Physical Assessment
You will perform a history of a respiratory problem that either your instructor has provided you or one that you have experienced and perform a respiratory assessment. You will document your subjective and objective findings, identify actual or potential risks, and submit
Literature
Title page
Introduction section
A comparison of research questions
A comparison of sample populations
A comparison of the limitations of the study
A conclusion section, incorporating recommendations for further research
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.
Getting Started
In NUR-415, you learned that strategic planning is a systematic process, by which opportunities for change are identified and appropriate procedures to actualize those changes are designed, implemented, and evaluated. In today's turbulent and complex healthcare environment, strategic planning is a vital and fundamental tool for the achievement of an organization's goals and desired outcomes. Strategic planning and effective project management guide the operational activities of an organization and result in strong and efficient use of resources.
In this analytical exercise, you will develop a problem statement, carefully constructing it so that it accurately states the problem your planned change project will address. Aspects of this exercise include exploring potential outcomes you wish to accomplish through the planned change and the feasibility of the planned change. In Discussion 1.4, you will develop the background of the problem incorporating support of the planned change with current scholarly literature, the project outcome, the activities and timeline, and the evaluation plan. This exercise will assist you in refining information about your capstone project that you will post in Discussion 1.4.
Upon successful completion of the course material, you will be able to:
Identify a specific problem or need in a healthcare setting.
Analyze the feasibility of a proposed planned change project.
Resources
Textbook: Leading and Managing in Nursing
Textbook: Fundamentals of Project Management
File: Capstone Project Overview.pptx
File: How To Write a Problem Statement.pptx
Background Information
Developing a planned change project is an ongoing process, which first requires an accurate internal and external assessment of the situation that needs the change. The background of the situation for desired change is thoroughly explored and the need for the change supported by evidence-based literature. A problem statement and realistic desired outcomes flow from the assessment. It is important to avoid confusing the identified problem with the symptoms of the need. The astute project manager remembers that the manner in which a problem is defined, guides the development of the strategies for resolution. In an effective change project, the planned change is feasible. To determine feasibility, the project manager analyzes all factors, weighing strengths and barriers. If the weight of the barriers outweighs the strength of the change facilitating factors, the feasibility of the project must be reconsidered.
Instructions
Review the rubric to make sure you understand the criteria for earning your grade.
Review Chapters 18 and 30 in the textbook, Leading and Managing in Nursing.
Read Chapters 1 to 5 in the textbook, Fundamentals of Project Management.
Download and view the Capstone Project Overview.pptx and How To Write a Problem Statement.pptx PowerPoint presentations.
Review your Strategic Plan assignment from the NUR-415 course, or if necessary address another change initiative for your capstone project, critically consider and select a topic. Your project must be patient-focused and include a goal to improve patient outcomes. Your assessment of the problem and feasibility of a solution must include direct input from patients or recipients of care (survey results, comments, interviews, patient data, etc). Review Chapter 22 in the textbook, Leading and Managing in Nursing regarding patient-centered care.
Navigate to the threaded discussion and post your discussion response according to the following instructions.
Utilizing the topic from your NUR-415 strategic plan or another change initiative you selected that meets the criteria listed above, include the following headings to compose your discussion:
Definition of the Problem: Present a detailed description of the elements of the problem.
Development of Solution Options: Identify the desired future state/conditions that would ideally solve the problem. Include the actions that would be required to achieve the desired change.
Feasibility of Planned Change: Evaluate the feasibility of your planned change by addressing physical resources, time resources, financial resources, and stakeholder involvement. Refer to Figure 1.4 on p. 15 in the textbook, Fundamentals of Project Management (Heagney, 2016) and address the questions listed under ""Plan the Project.""
Problem Statement: In two to three concise sentences, list the problem statement you have developed from this analytical exercise.
Post your discussion by the third day of the workshop for faculty review and approval. Be sure to await feedback and approval from your instructor regarding your capstone project; modify your plan as recommended by your instructor before proceeding to Discussion 1.4.
Review your classmate's postings. No further discussion or interaction with peers is required in this forum.
Pediatric Discussion
Please reply to the following discussion with one reference. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates.
KN Discussion:
Why is developmental assessment essential in the provision of primary care for infants, children, and adolescents, and what are the essential components of this assessment on the basis of this child’s age?
Developmental assessment is crucial in monitoring a child’s performance in in several evaluated areas, like physical, emotional, neurological, and psychosocial development. It is routinely performed at each well - child visit and may be done additionally if there is a concern. According to American Academy of Pediatrics (AAP) and CDC (2021), developmental screenings should be completed at least at 9 months, 18 months, and 24 or 30 months. During infancy kids develop at rapid speed at it is vital to catch any type of delay and initiate early intervention if needed (Vitrikas et al., 2017). In fact, developmental assessment changes as children grow, and parameters evaluated in infants will be totally different from those evaluated in school age kids, toddlers, and adolescents (Stoppler, 2018). Primary care providers are responsible for careful monitoring of child development and identification of any kind of deficits, as well as, timely addressing it (Stoppler, 2018). It may be hard for families to understand the situation and accept help; yet, the education and proper referral is another essential task for a healthcare provider. According to CDC (2021), AAP recommends assessing the following areas of performance in pediatric patients as developmental screening:
Motor development
Cognitive development
Language development and communication
Social and emotional development, as well as mental health screening.
Besides, each healthcare provider should implement the following into practice routine (CDC, 2021):
Monitor development of the child at every visit.
Use reliable and valid screening tool for scheduled screenings.
Refer for additional evaluation and complete more comprehensive assessment if a concern is identified.
Which tools will you use to assess specific components of development (such as speech, motor skills, social skills, etc.)? Which tools do you think are the most accurate in assessing the developmental components and why?
There is an abundance of valid screening tools that can be used by healthcare providers for developmental assessment. As mentioned above, first years and even more months of human life are crucially important for development and utilizing a valid screening tool may aid in early recognition and timely intervention if there are any deficits (Vitrikas et al., 2017). The areas of child’s development being routinely assessed are social/emotional behavior, vision and hearing, gross and fine motor skills and coordination, cognitive abilities, speech and language (Stoppler, 2018). Parents are the main source of information during early stages of life. It is vital to make sure they understand the purpose of developmental screening and are willing to collaborate. Gross and fine motor skills may be assessed by a standardized screening tool Ages & Stages Questionnaire (ASQ) (Vitrikas et al., 2017). A provider may observe the key elements like walking, sitting, coordination, fine motor skills during the visit and also ask pertinent questions to parents (Stoppler, 2018). Language assessment is an important part of each child’s development and is proven to affect learning abilities and pattern of learning. In early stages the assessment is greatly dependable on the children’s caregivers (Vitrikas et al., 2017). A standardized tool, like Early Language Milestone (ELM) could be used to evaluate child’s language development (Vitrikas et al., 2017). A provider should ask about vocabulary, attempts to mimic sounds, communication abilities, as some children are not willing to perform during the visit (Stoppler, 2018). Physical exam may reveal some abnormalities that interfere with normal speech development; thus, assessment of oral structures should be taken seriously (Stoppler, 2018). As pertains to growth and weight gain monitoring a growth chart may be used (AAP, 2019). It consists of a series of percentile curves that illustrate the distribution of selected body measurements in children (CDC, 2021).
Overall, the at ASQ is a reliable, affordable, and easy to use screening tool.
Which components would you consider in assessing the basic biological functioning and well-being of your pediatric patients? Why are these components important in providing primary health-care services to children?
Multiple factors may influence the development and wellbeing of the child. This begins from preconception care and parental genetics and sometimes abnormalities are going to be present despite the high level of care and prevention measures (Vitrikas et al., 2017). Nutrition and environmental factors are also vital for proper growth and development. Therefore, during each visit a healthcare provider should assess the child and educate the parent on what to expect from the next stage of development (Stoppler, 2018). Following are the main components of physical assessment (Stoppler, 2018):
head circumference
weight
height
temperature
Heart rate
Respiratory rate
Besides, the skin, abdomen, oral cavity, head, neurological development, as well as vision, hearing, cognitive abilities, and mental state should be assessed during the visit (AAP, 2019). According to guidelines, annual well child visit should also include urinalysis and anemia screening (AAP, 2019).
These components are essential to evaluate in assessment of biological functioning and wellbeing baseline criteria.
References
American Academy of Pediatrics: Universal Screening Urged for Developmental Delays. (2019). American Academy of Pediatrics. https://www.healthychildren.org/English/news/Pages/Identifying-Developmental-Disorders-Through-Surveillance-and-Screening.aspx
Developmental Monitoring and Screening for Health Professionals. Centers for Disease Control and Prevention. (2021). https://www.cdc.gov/ncbddd/childdevelopment/screening-hcp.html
Factors Affecting Child Development. (n.d.). https://www.beststart.org/OnTrack_English/2-factors.html#biological
Sheldrick, R. C., Schlichting, L. E., Berger, B., Clyne, A., Ni, P., Perrin, E. C., & Vivier, P. M. (2019). Establishing new norms for developmental milestones. Pediatrics, 144(6).
Stoppler, M. (2018). Developmental Screening – Critical for Every Child. https://www.medicinenet.com/developmental_screening_-_critical_for_every_child/views.htm
Vitrikas, K., Savard, D., & Bucaj, M. (2017). Developmental delay: when and how to screen. American family physician, 96(1), 36-43.
Nursing Project
Powerpoint template attached.
HERBS ASSIGNED: Red Yeast Rice & Co-Q10
Instructions
Pharmacological-Herbal Management PowerPoint Presentations
For this assignment, you are to complete a PowerPoint presentation addressing the specific criteria below.
The PowerPoint presentation will be based on the topic assigned to you.
Assignments will be posted in announcements during Week 1. If you cannot locate your assignment contact the instructor.
Your presentation must include the following headings.
Heading - Title Page
Heading - Assigned Herbs & Reported Uses
Heading - Reported Doses of Assigned Herbs
Heading - Cautions of the Assigned Herbs
Heading - Drug Interactions of the Assigned Herbs
Heading - Adverse Reactions of the Assigned Herbs
Heading - Conclusions
Heading - Reference Page
The Powerpoint template titled Pharmacological - Herbal Management Project for you to follow as a guide for this week's assignment
Nursing and Non-Nursing Theory
The future of healthcare is focused upon improving patient outcomes and patient satisfaction. Through the application of research studies and theory, evidence based practice development will lead the profession of nursing into the future whereby knowledge and skills support the practice of providing quality care.
Locate one nursing theory and one non-nursing theory. Describe how two practitioners can bring these separate theories together to provide meaningful patient care.
at least 4 reference and 3 paragraphs
Please review the Discussion Board Participation grading rubric under Course Resources. This is important information that will ensure that you earn maximum points. Your postings should be qualitative and provide substantive depth that advances the discussion. Please see the Academic Success Center located in the student portal for assistance with writing, APA, and online communication.
Discussion Post
Must have 3 scholarly articles to support discussion posting that are less than 5 years old.
Post and Explanation of the primary diagnosis, as well as 3 differential diagnoses, for the patient in the case study that you were assigned.
Describe the role the patient history and physical exam played in the diagnosis.
Then, suggest potential treatment options based on your patient diagnosis.
Case Study 2
K.B., a 52 year old Irish American patient who present today complaining of “a mole” on the skin that is changing colors. He said he has had this ‘mole’ for almost two years. K.B. is a construction worker currently residing in Hawaii. As a teen he worked outside and visited the tanning bed several times a month. He is a worried that this “mole” doesn’t look like the others on his body.
On your examination, you note, the lesion as round, dark colored in appearance, and scaly. You also note the mole has an irregular border and about 0.2cm in size.
Ethical and Legal
Aspects of Nursing Practice DQ # 6 Student reply Martha Gomez,"Reply to this student post adding extra information related with this student post
less than 20 % similarity.
Question 1
The American Nurses Association recommends three general approaches for the maintenance of sufficient staffing. The first approach require hospitals to get nurse driven staffing committees that create staffing plans that reflect the needs of the patient population. The committee should also ensure that the plans match the skills and experience of the staff present (Houston, 2020). The second approach that legislators should match patient ratios to regulations and legislation. The third approach requires that facilities disclose their nurse staffing levels to regulatory bodies or the public.
Question 2
The main arguments for the establishment of minimum staffing ratio legislation revolve the improvement of the overall working conditions in hospitals. Among the findings cited for creating minimum nurse-to-patient staffing rations hold that patients are getting harmed inadequate staffing (Lu & Lu, 2017). In these seminars, the fact that poor nurse-to-patient ratio increases leads to a decline in the quality of care and negative outcomes is cited. Another commonly cited finding is that the cost associated with additional staffing is lower than the cost of losing patients due to poor healthcare outcomes. The advocates hold that legislation will promote the creation of valid, reliable units and patient specific staffing plans among nurses and promote increase public reporting.
Question 3
The major argument for minimum mandatory nurse-patient ratio is that specific, guaranteed nurse staffing has the capacity to produce greater outcomes in patient care and alleviate workload from nurses. Limiting patient to nurse ratio could improve occupational safety, lead to increased nurse retention rates and lead to the promotion of health outcomes (Houston, 2020). On the other hand, opponents old that the minimum nurse staffing ratios would lead to increased cost of healthcare and cause the closure of many hospitals (Livanos, 2018). As such, most stakeholder, primarily hospitals are opposed to the legislation.
References
Houston, C. (2020). Professional issues in nursing: Challenges and opportunities. Philadelphia: Wolters Kluwer. ISBN-13: 978-1-4963-9818-5
Livanos, N. (2018). A broadening coalition: Patient safety enters the Nurse-to-Patient ratio debate. Journal of Nursing Regulation, 9(1), 68-70.
Lu, S. F., & Lu, L. X. (2017). Do mandatory overtime laws improve quality? Staffing decisions and operational flexibility of nursing homes. Management Science, 63(11), 3566-3585.
Literacy program
Read the scenario below.
Respond to the questions in full sentences. Be sure to use standard English grammar and spelling
Why is information on health literacy essential for this group?
What is the initial step you would take before designing the program?
What role/function would you play in the beginning of the assessment phase?
What role/function would you play at the end of the program?
What additional resources would be needed to implement this program?
Scenario:
As a Community Health Nurse, you are assigned to develop a health literacy program at the Yvonne Learning Center to promote health literacy in a low-income urban area. This program will focus on children ages 3-7 years old, 9-12 years old and 14 to 18 years old.
You will provide basic health information and services about health and teach the children about their bodies and how having a positive attitude and good behaviors influence their health in general.
The goal of information literacy is to promote self-learning and the ability to be self-sufficient.
Literacy program
Read the scenario below.
Respond to the questions in full sentences. Be sure to use standard English grammar and spelling
Why is information on health literacy essential for this group?
What is the initial step you would take before designing the program?
What role/function would you play in the beginning of the assessment phase?
What role/function would you play at the end of the program?
What additional resources would be needed to implement this program?
Scenario:
As a Community Health Nurse, you are assigned to develop a health literacy program at the Yvonne Learning Center to promote health literacy in a low-income urban area. This program will focus on children ages 3-7 years old, 9-12 years old and 14 to 18 years old.
You will provide basic health information and services about health and teach the children about their bodies and how having a positive attitude and good behaviors influence their health in general.
The goal of information literacy is to promote self-learning and the ability to be self-sufficient.
