System Change
Discuss an example of how a nurse leader was successful in spearheading change within an organization, institution, or the government that impacted healthcare policy. What driving forces led to the nurse leader’s success? What obstacles were encountered and how were they addressed?
Length: A minimum of 280 words, not including references
Citations: At least one high-level scholarly reference in APA from within the last 5 years
Discussion
LW is a 32 year old female patient who comes to your medical clinic for primary care. She has been on hormonal contraceptives for years, although she's just been married and has stopped her pills in hopes of becoming pregnant. Her PMHx includes obesity, HTN (diagnosed 3 years ago), familial hypercholesterolemia, and PCOS. Her current medications are as follows: Metformin 2000 mg PO daily, Lisinopril 10 mg PO daily, rosuvastatin 5 mg PO daily, and a multivitamin.
GD is an 82-year-old patient is taking 2 mg of terazosin for BPH every morning. He comes in complaining of dizziness, generalized muscle weakness and persistent lower urinary tract symptoms (LUTS).
How should you advise these patients and manage their medications? What was the process you went through to assess the current medications and to recommend an updated regimen?
Post your initial response by Wednesday at midnight. Respond to one student by Sunday at midnight. Both responses should be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references are required (other than your text). Refer to the Grading Rubric for Online Discussion in the Course Resource section.
Discussion
Discussion board regarding the roles of nurses in research: Perform a database search on urinary tract infections.,"Instructions:
Perform a database search on urinary tract infections. There are various levels of evidence. Select the article that has the best level of evidence.
Please write an 150 word discussion with a 50 word reply to a colleague answering the following questions:
1. Describe why this article was selected and how it meets the criteria to be considered the best level of evidence.
2. Describe if this is a peer-reviewed article. Why is it significant to find peer-reviewed versus non–peer-reviewed articles for research?
3. Describe the nurses’ role in research in this type of research.
Older adult patients
Older adults (OA) are at risk for potential hazards of hospitalization, these include: immobility, delirium, medication side effects, malnutrition, pressure ulcers, procedures, peri- and postoperative periods, and hospital-acquired infections and more. Discuss in detail three potential hazards for this population while in the hospital and identify potential prevention strategies for each hazard.
Your initial posting should be at least 400 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 200 words in length.
Proposal
Write a proposal discussing the culture you would like to present in class. The proposal should include:
250-words minimum
The culture you are choosing ( Bahamian culture)
What you intend to learn and disseminate about the culture
One part of the culture’s approach to healthcare you will be presenting.
A reference page with at least three scholarly references in APA format. You will use these references in your final version of your Culture Paper as well as the Culture Presentation.
Professional Doctoral Capstone/Project
Topic: The relationship between nurse manager leadership styles and subordinate job satisfaction within hospitals.
Research for (4) Related articles within this topic
Select 10 Annotated Bibliography and answer all the questions in prospectus form.
Please write professional This goes to Chair and boards
Medicine and surgery
The assessment portion of the nursing process is where the nurse will collect data about the patient. This information will encompass physical findings, psychological, cultural, social, family, and nursing histories as well as accessing the medical record and obtaining diagnostic test results. A nurse should not implement interventions until a complete assessment has been done. Discuss.
Students will post to initial discussion before Wednesday January 13, 2021 @ 11:59 pm
Note: APA 7th edition is required.
Not less than 250 words
Healthcare ethics
Mr. Corley Case Study:
Walter and Sheila Corley were married on January 20, 1984. At the time, they lived in Texarkana, Arkansas. Their son Jerry was born in July 1985. Later that year, the Corleys separated and were divorced. Sometime thereafter, the Corleys reconciled and resumed living together, holding themselves out to others as a married couple. In February 1988, the Corleys moved to Mr. Corley's hometown of Ferriday, Louisiana. The Corleys were remarried in December 1988.
Neurofibromatosis, a disease of the peripheral nerves of the body, is a condition marked by the presence of numerous neurofibromas, which are tumors or growths arising from the Schwann cells which form the covering membrane or sheath of a nerve fiber. Persons with neurofibromatosis frequently have café au lait spots of varying sizes on their bodies as well. In addition, people afflicted with neurofibromatosis experience a significantly increased risk of developing cancer.
In 1978, Mr. Corley was diagnosed with neurofibromatosis and had four neurofibromas removed from his head, arm, hip and leg by a physician in Texarkana. Thereafter, a few months prior to his return to Louisiana in 1988, Mr. Corley, who had no other known health problems, began experiencing low back pain.
On February 11, 1988, Mr. Corley sought medical treatment from Dr. Maurice Gremillion, a family practitioner in Ferriday. On that date, Mr. Corley complained that he had been experiencing low back pain and abdominal discomfort for approximately four months. He also noted that he had intermittent right shoulder pain and trouble sleeping. At Mr. Corley's request, Dr. Gremillion ordered a total work-up which included x-rays of the lower spine, chest, kidneys and gall bladder, as well as an upper GI series. Dr. Gremillion also prescribed Flexeril, a muscle relaxer, and Anaprox, an anti-inflammatory pain medication. Dr. Gremillion, feeling that Mr. Corley should be seen by a specialist, then gave him a written referral to E.A. Conway Medical Center in Monroe for an orthopedic evaluation.
E.A. Conway, which is part of the L.S.U. system, is a teaching facility staffed by permanent, full-time physicians as well as by doctors who are employed on a temporary, rotating basis as interns and residents following their graduation from medical school. The general operating procedure of E.A. Conway at the time of Mr. Corley's presentment was that all new patients, even those who have referrals to a specific service or department, first go through the emergency room. At that time, a patient is charted and evaluated by an emergency room physician. From there, the patient is either treated or referred to a specific clinic for further follow-up. In most cases, patients see different doctors each time they report to the hospital or one of its clinics.
On March 2, 1988, Mr. Corley, accompanied by Sheila Corley, reported to the E.A. Conway Emergency Room. The Corleys presented admitting personnel with all of Mr. Corley's records from Dr. Gremillion, including the x-rays and other test reports. Dr. Bruce Fuller, an emergency room physician, took a history from Mr. Corley and reviewed Dr. Gremillion's notes and the x-ray reports. He also conducted a routine physical examination and had x-rays made of Mr. Corley's low back. Notwithstanding the presence of several growths and café au lait spots on Mr. Corley's back and torso, Dr. Fuller was unaware that his patient had neurofibromatosis.
Dr. Fuller found everything to be within normal limits and it was his impression that Mr. Corley was suffering from low back pain based on minimal subjective complaints of pain. Dr. Fuller continued Mr. Corley on the medication prescribed by Dr. Gremillion and made an appointment for him with the Orthopedic Clinic on March 16, 1988.
On that date, Mr. Corley was seen in the Orthopedic Clinic by fourth year resident McIntyre Bridges. Dr. Bridges does not recall looking at or reading the x-rays or reports from Mr. Corley's previous examinations. Dr. Bridges conducted a physical exam, which was normal, and started Mr. Corley on a conservative course of treatment for low back pain. Dr. Bridges' notes from this date indicate his awareness of Mr. Corley's neurofibromatosis.
Mr. Corley was next seen on April 20, 1988 by Dr. David Mehta. At the time, Dr. Mehta was doing a surgical internship and was rotating through the Orthopedic Department. Dr. Mehta's notes reflect that his physical exam of Mr. Corley was normal, but that he felt that Mr. Corley had a posture problem and referred him to physical therapy for correction of his posture. Again, the notes do not reflect whether Dr. Mehta reviewed any of Mr. Corley's previous medical records, x-rays or reports.
On September 14, 1988, Mr. Corley was seen by fourth year surgical resident Keith White. On that date, Mr. Corley noted that his pain had worsened and was occasionally affecting his walking. Dr. White's examination yielded no objective findings of low back pain, but he did notice several café au lait spots indicative of neurofibromatosis so he ordered a CT scan of Mr. Corley's low back to rule out any neurofibroma changes in the nerve roots. Dr. Ellis, a radiologist at E.A. Conway, interpreted the CT scan as showing arthritis consistent with fibrosis or spinal stenosis and possible edema of the right L-5 nerve root, which, according to Dr. White, may or may not have been the cause of Mr. Corley's back pain. As with Drs. Bridges and Mehta, Dr. White did not review any of the previous medical records, x-rays or reports. Mr. Corley's last visit to E.A. Conway was September 21, 1988. On that date, Dr. White reviewed the results of the CT scan with Mr. Corley, continued him on an anti-inflammatory drug and encouraged him to continue his back exercises. Dr. White instructed Mr. Corley to return to the clinic in three months.
Thereafter, on October 26, 1988, Mr. Corley, plagued by constant back pain and beginning to experience difficulty breathing, consulted Dr. Rick Maxwell, a chiropractor, who did a full spinal x-ray which revealed a markedly diminished right lung area. Dr. Maxwell sent Mr. Corley to his father, also a chiropractor, who confirmed that there was a potential problem with Mr. Corley's right lung and recommended that he see a pulmonary specialist.
On October 31, 1988, Mr. Corley presented to Dr. Gremillion complaining of chest congestion and shortness of breath. Dr. Gremillion diagnosed him with bronchitis and implemented treatment accordingly. Mr. Corley returned to Dr. Gremillion on November 14, 1988 with complaints of shortness of breath and marked weight loss. Subsequent diagnostic testing confirmed the presence of a very large mass in Mr. Corley's right chest.
Prior to his death on January 23, 1990, Mr. Corley received radiation and chemotherapy treatment at LSU Medical Center in Shreveport.
Corley v. State Department of Health Hospitals. http://caselaw.findlaw.com/la-court-of-appeal/1071352.html
Student should address the following questions regarding this case in an APA paper
What are the facts of the case? This should include: what do we need to know, who is involved in the situation, where does the ethical situation take place, and when does it occur?
What is the precise ethical issue in regards to autonomy, nonmaleficence, beneficence, fidelity, and justice?
Identify the major principles, rules, and values of the case. Values are sets of beliefs about good and bad, right and wrong, and about many other aspects of living and interacting in the society with others. A principle is a personal rule that governs personal behavior. A rule is generally imposed by a figure of authority, and used to guide and govern people.
Is there legal ground for this case, if so what? Who is at fault? What legal action should be taken?
Are there alternatives to the actions completed in this case by both the patient and healthcare facility? Do you feel the physicians were following hospital protocol?
If you were a member of the ethics committee at this facility, what actions or changes would you recommend changing? Why?
For the case study, an APA formatted paper should be used, and needs to include a title page, level headings, references and citations. This assignment should include at least 2 references and should be at least five pages in length. Students should address the proposed questions providing ample detail, examples, and additional support.
Assignment Expectations:
Length:
answers must thoroughly address each question in a clear, concise manner; complete answers will likely take 5-6 pages
Structure:
reference page required
address each question in a numbered list
References:
Two references required
Format:
save your assignment as a Microsoft Word (.doc or .docx), Open Office (.odt) or rich text format (.rtf) file type
Healthcare Planning and Evaluation
Michael Porter (1980) created a strategic analysis called 5 Forces. Using your chosen organization or another healthcare business, use the analysis tools and provide one of the 5 forces to review and provide content how it can be used in a best practice healthcare setting. Why or why not.
Do not provide the content from the page in the book, it is merely a tool to help you find the correct content. It is your weekly guide and examples.
Use an outside resource for your initial post. Seek information through healthcare news articles and journals. Write in third person and do not use “I think or in my opinion”. Keep your information factual and follow APA standards on referencing. Please use the NAU Library APA guide for assistance.
.A minimum of 250 words for your initial discussion post.
.Write in paragraph form in the discussion
.Also, do not post an attachment in your discussion.
.Use an outside resource for your initial post.
.Seek information through healthcare news articles and journals.
.Do not go back any further than 5 years.
.Follow APA standards on referencing. Please use the NAU Library APA guide for assistance.
Humanities and Contemporary Popular Culture
Evaluation Title: What is Pop Culture?
One way to identify changes in popular culture is to examine new terms and concepts that arise and quickly become prevalent in society. For example, you may be familiar with the new phrases that arose with the use of smartphones (LOL! OMG! YOLO!) and the new meanings for already familiar words such as text, data, refresh, application, etc. We use “Google” as a verb today, “Spam” used to be a canned meat product, and “Amazon” no longer first brings to mind a river in South America.
Oxford Dictionary (https://en.oxforddictionaries.com/ (Links to an external site.)) takes on the challenge of the ever-changing English language by providing definitions for newly adopted and used words in the English language and even selects a “Word of the Year” – a word that takes on a certain significant meaning in the context of current events and culture. In 2015, it was notable that the “word” of the year wasn’t even a word at all, but instead an emoji! No one 10 years ago could have predicted this, and it demonstrates clearly the role that communication via technology has in today’s culture.
For this assignment, you will be creating a PowerPoint presentation about popular culture and this year’s Word of the Year. Look up Oxford Dictionaries’ most recent Word of the Year and consider the cultural influences and events that drove this word selection. What events are related to this word and what is their significance? How does this word present itself in your own thoughts, experiences, and beliefs? What is the connection between the “Word of the Year” and the concept of Popular Culture?
Specifications:
Submission: A 10-12 slide PowerPoint presentation or Prezi to address the questions posed above. Include speaker notes or a voice-over, images, and videos where applicable. If you choose the voice-over option, you will upload your recording web link (URL).
In your presentation:
Clearly explain the meaning of the Word of the Year.
Provide 4-5 examples of cultural events that led up to or evolved from this word usage.
Reflect on thoughts, experiences, and beliefs regarding this word’s usage in society and your own life.
Provide speaker’s notes or a voice-over on the PowerPoint to accompany each slide. If you choose speaker’s notes, the total word count of your notes should be 750-1000 words. If you choose to create a voice-over recording your presentation should be 4-6 minutes long.
Include a title slide and include your references page in APA format on the last slide of the presentation.
Helpful Resources:
Screencast-o-Matic is an easy, free tool to use to create your voice over. Get free access at https://screencast-o-matic.com/ (Links to an external site.)
If you are new to using Screencast-o-Matic, tutorials are available at http://help.screencast-o-matic.com/ (Links to an external site.)
For information on using PowerPoint speaker notes, see: https://support.office.com/en-us/article/Add-speaker-notes-to-your-slides-26985155-35f5-45ba-812b-e1bd3c48928e
