In a short essay (500-750 words), answer the Question at the end of Case Study 2

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.

public health discussion law and ethics

Public health is an essential function of the government on a par with, and for reasons similar to, national defense and law enforcement. Specific public health needs, such as sanitation systems and clean water, cannot be met by individuals acting alone. The government is required to organize community efforts as well as compel cooperation when necessary; otherwise, individuals would be free to benefit from, but not contribute to, the resulting public good.

Considering the above, respond to the following:

  • What are the key roles for government in serving the public’s health? Why?

Submission Details:

  • Post your response to the Discussion Area by the due date assigned. Respond to at least two posts by the end of the week.Give examples and reasons in support of your responses.Write your initial response in 300–500 words.

Evolving Practice of Nursing and Patient Care Delivery Models


As the country focuses on the restructuring of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and fewer will be available in acute care hospitals.

  1. Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and change. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics, and medical homes.In 800-1,000 words summarize the feedback shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.A minimum of three scholarly references are required for this assignment.

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be 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. Please refer to the directions in the Student Success Center.



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.


Centers for Disease Control and Prevention (2017, May 5).  Clean Hands Count for Safe Healthcare. Retrieved from

World Health Organization (2018, May 5). Infection Prevention and Control. Retrieved from




Do adults with type 2 diabetes who attend ongoing education with family members compared to those who have limited education adhere to lifestyle changes more positively over the first year from diagnosis?


Does the adult patient with type 2 diabetes experience lifestyle changes better when family support is given during the first year?


Do regular family support classes help adults with type 2 diabetes lead to improved lifestyle changes over the 1st year of treatment compared to those with limited education?

Type 2 diabetes has become a top issue in the United States.  “Diabetes is a leading cause of new cases of blindness, kidney failure and non-traumatic amputations (Weller, Baer, Nash and Perez 2017).”  Family support can have a great impact on a person’s ability to maintain healthy lifestyle changes.  When we get everyone involved we not only change the life of the patient we also impact the lives of the family.  “Family members can have a positive and/or negative impact on the health of people with diabetes, interfere with or facilitate self-care activities (e.g., by buying groceries or refilling a prescription), and contribute to or buffer the deleterious effects of stress on glycemic control (Mayberry & Osborn, 2012).”


Mayberry, L., Osborn, C. (2012). Family support, medication adherence, and glycemic control among adults with type 2 diabetes. Diabetes Care, 11, 1. https://www.DOI:10.2337/dc11-2103

Weller, S., Baer, R., Nash, A., and Perez, N. (2017). Discovering successful strategies for diabetic self-management: A qualitative comparative study. BMJ Open Diabetes Research & Care, 5(1), 2. https://doi:10.1136/bmjdrc-2016-000349


Hello to all of my classmates and professor.  My name is Brent Braswell.  After serving in the US Air Force for almost a decade, I decided to become a nurse.  I started as a LVN (LPN) and a year later I went back for my RN.  I tried hospital nursing and while the acute experience is very valuable, I simply was not happy.  I soon found myself trying other things such as hospice and even the county jail, yet I could still not find that happy place I was searching for.  Then I discovered geriatrics and there was the icing on my cake! I absolutely found my calling in long term care and rehabilitation.  After a short time working as a floor nurse I was asked to fill in for the director of nursing while they were out on a family emergency.  After that I was addicted and have been a director of nursing for skilled facilities ever since and I have no regrets.  It has been amazing and while many times my frustration with the system can grow, I always know in my heart that geriatrics is my passion.

Leadership Style

                My leadership style is hard for me as I vary from one to another depending on the situation.  Predominantly I would have to choose democratic leadership as my primary choice.  A democratic leader encourages participation and exchange of ideas from her/his team regarding the directions the team should take and what actions they should prioritize. When faced with a complex problem, she/he will elicit ideas from others, listen attentively and build consensus, but may put off making difficult decisions (Chapman, Johnson, & Kilner, 2016).


It is very important to me that I always include my staff in decision making. I am the boss, but that does not mean that I know everything or that I think of all possibilities.  Encouraging my staff to speak up and pass along their ideas brings about camaraderie and trust with each other. I also believe in autonomy. I have three assistants that are called unit managers. Until they were to give me a reason to micromanage their jobs, I simply will not. This allows me to show that I trust their judgment and knowledge.  The nurses who work the floor are full of ideas concerning the specific needs of their patients. I do not take care of these patients all day, so why on earth would I not ask their opinion when an issue arises? When there is a change in regulations it is my job to know and understand the details of that change and how it may impact daily routines. It is also my job to explain it to the staff so that they understand. At that point I will have already formed ideas of how to make it work, but I still call a meeting with my staff to teach the change and to share ideas of the best way to implement the change.

Chapman, A. L., Johnson, D., & Kilner, K. (2016). Leadership styles used by senior medical leaders: Patterns, influences and implications for leadership development. Leadership in Health Services; Bradford Vol. 27, Iss. 4, (2014): 283-298. , 8.

Professional Capstone and Practicum Reflective Journal

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.

Human Diversity Quiz

Due in an hour,

Questions are like this

We are confident that our ancestors originated in Africa because

The earliest fossils of ancestral hominids (australopiths) are found there.

The oldest remains of modern human beings (Homo sapiens sapiens) occur there.

African populations have the highest genetic diversity, which would have required longer to evolve.

We all share and diverge from our African DNA, indicating that it is our original DNA.

All of the these

None of these.

Assignment Directions

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.