Discussion
"Discussion post on the concepts of cost and revenue , assess the benefits and limitations of the major form of reimbursement on the delivery of health care services.","Differentiate the concepts of cost and revenue and assess the benefits and limitations of the major form of reimbursement on the delivery of health care services.
discussion post most be 100 to 300 word maximum.
APA format with in text situation, and references maid use more then one reference if you like. references most be with in the last 5 years.
The book being use is
Financial Management for nurses manager and executives 5 edition chapters 8 and 9 if you have assess to it
Meeting Essential
This week, reflect on ethical principles and your understanding of ethical decision-making frameworks as they have evolved over the course of your RN-BSN program at WCU. Identify specific ethical standards and moral conduct codes. How does your academic work support evidence of meeting the following?
Essential VIII: Professionalism and Professional Values
Outcome #1:Demonstrate the professional standards of moral, ethical, and legal conduct.
Review your past academic work, evaluate your effectiveness at meeting this program essential, and ponder the impact that this proficiency will have on your future.
Identify how you met the essential by referring to the assignment(s) specifically in your response. Additionally, reflect on and make connections between your academic experience and real-world applications.
Recommended: Refer to work you completed for NURS 521 Ethics in Heath Care and NURS 510 Policy, Organization, and Financing of Health Care, as well as other courses, to gather academic examples and evidence of having met this essential.
Your reflection should be 1-1/2 to 2 pages and APA Style. Reference and cite any sources you use
Essay
You are working in an ICU where a 16-year-old girl is in critical condition after an auto accident. Her mother comes in and begins to sing, sprinkle tobacco around the bed, hang eagle feathers and crystals around the room, and move her hands back and forth above the girl’s body. The girl’s nurse tells the mother that visiting time is over and that she should take all these dirty things out of the room. The mother insists on staying by the bedside and says that if she had placed rosary beads or Bibles in the room she would not have been questioned.
What cultural and spiritual issues are evident in this situation?
Cultural care is a type that involves the delivery of care in a non-conventional where care should be delivered in a way to accommodate the patient’s preference. The way that transcends cultural boundaries and considers a client’s culture as it affects health, illness and lifestyle, communication, dietary preferences, and dress are influenced. In this case, hang eagle feathers and crystals around the room can be accommodated if it will not interfere with scientific care.
Apply cultural competence to this case
Cultural competence is the ability of nurses to understand and address the entire cultural context of each client within the realm of the care they deliver. The nurse should be able to allow cultural exceptions for the patient and her mother. The patient’s mother’s faith was tied to the artifacts that she brought and will help the girl get better the moment she sees those things.
Discuss complementary therapies evident in this situation
In this situation, the mother is applying holistic/cultural care to the conventional scientific care the nurse is providing. This accommodation is will enhance nurse-patient interaction and relationships.
How would you incorporate spiritual care?
Nurses can provide spiritual care by attending to several important spiritual elements. This includes supporting the patient's spiritual beliefs and needs and individualizing spiritual care to the patient. I would start by taking cues from the patient including but not limited to asking for the patient's preferences. Also, supporting the patient within the limits of their faith and share encouraging thoughts or words.
How would you approach this situation?
I will approach this situation with caution and respect. I will create accommodations with the hospital policy in mind. By attending to the patient’s several important spiritual elements. The patient’s family acknowledges the higher powers and believes in the intervention of higher power. I will not stand in the way.
What principles would guide you?
I will base my guide on the ethical principles of patient-centeredness, holism, discretion, accompaniment, and tolerance. These are the core principles that guide spiritual care.
References
Hodge, D. R., & Limb, G. E. (2011). Spiritual assessment and Native Americans: establishing the social validity of a complementary set of assessment tools. Social Work, 56(3), 213–223.https://doi-org.resu.idm.oclc.org/login.aspx?direct=true&db=mdc&AN=21848086&site=ehost-live
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Discussion
1) Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention.
2)Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population
Journal
Think about the evidence, concepts, and/or theories (evidence) learned throughout this program and your nurse executive specialization.
Analyze a problem, issue, or situation that you have observed during your practicum experience.
Using a minimum of three peer-reviewed sources of evidence, consider what you have observed within the context of your specialty using appropriate concepts, principles, and theories. Give special attention to observed events that vary from the scholarly literature.
Including personal communications from leaders in health care administration is acceptable; however, this does not replace the requirement for three peer-reviewed sources of evidence.
Determine the degree to which the problem, situation, or issue was addressed in a manner consistent with the theory, concepts, and principles detailed in the evidence.
Given the various evidence-based approaches that can be used in addressing the observed problem, situation, or issue, think about a plan for approaching the matter differently.
Discussion
Explain the role of the community health nurse in partnership with community stakeholders for population health promotion.
2)Explain why it is important to appraise community resources (nonprofit, spiritual/religious, etc.) as part of a community assessment and why these resources are important in population health promotion.
Social media Abuse
You are viewing social media at home when you notice one of your coworker’s post on Facebook. The post is complaining about an elderly patient on your unit at work. The post reveals that the patient has Alzheimer’s disease and is “crazy” and your coworker states “I can’t wait until she is transferred out of here and back to Comfort Care Homes. After this shift, you will find me at the bar, line them up, I will need it.” Additionally, the coworker’s full name, occupation and employer are listed on their “about me” page.
Answer the following question:
1. What would you do regarding this posting? Explain clearly what you would do and why.
Direct-to-Consumer Advertising
Respond to the Case Study presented in Chapter 12 (p. 286) about direct-to-consumer advertising of prescription drugs. What impact have you observed in the populations you serve in your nursing practice? Comment on the ethics of this practice, in terms of autonomy, beneficence, non-maleficence, and justice.
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources
Visit the CINAHL Complete under the A-to-Z Databases on the University Library's locate and read the article(s) below:
· Arritt, T. (2014). Caring for patients of different religions. Nursing Made Incredibly Easy, 12(6), 38-45.
· Hudson, C.C., Adams, S., Lauderdale, J. (2016). Cultural expressions of intergenerational trauma and mental health nursing implications for U.S. health care delivery following refugee resettlement: An integrative review of the literature. Journal of Transcultural Nursing, 27(3), 286-301. doi: 10.1177/1043659615587591.
Discussion
Write a discussion summarizing the difference between infective endocarditis and rheumatic fever. Include cause, effects, possible complications, and prevention.
Pharmacokinetics, Pharmacodynamics and the Aging Process
As the body ages the decline in function of body systems affects the way that drugs are absorbed, metabolized, and excreted. This creates a challenge for healthcare providers to appropriately provide treatment to the older adult as they need to be cognizant of these changes and their effect. This might also have a negative effect on the older adult as they may experience severe side effects or not gain full therapeutic effect of the drug. This can lead to nonadherence of medication regimen in the older population.
The Effects of Aging on Drug Absorption, Metabolism, and Excretion
The way drugs are absorbed, metabolized, and excreted by the body changes with aging due to a slowing down of bodily functions pertaining to the systems that perform these functions. According to Meiner & Yeager (2018) In order for a drug to be absorbed it must travel from the site of administration into the systemic circulation. Absorption of drugs in the older adult is affected by decreased gastric acid secretion, slowing down of peristalsis within the gastrointestinal tract, slowed gastric emptying, and decreased subcutaneous fat related to aging. These changes alter the way and how long it takes a drug to be absorbed into the body.
As per Meiner & Yeager (2018) Metabolism is the transformation of drugs into smaller molecules that are easier for the body to excrete. Metabolism in the elderly is only affected by alterations due to the aging process if it involves the hepatic system. First pass metabolism is when drugs are absorbed from the intestine and enter the hepatic circulation where a portion is metabolized before entering the systemic circulation. In the older adult the hepatic blood flow decreases this can lead to a decrease in drugs metabolized in the hepatic system. This can create drug toxicity in the older adult due to a greater number of drugs entering the systemic circulation at a slower pace therefore extending the half life and increasing the risk of drug buildup.
Excretion is the removal of drugs from the body that happens mainly through the kidneys. With aging renal function decreases which means it takes a longer period to get rid of the body’s byproducts. This can have a negative effect on the excretion of drugs as the slowing down of the renal system will slow down the excretion of drugs also. This can increase the half life of the drug and create greater accumulation in the body which can lead to toxicity.
Salt Substitutes and Hyperkalemia
The use of salt substitutes in the older adult should be done with caution as this can lead to life threatening events due to an increase in potassium level. Older adults who consume salt substitutes are usually those who have hypertension or heart failure they do this to decrease blood pressure. Use of salt substitutes containing potassium chloride is a potential strategy to reduce sodium intake, increase potassium intake, and thereby lower blood pressure and prevent the adverse consequences of high blood pressure, (Greer et al.,2019). The use of salt substitutes with certain medications such as: potassium sparing diuretics, angiotensin converting enzyme inhibitors, angiotensin receptor blockers, and nonsteroidal anti-inflammatory drugs has the potential to cause hyperkalemia in the older adult.
How to Prevent and Evaluate Risk Factors for Medication Nonadherence in the Older Adult.
Medication nonadherence in the elderly is a challenge for the healthcare professional to overcome as there are many factors that can contribute to this. In order for the nurse to promote compliance with medication regime he or she must assess the patient for risk factors such as : socioeconomic status, alterations in cognition, functional status, health literacy, cultural ideals regarding medications, and side effects experienced that might deter the older adult from adhering to the regimen. The nurse should provide teaching in a language that is understood by the patient, create a schedule that is not complicated and that does not interfere with the patient’s daily activities. Promote the use of drugs that are acceptable to the persons culture, encourage use of drugs that have the risk of less severe side effects, and encourage the patients to use the same pharmacy to fill prescriptions. For those with financial issues the nurse can educate them on programs that provide coupons, pharmacies that offer low price generic drugs, or patient assistance programs.
References
Greer, R. C., Marklund, M., Anderson, C. A., Cobb, L. K., Dalcin, A. T., Henry, M., & Appel, L. J. (2019). Potassium-Enriched Salt Substitutes as a Means to Lower Blood Pressure. Hypertension,75(2). doi:10.1161/hypertensionaha.119.13241
Meiner, S., & Yeager, J. J. (2019). Gerontologic nursing (6th ed.). Elsevier.
REPLY 2
Therapeutic drug monitoring is usually used to assist doctors with monitoring and maintaining drugs within the therapeutic range. The therapeutic window refers to the concentration degree whereby a medication applies its clinical impact with insignificant unfavorable impacts. Therapeutic drug monitoring is typically helpful in observing medications that get utilized for long-term conditions or medications with a limited therapeutic range (Prso et al., 2020). Some medications have peak and trough levels which are used to screen the accomplishment of the therapeutic concentration (peak) and medication clearing to keep away from toxicity (trough). Therapeutic drug monitoring is also essential in distinguishing and monitoring drug interactivity and to recognize poor adherence as a cause of poor treatment reaction. It is imperative to note that every medication's pharmacokinetics may differ from the victims' age, weight, clinical status, and sex.As an individual's age increases, drug absorption gets affected by aging gastrointestinal mucosa and decreased gastric acid production from 25 to 20 percent. Due to the weakening of the gastrointestinal movements in aged people and low gastric emptying rate, drugs may stay for a longer period in the gastrointestinal tract, which is favorable for slow drug absorption. In drug metabolism, aging reduces the liver's parenchymal cells and decreased blood flow in the liver which impacts the liver's capability to efficiently carry out drug metabolism. As one becomes older, liver enzymes decrease and the half-life of taken drugs gets prolonged. The kidney, which is the primary organ utilized in drug excretion, reduces its functionality as an individual becomes older (Gujjarlamudi, 2016). Therefore, the younger generation generally has a greater drug excretion rate than the elderly, whereby toxic drug reactions are more prone in older adults.Potassium-sparing diuretics such as spironolactone, triamterene, and amiloride can cause hyperkalemia. However, the risk increases when these potassium-sparing diuretics get used together with salt substitutes and potassium supplements. The danger of hyperkalemia in conjunction with spironolactone elevates by threefold if taken together with potassium supplements. The usage of concurrent loop diuretics hardly guarantees the occurrence of hyperkalemia. Potassium supplements need to be avoided in the individuals being treated with potassium-sparing diuretics. Also, the utilization of immunosuppressants such as tacrolimus and ciclosporin in conjunction with potassium-sparing diuretics or the aldosterone antagonists increases hyperkalemia risks (Maideen, 2020). Various groups of people are at high risk of getting hyperkalemia. These include patients suffering moderate to serious renal insufficiency, hypoaldosteronism, and other illnesses related to adverse reactions to aldosterone's potassium secretory impacts. Hypoaldosteronism is frequently found in older patients with persistent renal impairments or diabetic nephropathy, or even those suffering from an adrenal disease.Education levels, dosing frequency, explanation of the medications, health-related issues, and satisfaction with the patient's counseling are factors associated with medication adherence and compliance. While preventing medication non-adherence in older adults, patients should take their medications as directed by physicians (Zhao et al., 2019). However, a patient's literacy may contribute to the wrong administration of drugs. The use of reminder packaging or pillboxes can help to prevent forgetting drug administration by patients. Pharmacists and physicians have to consider older adults' characteristics like educational background and unique patient's health-related issues to explain treatment and assure that patients understand their counseling.
ReferencesGujjarlamudi, H. B. (2016). Polytherapy and drug interactions in elderly. Journal of Mid-Life Health, 7(3), 105. https://doi.org/10.4103/0976-7800.191021. (Links to an external site.)Maideen, N. M. P. (2020). Pharmacologically Relevant Drug Interactions of Potassium-Sparing Diuretics. J Pathol Toxicol Res, 1(1), 1-4.Prso, K., Zidekova, N., Dohal, M., Porvaznik, I., Prso, M., Kertys, M., & Mokry, J. (2020). Benefits of Therapeutic Drug Monitoring of First Line Antituberculosis Drugs. Acta Medica Martiniana, 20(2), 45–55. https://doi.org/10.2478/acm-2020-0006. (Links to an external site.)Zhao, Y.-Y., Dang, F.-P., Zhai, T.-T., Li, H.-J., Wang, R.-J., & Ren, J.-J. (2019). The effect of text message reminders on medication adherence among patients with coronary heart disease. Medicine, 98(52), e18353. https://doi.org/10.1097/md.0000000000018353 (Links to an external site.).
All replies must be constructive and use literature where possible.
