Moore et al. (2019) mention that researchers should seek
[ANSWERED 2023] An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these
An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. Module 2 Assignment: Case Study Analysis An understanding of the cardiovascular and respiratory systems is a critically important component of disease diagnosis and treatment. This importance is magnified by the fact that these two systems work so closely together. A variety of factors and circumstances that impact the emergence and severity of issues in one system can have a role in the performance of the other. Effective disease analysis often requires an understanding that goes beyond these systems and their capacity to work together. The impact of patient characteristics, as well as racial and ethnic variables, can also have an important impact. An understanding of the symptoms of alterations in cardiovascular and respiratory systems is a critical step in diagnosis and treatment of many diseases. For APRNs this understanding can also help educate patients and guide them through their treatment plans. In this Assignment, you examine a case study and analyze the symptoms presented. You identify the elements that may be factors in the diagnosis, and you explain the implications to patient health. To prepare: By Day 1 of this week, you will be assigned to a specific case study scenario for this Case Study Assignment. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor. Scenario: A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF). your Case Study Analysis related to the scenario provided, explain the following Assignment (1- to 2-page case study analysis) In your Case Study Analysis related to the scenario provided, explain the following The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms. Any racial/ethnic variables that may impact physiological functioning. How these processes interact to affect the patient. By Day 7 of Week 4 Submit your Case Study Analysis Assignment by Day 7 of Week 4 GRADING RUBRIC: Develop a 1- to 2-page case study analysis, examing the patient symptoms presented in the case study. Be sure to address the following:Explain both the cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms.– Excellent 28 (28%) – 30 (30%) Good 25 (25%) – 27 (27%) Fair 23 (23%) – 24 (24%) Poor 0 (0%) – 22 (22%) Explain how the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient.– Excellent 28 (28%) – 30 (30%) Good 25 (25%) – 27 (27%) Fair 23 (23%) – 24 (24%) Poor 0 (0%) – 22 (22%) Explain any racial/ethnic variables that may impact physiological functioning.– Excellent 23 (23%) – 25 (25%) Good 20 (20%) – 22 (22%) Fair 18 (18%) – 19 (19%) Poor 0 (0%) – 17 (17%) Written Expression and Formatting – Paragraph Development and Organization:Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Written Expression and Formatting – English Writing Standards:Correct grammar, mechanics, and proper punctuation– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list.– Excellent 5 (5%) – 5 (5%) Good 4 (4%) – 4 (4%) Fair 3 (3%) – 3 (3%) Poor 0 (0%) – 2 (2%) Total Points: 100 Expert Answer and Explanation Cardiovascular and Cardiopulmonary Pathophysiologic Processes The clinical interventions have seen some specific advancements that have improved medical professionals’ ability to provide safe and quality care to patients. However, medical professionals have found it hard to manage cardiovascular diseases despite the advancements present in the field of medicine as of now. Reamy, Williams, and Odom (2017) argue that the challenge of managing cardiovascular diseases can be reflected in the higher number of patients with the diseases being readmitted to hospitals even after holistic and intensive care. Also, a great number of patients have died of cardiovascular disease despite getting quality and safe medical interventions (McCance & Huether, 2019). Researchers have found that to provide better care to patients with cardiovascular diseases, clinicians should know the pathophysiologic processes resulting in the symptoms. The Cardiovascular and Cardiopulmonary Pathophysiologic Processes Various cardiovascular and cardiopulmonary processes resulted in the symptoms presented by the patient. The shortness of breath was caused by interactions between the cardiovascular system, oxygen carriers, neural responses, and the respiratory system (Coccia, Palkowski, Schweitzer, Motsohi, & Ntusi, 2016). The symptom occurred when the drive to breath was not matched by pulmonary ventilation. The process is often triggered by the mismatch between the lungs, chest wall structures, receptors in the airways, and the central respiratory motor activity. The patient experienced pleuritic chest pain because the two large layers of tissues separating the patient’s lungs were inflamed (Inamdar & Inamdar, 2016). The patient felt chest pain because the pleural membrane layers were swollen and rubbing against each other when he breathes. According to Ashton and Raman (2015), there are no clinical reasons for the symptoms of palpitations. However, the authors note that palpation occurs when the cardiac rhythm or rate changes or when the heart moves abnormally in the chest. Racial/Ethnic Variables that may Impact Physiological Functioning Many existing genetic variables may impact the physiological functioning of patients. One such variable is peroxisome proliferator activated‐receptor γ (PPARγ). One of the functions of this variable is regulating the fat cell. Also, activated PPARγ works with thiazolidinediones to block the channel activity of calcium smooth muscle cells, lower blood pressure, promote the secretion of the vasodilator C‐type natriuretic peptide, and prevents the release of
[SOLVED 2023] Select an adult patient that you examined during the last 4 weeks who presented with a disorder other than the disorder present in your Week 3 Case Presentation
Select an adult patient that you examined during the last 4 weeks who presented with a Create a Focused SOAP Note on this patient using the template provided in the Learning Resources. There is also a completed Focused SOAP Note Exemplar provided to serve as a guide to assignment expectations. Please Note: All SOAP notes must be signed, and each page must be initialed by your Preceptor. Note: Electronic signatures are not accepted. When you submit your note, you should include the complete focused SOAP note as a Word document and PDF/images of each page that is initialled and signed by your Preceptor. You must submit your SOAP note using SafeAssign. Note: If both files are not received by the due date, faculty will deduct points per the Walden Grading Policy. Then, based on your SOAP note of this patient, develop a video case study presentation. Take time to practice your presentation before you record. Include at least five scholarly resources to support your assessment, diagnosis, and treatment planning. Ensure that you have the appropriate lighting and equipment to record the presentation. The Assignment Record yourself presenting the complex case study for your clinical patient. In your presentation: Dress professionally and present yourself in a professional manner. Display your photo ID at the start of the video when you introduce yourself. Ensure that you do not include any information that violates the principles of HIPAA (i.e., don’t use the patient’s name or any other identifying information). Present the full complex case study. Include chief complaint; history of present illness; any pertinent past psychiatric, substance use, medical, social, family history; most recent mental status exam; current psychiatric diagnosis including differentials that were ruled out; and plan for treatment and management. Report normal diagnostic results as the name of the test and “normal” (rather than specific value). Abnormal results should be reported as a specific value. Be succinct in your presentation, and do not exceed 8 minutes. Specifically address the following for the patient, using your SOAP note as a guide: Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life? Objective: What observations did you make during the psychiatric assessment? Assessment: Discuss patient mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses and why you chose them. List them from highest priority to lowest priority. What was your primary diagnosis, and why? Describe how your primary diagnosis aligns with DSM-5 diagnostic criteria and supported by the patient’s symptoms. Plan: What was your plan for psychotherapy? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Be sure to include at least one health promotion activity and one patient education strategy. Reflection notes: What would you do differently with this patient if you could conduct the session over? If you are able to follow up with your patient, explain whether these interventions were successful and why or why not. If you were not able to conduct a follow up, discuss what your next intervention would be. Learning Resources Required Readings (click to expand/reduce) Carlat, D. J. (2017). The psychiatric interview (4th ed.). Wolters Kluwer. Chapter 28, “Assessing Neurocognitive Disorders (Dementia and Delirium)” Expert Answer and Explanation Schizoaffective Disorder Subjective: CC (chief complaint): “They want to kill me but people do not believe me. I can even hear them talk.” HPI: JW is a 45-years-old male of Caucasian origin who came to the healthcare facility complaining of auditory and visual hallucinations. The patient has not been prescribed any medications at the moment until screening and testing are done. He complains that he has been seeing people around his home and hearing them planning his death. She has been reporting hallucinations for the past six weeks or so. He was accompanied by his wife to the office. The wife noted that the patient has been showing catatonic behavior for the past weeks. She narrated that the patient sometimes grabs his gun and speaks to himself by saying that he will kill them before they kill him. He has also been spotted echoing words as if he is repeating someone else’s words. The wife argued that when the client is not experiencing hallucinations, he experiences a depressed mood by not eating or wanting to be near anybody. When he is moody, he wants to be isolated and away from the world. The wife noted that the symptoms have pushed him away from his work and family. He was given leave to go and sought himself out. Substance Current Use: The patient has a history of taking drugs. He reports using illicit drugs such as cocaine and meth. However, he denies using alcohol or cigarettes. Medical History: He was diagnosed with hypertension but stopped taking medications noting that “they” want to kill him using medications. Current Medications: He is not on any medications at the moment. Allergies:No allergies. Reproductive Hx:He has not been able to engage in sexual activities in the past seven months. ROS: GENERAL: Wife reports weight loss. The client reports fatigue and weakness on some occasions. Denies fever or chills. HEENT: Eyes: No eye diseases or abnormalities. Ears, Nose, Throat: He denies hearing loss or infections. He denies a runny nose, sore throat, congestion, or sneezing. SKIN: No rash. CARDIOVASCULAR: No chest pressure, edema or palpitations, chest discomfort, or chest pressure. RESPIRATORY: No difficulty breathing, sputum, or cough. GASTROINTESTINAL: No abdominal pain, diarrhea, vomiting, nausea, or anorexia. GENITOURINARY: No odd color, hesitancy, odor, urgency, or burning during urination. NEUROLOGICAL: No tingling or numbness of the legs or fingers. No dizziness, headache, ataxia, paralysis, or bowel problems. MUSCULOSKELETAL: No stiffness or pain in the joints and muscles. No muscle, back pain, joint pain, or stiffness. HEMATOLOGIC: No anemia, clotting abnormalities, or abnormal hematologic status. LYMPHATICS: No enlarged nodes. ENDOCRINOLOGIC: Denies polydipsia, cold, sweating, polyuria, or heat problems. Objective: Physical Exam: Temp 36, BP 137/90, Ht. 6’2, Wt. 145lbs, P 78, RR 18. HEENT: Head: Face is symmetrical. Cranial nerves V and VII around the head are intact. He can move facial muscles at will. The shape of the head is rounded and there are no involuntary muscle movements.Eyes: Cornea, conjunctiva, lacrimal system, anterior chamber, and pupils are intact. The eye is not painful or red. Vision intact. Lacerations positions normal. Ears: Hearing
[ANSWERED 2022] In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so
In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating Reaching out a Solution In a Microsoft Word document of 4-5 pages formatted in APA style, you will develop a process for advocating about an issue as a nurse, from identifying a problem that needs to be solved through articulating a process for doing so. This assignment consists of answering each of the questions listed below from the “Political Analysis and Strategies” chapter of your course textbook. Write each question as a new topic area; then follow with a paragraph or two to answer the question. Let us assume that you are a school nurse in a high school. At a recent school athletic event, a spectator suffered a cardiac arrest in the stands. A coach of the home team went into the high school to fetch the automatic emergency defibrillator (AED) only to find out that it was not readily available. In the meantime, an emergency squad arrived and resuscitated the spectator. On Monday morning, you learn of the absence of the AED only to find out that it had been locked in the custodian’s closet. Reflect on the following questions outlined in the “Political Analysis and Strategies” chapter What is the issue? Is it my issue, and can I solve it? Is this the real issue or merely a symptom of a larger one? Does it need an immediate solution, or can it wait? Is it likely to go away by itself? Can I risk ignoring it? What are the possible solutions? Are there risks to these solutions? What steps would you need to take in order to solve the issue? Does anyone else at the school need to be involved in the solution? Where is the power leverage in the school to reach the preferred solution? Reaching a solution requires the use of power vested in the nurse. Review Box 9-1 (Sources of Power) and determine which type(s) of power the school nurse has in this situation. State your reasons for your answer. On a separate reference page, cite all sources using APA format. Please note that the title and reference pages should not be included in the total page count of your paper. Expert Answer and Explanation Reaching out a Solution What is the issue? Nurses have to go through many issues that need their attention in their line of work. The problems can include but not limited to, policy-based, medical equipment based, and financial-based problems. In this scenario, the high school nurse is experiencing the issue of poor storage of medical emergency equipment. Is it my issue, and can I solve it? Poor storage of medical equipment is a nursing issue, and they should be part of the team that provides solutions. According to Lavin et al. (2015), nurses should have medical equipment readily available so that they can effectively discharge their duties. However, if the tool is out of reach, the nurses will not save lives are required of them. Is this the real issue or merely a symptom of a larger one? The inadequate storage of medical equipment is not the real issue in this situation. The problem is part of a more significant issue, which is the lack of training staff on how to handle medical equipment. If the workers are not well trained, they will not have proper knowledge of how to handle medical tools (Freeland et al., 2016). Institution managers should also be trained on how to manage health tools. Does it need an immediate solution, or can it wait? A patient might die if not given immediate first aid treatment. However, Bojarski et al. (2016) report that nurses cannot provide proper first aid when the equipment to do so is lacking. Thus, this issue should be solved immediately to avoid significant situations in the future. Is it likely to go away by itself? Poor handling of medical equipment is part of the lack of training. Thus, it cannot go by itself. On that note, nurses should be involved in solving it. Can I risk ignoring it? A nurse or any other stakeholder cannot ignore the issue of improper handling of medical equipment. Freeland et al. (2016) argue that if emergency medical tools are missing, many people can die. Therefore, the nurse should step up and handle the issue with all the resources at his or her disposal. What are the possible solutions? Are there risks to these solutions? The first possible solution to mishandling medical equipment is training staff on how to handle the tools. The custodian could have been educated to give a nurse or any person in charge of student health who was on the shift to control the automatic emergency defibrillator (AED). The second solution is employing trained personnel to handle medical equipment. The custodian of the AED was not medically trained to handle the therapeutic tool. The final solution is firing the custodian of AED for not being present during such a huge event where a person might develop a health issue. What steps would you need to take in order to solve the issue? The first step a nurse can take in solving the issue is researching, asking why the AED was not available when needed. Second is writing a report on the findings and presenting it to the revenant authorities within the school. Lastly, following up to check if his or her recommendations are being implemented. Does anyone else at the school need to be involved in the solution? Many people in the school need to be involved in solving the issue. The management should be included, and their thoughts collected. Also, the nurse should meet the finance and HR departments and discuss with them why they need to fire the current custodian and hire another person who is more qualified to handle medical equipment such as AED. Where is the power leverage in the school to reach the preferred solution? The school nurse can