[ANSWERED] Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills
Mrs. Allen is a 68–year–old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago [ANSWERED] Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. Case Study: Chief complaint: “I’m here for a medication refill because I ran out of my medicines”. Noticed shortness social history Social history: High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago. Family history: Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52. >ros ROS: Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks. Psychiatric: Non-contributory. Physical examination: 5 feet 1 inches weight Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111, R 22 and non-labored HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred.MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin. >labs Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98. A: Primary Diagnosis: Congestive Heart Failure (CHF) Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA) Peripheral vascular disease Differential Diagnosis: Peripheral Vascular Disease (PVD) Plan: Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index. Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 % >bnp – BNP – not available. As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease). Questions: 1. According to the ACC/AHA guidelines, what medications should this patient be prescribed? 2. Does he need medication(s) given his history of MI? NOTE: All posts must be supported by at least 2 peer reviewed references and all paragraphs must be cited. EXPERT ANSWER AND EXPLANATION Case Study on Myocardial Infarction Medications that should be given to the Patient According to ACC/AHA Guidelines The American College of Cardiology (ACC) and American Heart Association (AHA) is focused on improving cardiovascular health through the proper management of health conditions. Mrs. Allen presents to the facility with the chief complaint of ‘medication refill,’ but she has fears that taking her medication would not help in her condition. She has hypertension which is presented by numerous symptoms such as shortness of breath (SOB), and she also has a 1 year history of MI (Anderson & Morrow, 2017). The first step that should be made in improving her condition is the education therapy with the aim of helping her understand the way the drugs work with alleviating her conditions. Other medications I would give to the patient include thrombolytic and antiplatelet drugs which would prevent the formation of blood clots and hence prevent the occurrence of instances of SOB. Need for Medication Given the History of MI Evidence-based practice recommends Mrs. Allen’s family is seen to have a history of MI, and this shows that she is more likely to suffer just like them. Her father has history for valvular heart disease as well as MI, while her brother, who is 57 years, has a 5 years history of MI. Evidence-based practice recommends that patients with a history of MI can be placed on medications such as beta blockers and antiplatelet agents (Muntner et al. , 2017). These would reduce the negative health outcomes as well as the number of deaths associated with the condition. Superstitions such as the idea that patients with MI history should not spend too much on their medication should be completely dismissed as they could become great barriers to access of healthcare. References Anderson, J. L., & Morrow, D. A. (2017). Acute myocardial infarction. New England Journal of Medicine, 376(21), 2053-2064. Muntner, P., Carey, R. M., Gidding, S., Jones, D. W., Taler, S. J., Wright, J. T., & Whelton, P. K. (2018). Potential US population impact of the 2017 ACC/AHA high blood pressure guideline. Journal of the American College of Cardiology, 71(2), 109-118. Place your order now on the similar assignment and get fast, cheap and best quality work written by our expert level assignment writers. Other Solved Questions: SOLVED! How do you think evidence from nursing journals SOLVED!! Nursing C228: Task 1 SOLVED! Describe the difference between a nursing practice SOLVED! Case C 38-year-old Native American pregnant ANSWERED!! Assume you are a nurse manager on a unit FAQs The nurse is caring for a client with spastic bladder what is the nurses priority? The nurse’s priority when caring for a client with spastic bladder would be to manage the client’s symptoms and prevent complications associated with the condition. Some of the nursing interventions that the nurse might implement include: Monitoring the client’s urinary output and assessing for signs of urinary retention, such as bladder distention, discomfort, and overflow incontinence. Administering medications as prescribed, such as anticholinergics, to reduce bladder spasticity and improve bladder control. Implementing bladder retraining techniques, such as timed voiding and pelvic floor exercises, to improve bladder function and reduce incontinence. Assessing the client’s fluid intake and output to ensure adequate hydration and to prevent bladder irritation and infection. Educating the client on proper hygiene techniques to prevent urinary tract infections and other complications associated with spastic bladder. Ultimately, the nurse’s priority would be to help the client achieve optimal bladder function and prevent complications
[ANSWERED 2023] Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including
Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality For this Discussion, review the Learning Resources and reflect on the concepts of foundational neuroscience as they might apply to your role as the psychiatric mental health nurse practitioner in prescribing medications for patients. Explain the agonist-to-antagonist spectrum of action of psychopharmacologic agents, including how partial and inverse agonist functionality may impact the efficacy of psychopharmacologic treatments. Compare and contrast the actions of g couple proteins and ion gated channels. Explain how the role of epigenetics may contribute to pharmacologic action. Explain how this information may impact the way you prescribe medications to patients. Include a specific example of a situation or case with a patient in which the psychiatric mental health nurse practitioner must be aware of the medication’s action. ******* REQUIRED READINGS/RESOURCES -Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier. http://neuroanatomy.ca/videos.html Expert Answer Neurotransmitters and Receptor Theory Agonist-To-Antagonist Spectrum of Action of Psychopharmacologic Agents An agonist is a chemical that fixes a receptor and activates it to yield a biological response. However, an antagonist is a group of institutions, characters, or concepts representing or stands in opposition and must be contended by the protagonist (Wager et al., 2017). In other words, the antagonist is an individual or group of persons opposing a protagonist. The agonist and antagonist’s difference is that agonist causes an action while antagonist opposes an action of the former. Inverse agonist produces a biological response opposite from that of agonist. In pharmacology, partial agonists are medications that fit themselves on a given receptor and activate them. Their efficacy is partial compared to full agonists (Camprodon & Roffman, 2016). Partial agonists can be used to activate the receptors so that they can respond to medications. Inverse agonists can be used to induce a pharmacological response of the agonist. Actions of G-Couple Proteins and Ion Gated Channels G couple proteins receptors, also known as &TM receptors or serpentine receptors, are part of evolutionarily-related proteins, the largest and diverse class of membrane receptors found in the eukaryotes (Meng, Kang & Zhou, 2018). The g couple proteins function as an inbox for messages in peptides, light energy, sugars, lipids, and proteins. On the other hand, ion gated channels are a group of proteins known as transmembrane ion-channel, which open to permit ions, such as sodium, calcium, potassium, or chloride, to pass through the cell membrane in response to the action of a ligand. The key difference between the two elements is that G protein-coupled receptors have a wide variety of functions, including transmitting signals from many stimuli outside the cell into the cell. However, ion gated channels are pores in the cell membrane that allow the passage of in and out of the cell. The similarity is that these two elements are fundamental in pharmacology in that they determine how humans respond to certain medications. Impact of Epigenetics Role in Pharmacologic Action Epigenetics is the study of how environment and behavior can cause transitions that impact the functions of one’s genes. Unlike genetics, epigenetics changes cannot alter the DNA sequence and are reversible but can change how the body sees the DNA sequence. The role of epigenetics may have a huge contribution to pharmacologic action, especially pharmacokinetics or drug metabolism. The changes in the expression of enzymes involved in drug metabolism can impact the pharmacokinetic process. For instance, Mestre-Fos et al. (2018) report that minRNAs can help medication behavior by changing the drug’s distribution of metabolism. Impact of the Information in Drug Prescription Epigenetic alterations are fundamental in both disease and normal state of a patient. The alterations include phosphorylation, acetylation, methylation, and ubiquitylation of the histone chromatin and the DNA (Mestre-Fos et al., 2018). Few patients respond to standard therapies because of various gene alterations in their cells. Therefore, when prescribing medications, a caregiver should evaluate the patient’s epigenetics. In mental health, epigenetics can determine the side effects of medications and identify new pharmaceutical targets for treatment (Camprodon & Roffman, 2016). For instance, a drug such as aripiprazole can have an epigenetic effect on a patient’s gene. Hence, when prescribing it, psychiatric mental health should be aware of its action. References Camprodon, J. A., & Roffman, J. L. (2016). Psychiatric neuroscience: Incorporating pathophysiology into clinical case formulation. In T. A. Stern, M. Favo, T. E. Wilens, & J. F. Rosenbaum. (Eds.), Massachusetts General Hospital psychopharmacology and neurotherapeutics (pp. 1–19). Elsevier. Meng, X. Y., Kang, S. G., & Zhou, R. (2018). Molecular mechanism of phosphoinositides’ specificity for the inwardly rectifying potassium channel Kir2. 2. Chemical science, 9(44), 8352-8362. DOI: 10.1039/C8SC01284A Mestre-Fos, S., Penev, P. I., Suttapitugsakul, S., Ito, C., Petrov, A. S., Wartell, R. M., … & Williams, L. D. (2018). Dynamic G-quadruplexes on the surface of the human ribosome. bioRxiv, 435594. doi: 10.1016/j.jmb.2019.03.010 Wager, T. T., Chappie, T., Horton, D., Chandrasekaran, R. Y., Samas, B., Dunn-Sims, E. R., … & Schmidt, C. J. (2017). Dopamine D3/D2 receptor antagonist PF-4363467 attenuates opioid drug-seeking behavior without concomitant D2 side effects. ACS chemical neuroscience, 8(1), 165-177. https://doi.org/10.1021/acschemneuro.6b00297 Alternative Answer Agonist-Antagonist Spectrum of Action of Psychopharmacologic Agents Foundational neuroscience is one of the crucial backgrounds that mental health practitioners should have. Knowledge in this field allows to increase the understanding of the pathophysiology of mental conditions as well as how the medications affect the central nervous system (Saleh et al., 2016). An agonist is a chemical or biomolecule which interacts with a cell receptor to produce relevant reaction while an antagonist is substance which reduces or opposes the action of an agonist (Saleh et al., 2016). A drug that has the agonist characteristics often ties to the site of reception and causes the required response. On the other hand, antagonists bind with the receptors and limit such action by reducing the number of sites available for the agonist to
[ANSWERED 2023] Characterize the major differences between Sparta and Athens, including your view of the strengths and weaknesses of each
Characterize the major differences between Sparta and Athens, including your view of the strengths and weaknesses of each. Which do you think reflected qualities necessary to the maintenance of present-day democracies, and why? EXPERT ANSWER Athenian and Spartan culture were altogether different in numerous angles. Nevertheless, in the meantime, the two shared a series of common characteristics. The distinctions are what separated the two, while common beliefs and cultures joined them as Greek city-states. System of Governance Sparta One of the main differences between Athens and Sparta relates to the way their governments were structured. The system of government for Sparta was Oligarchy. Every year, there was election of Ephors (Wright, 2015). Five of them were elected. They were accompanied by two kings. These kings passed on crowns to their respective chosen sons. “Gerousia” represented the senate. Kings and Ephors could often meet in the “appella” which represented national assembly to make decisions regarding various civil issues. Decisions were reached through the power of the majority. What was only required was just a shouting of “no” or “yes” Due to power of majority, the five Ephors had the ability to overrule the decision made by the kings. They had an exclusive form of government although the participation was exclusively open to members from the highest social ranking. With oligarchy, power was consolidated on experienced people only. With experienced people come best decisions. On the other hand, this system opened avenue for social division. Athens On the flip side, Athens practiced democratic system of government whereby the people, regardless of their social status, had a say in regard to state proceedings and affairs. This is different from the Sparta’s system of governance. In Athens, 5,000-6,000 people were reduced to group consisting of 500 people. The 500 people could then be divided further to groups of 50. Every group would be in charge for like a month. Ten generals were elected automatically as a result of their experience (Mitchell, 2015). The others were selected through “lot” voting. They an assembly referred to as “ekklesia”, where they sat and discussed militaristic, social and political matters. Athens formed the foundation of modern democracy. Democracy promotes equality, encourages personal development and leads to societal consistency despite the fact it takes time to actually mature in any country. It is the best system of government which reflects the will of the majority unlike oligarchy which represents the will of few powerful individuals. Military Sparta Both the two great powers had established strong sea and land forces at various phases in their history. However, each had dominance in one specific arm of military. Sparta dominated on land-based military made up of armored hoplites. Spartan hoplites went through extensive training from as early as 7 years old, making them among the finest brand of warriors of the ancient times. Their education system referred to as “agoge” entailed harsh training which took place in the wilderness (Wright, 2015). This greatly improved their performance in the battlefield. Athens On the other hand, Athens was popular for when it came to navy. While at particular stages, particularly under the Demosthenes, Athenian military developed substantial strength, nearly matching that of Spartans, generally it was not superior. They had special and powerful ship comprised of Triremes. This was a revolutionary ship, comprising of one hundred and seventy oarsmen, sailors, soldiers, and a captain. It was maneuverable and fast because of its in-battle ferocity. It played a great role during the countering of the Persian threat during the invasion of Greece by Xerxess (Mitchell, 2015). References Mitchell, T. (2015). Democracy’s Beginning (pp. 203-246). New Haven: Yale University Press. Wright, A. (2015). City States (pp. 10-12). Hoboken: Taylor and Francis. 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
[ANSWERED] Read the Ricks New Job case analysis at the end of Chapter 3 of the Blanchard and Thacker (2013)
Read the Ricks New Job case analysis at the end of Chapter 3 of the Blanchard and Thacker (2013) text. In an 800 to 1,000 word paper (excluding the title and reference pages) Week 1 – Assignment Case Analysis: Rick’s New Job Read the Rick’s New Job case analysis at the end of Chapter 3 of the Blanchard and Thacker (2013) text. In an 800 to 1,000 word paper (excluding the title and reference pages), respond to the following case questions: Explain why Rick was let go and how reinforcement theory applies to this situation. Explain Rosie and Walter’s reaction to Rick’s computer in terms of resistance to change. Use the concepts in this chapter to explain how Rick might have approached the computer situation so as to gain acceptance. Explain Rick’s inability to “fit in” using social learning theory. Identify where breakdowns occurred. If Val hired you to develop a management training program for the senior managers at PPP, explain how you would go about designing the program. Provide appropriate theoretical rationale to support your position. Your paper must be formatted according to APA style as outlined in the Ashford Writing Center. Your paper must also include citations and references for the Blanchard and Thacker (2013) text and at least two scholarly sources from the Ashford University Library. An Abstract is not required. Use APA formatted headings, rather than numbers, to delineate your response to each case question. For example, the following headings (or equivalent) can be used to identify each section of your paper: Reinforcement Theory Resistance to Change Social Learning Theory Designing a Management Training Program The paper Must be 800 to 1,000 words, double-spaced (excluding title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center. (Links to an external site.) Must include a separate title page with the following: o Title of paper o Student’s name o Course name and number o Instructor’s name o Date submitted Must use at least two scholarly sources in addition to the course text. Must document all sources in APA style as outlined in the Ashford Writing Center. Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center. Required Resources Text Blanchard, P. N., & Thacker, J. W. (2013).Effective training: Systems, strategies, and practices (5th ed). Upper Saddle River, NJ: Pearson Education, Inc. Expert Answer and Explanation Introduction The reinforcement theory can either trigger positive or negative reaction after past encounters. This is because the individual who has been rewarded or punished will be keen to ensure that pleasant outcomes are enhanced while unpleasant outcomes are minimized. In Rick’s case study, the reinforcement theory was used to punish him for using the wrong behavior as he tried to introduce changes in the sales department. Reinforcement Theory According to the case study, Rick was let go because there was no way his ideas would have been introduced without the other managers feeling threatened. All the steps he took to try and introduce change in the organization did not yield the kind of outcome expected. Also, Rick became so close to Val, and he would communicate to him regarding his plans for the sales department, forgetting that the other managers were equally concerned (Blanchard & Thacker, 2013). Instead, they were left uninformed, with nothing to work with but assumptions and hypotheses (Shimoni, 2017). PPP is an organization with a culture whereby all managers were fearful of changing the way of doing things, except for Val. The rest did not seem to think that there is a problem in the system needing change. Rosie and Walter had a fear of incompetence due to their uneducated backgrounds. Diane, on the other hand, feared lost influence. According to the reinforcement scenario, wanted behavior is rewarded while unwanted behavior is punished. In this case, Rick seems to have been punished for wanting to introduce change in an organization whose culture was clearly not well prepared for it (Morris, 2019). Therefore, in future, Rick will have a problem trying to introduce relevant ideas since he will be scared of a repeat of the same unpleasant outcome. Resistance to Change Rosie and Walter’s response to Rick bringing his computer to work was due to resistance to change. These two individuals did not feel like there was a need to introduce new technology in the office. Also, they did not think that a computer was of more value than what had been happening in the office currently. These managers were clearly not even interested in learning more about the computer and how it would improve the performance of the sales department (Shimoni, 2017). These individuals were already accustomed to doing things in a particular way without technology. Therefore, even as the market was changing and becoming more complex and competitive, they still held on to their approach of pen and paper. It is clear that Rick and Val did not take the necessary steps to prepare these individuals for the change that would eventually benefit the organization as a whole (Morris, 2019). The value of change was also not communicated to them as required. Therefore, the managers simply did not understand what was happening in their usual workplace environment. Before introducing any changes, Rick needed to understand that these two did not see a problem with their approach of doing things(Blanchard & Thacker, 2013). Therefore, the factors triggering a resistance to change needed to be identified and analyzed. Those that relate to the current situation include, far of the unknown, loss of rewards, incompetence, lost investments and even group dynamics. Social Learning Theory Rick’s inability to blend in is due to the behaviors he showcased when he was given a chance to become a part of the team. Rather than reflecting the behaviors of others in the company and the efforts they made to become accepted, Rick chose to become much closer to Val. He ignored the managerial roles of
[ANSWERED] In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal.
In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Capstone Project Topic Selection and Approval In collaboration with the approved course preceptor, students will identify a specific evidence-based topic for the capstone project change proposal. Students should consider the clinical environment in which they are currently employed or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a leadership or quality improvement initiative, or an unmet educational need specific to a patient population or community. The student may also choose to work with an interprofessional collaborative team. Students should select a topic that aligns to their area of interest as well as the clinical practice setting in which practice hours are completed. Write a 500-750 word description of your proposed capstone project topic. Include the following: The problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project that will be the focus of the change proposal. The setting or context in which the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project can be observed. A description (providing a high level of detail) regarding the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project. Effect of the problem or issue, intervention, quality initiative, educational need, or collaborative interprofessional team project. Significance of the topic and its implications for nursing practice. A proposed solution to the identified project topic with an explanation of how it will affect nursing practice. You are required to cite to a minimum of eight peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice. Plan your time accordingly to complete this assignment. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Prepare this assignment according to the guidelines found in the APA Style Guide. Expert Answer and Explanation Capstone Project Topic Selection and Approval Nurses should ensure that patients receive safe and quality care. This capstone project focuses on fall prevention, an issue that has significant implications on the safety and quality of care. The information concerning this topic is detailed as follows; The Problem This Capstone project centers on falls among geriatric patients. Patient falls are one of the major concerns affecting the safety and wellbeing of patients, especially in geriatric facilities. According to estimates by the Agency for Healthcare Research and Quality, approximately a million patients fall each year. The same report attributes almost 10% of total adverse events in health care facilities to falls resulting in significant injuries. The problem poses a significant concern not only on the health outcomes of patients but also on the cumulative health care costs attributed to treating fall-related injuries. Based on these factors, it was considered a significant problem that needed to be addressed. The setting in which the Problem Occurs. Falls are an issue that occurs in both community settings and within health care facilities. From the estimates provided by the AHRQ, the cases of hospital falls show that it is a major challenge affecting the health outcomes of patients. The prevalence of community-related falls is even higher, with geriatric patients being at a higher risk than any other population group, as per Bor et al. (2017). Due to the fragile nature of geriatric patients, the rate of falls in nursing homes and other geriatric care facilities experience higher cases of fall-related injuries compared to other health care settings. Therefore, a targeted solution focusing on this setting is essential in improving the health outcomes of geriatric patients (Prabhakaran et al., 2020). Description of the Issue Hopewell et al. (2018), in their study, noted that patients who are 65 years and above are at a higher risk of experiencing falls. There are various factors associated with falls among the elderly population. For example, a study by Hamza et al. (2019) identifies a positive link between falls and medication use in assisted living facilities. Moreira et al. (2018) noted that fall risk awareness, functional capacity, and physical activity level were significant predicting factors associated with falls among older adults. Understanding these factors is crucial in coming up with viable interventions to reduce falls-related injuries among older patients. Effect of the Problem Falls should be an issue of concern to all care providers as noted by Aryee et al. (2017). Aryee et al. note some of the implications relating to falls which include increased cost of care, long hospital stays, hospital readmissions, risk of permanent disability, and unfortunately, at times even death. Sherrington et al. (2017) list patient falls as a leading cause of morbidity and mortality among older adults, with significant socio-economic burdens for patients and their families. The significant impact of the issue makes it a cause for concern that should be handled with utmost priority by care providers. Significance of the Topic and its Implications for Nursing Practice Falls and falls prevention is a significant topic in nursing practice. Nurses are supposed to advocate for patient safety and quality of care (Abbasinia et al., 2020). Therefore, the prevention of falls among geriatric patients aligns with this mandate. Similarly, as a way of improving the health outcomes of patients, reducing falls-related incidents within geriatric facilities. Proposed Solution The proposed falls prevention solution is to initiate a nurse education intervention, to inform and remind nurses of some of the best evidence-based practices relating to falls prevention. Some of these practices include proper medication administration practices, effective risk assessment strategies, use of risk identification tags, to list a few. The efficacy of educational interventions for health care professionals as a way of reducing incidents of falls is supported by Shaw et al. (2020). Conclusion This paper has provided an overview of the capstone topic and why it is relevant in nursing practice. Addressing the issue of falls in older adults will go
[ANSWERED 2023] Lab Assignment Assessing the Abdomen
Lab Assignment Assessing the Abdomen A male went to the emergency room for severe midepigastric abdominal pain. He was diagnosed with AAA ; however, as a precaution, the doctor ordered a CTA scan. Because of a high potential for misdiagnosis, determining the precise cause of abdominal pain can be time consuming and challenging. By analyzing case studies of abnormal abdominal findings, nurses can prepare themselves to better diagnose conditions in the abdomen. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible To Prepare Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study. With regard to the Episodic note case study provided: Review this week’s Learning Resources, and consider the insights they provide about the case study. Consider what history would be necessary to collect from the patient in the case study. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. 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. 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. Optional Resource LeBlond, R. F., Brown, D. D., & DeGowin, R. L. (2014). DeGowin’s diagnostic examination (10th ed.). New York, NY: McGraw Hill Medical. Chapter 9, “The Abdomen, Perineum, Anus, and Rectosigmoid” (pp. 445–527)This chapter explores the health assessment processes for the abdomen, perineum, anus, and rectosigmoid. This chapter also examines the symptoms of many conditions in these areas. Chapter 10, “The Urinary System” (pp. 528–540)In this chapter, the authors provide an overview of the physiology of the urinary system. The chapter also lists symptoms and conditions of the urinary system. NURS_6512_Week_6_Assignment_1_Rubric NURS_6512_Week_6_Assignment_1_Rubric Criteria Ratings Pts This criterion is linked to a Learning Outcome With regard to the SOAP note case study provided, address the following:Analyze the subjective portion of the note. List additional information that should be included in the documentation. 12 to >9.0 pts Excellent The response clearly, accurately, and thoroughly analyzes the subjective portion of the SOAP
[ANSWERED 2023] Using the Marketing Plan Outline
Using the Marketing Plan Outline WHAT: Using the Marketing Plan Outline on pages 84-66 in Chapter 2, create a Marketing Plan for a health care provider of your choice (real or fictional). See Exhibit 1-1 on page 25 for some examples of “primary providers” – use one of these types of providers. The Marketing Plan should include the following sections: I. Management Summary II. Economic Projections III. The Market – Qualitative IV. The Market – Quantitative V. Trend Analysis VI. Competition VII. Problems and Opportunities VIII. Objectives and Goals IX. Action Programs WHEN: You should have already posted your topic during Week One. Your final project will be due on Saturday of Week 4. WHERE: Post the Marketing Plan as a Word document by clicking on the title above Week 4 Final Project. Final Project Grading Criteria: Marketing Plan Content: 50 points possible Followed Guidelines: 20 points possible Grammar/Spelling: 20 points possible Creativity: 10 points possible Total: 100 points possible Expert Answer and Explanation Marketing Plan for NHC Place at Cool Springs HealthCare Overview of the Organization NHC Place at Cool Springs HealthCare is a private long-term care facility providing nursing care and therapy services to patients with long-term health problems and senior people in Franklin, Tennessee, a city with a population of about 83,454. The healthcare facility was started in 1971 as part of a larger corporation known as the National HealthCare Corporation (NHC) by Dr. Carl E Adams, a community leader in Murfreesboro and a physician. The facility is home to a 180-bed post-acute 24-hour skilled nursing HealthCare Center. It provides care to people to need skilled nursing care after a serious illness, joint replacement surgery, stroke, and a cardiac procedure. The facility has a team of specialized nursing practitioners, physicians, therapists, and nurses. It provides 24-hour nursing care using licensed nursing professionals. Services provided by the facility include diabetes management, ambulatory care, memory care, high acute care, staffing and ancillary services, incontinence care, and medication management. It also provides specialized care services such as podiatry care, wound care, IV therapy, psychological services, and pain management. The vision of the facility is to provide care to all patients in a better way every day. The current strategic plan of the facility is to expand its services to Brownsville, Haywood County, Tennessee. Management Summary The healthcare facility is managed by a board of directors. The chairman of the board is Robert G. Adams. Stephen F, Flatt is the Chief Executive Officer & Inside Director of the healthcare facility. Other leaders of the organization are Vicki Dodson, Senior Vice President, Patient Service, Michael Ussery, Senior Vice President & Treasurer, Jeffrey R. Smith, Senior Vice President & Chief Information Officer, B. Anderson “Andy” Flatt, President & Chief Operating Officer, Bubba McIntosh, Senior Vice President, Ancillary Services and Service Strategy, and Brian F. Kidd, Senior Vice President, Controller & Principal Accounting Officer. Economic Projections Economic projections show that economic factors that will affect the marketing of the healthcare facility’s services in the coming years. One of the factors that will impact the marketing of NHC Place at Cool Springs HealthCare’s service is inflation. There has been a rise in inflation in recent years. Adam et al. (2022) noted that the cost of commodities has increased since 2020. The authors noted that covid-19 impacted production and thus decreased the number of goods in the market. As a result, the supply of goods decreased and demand and prices increased. The rising costs of oil will also affect the marketing of the facility’s services. increasing oil services will increase the cost of transporting drugs and other healthcare facility equipment to the new city and this will increase marketing costs. The business expectations will also impact the marketing of NHC Place at Cool Springs HealthCare’s service. The facility expects to attract customers from all over Haywood County by the end of the year. As such, the facility’s management will increase financial support for a marketing campaign. The facility aims to capture a huge market share in Haywood County. The Market – Qualitative Demographics is defined by Sánchez-Cabrero et al. (2018) as information used by marketers to describe populations affected by the marketing plan. According to the authors, marketers must understand their customers to provide products and services that meet their needs. In marketing, marketers should understand the target market to better appeal to their needs (Sánchez-Cabrero et al., 2018). NHC Place at Cool Springs will provide care services to various people including the senior population, individuals with long-term health problems, such as diabetes, major surgeries, serious heart conditions, patients with drug and alcohol addiction, those who need physical therapy, and those who need palliative care. The facility targets all members from all races and age groups. It will also provide mental health and rehabilitation services. The facility will target those who need its services regardless of their income. The population’s culture will not be considered when providing them. Some of the programs the facility will work with include Medicare, Medicaid, and TRICARE. These programs provide health insurance services to many Americans. The organization will also work with third-party payers, such as employee insurers in providing health services to their patients. Other healthcare institutions will also be part of the organization. The facility will work with neighboring hospitals and clinics to get referrals for patients who need long-term care. Some of the healthcare organizations that will be targeted by NHC Place at Cool Springs HealthCare include Rhea Medical Center Physician Group, A Pattern Medical Clinic, A Pattern Medical Clinic, Rhea Medical Center Physician Group, and Fairfield Memorial Hospital. The Market-Quantitative The healthcare facility seeks to open another office in Brownsville City. According to the Tennessee Department of Health (n.d), the state is ranked 31 in the US in terms of nursing homes that meet the CMS National Nursing Quality Care Collaborative score meaning that most of the nursing homes in the state provide quality care that is above average. The state has a composite score of 10.97% against the US average of 8.2. Image 1 below shows how