Category: Nursing

  • Functional Health Pattern Assessment (FHP)

    Functional Health Pattern Assessment (FHP)

    Pattern of Health Perception and Health Management:

    • How does the person describe current health?

    • What does the person do to maintain health?

    • What does person know about links between lifestyle and health?

    • How big a problem is financing health care for this person?

    • Can this person report his/her medications and the reason for taking them?

    • If this person has allergies, what does he/she do to prevent/manage them?

    • What does the person know about medical problems in his/her family?

    • Have there been any important illnesses/injuries in this person’s life?

    Nutritional-Metabolic Pattern:

    • Is this person well-nourished?

    • How does this person’s food intake compare with recommended food intake?

    • Does this person have any disease that affects nutritional/metabolic function?

    Pattern of Elimination:

    • Are the person’s excretory functions within normal range?

    • Does the person have any disease of the digestive system, urinary system, or skin?

    Pattern of Activity and Exercise:

    • How does this person describe his/her weekly pattern of:

    Activity/Leisure?–Exercise/Recreation?

    • Does this person have any disease that affects his/her:

    Cardio/Respiratory System?–Musculoskeletal System?

    Cognitive/Perceptual Pattern:

    • Does this person have any sensory deficits?If yes, are they corrected?

    • Can this person express himself/herself clearly and logically?

    • What is this person’s level of education?

    • Does this person have any disease that affects mental or sensory functions?

    • If this person has pain, describe it and its causes.

    Pattern of Sleep and Rest:

    • Describe this person’s sleep/wake cycle.

    • Does this person appear physically rested and relaxed?

    Pattern of Self-Perception and Self-Concept:

    • Is there anything unusual about this person’s appearance?

    • Does this person seem comfortable with his/her appearance?

    • Describe this person’s feeling state.

    Role-Relationship Pattern:

    • How does this person describe his/her various roles in life?

    • Has, or does this person presently have positive role models for these roles?

    • Which relationships are most important to this person at this time?

    • Is this person presently going through any changes in role or relationships?If yes, describe changes.

    Sexuality – Reproductive Pattern:

    • Is this person satisfied with his/her situation related to sexuality?

    • Does this person have any disease/dysfunction of the reproductive system?

    • Is this person satisfied with his/her plans regarding children?

    Pattern of Coping and Stress Tolerance:

    • How does this person cope with difficult situations/problems?

    • Do these coping mechanism/actions help or make things worse?

    • Has this person had any treatment for emotional distress?

    Functional Health Pattern Assessment (FHP)- Pattern of Value and Beliefs:

    • What principles did this person learn as a child that are still important to him/her?

    • Does this person identify with any social, religious, ethnic, regional, cultural, or other groups?

    • What support systems does this person currently have?

  • Nurse Shortage in US Health Care

    Nurse Shortage in US Health Care

    Background information

    There is a projection that the United States health care system is going to experience a great shortage of the registered nurses as the health care needs continue to intensify (Yang, Hung, & Chen, 2015). Quality and outcome measurement are valuable methods of determining the influence of nurse staffing and achieving the desired patient outcome goals. A number of effort have been made to improve the capacity of the nursing schools across the US so as to have more students enrolling so as to assist in meeting the increased demand of the elevating demand for health care system. The American Association of Colleges of Nursing has made various cooperation with institutions and policy makers have tried to make this health concern as a global problem. Following a report by the bureau of labor statistics, registered nurse employment was projected to be among the top occupations in terms of growth form 2014-2024(Robert,2017). This growth in the health workforce is expected to elevate form 2.6 million in 2014 to 3.1 million by 2024 which will be translated as a 16% increase (Robert, 2017).

    Further research by the American journal of medical quality explains that nurse shortage is projected to rise around the United States between 2013 -2030 (Nantsupawat, Nantsupawat, Kulnaviktikul, & McHugh, 2014). A report by the institute of medicine on the focus on future of nursing highlighted that there was a need to significantly increase the number of baccalaureate nurses in the health work force to 80% as well as increasing the number of nurse by two (Yang, Hung, & Chen, 2015). There is only 55% of the baccalaureate registered nurses and thus creating a big deficit. In a systematic review performed in the hospital setting, it was identified that increased patient load to a single nurse due to shortage was highly associated with elevated rates of patient readmission. Inaddition, American journal of nursing highlights that increased patient to nurse ration was greatly linked with rising incidences of nurse burnouts and profound health acquired infections such as urinary tract infection.

    Significance of the problem

    With a well proportion number of health care providers within the health care system, there will be reduced number of nurse burn out, reduced job dissatisfaction and finally enhances the health well-being of both the patients and the nurses. As a result of the escalating global nurse shortage, cases of medical errors are regularly being reported. This problem has been contributed by many factors among them being the ageing of the baby boomer generation. Yang, Hung, and Chen (2015)indicated that majority of the health care providers in the United States are aged above 65yeasr and thus approaching retirement age hence creating the shortage. Despite nursing being explained as the fastest growing profession in the US, about 1.2 job vacancies of registered nurses are likely toemerge between 2014 -2022 (Robert, 2017). It is very significant to address this issue and acquire a lifelong intervention to the problem.Measure of addressing this health issue must however focus on preparing more baccalaureate-prepared nurses in order to ensure access to high quality, safe patient care. Increasing the capacity of nursing schools is also very essential as this would at long last increase the number of physicians joining the job marketand hence reduce the remedying the shortage. With increased and appropriate number of nurses within the health care systems, patient’s health outcomes will be improved as well as ensuring a positive well-being of the care providers. With nursing care being a primary factor in patient satisfaction and little relief from shortages, nursing leaders are compelled to establish methods of measuring staffing effectiveness.

     

    Problem Statement

    The United States has the highest number of registered nurses of over 3 million nurse though there still exist a great deficit (Yang, Hung, and Chen, 2015). The most significant cause of the is nurse shortage in this great nation is the elevating aging population that has led to more incidences of chronic diseases, there is also a large number of old nurse work force as well  as the nursing institutions lack the capacity to satisfy the entire health care center with care providers. With the increased nurse shortage, there have been raise cases of job dissatisfaction which results from stressful working condition brought about by workload. Moreover, the nurses are pressured to leaving the job and find alternative career. Patient safety is another issue of concern that come about by reduced nurse number. In a research conducted by the health service research, it was indicated that a reduced patient to nurse ratio on both medical and surgical units consequently led to low numbers of death (Robert, 2017).

    According to a study carried out in Canada, it was explained that there were 4.9 fewer deaths per 1,000 patients on intensive care units staffed with a higher percentage of nurses with bachelor’s degrees (Van et al., 2013). In a meta-analysis performed by the agency for health research and quality, it was found that registered nurse reduction plus increased nurses workload posed a significant threat to patient’s quality and safety during acquisition of health services. The main purpose of this research proposal is to examine the association between registered nurse shortage to the patients’ health outcome and wellbeing to the nurses.

     

     

     

    Research questions

    What are the main causes of increasing nurse shortage in the United States?

    Is there a relationship between nurse shortage and patients health outcome and nurse well-being?

    Hypothesis

    H
    0
    : increased incidences of nurse shortage in the United States health care system is directly associated with poor patient outcome, job dissatisfactionand burnout among health career providers.

    H
    1
    : There is no direct association in deteriorating the patient’s health outcome and job dissatisfaction, nurse burn out with the increasing nurse shortage in the United States health care system.

    Variables

    The independent variables will include the patient’s health outcomes, nurse job dissatisfactionand burnout. These variables will be determined by getting the total number of nurses in a hospital and the resultant rate of patient readmission and incidences of medical errors and this will signify the level of patient outcome. For the well-being of the nurses, intentions of the nurses to leave the career coupled with cases of burn out will highlight the level of satisfaction and dissatisfaction for the nurses and thus this will directly be related to patient outcome.

    The dependent variables that will be examined in the research paper will be the level of nurse shortage. This variable will be examined by determining the total number of nurses that are in a health care center compared to the appropriate number that should be present. This will however give out the nurse deficit.

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

    References

    Nantsupawat, A., Nantsupawat, R., Kulnaviktikul, W., & McHugh, M. D. (2014). Relationship between nurse staffing levels and nurse outcomes in community hospitals, Thailand. 
    International Journal of Nursing Practice
    17
    (1), 112-118. doi:10.1111/nhs.12140

    Robert, R. (2017). American Association of Colleges of Nursing | Nursing Shortage. Retrieved from
    http://www.aacn.nche.edu/media-relations/fact-sheets/nursing-shortage

    Van, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., &Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. 
    International Journal of Nursing Studies
    , 
    50
    (2), 185-194. doi:10.1016/j.ijnurstu.2011.12.001

    Yang, P., Hung, C., & Chen, Y. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing, 71(8), 1847-1856. doi:10.1111/jan.12643

  • Health History and Examination

    Health History and Examination

    Health Assessment of the Head, Neck, Eyes, Ears, Nose, Mouth, Throat, Neurological System, and the 12 Cranial Nerves Skin, Hair, Nails, Breasts, Peripheral Vascular System, Lymphatics, Thorax, Heart, Lungs, Musculoskeletal, Gastrointestinal, and Genitourinary Systems

    Save this form on your computer as a Microsoft Word document. You can expand or shrink each area as you need to include relevant data for your client.

    Student Name: Date:

    Client/Patient Initials: Sex: Age:

    Occupation of Client/Patient:

    Health History/Review of Systems

    (Complete and systematic review of systems)

    Neurological System (headaches, head injuries, dizziness, convulsions, tremors, weakness, numbness, tingling, difficulty speaking, difficulty swallowing, etc., medications):

    Head and Neck (pain, headaches, head/neck injury, neck pain, lumps/swelling, surgeries on head/neck, medications):

    Eyes (eye pain, blurred vision, history of crossed eyes, redness/swelling in eyes, watering, tearing, injury/surgery to eye, glaucoma testing, vision test, glasses or contacts, medications):

    Ears (earache or other ear pain, history of ear infections, discharge from ears, history of surgery, difficulty hearing, environmental noise exposure, vertigo, medications):

    Nose, Mouth, and Throat (discharge, sores or lesions, pain, nosebleeds, bleeding gums, sore throat, allergies, surgeries, usual dental care, medications):

    Skin, Hair and Nails (skin disease, changes in color, changes in a mole, excessive dryness or moisture, itching, bruising, rash or lesions, recent hair loss, changing nails, environmental hazards/exposures, medications):

    Breasts and Axilla (pain or tenderness, lumps, nipple discharge, rash, swelling, trauma or injury to breast, mammography, breast self-exam, medications):

    Peripheral Vascular and Lymphatic System (leg pain, cramps, skin changes in arms or legs, swelling in legs or ankles, swollen glands, medications):

    Cardiovascular System (chest pain or tightness, SOB, cough, swelling of feet or hands, family history of cardiac disease, tire easily, self-history of heart disease, medications):

    Thorax and Lungs (cough, SOB, pain on inspiration or expiration, chest pain with breathing, history of lung disease, smoking history, living/working conditions that affect breathing, last TB skin test, flu shot, pneumococcal vaccine, chest x-ray, medications):

    Musculoskeletal System (joint pain; stiffness; swelling, heat, redness in joints; limitation of movement; muscle pain or cramping; deformity of bone or joint; accidents or trauma to bones; back pain; difficulty with activity of daily living, medications):

    Gastrointestinal System (change in appetite – increase or loss; difficulty swallowing; foods not tolerated; abdominal pain; nausea or vomiting; frequency of BM; history of GI disease, ulcers, medications):

    Genitourinary System (recent change, frequency, urgency, nocturia, dysuria, polyuria, oliguria, hesitancy or straining, urine color, narrowed stream, incontinence, history of urinary disease, pain in flank, groin, suprapubic region or low back):

    Physical Examination

    (Comprehensive examination of each system. Record findings.)

    Neurological System (exam of all 12 cranial nerves, motor and sensory assessments):

    Head and Neck (palpate the skull, inspect the neck, inspect the face, palpate the lymph nodes, palpate the trachea, palpate and auscultate the thyroid gland):

    Eyes (test visual acuity, visual fields, extraocular muscle function, inspect external eye structures, inspect anterior eyeball structures, inspect ocular fundus):

    Ears (inspect external structure, otoscopic examination, inspect tympanic membrane, test hearing acuity):

    Nose, Mouth, and Throat (Inspect and palpate the nose, palpate the sinus area, inspect the mouth, inspect the throat):

    Skin, Hair and Nails (inspect and palpate skin, temperature, moisture, lesions, inspect and palpate hair, distribution, texture, inspect and palpate nails, contour, color, teach self-examination techniques):

    Breasts and Axilla (deferred for purpose of class assignment)

    Peripheral Vascular and Lymphatic System (inspect arms, symmetry, pulses; inspect legs, venous pattern, varicosities, pulses, color, swelling, lumps):

    Cardiovascular System (inspect and palpate carotid arteries, jugular venous system, precordium heave or lift, apical impulse; auscultate rate and rhythm; identify S1 and S2, any extra heart sounds, murmur):

    Thorax and Lungs (inspect thoracic cage, symmetry, tactile fremitus, trachea; palpate symmetrical expansion;, percussion of anterior, lateral and posterior, abnormal breathing sounds):

    Musculoskeletal System (inspect cervical spine for size, contour, swelling, mass, deformity, pain, range of motion; inspect shoulders for size, color, contour, swelling, mass, deformity, pain, range of motion; inspect elbows for size, color, contour, swelling, mass, deformity, pain, range of motion; inspect wrist and hands for size, color, contour, swelling, mass, deformity, pain, range of motion; inspect hips for size, color, contour, swelling, mass, deformity, pain, range of motion; inspect knees for size, color, contour, swelling, mass, deformity, pain, range of motion; inspect ankles and feet for size, color, contour, swelling, mass, deformity, pain and range of motion):

    Gastrointestinal System (contour of abdomen, general symmetry, skin color and condition, pulsation and movement, umbilicus, hair distribution; auscultate bowel sound;, percuss all four quadrants; percuss border of liver; light palpation in all four quadrants– muscle wall, tenderness, enlarged organs, masses, rebound tenderness, CVA tenderness):

    Genitourinary System (deferred for purpose of this class)

    FHP Assessment

    Cognitive-Perceptual Pattern:

    Nutritional-Metabolic Pattern:

    Sexuality-Reproductive Pattern:

    Pattern of Elimination

    Pattern of Activity and Exercise:

    Pattern of Sleep and Rest:

    Pattern of Self-Perception and Self-Concept:

    Summarize Your Findings

    (Use format that provides logical progression of assessment.)

    Situation (reason for seeking care, patient statements):

    Background (health and family history, recent observations):

    Assessment (assessment of health state or problems, nursing diagnosis):

    Recommendation (diagnostic evaluation, follow-up care, patient education teaching including health promotion education):

  • Nurse Shortage in Health Care

    Nurse Shortage in Health Care

    Problem Statement

    The United States health care system is experiencing a great demand for health care services beyond the capacity in which they can hold. According to the bureau of labor statistic, there united states have the largest number of health care providers adding to a total of 3million (Darkwa, Newman, Kawkab, & Chowdhury, 2015). Despite this enormous number, there exist a great nurse shortage which has been represented by the increased patient to nurses ration of ten nurses to responsible for providing care for 1000 patients (Van et al,. 2013). With this high nurse patient dependency ratio, research highlights that there is a growing demand for health care professionals where there has been a projection of about 16% growth in the nursing occupation by 2024 (Yang, Hung, & Chen, 2015). Due to this issue patient are experiencing reduced quality health outcomes since the present health care providers are not able to satisfy the needs of the population. As a result, there is an elevating workload for these hospital workforce that lead to reduced patient safety and thus increased incidences of medical errors.

    In addition, the problem have also increased nurse burn outs and intention to leave the nursing career among the care providers have also escalated. This has consequently led to the increasing challenge. The increased aging population of care providers have significantly contributed to the growing shortage as more nurses are retiring form the job and thus not meeting the demand (Darkwa et al., 2015). However, the increasing number of aging population is experiencing major chronic medical conditions that are consequently demanding for more attention. This therefore have led to the elevation of this problem in the United States. The purpose of the research proposal is to examine the association between nurse shortage and patient health outcomes as well as developing an appropriate intervention to solve this critical issue in the health care system.

    Research Questions

    1. What are the major causes of nurse shortage in the United States health care problem?

    2. Is there an association between nurse shortage and patient

    health outcomes?

    3. Which is the most appropriate intervention to reduce nurse shortage in the US health care system?

    Picot Question

    For hospital having current number of nurses {P} , how does increasing nursing schoolcapacity to have more qualified nurses in the market {I}, compared to the existing nurse shortage {C} influence the patient outcome [O] over the years {T}.

    Purpose of the Research

    There is a nurse shortage in the health care system of the United States. In addressing this issue the researchers will be focused in determining the age, gender and the level of satisfaction of the nurses as the main characteristics.

    Condition

    TheUnited States nursing is among the leading job creators in the US economy contributing to over 2.7 million health care nurses. It is projected that form 2014-2024, there will be an increased job vacancy of over 1.3 nursing vacancies (Van et al., 2013)There is reduced number of nursing students enrolling for nursing course and this has created more shortage. In a research by the American journal of nursing about 56 % of all the 756 nursing schools reported to have a great deficit in the holding capacities of the school amounting to 1236 vacancies(Dawson et al., 2014). A significant nurse shortage issue thus exist.

    Intervention

    Following this problem in this critical health system an appropriate and long life intervention is desired so as to solve the issue. The government need to increase funding for nursing education which can significantly increase the nursing student enrollment. With increased qualified and skilled nurses within the health care centers patient outcome would greatly be reduced as a result of reduced workload and job satisfaction among nurses.

    Alternative to the intervention

    An alternative approach that would also enhance increased patient outcome as well as reduced nurse shortage due because of increased job retention is providing high wages and improving the hospital working environment.

    Outcome

    With the development of appropriate intervention to reduce nurse shortages within the nursing environment, patient health outcomes would also be enhanced. This would as well improve provision of quality services since nurses would no longer experience workload leading to burnout. Additionally, it’s expected that nurses would also have job satisfaction and thus serving the health care for a longer period. It is expected that patient safety would also be enhanced due to reduction in incidences of medical errors.

    References

    Darkwa, E. K., Newman, M. S., Kawkab, M., & Chowdhury, M. E. (2015). A qualitative study of factors influencing retention of doctors and nurses at rural healthcare facilities in Bangladesh. BMC Health Services Research, 15(1). doi:10.1186/s12913-015-1012-z

    Dawson, A. J., Stasa, H., Roche, M. A., Homer, C. S., & Duffield, C. (2014). Nursing churn and turnover in Australian hospitals: nurses perceptions and suggestions for supportive strategies. BMC Nursing, 13(1). doi:10.1186/1472-6955-13-11

    Van, K., Florquin, M., Bruyneel, L., Aiken, L., Diya, L., Lesaffre, E., &Sermeus, W. (2013). Effective strategies for nurse retention in acute hospitals: A mixed method study. International Journal of Nursing Studies, 50(2), 185-194. doi:10.1016/j.ijnurstu.2011.12.001

    Yang, P., Hung, C., & Chen, Y. (2015). The impact of three nursing staffing models on nursing outcomes. Journal of Advanced Nursing, 71(8), 1847-1856. doi:10.1111/jan.12643

  • SMART Goals and Project Objectives

    SMART Goals and Project Objectives

    Module 2: Capstone Project – SMART Goals and Project Objectives

    Name: Date:

    Overview: Capstone Project – Smart Goals and Project Objectives

    In this assignment, you will locate and summarize content of 2 articles on the use of SMART goals/objectives: what they are, how they are used, and why they are effective. Assignment must contain citations and references in correct APA format.

    You will also select 3 peer reviewed articles that address your chosen focus area for your Capstone Project and create 3-5 goals/objectives for your Capstone Project using the SMART Goals/Objective format.

    Objectives

    • Summarize 2 articles discussing what SMART goals are, how they are used, and/or why they can be an effective tool.

    • Select 3 peer reviewed articles addressing chosen focus area to include in the provided grid.

    • Create 3-5 objectives for Capstone Project using SMART format.

    ORDER A PLAGIARISM-FREE PAPER NOW

    Rubric

    Use this rubric to guide your work on the Module 2 assignment.

    NOTE: All assignments and discussion posts are expected to be completed on time.

    Tasks Target Acceptable Unacceptable

    1. SMART Goals Article Summary

    (40 pts) Clear and strong summary of 2 articles on use of and purpose of SMART goals. Writes 2 summaries – one summary for each article. Each summary is 1 paragraph of 3-4 well-written, original sentences.

    (40 pts)

    General statements reflecting article summary and/or missing one article summary, missing SMART goal format.

    (20 pts) No synthesis of articles on use of and formulating SMART goals.

    (0 pts)

    2. Creates 3-5 SMART goals/objectives.

    (20 points) Creates 3-5 goals/objectives using SMART format including Bloom Taxonomy terms.

    (20 points) 2 or less goals/objectives utilizing SMART goal format using Bloom Taxonomy terms.

    (10 points) Goals/Objectives not written in SMART goal format and/or no use of Bloom Taxonomy terms.

    (0 points)

    3. Cites 3 peer reviewed articles related to the chosen focus area of Capstone project (management, education, or clinical specialty)

    (30 pts) Correctly cites 3 peer reviewed articles for chosen focus area of Capstone project

    (30 pts) Cites 2 or less peer reviewed articles. SMART Goals and Project Objectives

    (15 pts) No peer reviewed articles cited to support SMART goals/objectives.

    (0 points)

    APA format

    (10 pts) Articles and lists the APA references correctly – no errors. (10 pts) Articles and lists the APA references correctly. 1-3 errors. (6 pt.) Articles and lists the APA references correctly. 4 or more errors. (0 pts)

    1. Summarize Articles on SMART Objectives Format (Type in the box below)

    Summarize content of 2 articles found on SMART goals/objectives. Write your summary in proper APA format. Must include in-text citations and references for both articles. Write one paragraph for each article summary. Should have paragraphs.

    TYPE IN THE BOX BELOW (Box will expand as you type in it)

    2. Create 3-5 Project Objectives (Type in the grid provided below).

    3. Cite 3 Peer Reviewed Articles on Chosen Focus Area for Capstone Project

    Create a minimum of 3 and maximum of 5 objectives based upon Bloom’s Taxonomy (See http://mysite.cherokee.k12.ga.us/personal/drew_lawson/site/Subject%203%20Notes/1/Blooms%20Taxonomy.pdf and/or https://tips.uark.edu/using-blooms-taxonomy/ and you can always “google” Bloom Taxonomy for more information). These objectives reflect the changes you want to see in the behavior of the participants/audience as a result of acquiring the information that you present. Remember: Objectives must be specific, measurable, attainable, realistic, and timed (S.M.A.R.T.) and each must include a Bloom term. At a minimum, at least one objective should be “immediate” and one “long term.” Use the table below to record the Objectives and Content for your Capstone Project. (You must create at least three objectives. If you have more, insert rows in the table). Remember that your final project will need at least three references (less than five years old). See the example for how to format this grid. SMART Goals and Project Objectives

    Example Objectives

    (3-5 Objectives) Example Content and Citing of Peer Reviewed Articles

    (Total of 3)

    1. By the end of the presentation, 98% of the audience will be able to identify three ways to prevent falls in the LTC until.

    (Note: this is an immediate outcome, there is a time frame, there is a % of the audience, identify is the Bloom term. This goal is measurable). • Fall prevention

    Doe, J. (2014). How to prevent falls in a long term care unit. Journal of Fall Prevention, 8(26), 23-32. Retrieved from EBSCOhost.

    2. Within three months of the presentation, 95% of the audience will be able to recite three reasons to use a fall assessment form with any change in condition for residents. SMART Goals and Project Objectives.

    (Note: this is a long-term goal, there is a time frame, there is a % of the audience, and “recite” is the Bloom term. This goal is measurable). • Fall assessment forms

    Smith, J. (2013). Why are fall assessment forms important? Journal of Fall Assessments, 7(4), 12-15. Retrieved from EBSCOhost.

    3. (Write your third outcome here – it can be either immediate or long-term. Remember it must be SMART and include a Bloom term). • Content Topic

    Must have at least one reference here as three are required for this assignment – one for each outcome. Please note that for your final project, you will need three references for each outcome that you have for a minimum of nine references. If you have four outcomes, you will need a minimum of twelve references. SMART Goals and Project Objectives

    Grid provided below for assignment completion.

    Complete this grid with your information. Must have a minimum of 3 and maximum of 5.

    Project Objectives

    (3-5 Objectives) Content and Citing of Peer Reviewed Articles

    (Cite 3 Articles)

    1. •

    2. •

    3. •

    4. •

    5. •

    Uploading Completed Assignment Template:

    • Save this completed assignment template with your individual assignment content to your computer in a file you can easily retrieve.

    • Upload the completed assignment template into Module 2: Assignment 2 of 2 area in Module 2 of the course. SMART Goals and Project Objectives.

  • Alzheimer’s Disease

    Alzheimer’s Disease

    The Assignment: Assessing and Treating Clients with Dementia

    The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.

    Examine Case Study: An Elderly Iranian Man w/ Alzheimer’s Disease

    You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point there will be three decisions. I will choose one out of the three and give the outcome. At each decision point these are the thoughts to ponder:

    Decision #1

    Which decision did you select?

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

    Decision #2

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    ***Also include how ethical considerations might impact your treatment plan and communication with clients. ***

    Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen).

    2. Write paper addressing all section listed based on the decision tree.

    Case Study: An Elderly Iranian Man with Alzheimer’s Disease

    BACKGROUND

    Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

    According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

    Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

    SUBJECTIVE

    During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

    MENTAL STATUS EXAM

    Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

    Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

    Decisions Made and Outcomes (Needed to formulate the paper) (Must use and formulate paper based off of the chosen decision. Then tell why the other two decision were not a good choice with in-text citations noted for each.)

    Choices for Decision 1: Select what the PMHNP should do:

    Begin Exelon (rivastigmine) 1.5 mg orally BID with an increase to 3 mg orally BID in 2 weeks

    Begin Aricept (donepezil) 5 mg orally at BEDTIME

    Begin Razadyne (galantamine) 4 mg orally BID

    Decision Choice Chosen: Begin Aricept (donepezil) 5 mg orally at BEDTIME

    ***Explain why other two choice were rejected (not adequate choices)***

    Outcome: RESULTS OF DECISION POINT ONE:

    Client returns to clinic in four weeks

    The client is accompanied by his son who reports that his father is “no better” from this medication

    He reports that his father is still disinterested in attending religious services/activities, and continues to exhibit disinhibited behaviors

    You continue to note confabulation and decide to administer the MMSE again. Mr. Akkad again scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall

    Choices for Decision 2: Select what the PMHNP should do:

    Increase Aricept to 10 mg orally at BEDTIME

    Discontinue Aricept and begin Razadyne (galantamine) extended release 24 mg orally daily

    Discontinue Aricept and begin Namenda (memantine) extended release, 28 mg orally daily

    Decision Choice Chosen: Increase Aricept to 10 mg orally at BEDTIME

    ***Explain why other two choice were rejected (not adequate choices)***

    Outcome: RESULTS OF DECISION POINT TWO:

    Client returns to clinic in four weeks

    Client’s son reports that the client is tolerating the medication well, but is still concerned that his father is no better

    He states that his father is attending religious services with the family, which the son and the rest of the family is happy about. He reports that his father is still easily amused by things he once found serious

    Choices for Decision 3: Decision Point Three Select what the PMHNP should do next:

    Continue Aricept 10 mg orally at BEDTIME

    Increase Aricept to 15 mg orally at BEDTIME x 6 weeks, then increase to 20 mg orally at BEDTIME

    Discontinue Aricept and begin Namenda 5 mg orally daily

    Decision Choice Chosen: Continue Aricept 10 mg orally at BEDTIME

    ***Explain why other two choice were rejected (not adequate choices)***

    Outcome: Guidance to Student

    RESULT FROM CHOOSING TO MAINTAIN CURRENT DOSE OF ARICEPT 10 mg ORALLY AT BEDTIME

    Guidance to Student

    At this point, it would be prudent for the PMHNP to continue Aricept at 10 mg orally at bedtime. Recall that this medication can take several months before stabilization of deterioration is noted. At this point, the client is attending religious services with the family, which has made the family happy. Disinhibition may improve in a few weeks, or it may not improve at all. This is a counseling point that the PMHNP should review with the son.

    There is no evidence that Aricept given at doses greater than 10 mg per day has any therapeutic benefit. It can, however, cause side effects. Increasing to 15 and 20 mg per day would not be appropriate.

    There is nothing in the clinical presentation to suggest that the Aricept should be discontinued. Whereas it may be appropriate to add Namenda to the current drug profile, there is no need to discontinue Aricept. In fact, NMDA receptor antagonist therapy is often used with cholinesterase inhibitors in combination therapy to treat Alzheimer’s disease. The key to using both medications is slow titration upward toward therapeutic doses to minimize negative side effects.

    Finally, it is important to note that changes in the MMSE should be evaluated over the course of months, not weeks. The absence of change in the MMSE after 4 weeks of treatment should not be a source of concern.

    ***Write on each decision. Make sure that in each decision choice that you explain why the other two decisions were not good choices. Use cited sources to validate points. Make sure that this paper has at least 7 References. Please use in-text citations for each section of each decision. Don’t forget the ethical considerations for this assignment. Make it a section by itself.***

    ***Also please make sure when looking at the ethical consideration for this assignment that you look at how the Caucasian (male) ethnicity and pain medications interact.***

    Please use the following format when formulating the paragraphs for each section. Don’t forget the intext citations. Remember to use at least 7 references.

    Introduction

    Decision #1

    Reasons for Choosing the Decision (Why is it the best choice out of the 3 choices)

    Anticipated Results (of Chosen Decision)

    Difference in Results (Anticipated VS Actual)

    Decision #2

    Reasons for Choosing the Decision (Why is it the best choice out of the 3 choices)

    Anticipated Results (of Chosen Decision)

    Difference in Results (Anticipated VS Actual)

    Decision #3

    Reasons for Choosing the Decision (Why is it the best choice out of the 3 choices)

    Anticipated Results (of Chosen Decision)

    Difference in Results (Anticipated VS Actual)

    Ethical Considerations

    Conclusion

    References

  • Assessing and Treating Clients with Dementia

    Assessing and Treating Clients with Dementia

    The Alzheimer’s Association defines dementia as “a general term for a decline in mental ability severe enough to interfere with daily life” (Alzheimer’s Association, 2016). This term encompasses dozens of cognitive disorders of impaired memory formation, recall, and communication. The care and treatment of clients with dementia is dependent on multiple factors, including the stage of dementia, comorbidities, family support, and even the care setting. In your role, as the psychiatric mental health nurse practitioner, you must be prepared to not only treat clients with these various cognitive disorders, but also the multiple behavioral issues that often accompany them. For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat clients presenting with dementia.

    Examine Case Study: An Elderly Iranian Man w/ Alzheimer’s Disease

    You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

    At each decision point there will be three decisions. I will choose one out of the three and give the outcome. At each decision point these are the thoughts to ponder:

    Decision #1

    Which decision did you select?

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?

    Decision #2

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?

    Decision #3

    Why did you select this decision? Support your response with evidence and references to the Learning Resources.

    What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.

    Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

    ***Also include how ethical considerations might impact your treatment plan and communication with clients. ***

    Finally: 1. Complete the decision tree (keep track of what you selected. come up with a rational reason why you chose it. Come up with patient specific rational reason behind not choosing the other two options not chosen).

    2. Write paper addressing all section listed based on the decision tree.

    Case Study: An Elderly Iranian Man with Alzheimer’s Disease

    BACKGROUND

    Mr. Akkad is a 76 year old Iranian male who is brought to your office by his eldest son for “strange behavior.” Mr. Akkad was seen by his family physician who ruled out any organic basis for Mr. Akkad’s behavior. All laboratory and diagnostic imaging tests (including CT-scan of the head) were normal.

    According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that Mr. Akkad’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.”

    Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.

    SUBJECTIVE

    During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia.

    MENTAL STATUS EXAM

    Mr. Akkad is 76 year old Iranian male who is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He denies visual or auditory hallucinations. No delusional or paranoid thought processes noted. He is alert and oriented to person, partially oriented to place, but is disoriented to time and event [he reports that he thought he was coming to lunch but “wound up here”- referring to your office, at which point he begins to laugh]. Insight and judgment are impaired. Impulse control is also impaired as evidenced by Mr. Akkad’s standing up during the clinical interview and walking towards the door. When the PMHNP asked where he was going, he stated that he did not know. Mr. Akkad denies suicidal or homicidal ideation.

    Diagnosis: Major neurocognitive disorder due to Alzheimer’s disease (presumptive)

  • Combining Nurse Leader With Advocacy

    Combining Nurse Leader With Advocacy

    Rate yourself using the results from the “Nurse Manager Skills Inventory”:

    http://www.aone.org/resources/nurse-manager-skills-inventory.pdf

    Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

    Personal and professional accountability

    Career planning

    Personal journey disciplines

    Reflective practice reference behaviors/tenets

    Discuss how you will use your current leadership skill set to advocate for change in your workplace.

    Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.

    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 Turnitin. Please refer to the directions in the Student Success

  • Nurse manager skill inventory

    Nurse manager skill inventory

    Rate yourself using the results from the “Nurse Manager Skills Inventory”:

    http://www.aone.org/resources/nurse-manager-skills-inventory.pdf

    Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

    Personal and professional accountability

    Career planning

    Personal journey disciplines

    Reflective practice reference behaviors/tenets

    Discuss how you will use your current leadership skill set to advocate for change in your workplace.

    Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.

    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 Turnit

  • VARK Analysis

    VARK Analysis

    Provide a summary of your learning style according the VARK questionnaire.

    Human beings start learning from birth and continue to learn until they die. Each individual’s learning styles are different, making it essential for every human being to find the learning style that is better for him or her (Husmann & O’Loughlin, 2019). People can recognize their learning style using visual, aural, read/write and kinesthetic (VARK), a unique analysis tool used in the education process. A scientist named Neil Fleming in the year 1987 as sixteen question assessment scores too designed this special. The tool work by tallying results and finally showing where specific people fall. Five strategies are used to place each individual where they belong using VARK. Knowing individuals’ learning styles makes it easy to teach them. This paper aims to discuss the VARK question scores for the nurse, compare the learning styles identified with the rest, and address the changes required to improve individual learning behavior.

    ORDER A PLAGIARISM-FREE PAPER HERE

    Describe your preferred learning strategies. Compare your current preferred learning strategies to the identified strategies for your preferred learning style.

    The modes that are used to collect, process, interpret, and reflect on educational materials are the learning styles. Learning preferences are those learning modes that a person naturally prefers. It is essential for educators to successfully provide knowledge in accordance with the demands of the students because kids have varied learning preferences. Learners comprehend concepts effectively when teaching strategies incorporate many activities that excite and improve the visual, aural, read/write, and kinesthetic learning modalities. According to the scores I tallied, I am a multimodal learner with a mix of read/write and kinesthetic. A combination of at least two learning styles is referred to as multimodal. This is why I am flexible in delivering information to different people, as described by Fleming. However, Idrizi & Filiposka(2018) say that people like me require sensory input and output in all modes to be satisfied with the teachings or what they have learned. Honestly, these results did not meet be of guards as a nurse because those are the modalities I intended to apply.

    Describe how individual learning styles affect the degree to which a learner can understand or perform educational activities.

    According to the questionnaire results I analyzed, kinesthetic had the highest score. I agree with the results because doing things and on helps me understand the educational material better. I familiarize myself better with certain things after doing them, especially during my clinical rotations. The insertion of catheters is one instance. I perform well by combining the two learning modalities while using visual aids, a hands-on approach, dictionaries, and handouts. I believe that reading textbooks and other written materials are crucial while preparing for tests and quizzes. I am partial to gaining knowledge through exposure and practice as a kinesthetic learner. As per my understanding, knowledge acquisition is associated with reality. I can use all senses to gain a hearing, smelling, touching, tasting, and seeing knowledge. Mainly, working in the medical lab, going on field trips, listening to lectures about real-life situations, working hands-on, and looking at recipes have the ability to solve a problem. Lessening the number of notes and utilizing visuals to clarify ideas improve memory retention.

    Visual and aural modalities occupied the third and fourth spots, respectively. The fact that graphic graphs and coloration capture my attention and help me remember the material given shows my predisposition for visual learning. I use the aural modality in particular by participating in class discussions since doing so helps me understand the material better. I noted that my preferred method is visual and kinesthetic during the comparison. However, it was surprising that the visual modality did not come in the first place. The most popular modality was kinesthetic, and I thought it was strange that learning by doing and visual modality correlated.

    I performed well in all four modalities, demonstrating my usefulness and flexibility in various educational contexts. However, I believe that the aural learning method leaves room for inaccuracy. Learning the necessary information is essential, as is understanding it rather than constantly going over it in your head. Reading and writing both help with memorization. Nurses should learn in the profession of nursing through understanding rather than memorization of information that may be examined as a broader subject in the future.

    Discuss why understanding the learning styles of individuals participating in health promotion is important to achieving the desired outcome. How do learning styles ultimately affect the possibility for a behavioral change? How would different learning styles be accommodated in health promotion?

    After analyzing the various learning types, it is crucial to note that some adjustments are necessary to enhance my learning abilities. There have been significant adjustments, such as adding more diagrams and books. It is also crucial to explain statistics to people who do not understand what they are learning and use a tape recorder to record brainstorming sessions for ideas. Since one effectively understands themselves through collecting knowledge about general learning theories, information about learning styles will be of great value. Using various tactics, I will strengthen my study habits, education, and grades, increasing my overall contentment with my work and studies.

    To accommodate the interests of each learner, educators ought to diversity their teaching methods, claim Khongpit et al. (2018). To enable education to shift from a traditionally teacher-centric approach to a student-centric reciprocal process, it is vital to know preferred learning styles for various learners. In order to effectively shape students’ educational preferences, a variety of information modalities are essential. To effectively comprehend educational materials, people with multimodal educational preferences need similar objectives delivered in many modalities. Previous research has found that teachers who adapt their instruction to students’ preferred learning styles achieve higher test results (Mozaffari et al., 2020). Additionally, it facilitates and enhances learning.

    In conclusion, VARK allows individuals to understand their preferred learning styles. Using the tools created especially for a person helps them study and understand different educational content. My learning style was multifocal, with a strong propensity for kinesthetic learning. VARK also emphasized additional learning modalities that may be used to strengthen one’s study habits.

    References

    Husmann, P. R., & O’Loughlin, V. D. (2019). Another nail in the coffin for learning styles? Disparities among undergraduate anatomy students’ study strategies, class performance, and reported VARK learning styles. Anatomical sciences education, 12(1), 6-19.

    Idrizi, E., & Filiposka, S. (2018). VARK learning styles and online education: Case Study. learning, 5-6.

    Khongpit, V., Sintanakul, K., & Nomphonkrang, T. (2018). The VARK learning style of the university student in computer course. International Journal of Learning and Teaching, 4(2), 102-106.

    Mozaffari, H. R., Janatolmakan, M., Sharifi, R., Ghandinejad, F., Andayeshgar, B., & Khatony, A. (2020). The relationship between the VARK learning styles and academic achievement in Dental Students. Advances in medical education and practice, 11, 15.

     

    VARK Analysis

    Complete “The VARK Questionnaire: How Do I Learn Best?”

    The VARK Questionnaire

    Click “OK” to receive your questionnaire scores.

    Once you have determined your preferred learning style, review the corresponding link to view your learning preference. (MY LEARNING STYLE IS MULTIMODAL)

    Review the other learning styles: visual, aural, read/write, kinesthetic, and multimodal (listed on the VARK Questionnaire Results page).

    Compare your preferred learning strategies to the identified strategies for your preferred learning style.

    Appraise how this awareness of learning attributes influences your perceptions of teaching and learning.

    In a paper (750-1,000 words), summarize your analysis of this exercise. Include the following:

    Provide a summary of your learning style.

    List your preferred learning strategies.

    Compare your preferred learning strategies to the identified strategies for your preferred learning style.

    Discuss how the awareness of individual learning styles, preferences and strategies influence teaching (those who are in a position to teach) and learning (those who are in a position to learn).

    Cite a minimum of three references in the paper.

    Although the topic of this assignment refers to your individual learning style, avoid the use of first person voice (words such as, “I, we, our”) in your essay.

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

    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 Turnitin.