Max is an 80-year-old male with a history of gastroesophagea
Max is an 80-year-old male with a history of gastroesophageal reflux disease (GERD), hypertension (HTN) CC: “I have stomach pain.” HPI: Max is an 80-year-old male with a history of gastroesophageal reflux disease (GERD), hypertension (HTN), and a pacemaker placed 10 years ago for third-degree heart block. He presents today with a complaint of abdominal pain. You suspect a bowel obstruction in Max, an 80-year-old patient with complaints of cramping abdominal pain, nausea, and vomiting for 4 days. Describe six (6) ROS questions you would explore further with him to determine the location, severity, and timing of his pain. PE: On exam, the abdomen appears distended, Max has generalized tenderness over the epigastric region on palpation. He is guarding so the exam is limited. Bowel sounds are decreased. His vital signs are normal. He describes his abdominal pain as 7/10. As the APRN, you order an abdominal x-ray. Test results: The abdominal x-ray is indeterminate. What are your next diagnostic choices to determine a bowel obstruction in this patient? List at least three differential diagnoses for abdominal pain. The CT scan shows that Max has a small bowel obstruction. What is your next step? Expert Answer and Explanation Focused SOAP Note Small Intestine Obstruction Patient Information: Max, 80 years, male, African American S CC: “I have stomach pain.” HPI: Max is an 80-year-old male of African American origin who came to the health clinic complaining of abdominal pain. The pain is located in the abdominal area. It started four days ago. The character of pain is cramping and intermittent. Associated signs include nausea and vomiting. The patient notes that the severity of the pain is 7/10. Current Medications: No medications. Allergies: No food, dug, or environmental allergies. PMHx: Past major illnesses include hypertension (HTN), gastroesophageal reflux disease (GERD), and a pacemaker placed 10 years ago for third-degree heart block. He does not remember when he took tetanus or pneumonia shots. Soc and Substance Hx: He took alcohol in his thirties and quit over 45 years ago. He comes from a working family. No history of illicit drug or tobacco use. He says that he has smoke detectors in his house and wears seat belts while driving. His support system is his son and two daughters. Fam Hx: His father died from colon cancer. His mother died from type II diabetes. His older son died in an accident at the age of 28. His second child has type two diabetes. His grandchildren are healthy. Surgical Hx: He reports a knee operation at 33 years old. Mental Hx: No mental health disorder diagnosis and treatment. No history of self-harm. Violence Hx: No history of violence. Reproductive Hx: He is sexually inactive and has no reproductive health. ROS GENERAL: He reports fatigue and weakness. No fever or chills. HEENT: Eyes: No visual loss. Ears, Nose, Throat: No congestion, sneezing, hearing loss, sore throat, or runny nose. SKIN: No rash or itching. CARDIOVASCULAR: No chest discomfort, pressure, pain, or edema. RESPIRATORY: No shortness of breath. GASTROINTESTINAL: No diarrhea or anorexia. GENITOURINARY: No burning on urination. NEUROLOGICAL: No dizziness, headache, paralysis, or syncope. MUSCULOSKELETAL: No joint or muscle pain. HEMATOLOGIC: No anemia. LYMPHATICS: No enlarged nodes. O Physical exam: Vitals: BP 139/92, Temp 35, P 78, Ht. 5’9, Wt. 87kgs. Cardiovascular: No cracks in the chest. No edema. Respiratory: No breathing distress. No wheezes or crackles. No fluids in the lungs. Genitourinary: No urinary retention. No renal angle tenderness. No tender bowel loops. No abdominal masses. Gastrointestinal: Bowel sounds absent on inspection. Distension of the abdomen on auscultation. Diagnostic results: The abdominal x-ray is indeterminate. Since an x-ray is indeterminate, a CT scan should be ordered. A CT scan combined with X-ray images. Dou et al. (2022) noted that a CT scan combined with multiple X-ray images will show intestinal obstructions. Blood test: A blood test will be used to identify whether the patient has intestinal infections. A Differential diagnoses: Small intestine obstruction: The primary diagnosis for this case is small intestine obstructions. According to Jackson and Cruz (2018), the symptoms of small intestine obstructions include vomiting, crampy abdominal pain and comes and goes, constipation, loss of appetite, swelling of the abdomen, and inability to pass gas or have a bowel movement. Small intestine obstruction is the main diagnosis because the patient complains of crampy abdominal pain, nausea, and vomiting which are major symptoms of the disease (Jackson & Cruz, 2018). Physical exam results (bowel sounds absent on inspection, distension of the abdomen on auscultation) also show that the patient has a small intestine obstruction. Appendicitis: The second diagnosis is appendicitis. The symptoms of appendicitis include flatulence, loss of appetite, vomiting and nausea, sudden pain that starts in the lower abdomen, pain that worsens when one coughs, diarrhea and constipation, low-grade fever and might increase if the illness progresses, and abdominal bloating (Talan & Di Saverio, 2021). The disease has been included because the patient reports abdominal pain, nausea, and vomiting which are part of the clinical manifestations of appendicitis. However, it is a secondary diagnosis because the patient does not have a low-grade fever, diarrhea, or pain in the lower abdomen. Intestinal Infection: The last diagnosis is an intestinal infection. The symptoms of intestinal infection include headache, vomiting, nausea, diarrhea, crampy abdominal pain, and fever (Guo et al., 2021). The disease has been ruled out because the patient does not have a headache or fever. P The patient will be recommended to undergo a CT scan combined with a series of X-ray images of the small intestine. The patient will also undergo blood tests. These tests will help identify the actual disease affecting the patient. Since it is suspected that the patient has small intestine obstructions, he should be hospitalized (Ten Broek et al., 2018)). The pain should be stabilized by placing an intravenous (IV) line into the patient’s arm so that he can be given fluids. Abdominal swelling should be relieved by putting a nasogastric tube inside the patient’s nose into his stomach to suck out fluids
Rough Draft Qualitative Research Critique and Ethical Consid
Rough Draft Qualitative Research Critique and Ethical Considerations Rough Draft Qualitative Research Critique and Ethical Considerations Write a critical appraisal that demonstrates comprehension of two qualitative research studies. Use the “Research Critique Guidelines – Part 1” document to organize your essay. Successful completion of this assignment requires that you provide rationale, include examples, and reference content from the studies in your responses. Use the practice problem and two qualitative, peer-reviewed research article you identified in the Topic 1 assignment to complete this assignment. In a 1,000–1,250 word essay, summarize two qualitative studies, explain the ways in which the findings might be used in nursing practice, and address ethical considerations associated with the conduct of the study. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Expert Answer and Explanation Research Critique Guidelines – Part II (Quantitative Studies) Dealing with postoperative pain, nausea, and vomiting is one of the issues that patients encounter after surgical procedures that affect their comfort and satisfaction and outcomes. Dealing with these challenges can affect the recovery process of the patient and may even prolong the discharge period. Several studies have tried to pinpoint different interventions that can assist in dealing with the issue of postoperative pain nausea and vomiting, with each having different results. The PICOT question, therefore, aimed to establish whether in adult patients undergoing general anesthesia, does giving preoperative analgesic and antiemetics decrease pain, nausea and vomiting postoperatively and provide better patient outcomes as compared to not receiving preoperative meds. Quantitative Studies To answer the PICOT question, this paper selected two quantitative research studies that had evidence-based interventions of dealing with postoperative pain nausea and vomiting. The selected studies were conducted by Elgohary et al. (2017) and Chetna et al. (2014). Some of the elements identified from the studies are detailed in the subsequent sections Background The first quantitative article reviewed was an article by Elgohary et al. (2017). The study wanted to carry out a comparison between the effectiveness of the ERAS program and the conventional perioperative care in patients who have undergone elective colorectal surgery. The author notes that the ERAS program has been revolutionary is assisting patients who have undergone colorectal surgery, among other surgical procedures, to respond better to stress and improving postoperative outcomes. The authors also note that the main aim of the ERAS pathway is to reduce the duration of hospitalization and allow the patient to recover quickly. However, the adoption of the program, especially in developing countries, has been slow despite sufficient evidence showing the effectiveness of the program. Therefore, the authors wanted to carry out a supportive investigation on the effectiveness of the ERAS pathway in patients after undergoing elective colorectal surgery. The findings collected in this study holds major significance in nursing practice since the results collected will facilitate the adoption of the ERAS pathway as a viable intervention in improving postoperative patient outcomes. The main aim of the research conducted by Elgohary et al. (2017), was to examine the feasibility and safety of the ERAS pathway in elective colorectal surgery. The research question identified from this objective can be quoted as “is the ERAS pathway feasible and safe for use in patients who have undergone elective colorectal surgery. The second quantitative study selected was conducted by Chetna et al. (2015). The study elaborated on the use of gabapentin for postoperative pain relief for patients who have undergone upper abdominal surgery. The researcher noted that in patients who have undergone upper abdominal surgeries, postoperative pain not only causes them distress but also leads to inadequate respiratory effort and cough reflexes, therefore, a need to have a pain relief strategy. The authors go further to site the efficacy of gabapentin in dealing with pain on patients who have undergone other types of surgical procedures. Therefore, the study was purposed at identifying whether the drug will still be effective in dealing with postoperative pain, for patients who have undergone upper abdominal surgery. The findings obtained in that research are relevant in enhancing patient recovery period and outcomes by eliminating postoperative pain, and in turn, improving respiratory efforts and cough reflex of the patient. The research question used in the study can be quoted as follows “How effective is gabapentin in reducing postoperative pain in patients who have undergone upper abdominal surgery?” How do these two articles support the nurse practice issue you chose? The main aim of the PICOT question was to establish viable methods of dealing with postoperative pain, nausea, and vomiting. The two articles provide evidence-based interventions on how postoperative pain can be dealt with. The first article by Elgohary et al. (2017) focuses on the ERAS pathway on reducing postoperative pain while the second article by Chetna et al. (2015) focuses on gabapentin on dealing with postoperative pain in patients who have undergone upper abdominal surgery. The finding on both studies will be used as a basis of assessing the effectiveness of using preoperative analgesics and antiemetics to decrease pain, nausea, and vomiting in patients postoperative as intended by the PICOT question. The first study was majorly focused on patients who have undergone elective colorectal surgery, while the second article was focused on patients who have undergone upper abdominal surgery. For both studies, the participants were placed in two groups. The first study by Elgohary et al. (2017) used the conventional recovery pathway as their comparison group, while the second study placed their comparison group under placebo. The intervention groups were placed under different perioperative pain regimen. This will be the same approach to be used by the PICOT question, with the difference being the target participants. The PICOT question used adult patients who had undergone general anesthesia
Identify your selected healthcare concern in your city or
Identify your selected healthcare concern in your city or state that needs your advocacy Identify your selected healthcare concern in your city or state that needs your advocacy with an elected official. What is the impetus and rationale for your selection? What is your solution to this concern? Describe the model of policy making that you feel would be best applied to your policy concern and the rationale for selecting this model. Expert Answer and Explanation The selected Healthcare Issue and Rationale for the Selection Mental health is the selected concern, and it encompasses various mental disorders and conditions. Examples are depression, phobia and schizophrenia. There is disparity in access to the mental health services, and people with mental health problems often face discrimination. In Texas, these concerns can impede efforts focused on meeting the health needs of people with mental illnesses. This is a key rationale for the selection of the mental illness as a problem that requires advocacy (Boehme, Biehl, & Mühlberger, 2019). Another reason why healthcare professionals need to advocate for the issue is to help reduce mortality rates based on mental health concerns. The Solution for the Concern The key solution for this concern is the expansion and funding of programs focused on increasing screening and treatment of people with mental health problems. In this case, it is important to call for the state government to allocate more funds into programs which address this particular health concern. The funds can be used to purchase medications, and resources which create awareness about mental health problems. However, subsidizing costs of treating this healthcare concern, through government-managed insurance plans, can equally help address the problem (Li et al., 2021). The Suitable Model of Policy Making and Rationale The institutional model would apply to the policy concern. Under this model, the authority lends legitimacy to the laws, and these laws equally apply to everyone. This is the rationale for the selection of the model. Using this model, the government can come up with policies which require the allocation of resources and funds to help manage the mental health challenges (Niedziałkowski & Putkowska-Smoter, 2020). It can use the local authorities or agencies which are responsible of enforcing the laws. References Boehme, S., Biehl, S. C., & Mühlberger, A. (2019). Effects of Differential Strategies of Emotion Regulation. Brain sciences, 9(9), 225.Doi: https://doi.org/10.3390/brainsci9090225. Li, Y., Scherer, N., Felix, L., & Kuper, H. (2021). Prevalence of depression, anxiety and post-traumatic stress disorder in health care workers during the COVID-19 pandemic: A systematic review and meta-analysis. PLoS ONE 16(3), e0246454.Doi: https://doi.org/10.1371/journal.pone.0246454. Niedziałkowski, & K., Putkowska-Smoter, R. (2020). What makes a major change of wildlife management policy possible? Institutional analysis of Polish wolf governance. PLoS ONE 15(4), e0231601. Doi: https://doi.org/10.1371/journal.pone.0231601. Place your order now on the similar assignment and get fast, cheap and best quality work written from scratch by our expert level assignment writers. Other Solved Questions: SOLVED! How would your communication and interview SOLVED! Describe the difference between a nursing practice SOLVED! Discuss how elimination complexities can affect SOLVED! Case C 38-year-old Native American pregnant ANSWERED! In a 1,000–1,250 word essay, summarize two [ANSWERED] Students will develop a 1,250-1,500 word paper that includes [ANSWERED] Post a description of the national healthcare ANSWERED!! Explain how you would inform this nurse ANSWERED!! In a 4- to 5-page project proposal written to the
Reflect on the mission, vision, values, and goals of your
Reflect on the mission, vision, values, and goals of your healthcare organization and provide examples of how individual employees, departments Assignment: This assignment has two parts: an essay and a business plan. PART I – develop an essay to address the following information: Reflect on the mission, vision, values, and goals of your healthcare organization and provide examples of how individual employees, departments, and work units support all four of these as a foundation for directional strategies. Describe positive and negative aspects of abandoning traditional healthcare strategic planning processes and adopting a contemporary approach. How does complexity influence budget strategies and their implementation? Give examples. Discuss the process of external and internal environmental analyses, and then speculate on scenarios that may result if these steps in strategic planning are omitted or are not done well. Discuss mechanisms that nurse manager can use to ensure they make the best decisions for supporting the financial goals of the organization. PART II – develop a Business Plan Identify an opportunity for implementing a new service or a cost-reducing idea in your organization and write a business plan to describe your idea: explain the need (why) for it, identify stakeholders (who) will be impacted, discuss the benefits versus the disadvantages, describe the costs/expenses for the idea, and outline the implementation plan. Expert Answer and Explanation PART 1: Strategic Healthcare Management Planning is a concept that is used every day in our personal lives and the same behavior also translates into the management of organizations. The top leadership of organizations usually formulate strategies to meet the mission and vision of their organization. It is important because with every organizational activity, risk and resources are usually involved and they have to be adequately managed lest the organization loses its ability to function properly. The purpose of this paper will be to expound on different aspects concerning the application of strategic management practices in healthcare. Support for Mission Vision, Values, and Goals The organization is usually driven by its mission, vision, values, and goals formulated. The efforts of all individuals and organs functioning within the organization should be aligned to realize the accomplishment of these elements. A mission statement is one that highlights where the organization is going (Cronin & Bolon, 2018). For example, the mission for the healthcare facility I work for is “to provide quality and compassionate healthcare accessible to everyone.” Vision on the other hand is the future position of where the organization wants to be, while the values are the beliefs and practices uphold by the organization (Lahey & Nelson, 2020). The values for the organization I work for include teamwork, integrity, excellence, innovation, and compassion. Our goals are aligned to meet the said mission and vision of the organization while using our core values during our transactions with other stakeholders. The role of individual employees, departments, and work units in accomplishing this mission is to ensure that they channel all their efforts into fulfilling this mission. This includes identifying and removing any barriers that may hinder collaboration or promote conflicts due to differences in personal goals and objectives (Lahey & Nelson, 2020). It is also the role of individual employees and work teams to collect information on behalf of the organization on what other competing organizations are doing to accomplish goals employees can also support all the four elements by ensuring that they align how they discharge their duties with the values of the organization. Impact of Adopting a Contemporary Approach to Strategic Planning Strategic planning was developed due to the increased complexity of how the economy and organizations operate (Esfahani et al., 2018). The used traditional approach was a systematic process that emphasized on the mission and vision of the organization without considering other factors as equally important. The processes also involved coming up with the short term, medium, and long-term objectives, which were to be followed to the latter to gain a competitive edge. However, this approach had its drawbacks which made it be abandoned for a contemporary approach that was considered to be more responsive to the current business environment (Grube & Crnkovich, 2017). One of the positive aspects of abandoning the traditional approach to strategic management and transitioning to the contemporary approach is that a more responsive process that factors in day to day operational issues is considered. This means that organizations can easily make adjustments to their strategic decisions based on the current changes in operations. Another positive aspect of adopting a contemporary approach is that it treats strategic planning as a process and not an event (Grube & Crnkovich, 2017). This means that it is continuous and adjustable to changes in both the internal and external organization environment. The negative aspect is that the contemporary approach does not offer a predictable methodology or timeframe to strategic planning as it was with the traditional approach. Budget Strategies The current environment in the management of healthcare organizations has become more and more complex with increasing risks and stakeholders to transact with. This has also made healthcare financial managers restructure their methods to adjust to these complexities; this includes the budget-making process and implementation. One of the complexities has been the adoption of the contemporary approach to strategic planning that requires adjustment of organizational strategies with changes in the internal and external business environments (Walsh, 2016). Given that these adjustments can be abrupt, it becomes difficult to forecast and give accurate budgetary figures in an environment of uncertainty (Hill, 2016). Another factor is the addition of more stakeholders involved in decision making. This means that more data needs to be collected to make accurate budgetary forecasts which can also be time-consuming (Hill, 2016). As such, there is also a likelihood that the budget implementation timelines will also be affected. Process of External and Internal Environmental Analyses In the strategic management process, one of the core steps is to carry out an internal and external organization analysis. This allows the organization to collect its efforts in response to the findings of the two analyses. The process of carrying out environmental analysis is a five-step process that includes; first an analysis of the external environment (Esfahani et al., 2018). This
Mrs. J is a 63-year-old married woman who has a history of
[ANSWERED] Mrs. J is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD) It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span. Evaluate the Health History and Medical Information for Mrs. J., presented below. Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below. Health History and Medical Information Health History Mrs. J is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD. Subjective Data Is very anxious and asks whether she is going to die. Denies pain but says she feels like she cannot get enough air. Says her heart feels like it is “running away.” Reports that she is exhausted and cannot eat or drink by herself. Objective Data Height 175 cm; Weight 95.5kg. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin. Intervention The following medications administered through drug therapy control her symptoms: IV furosemide (Lasix) Enalapril (Vasotec) Metoprolol (Lopressor) IV morphine sulphate (Morphine) Inhaled short-acting bronchodilator (ProAir HFA) Inhaled corticosteroid (Flovent HFA) Oxygen delivered at 2L/ NC Critical Thinking Essay In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following: Describe the clinical manifestations present in Mrs. J. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered. You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. EXPERT ANSWER AND EXPLANATION Patient Assessment and Treatment One’s physiological wellbeing depends on a wide range of factors including lifestyle behaviors. The prolonged use of the psychotic substances, for example, can expose one to the risk of developing health problems, and the nature of the medical condition one develops depends on the substance they use. For instance, smoking tobacco exposes smokers to the risk of developing respiratory issues. Equally, the type of food one eats and their levels of physical activity can have a certain level of impact on their physiological wellbeing. It is imperative to explore the case of patient with COPD, in terms of the effectiveness of the intervention she receives, and examine the contributors to the heart failure. Mrs. J’s Clinical Manifestations Based on the Mrs. J’s medical history and subjective data, she exhibits a number of clinical manifestations. One of these manifestations is the acute exacerbation of the chronic obstructive pulmonary disease (COPD). Another clinical manifestation present in the patient is acute decompensated heart failure. These two conditions explain the reason why she experiences difficulties breathing, and her heart rate is irregular. She has Congestive Heart Failure (CHF). Mrs. J also shows sign of hypertension considering that her blood pressure level is 90/58, and this is more than the 120/80 average (Lin et al., 2016). Additionally, the patient has fever, and besides this fever, she cannot perform Activities of Daily Living (ADLs). She coughs blood-tinged sputum, and this indicates a possible respiratory problem. Assessment of the Effectiveness of the Nursing Interventions Mrs. J takes a number of medications to help promote her recovery, and while these medications are effective, some may not be necessary in her case. She takes IV furosemide, and this intervention is appropriate based on her case. This is because this medication would help relieve her heart failure problem by helping improve the heart’s blood-pumping capacity. Given the patient’s
A mother comes in with 9 month old girl. The infant is 68.5cm
A mother comes in with 9 month old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart) DQ1: Consider the following patient scenario: A mother comes in with 9 month old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). Describe the developmental markers a nurse should assess for a 9–month–old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice. DQ 2: Child abuse and maltreatment is not limited to a particular age—it can occur in the infant, toddler, preschool, and school-age years. Choose one of the four age groups and outline the types of abuse most commonly seen among children of that age. Describe warning signs and physical and emotional assessment findings the nurse may see that could indicate child abuse. Discuss cultural variations of health practices that can be misidentified as child abuse. Describe the reporting mechanism in your state and nurse responsibilities related to the reporting of suspected child abuse. DQ 1: Expert Answer and Explanation Health Assessment for Infant For a 9 month female infant at 25th percentile of height and head circumference, yet only in the 5th percentile in terms of weight demystifies that the infant is underweight. The CDC provides essential developmental markers that a nurse should consider when assessing the nine-month-old female infant (CDC, 2019). For instance, at the age of 9 months, the infant ought to have developed social and emotional markers such as being afraid of strangers, recognizing favorite toys, and being clingy to familiar adults. Communication makers include the ability to copy sound or gestures, use finders to point, and understanding “no.” In terms of the cognitive and physical development, the infant should be able to watch the path of a falling object, put items in mouth, move objects from one hand to the other, sit without support, crawling, and standing while holding on to something (CDC, 2019). The assessment can also include the nutritional and dieting aspect of the infant. As a nurse, I would recommend improvements regarding nutrition and diet, increased movements, and mental alertness. The recommendation is in light of the infant’s underweight appearance. I would first discuss with the mother the importance of a proper diet and nutritional value to the growth of the baby both physically and mentally (Green, 2018). I will also inquire about the breastfeeding routines if the infant is being given other formulas that improve their growth. It is essential for the mother to comprehend the relevance of breastfeeding and the type of food that an infant can begin to eat after the six months following the delivery. It is also essential to offer the mother nutrition awareness materials such as handouts so that she can refer and offer the child with appropriate meals for weight gain. References CDC. (2019). What developmental milestones is your 9-month-old reaching? Retrieved 18 May 2020, from https://www.cdc.gov/ncbddd/actearly/milestones/milestones-9mo.html Green, S. (2018). Health assessment: Foundations for effective practice. Retrieved from https://lc.gcumedia.com/nrs434vn/health-assessment-foundations-for-effective-practice/v1.1/ Alternative Expert Answer Developmental Markers for a 9-Month Old Baby When assessing a 9-month old female infant for any developmental issues, a nurse has to look at the developmental markers for a child at this age. On average, a female baby at this age weighs 8.2 kg. For a child at this age, still, their average length is 70.1 cm, and the size of their head is 44.5 cm. Although a baby starts to crawl when they reach this age, not all crawl when they hit 9 month after birth, and they may start walking after the 12 month. The baby also sits, babbles and express interest in picking things. Additionally, they reach for objects while sited, and they may pool themselves up using tables or chairs (Tandon, 2017). The child may express anxiety when separated from their parents. When examining this child, the nurse would need to take to consideration the fact that a baby at 9 months can respond to their name, and they know their parents (Breiner et al., 2016). The baby in the case seems to be experiencing the developmental issues. The baby’s weight is 6.75 kg which is lower than the average 8.2 kg. Their length is 68.5 cm, and this is slightly below the average length of 70.1 cm for female babies at this age. The circumference of her head is also slightly lower than that the average. As a nurse, I would recommend to the parent to encourage the baby to move. This would be important in helping build the baby’s muscles. The parent may hold the baby’s hands and pull them while they walk together (Tandon, 2017). It is also important for the parent to consider feeding the child a meal rich in protein so that the child gets to meet her nutritional needs. This would help her gain weight. These recommendations can translate to better clinical outcomes because a number of studies link practice and nutrition to the improved child development (Tandon, 2017). References Breiner, H., Ford, M. A., Gadsden, V. L., & National Academies of Sciences, Engineering, and Medicine (U.S.). (2016). Parenting matters: Supporting parents of children ages 0-8. Washington: National Academies Press. Tandon, M. (2017). Early Childhood Mental Health: Empirical Assessment and Intervention from Conception through Preschool, An Issue of Child and Adolescent Psychiatric Clinics of North America. Amsterdam: Elsevier. DQ 2: Expert Answer and Explanation Child Abuse and Maltreatment Child neglect is the most common form of child abuse that school going children go through. The maltreatment has the capacity to negatively affect all aspects of their lives while in school. Poor grades and low self-esteem are some of the negative results of this form of maltreatment in school-going children (Zeanah, & Humphreys, 2019). Physical abuse is the second form of child maltreatment that is common in school-going children. Physical abuse may present itself in different forms. Beatings, stabbing, punching and kicking are ideal examples of physical abuses meted upon school going children. There are
[SOLVED 2023] In this assignment you will analyze a case involving public safety versus an individual’s privacy
In this assignment you will analyze a case involving public safety versus an individual’s Unit III Case Study Right to Privacy Case Study Certain freedoms such as civil liberties and civil rights are concepts highly revered by Americans; however, there are times when these two concepts conflict in the name of safety and national security. The Digital Age is having a profound effect on the privacy of individuals in both their daily and private lives. With technology like cameras and smartphones, the activities of people are being recorded more, whether it is running a red light, entering a building, playing in a park, or using an ATM machine. In this assignment you will analyze a case involving public safety versus an individual’s privacy. Read the following article from the New York Times concerning Carpenter v. United States, a case recently decided by the Supreme Court. Liptak, A. (2018, June 23). Warrant required for cellphone tracking data. New York Times, p. A1(L). Retrieved from http://link.galegroup.com.libraryresources.columbiasouthern.edu/apps/doc/A543973598/ STND?u=oran95108&sid=STND&xid=753160e8 For more background on the case, here is a link to the actual opinion written for this case: https://www.supremecourt.gov/opinions/17pdf/16-402_h315.pdf Please answer the following questions concerning this case. Address the questions in a cohesive essay. It should be at least two pages in length and should be double-spaced, and typed in 12-point Times New Roman font. Please be sure to provide an introduction to your essay, Which part of the Constitution addresses individual privacy rights? Do you believe that, with today’s technology, the Constitution still adequately protects those rights? Why, or why not? Describe the issue that was debated in this case. How was the need for public safety and security balanced with individual civil liberties and civil rights impacted by the final ruling in this case? Do you agree with the majority opinion or the dissenting opinion in this case? Explain your response. Where do you personally draw the line in this privacy issue? Explain how historical thought and tradition affect civil liberties and rights as they pertain to the issue presented in this case. Describe how politics can intersect with civil rights. What consequences do you support for those who violate constitutional rights? What, if any, compensation do you recommend for individuals whose rights have been violated by others? You must use at least two sources, in addition to the article given, to support your response. Make sure that all sources are cited and referenced using APA style. Expert Answer and Explanation Unit III Case Study Among the most discussed civil liberty in the US is the right to privacy. This is especially in the light of technology advancement, where in the recent past, there has been numerous technological advancements that infringe the rights of privacy by accessing personal data of individuals, especially through different telecommunication providers. The digital age has affected the private lives of Americans as they can be recorded when entering a building, passing a red light in traffic, playing in parks or even using ATM machines (Citron, 2018). This assignment involves an analysis of the Carpenter v. United States case, where privacy and phone location data as well as other elements are highlighted. Part of Constitution that Addresses Individual Privacy Rights and the Capacity of the Constitution to Protect those Rights The fourth amendment is the part of the constitution that protects individual privacy rights in an extensive way. Under this section of the constitution, which was added in December 1791, people are protected from searches that are unlawful or even seizures by authorities (Henderson, 2017). The police need to have a warrant to access your house and conduct extensive search. Issue debated in the Case In the Carpenter v. United States case, the issue debated about was the question as to whether or not the police, or other authorities, have the right to have unrestricted access to customer data through the telecommunications service providers (Chaudhari & Prasad, 2019). It was an issue that was raised in response to the anti-terrorism procedures set by the police of accessing different gadgets held by citizens to prevent unsafe digital activities. My Agreement in the Majority Opinion in the Case The majority opinion in the case held that there should be a warrant for the police to access the site location or other information of a citizen from a cell phone company. This majority opinion was held by Chief Justice Roberts, and was joined by justices Sotomayor, Kagan, Ginsburg, and Breyer (Chaudhari & Prasad, 2019). I agree with this opinion as it is among one of the only few ways that customers of telecom companies can feel safe using the devices to communicate amongst themselves. How Historical Tradition affects the thoughts as Pertaining to this Case One of the historical traditions that affected the thoughts pertaining to the case is that the police are meant to provide security for citizens, and that citizens should be willing to cooperate in all ways they are asked to. This traditional opinion dismisses the fact that some of these members of the police taskforce may be ‘dirty,’ and hence infringing the privacy of citizens would have the wrong beneficiaries. Intersection of Politics with Civil Rights Politics affect civil rights in a large way. In the Carpenter v. United States case, four justices including Justice Alito, Justice Gorsuch, Justice Kennedy, and Justice Thomas, has dissenting opinions, and several analysts argued that their indifference to the issue of privacy was on a political basis. Consequences for those Who Violate Constitutional Rights Violation of constitutional rights is a serious criminal offense, and I support the legal punishment of culprits of the same. However, there should be adequate warnings before serious actions are taken on the affected individuals. Compensation I Recommend for Individuals whose Rights are Violated by others A public pardon is best when a crime committed exposes a citizen to public shame. In other violations, I believe financial compensation to the individuals whose rights are violated should be done. I also believe that the culprits should compensate all other damages associated with the violations. References Chaudhari, N., & Prasad, S. K. (2019). Carpenter v. United States: State Surveillance and Citizen Privacy. NALSAR Stud. L. Rev., 13, 129. Citron, D. K. (2018).
[ANSWERED 2023] In this assignment you will write a critical appraisal that demonstrates comprehension of two quantitative research studies
In this assignment you will write a critical appraisal that demonstrates comprehension of two quantitative research studies. Use the practice problem and two quantitative, peer-reviewed research articles you identified in the Topic 1 assignment (or two new articles based on instructor feedback in Topic 1) to complete this assignment. In a 1,000–1,250-word essay, summarize two quantitative studies. Use the “Research Critique Guidelines – Part II” document to organize your essay. You are required to cite a minimum of three 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. Prepare this assignment according to the guidelines 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. You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance. Research Critique Guidelines – Part II Quantitative Studies Introduction Introduce your nursing practice problem and discuss the purpose of your paper. State your PICOT question. Background of Studies Summary of studies including problem, significance to nursing, purpose, objective, and research question. How Do These Two Articles Support the Nursing Practice Problem You Chose? Discuss how these two articles will be used to answer your PICOT question. Describe how the interventions and comparison groups in the articles compare to those identified in your PICOT question. Method of Studies State the methods of the two articles you are comparing and describe how they are different. State one benefit and one limitation of each method you have identified. Results of Studies Expert Answer and Explanation Research Critique Guidelines – Part II Quantitative Studies Introduction The project focuses on the issue of obesity and the nursing practice problem for this project since it affects a wide range of the adult population. Healthcare provides services to different patients, and each present with a different issue altogether. Obesity is a key issue in healthcare since it provides different issues to the care provider and undermines the efficiency of care. Obesity increases susceptibility to diseases and reduces the quality of life. Just like aging, and economic standpoints, obesity can be a risk factor for diseases and other forms of health factors. The susceptibility to disease from obesity increases with increase in age. Obesity and overweight are among the leading causes of many health problems, such as the occurrence of stroke and other forms of the disease. There are numerous complications that come with obesity, the most common including the buildup of fat in blood vessels, stroke, and heart attacks. Obesity interferes with the quality of life in different ways. To begin with, obesity makes it difficult for a person to lead a normal life. For instance, a person might encounter challenges with walking or climbing a flight of stairs. The inability to perform basic functions is a major concern for the health of a person. The purpose of this paper is to analyze the two quantitative research on that focus on the issues of obesity among elderly patients. PICOT Question: In non-Hispanic black adults aged 40-55 with BMI of 30 and above (P), does physical activity five days a week (I) compared to no practice (C) reduces BMI scale (O) in eight weeks (T)? Background of Studies The first quantitative study identified to address the issue of obesity among adults is the study by Dieli-Conwright et al. (2018). The article focuses on how care for breast cancer survivors can use aerobic and resistance exercise to improve physical fitness, bone health, and quality of life. The article contends that physical activity is the main treatment option for obese and overweight individuals that are looking to shed weight. The article makes use of a randomized controlled trial to help improve the outcome of care for obese and overweight patients. The identified problem in the article is the issue of obesity and overweight among cancer patients. The article is significant to the nursing profession as it offers evidence-based recommendations on proper physical activity for obese or overweight cancer survivors. The overall purpose of this trial was to compare a 16-week supervised moderate-vigorous intensity aerobic and resistance exercise intervention to usual care in physically inactive, overweight, and obese breast cancer survivors. The objective was to analyze the efficiency of aerobic and resistance exercises as forms of physical exercise to combat obesity. The research question used in the article is, “What is the impact of moderate-vigorous intensity and resistance exercise intervention aerobic in physically inactive, overweight, and obese breast cancer survivors?” The second article that focuses on the PICOT question is by Abdelbasset et al. (2019). The study provides insights on how an 8-week high-intensity interval exercise on intrahepatic triglycerides, visceral lipids, and health-related quality of life in diabetic obese patients. The identified problem focuses on how obesity is a major issue in society and can be mitigated through the use of physical activity. The article is significant to nursing as it creates a mean sin that nurses can use to help obese patients to overcome their weight issues. The purpose and objective of the study are to help create an effective strategy that can be sued to help treat obese patients using physical activity as the basis of care. The research question from the article is, “What are the effectiveness of 8-week high-intensity interval exercise on intrahepatic triglycerides (IHTG), visceral lipids, and HRQoL in diabetic obese patients with NAFLD?” How Do These Two Articles Support the Nursing Practice Problem You Chose? The two articles provide answers to the PICOT question as they both focus on the efficiency of physical activity as a means to mitigate obesity. The articles identify how different forms of physical activity can be used to mitigate obesity and lead to the desired outcome. The PICOT question is based on the intervention that the use
[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