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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?

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.
  2. Denies pain but says she feels like she cannot get enough air.
  3. Says her heart feels like it is “running away.”
  4. Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

  1. Height 175 cm; Weight 95.5 kg
  2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
  3. Cardiovascular: 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 fibrillation
  4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
  5. 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)
  2. Enalapril (Vasotec)
  3. Metoprolol (Lopressor)
  4. 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.

Evaluate the application of models of practice to the advanced nurse roles.

This Assignment targets this course outcome:

MN502-3: Evaluate the application of models of practice to the advanced nurse roles.

What is the difference between a model and a theory?

A model demonstrates the researcher’s interpretation of how concepts are related to one another and is developed based on qualitative research. A theory is a hypothesis tested and measured to explain, predict, describe, and prescribe relationships between concepts and is developed through quantitative research.

In short, the difference between a model and a theory is the amount of proof that exists in demonstrating the outcomes they predict.

What do models and theories have in common?

Both models and theories show relationships between concepts. Models often are precursors to theory development.

Directions

Locate a model of practice that you could apply to nursing. It does not need to be a nursing model. Models of practice can be found in leadership, business, education, and technology. Explain how you will use the model you chose in your advanced practice role.

Use the table template to organize your thoughts and present them for this Assignment. In the first column, list the characteristics of the model of practice you chose. In the second column, list your application to your advanced nursing practice role upon graduation. In the first row, in the first column, write the name of your chosen model. An example has been provided in the first rows to guide you. Please remove the examples when entering your information.

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources.

Assignment Requirements

Before finalizing your work, you should:

  • Minimum requirement of at least 5 sources of support
  • be sure to read the Assignment description carefully (as displayed above);
  • consult the Grading Rubric (under the Course Resources) to make sure you have included everything necessary; and
  • utilize spelling and grammar check to minimize errors.

Your writing Assignment should:

  • follow the conventions of Standard English (correct grammar, punctuation, etc.);
  • be well orderedlogical, and unified, as well as original and insightful;
  • display superior content, organization, style, and mechanics; and
  • use APA 6th Edition

How to Submit

Submit your Assignment to the unit Dropbox before midnight on the last day of the unit

In the past few decades physicians have attempted to balance their care by reclaiming medicine’s more spiritual roots, recognizing that until modern times, spirituality was often linked with health care (Puchalski,2001).

In the past few decades physicians have attempted to balance their care by reclaiming medicine’s more spiritual roots, recognizing that until modern times, spirituality was often linked with health care (Puchalski,2001).

Chapter three of the textbook Called to Care A Christian Worldview for Nursing states that the knowledge of nursing sciences coupled with spirituality, belief in God are both important to have, that they are both a gift of God. This would most likely be accepted by Christians without argument. The reading however also suggests that this is not simply a belief held by Christians, that we must be open minded to accept that this is a belief held by nurses, persons of other faiths than Christian. With this in mind, there is merit in learning what our patients believe in, that taking a spiritual history is as important as taking the patient’s health history. Their religious beliefs may have a direct effect on their healing process, those who have regular religious practices heal better and are sick less often than those who do not.

It is also important to point out that a person’s spiritual, religious beliefs can have a direct correlation on their belief as to why they became ill, or why their spouse of child died. They may see it as punishment, or judgement of God (Christian God, or no).

I think it strange how I seem to have found so much more information regarding the cultural tension of religion than that of the scientific. I absolutely believe that we can have great scientific knowledge of science, but to have great nursing, we have to also possess some form of religious treatment of all human beings, Christian or not. Even Atheists can be very kind and caring to humans and animals, which in its own sense is Godly.

Wiczynski, N., Lokker, C., McKibbon, K., Hobson, N., & Haynes, B. (2016). Limits of search filter development. Journal of the Medical Library Association, 104(1), 42- 46.

MD

Read the posts and respond. In your response, explain why you decided to respond to this particular post. Ask a question, propose other databases or search terms the learner might use, or suggest additional search strategies to continue the discussion thread and further conversation. Your response must be a minimum of 200 words in length. If your response offers an alternative viewpoint or refers to the ideas or work of others, it must be supported by citing an outside scholarly source, using APA style.

 

The Research

Top of Form

I have chosen to focus my project on the DNP role in organizational leadership and how the DNP prepared RN impacts leadership roles in healthcare. I have chosen this because most leaders in healthcare have traditionally pursued educational degrees in healthcare administration or business administration. Examining where the DNP prepared nurse falls in the ranks of leadership is necessary due to the fact that this role has been undefined since its inception. The role of the nurse leader has been changing over the years and the rapidly changing healthcare needs a leader who can ensure quality care of the patient, patient safety, patient outcomes, and efficiency of work processes.

Databases are necessary for any scholar to obtain relevant articles for research and references. It can be overwhelming for someone when first starting to research a subject. Finding the appropriate database as well as defining the correct terms for narrow the search can be frustrating and challenging. Search filters are designed to retrieve studies and articles that are relevant to the subject or terms being search (Wilczynski, Lokker, McKibbon, Hobson, & Haynes, 2016). Sometimes the use of search filters can increase the sensitivity of relevant articles and reduce the specificity of off- target articles (2016, p. 42). Knowing how to further filter down what articles are relevant and what articles are not can be daunting.

I used CINAHL Complete and OVID as my database searches for my article retrieval for this project. Defining search terms was an effort in trial and error. The terms that I used were DNP; leadership; healthcare; role.

 

 

Wiczynski, N., Lokker, C., McKibbon, K., Hobson, N., & Haynes, B. (2016). Limits of search filter development. Journal of the Medical Library Association, 104(1), 42- 46.

Bottom of Form

 

examine telehealth, discuss one specific emerging telehalth tool, and identify implications of how telehealth impacts emerging telehealth nursing roles.

Assignment 3: Scholarly paper- Telecommunication Technology and the delivery of Health Services

In healthcare today, many patient/clients are increasing using telehealth applications for monitoring their health status. At the same time, in clinics and hospitals, primary care providers (PCPs) including advanced practice nurses are being challenged by patient/client questions concerning healthcare-related information and practice reported on the internet. This assignment relates to telehealth care, the impacts of telehealth on the nursing role, and the use of standards to evaluate and recommend credible websites to patients.

Assignment Criteria/Directions:

In this paper, students will examine telehealth, discuss one specific emerging telehalth tool, and identify implications of how telehealth impacts emerging telehealth nursing roles. Students will also use standard criteria to identify credible websites for a selected telehealth population and design a teaching plan to empower this population to evaluate health information on the web. Include the following in the scholarly paper as the work is composed and organized:

1. Telehealth Care and Telenursing

  • Discuss the clinical and non-clinical uses of this technology and provide examples
  • Identify the required safety and security provisions/standards for telehealth applications:
    • Ethical (Including the American Nurses Association’s Code for Nurses with Interpretive Statements)
    • Legal (including “Meaningful Use” according to the American Recovery and Reinvestment Act [ARRA]).
    • Regulatory (Credentialing and certification)
  • Generate a table of the major benefits and current challenges to adoption of telehealth applications (support with references).
  • Analyze how telehealth affects patients’ empowerment and patients’ engagement in their own health.
  • As a master’s prepared nurse in an advanced practice role, discuss how you would evaluate the quality and effectiveness of a telehealth tool. Please use Evidence Based Practice (EBP) approach.

2. Telehalth Applications for a specific population

  • Select a patient population using telehealth applications and identify one specific remote monitoring system/telehealth tool that would be appropriate for this specific patient population. Please remember that the patient population must be specific, for example, cancer patients.
    • Identify which standardized nursing and medical language(s) are captured by this tool
    • Access the Institute for Healthcare Improvement’s [IHI] website at http://www.ihi.org/engage/initiatives/tripleaim/pages/default.aspx
    • Explain how this selected telehealth tool addresses each of the three dimensions of the “IHI Triple AIM”
    • Explain how the master’s prepared nurse will be impacted by this telehealth application
    • Analyze the role of the telenurse in using and educating the patient about this specific telehealth tool
      • · What training would be needed · What equipment would be used · How would you assess the patient and family’s response to this telehealth tool?

3. Evaluating Health-Related Websites for Populations

  • o For the preferred patient population, identify two credible health-related web sites that would be useful to ensuring this population’s effective health status. Remember that this must be in relation to selected patient population above. o Explain why (what specific aspects of the website) you would recommend these websites to this population. § What website evaluation criteria did you use? § Assess and report the reading level of information presented in each website o Present a teaching plan to educate these patients about how to select a reputable and credible health website to manage their health. Please remember to use EBP assessment tools.
  • This is a scholarly paper of 6 to 8 pages (excluding title page and reference page(s).
  • Students are expected to apply APA formatting to the entire document, including the title page/reference page(s), the level headings, and in-text citations/quotes.
  • All references and sources must meet the latest style of APA 6th edition.
  • All sources and references must not be older than 5 years old.
  • Ensure the use of Level 2 headings.
  • Must be double spaced and and written in Times New Roman 12 Font as per APA guidelines.
  • Use of proper English grammar is a MUST!
  • Use of proper English spelling is a MUST!

identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation.

Nursing Care Models Paper:

Guidelines

Purpose

The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.

Course Outcomes

Completion of this assignment enables the student to meet the following course outcomes.

CO#1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO #2)

CO#2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO #3)

CO#3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO #7)

CO#6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO #7)

CO#7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO #2, and #3)

CO#8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO#8)

 

Due Dates

This assignment is to be submitted to the Dropbox by Sunday, 11:59 p.m. MT, end of Week 4.

Points

This assignment is worth 200 points.

Directions

  1. Read your text, Finkelman (2012), pp- 118- 127.
  2. Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.
  3. Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.
  4. Write a 5-7 page paper that includes the following:
  5. Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.
  6. Review and summarize two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.
  7. Discuss your observations about how the current nursing care model is being implemented. Be specific.
  8. Recommend a different nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
  9. Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.
  10. Write your paper using APA format. Submit to the Dropbox.

 

Grading Criteria: Nursing Care Models Paper

Category Points % Description
Identify Nursing Care Model in practice including specifics about who, what when, where, etc. 60 30% Identifies Nursing Care Model for delivery of nursing care.  Provides specifics.
Besides Finkelman, locate scholarly resources related to Nursing Care Models 40 20% In addition to Finkelman, locates four scholarly resources related to Nursing Care Models. Summarizes all resources in body of paper.
Implementation and Recommendations 60 30% Describe implementation of current Nursing Care Model and recommend a different model that could be utilized to improve quality of nursing care, safety and staff satisfaction.
Conclusion/ summary 20 10% Summarize what you learned about this experience including new knowledge about nursing care models.
Clarity of writing 20 10% Content is organized, logical, and with correct grammar, punctuation, spelling, and sentence structure are correct.  APA formatting is apparent and CCN template is utilized. References are properly cited within the paper; reference page includes all citations; proper title page and introduction are present and evidence of spell and grammar check is obvious.

 

 

Grading Rubric

Assignment Criteria Outstanding or Highest Level of Performance

A

Very Good or High Level of Performance

B

Competent or Satisfactory Level of Performance

C

Poor, Failing, or Unsatisfactory Level of Performance

F

After an introduction paragraph, identifies Nursing Care Model in practice including specifics about who, what when, where, etc.

60 points

After an introduction paragraph, thoroughly identifies Nursing Care Model in practice including specifics about who, what when, where, etc.

55-60 points

After an introduction paragraph, clearly identifies Nursing Care Model in practice including specifics about who, what when, where, etc.

50-54 points

After an introduction paragraph, briefly identifies Nursing Care Model in practice including minimum specifics about who, what when, where, etc.

46-49 points

Does not provide an introduction paragraph but identifies Nursing Care Model in practice in first or subsequent paragraphs including minimum specifics about who, what when, where, etc.

0-49 points

Besides Finkelman, locate scholarly resources related      to Nursing Care Models

40 points

Thoroughly reviews and summarizes two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting; then, reviews and summarizes two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed.

37-40 points

Clearly reviews and summarizes two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting; then, reviews and summarizes two scholarly resources (not including your text) related to a nursing care model that is different from the one you observed.

34-36 points

Briefly reviews only one resource (besides text) related to nursing care model observed in practice setting and only one resource (besides text) related to a nursing care model that is different from the one you observed.

30-33 points

Briefly reviews only one resource (besides text) related to nursing care model observed in practice setting OR only one resource (besides text) related to a nursing care model that is different from the one you observed.

0-29 points

Implementation and Recommendations

60 points

Thoroughly describes implementation of current Nursing Care Model and recommends a different model that could be utilized to improve quality of nursing care, safety and staff satisfaction.

55-60 points

Clearly describes implementation of current Nursing Care Model and recommends a different model that could be utilized but omits quality or safety or staff satisfaction.

50-54 points

Briefly describes implementation of current Nursing Care Model and recommends a different model that could be utilized but omits two of the following (quality/safety/staff satisfaction).

46-49 points

Briefly describes implementation of current Nursing Care Model or recommends a different model that could be utilized. Various elements are missing related to improving quality of nursing care, safety and staff satisfaction.

0-45 points

Conclusion/ summary

20 points

Includes conclusion paragraph and thoroughly summarizes what you learned about this experience including new knowledge about nursing care models.

18-20 points

Includes conclusion paragraph and clearly summarizes what you learned about this experience including new knowledge about nursing care models.

16-17 points

Includes conclusion paragraph but briefly summarizes what you learned about this experience or includes new knowledge about nursing care models but not both.

14-15 points

Does not Include a conclusion paragraph or conclusion/summary is present but difficult to find in closing paragraphs of paper.

0-13 points

Clarity of writing

20 points

Content is organized, logical, and with correct grammar, punctuation, spelling, and sentence structure are correct. APA formatting is apparent utilizing CCN template. References are properly cited within the paper; reference page includes all citations; proper title page and introduction are present and evidence of spell and grammar check is obvious. Less than three errors noted.

18–20 points

Content is mostly organized, logical and with correct grammar, punctuation, spelling, and sentence structure are correct. APA formatting is apparent utilizing CCN template. References are properly cited within the paper; reference page includes all citations; proper title page and introduction are present and evidence of spell check and grammar check is obvious. Four to six errors noted.

16–17 points

Content is somewhat organized, logical and with correct grammar, punctuation, spelling, and sentence structure are correct. APA formatting is somewhat apparent but CCN template was not utilized. References are properly cited within the paper; reference page includes all citations; proper title page and introduction are present and evidence of spell check and grammar check are not obvious. Seven to 10 errors noted.

14–15 points

Content is disorganized and writing has numerous grammar, spelling, or syntax errors and APA formatting errors are obvious. Spell check and grammar check are not obvious. More than 11 errors noted.

0–13 points

Total Points Possible= 225 Points Earned = A quality assignment will meet or exceed all of the above requirements.

 

As an administrator, address the challenges of employee recruitment and retention of health care professionals. Additional subtopics may include trends in the nursing workforce, shortage of primary care physicians, staff turnover, retention, and staffing patterns. 

HCA459: Senior Project

TOPIC/TREND: As an administrator, address the challenges of employee recruitment and retention of health care professionals. Additional subtopics may include trends in the nursing workforce, shortage of primary care physicians, staff turnover, retention, and staffing patterns.

For this assignment, focus on a specific contemporary trend in health care and be sure to include all of the following influences:

  • Changes in client characteristics
  • Regulation of the health care industry
  • Reimbursement patterns and mandates
  • Restructuring of health care organizations
  • Impact of technology
  • Ongoing social and ethical factors

Address the information above as it pertains to your selected topic, in an eight to ten slide (excluding title and reference slides) PowerPoint presentation.

Your presentation should conclude with a summary describing the following concerns:

  • Overall, why should health care managers be aware of this change and trend?
  • What impact does this trend have on the stakeholder groups involved (e.g., patients, providers, administrators, third-party payers, legislators, etc.) for a specific organization specified (e.g., for profit, nonprofit, hospital, outpatient clinic, nursing home, etc.).

The information in this presentation will later be used as part of your Senior Project to set the context for the audience you select for a training program on the contemporary trend identified here.

Your presentation must include detailed speaker’s notes (i.e., at least 150 words) for each slide as well as a minimum of one to two scholarly sources from the Ashford University Library and one to two current, scholarly web sources.

Your presentation, and any citations used, must be in APA style as outlined in the Ashford Writing Center. Examples of scholarly web sources are available in this week’s recommended websites. These sources will also count toward the required sources for your Senior Project. Your presentation must be engaging and relevant to your audience. Lines of text on a slide will not be sufficient for this assignment. It should contain images, graphics, and/or multimedia that communicate your training program clearly to your audience. For tips on creating an excellent presentation, read this overview.

Transcultural Concepts in Nursing Care, Joyceen S. Boyle & Margaret M. Andrews. (2015), 7th edition.

This week, you will consider your own diverse cultural and generational background and how it impacts the care you provide to your patients. (I am African American

For this written assessment we will focus on generational diversity in the nursing population. Review table 12.2 on p. 379 of your textbook and address the following:

  1. Define and describe the four generations – name, timeframe, and a description of that group’s characteristics.
  2. Choose the group to which you belong. Explain how you think that you fit with this assessment of that generation.
  3. Select any other group to which you do not belong. Explain how those from your group can learn from that group, and explain how that group could learn from yours.

REQUIRED READING

Transcultural Concepts in Nursing Care, Joyceen S. Boyle & Margaret M. Andrews. (2015), 7th edition.

References

Minimum of four (4) total references: two (2) references from required course materials and two (2) peer-reviewed references. All references must be no older than five years (unless making a specific point using a seminal piece of information)

Peer-reviewed references include references from professional data bases such as PubMed or CINHAL applicable to population and practice area, along with evidence based clinical practice guidelines. Examples of unacceptable references are Wikipedia, UpToDate, Epocrates, Medscape,WebMD, hospital organizations, insurance recommendations, & secondary clinical databases.

PLEASE FOLLOW ALL INSTRUCTIONS AS WELL AS THE RUBRIC ATTACHED, PLAGIARISM WILL NOT BE ACCEPTED

2 REFERENCES MUST COME FROM THE CHAPTERS AVOVE AND ATTACHED BOOK

ATTACHED IS LINK TO BOOK FOR READING

https://books.google.com/books?id=Tq-rL8VcQBQC&pri…

https://books.google.com/books?id=XCWKCwAAQBAJ&pri…

The Development of a Job Orientation Checklist for New-Nurse Graduates for a new job within a hospital setting.

The paper topic is: The Development of a Job Orientation Checklist for New-Nurse Graduates for a new job within a hospital setting.

C. Summarize your project by doing the following:

1. Identify the clinical or organizational problem.

2. Describe why the problem you have identified requires a practice change, quality improvement, or innovation, including supporting evidence.

Note: Evidence can be internal, based on clinical expertise, and/or from scholarly literature.

3. Explain the causes of the problem.

4. Identify the stakeholders.

a. Discuss each stakeholder’s interest, power, and influence in relation to the project.

D. Explain the purpose of your project.

E. Explain your proposed solution for your project.

F. Provide an evidence summary to support your proposed change.

1. Provide a reference list for your evidence summary in APA format that includes a minimum of five scholarly, peer-reviewed sources that were published within the last five years.

Note: This reference list refers specifically to your evidence summary only.

G. Explain your proposed implementation plan, which includes the following:

1. plan of action

2. timeline

3. needed resources and personnel

4. proposed change theory

5. barriers to implementation

H. When you use sources, include all in-text citations and references in APA format.

You will not be conducting primary research and will not need human subject protection for your project. You will complete a review of the literature and then develop an evidence summary. You will identify best practices based on the evidence presented in the findings of the published literature.

Plan of Action

Be prepared to discuss the steps you have taken as you have been laying the foundation for your capstone project. You will need to describe meetings or agreements (support commitments or negotiations) that have occurred or will occur. These meetings/agreements may include those with your preceptor, stakeholders, management, or executives in your organization. Your plan of action needs to provide a succinct explanation of what will occur to successfully implement your capstone project. You may not have a step-by-step plan at this point, but you should have a clear idea of actions that need to occur.

Timeline

Your timeline at this point should be an estimated timeline. You do not have to know specific dates; however, you should be able to provide an estimation of the time involved with each step of your action plan. Your timeline should include general information about when you anticipate achieving the various milestones in your project.

Required Resources and Personnel

Identify the resources needed for the planning and implementation of your capstone project. Resources may include financial support, time, classroom space, printing cost, equipment, personnel adjustments, or reallocation of staffing.

Defining your Change Theory

Deciding on which change theory to use will help you develop a framework for your evidence-based project. A change theory can serve as a guideline for stakeholder interaction and can provide guidance for a process necessary to design a strong plan for implementation. The following article may be a good resource to assist you with selection of the appropriate change theory:

Barriers to Implementation