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In a short essay (500-750 words), answer the Question at the end of Case Study 2. Cite references to support your positions.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to LopesWrite.

This is the case study:

Max Points: 20.0

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

1. 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 so exhausted she cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5 kgVital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58Cardiovascular: 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 fibrillationRespiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

1. IV furosemide (Lasix)Enalapril (Vasotec)Metoprolol (Lopressor)IV morphine sulphate (Morphine)

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 rationale for each of the interventions you recommend.

PLEASE POST A RESPONSE TO THIS, MUST INCLUDE CITATIONS, REFERENCES. 150 words APA style. 

As a CNA to LPN, I have worked in an assisted living, rehabilitation center, and nursing homes. I worked alongside with so many people that have their routine, different culture and lifestyle. People who are comfortable using their hands to eat without any utensils. I also noticed people touching counters then putting their fingers inside their mouth or biting their nails. Some staff helped one patient and moved on to the next without handwashing. Based on so many research hand washing is very important. It is the first line of infection control and disease prevention.

Infection control is a necessity in any healthcare facilities. Healthcare personnel are the carrier to some diseases and may spread it among to different patients. No sick patients or frail residents who want to get an acquired facility infection. “It’s in your hands prevent sepsis in healthcare” World Health Organization (2018).  Patients, residents together with families are entrusting their lives to healthcare personnel to take care of them, to make them feel better. Not to get sepsis or worst diseases.

It is incredible that as simple as hand washing it will help to minimize or stop the spread of disease. I firmly believe and tried my best to abide by doing it the right way to protect myself, co-workers and especially the patients or residents. According to the Centers for Disease Control and Prevention (2017), between staff, patients and family, hand washing should be a main topic of education to protect themselves from or to stop the spread of infection. Education of proper and correct way of handwashing is important. Because doing it too quickly will not be enough to eradicate the germs.

Until now and going onwards handwashing will have a significant role not just in healthcare facilities but also in personal space. Education and in-services in proper hand washing will go a long ways towards the patients, and staff, from CNAs to nurses or all primary providers. Let us not forget that as simple hand washing is the best preventative measures for disease and infection.

Reference

Centers for Disease Control and Prevention (2017, May 5).  Clean Hands Count for Safe Healthcare. Retrieved from https://www.cdc.gov/features/handhygiene/index.html

World Health Organization (2018, May 5). Infection Prevention and Control. Retrieved from http://www.who.int/infection-prevention/campaigns/clean-hands/5may2018/en/

Throughout the course, students will engage in weekly reflection and scholarly activities. These assignments are presented in Topic 1 to allow students to plan ahead, and incorporate the deliverables into the Individual Success Plan if they so choose.

The weekly reflective journals and scholarly activities will not be submitted in LoudCloud each week; a final, culminating submission will be due in Topic 10. No submission is required until Topic 10.

Professional Capstone and Practicum Reflective Journal

Students are required to maintain weekly reflective narratives throughout the course to combine into a final, course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course. This course-long journal assignment will be due in Topic 10.

In each week’s entry, you should reflect on the personal knowledge and skills gained throughout the Professional Capstone and Practicum course. Your entry should address a variable combination of the following, dependent on the specific practice immersion clinical experiences you encountered that week:

1. New practice approachesIntraprofessional collaborationHealth care delivery and clinical systemsEthical considerations in health carePopulation health concernsThe role of technology in improving health care outcomesHealth policyLeadership and economic modelsHealth disparities

In the Topic 10 submission, each of the areas should be addressed in one or more of the weekly entries.

This reflection journal also allows students to outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how they met competencies and course objectives.

Scholarly Activities

Throughout the RN-to-BSN program, students are required to participate in scholarly activities outside of clinical practice or professional practice. Examples of scholarly activities include attending conferences, seminars, journal club, grand rounds, morbidity and mortality meetings, interdisciplinary committees, quality improvement committees, and any other opportunities available at your site, within your community, or nationally.

You are required to post one scholarly activity while you are in the BSN program, which should be documented by the end of this course. In addition to this submission, you are required to be involved and contribute to interdisciplinary initiatives on a regular basis.

In Topic 10, you will submit a summary report of your scholarly activity. You may use the “Scholarly Activity Summary” resource to help guide this assignment.

Assignment Directions

Discussion: Mr. Smith brings his 4-year-old to your office with chief complaints of right ear pain, sneezing, mild cough, and low-grade fever of 100 degrees for the last 72 hours. Today, the child is alert, cooperative, and well hydrated. You note a mildly erythemic throat with no exudate, both ears mild pink tympanic membrane with good movement, lungs clear. You diagnose an acute upper respiratory infection, probably viral in nature. Mr. Smith is states that the family is planning a trip out of town starting tomorrow and would like an antibiotic just in case.

Create a communication plan for Mr. Smith and/or families for both prescriptive and non-prescriptive drug therapies. Describe what you would tell Mr. Smith and the child. Provide resources that Mr. Smith could access which would provide information concerning your decision.

Assignment Requirements:

*****This Assignment may be submitted in a PowerPoint presentation with at least 10 slides or as an APA formatted paper of no more than five (5) pages excluding title page and references.