Tag: Clinical-Nursing

Comment on the following vulnerable groups paper post;

At-risk groups include groups of individuals that have high chances of contracting diseases or illnesses. An example of this would be adolescents and young adults. These groups are less likely to use protection with sexual activity. They are also at increased risk for using drugs and alcohol due to peer pressure. More at-risk groups include drug addicts, persons with multiple sex partners, and prostitutes (Smith 198). These groups become vulnerable in their community and then become at-risk because of the situation they are in.

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“Vulnerable” groups

Vulnerable groups include the elderly, infants, disabled, ill, and poor people (Smith 6). These groups of people are vulnerable to disease and illness and can’t help

themselves from debilitations in health.

Both groups have trouble advocating for themselves. Adolescents and young adults tend to shy away from healthcare whether it’s because of embarrassment, poor access, or oblivion. Infants cannot speak for themselves and may have caretakers that are able/willing to speak for them. The elderly often get “lost” in the system and have poor access to healthcare (much like infants). Disabled, ill, and the poor often don’t have access to healthcare as well or they have no one to help them.

 

I would advocate for healthcare for all communities. I would make access to health facilities more available for those in poorer communities. I would encourage free/low-cost preventative healthcare to poorer communities. I would also encourage access to sexual health for adolescents and young adults through schools and community clinics. I work with the elderly and always make sure they are well taken care of and if they are having trouble accessing the appropriate information, I am sure to get in touch with someone

that can help.

 

Everyone deserves access to their health.

 

Smith, Maurer a. Community/Public Health Nursing Practice: Health for Families and Populations, 4th    Edition. W.B. Saunders Company, 102008. VitalBook file.

Tragic reaction to stressful life situations essay:

Suicide is the taking of own life which is a “tragic reaction to stressful life situations (Suicide and suicidal thoughts, 2015).” The national institute of health reported ages 10-24 year olds in 2014 was the second leading cause of death with a total count of 5,504 deaths in the US (Advancing research to prevent youth,n.d.).  Erickson’s stages of development for the adolescent shows the teen must successfully concur the two stages of development – identity vs. identity confusion and intimacy vs isolation (Miller, 2017).  Teens who are struggling with the first and second stage will become socially isolated (Miller,2017). Erikson’s theory predicts “when adolescents are unable to successfully answer the questions of identity during this stage of development, they may experience feelings of inadequacy and despair, which can eventually lead to depression (Miller,2017).  Depression left untreated can lead to suicide.

Health professionals can utilize primary, secondary, and tertiary methods to help with health prevention of suicide.  “ Primary suicide prevention aims to reduce the number of new cases of suicide in the general population. Secondary prevention aims to decrease the likelihood of a suicide attempt in high-risk patients and Tertiary suicide prevention occurs in response to completed suicides and attempts to diminish suicide contagion (Ganz, n.d.).”

 

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In general, if a true emergency is occurring 9-1-1 should always be the first line to call for help.  When teens are struggling through thoughts of despair and potential suicide the communities do have resources to reach out to.  As followed are some of the resources: Transitional Age youth support- Mental health services: (360)918-7860; Crisis Line: (360)586-2800; National Suicide Prevention Lifeline: (800)273-Talk (community youth services, n.d.).

As the nurse it is our duty to obtain a precise assessment of the teen through thorough questions and observations.  The nurse should be mindful of some risk factors which place this age group at higher risk are as followed: a previous suicide attempt, mental disorders- schizophrenia/social anxiety, substance abuse, abused or mistreated, history found in family, hopelessness, lack of social support, access to means or methods for suicide (Preventing Teen Suicide, n.d.).  A main nursing intervention in assisting a suspected depressed teen is to show active listening and presence.

 

Advancing Research to Prevent Youth Suicide. (n.d.). Retrieved October 17, 2017, from https://prevention.nih.gov/programs-events/pathways-to-prevention/workshops/suicide-prevention

 

Ganz, D., Braquehais, M. D., & Sher, L. (n.d.). Secondary Prevention of Suicide. Retrieved October 17, 2017, from http://journals.plos.org/plosmedicine/article?id=10.1371%2Fjournal.pmed.1000271

 

(n.d.). Retrieved October 17, 2017, from http://www.communityyouthservices.org/p_suicide_prevention.shtml

 

Miller, R. (2017, June 13). Erik Erikson’s Theory About Adolescent Depression. Retrieved October 17, 2017, from https://www.livestrong.com/article/560899-erik-eriksons-theory-about-adolescent-depression

 

Preventing Teen Suicide. (n.d.). Retrieved October 17, 2017, from https://teens.webmd.com/preventing-teen-suicide#1

 

Suicide and suicidal thoughts: Take action to prevent a tragedy. (2015, August 28). Retrieved October 17, 2017, from http://www.mayoclinic.org/diseases-conditions/suicide/basics/definition/con-20033954

Tragic reaction to stressful life situations essay

Comment on the following vulnerable population assignment post;

Vulnerable population is a group or groups that are more likely to develop health-related problems, have more difficulty accessing health care to address those health problems, and are more likely to experience a poor outcome or shorter life span because of those health conditions. There are a number of characteristics, traits, or circumstances that enhance the potential for poor health. Healthy People 2020 (U.S. Department of Health and Human Services [USDHHS], 2010) has identified certain groups as more vulnerable to health risks, including the poor, the homeless, the disabled, the severely mentally ill, the very young, and the very old (Maurer & Smith, 2013). The most important factor associated with health status is economic status. Poverty drastically increases a person’s or group’s vulnerability to poor health status.

Not all people who are at risk for poor health would be considered vulnerable. To be considered vulnerable, a person or group generally has aggravating factors that place them at greater risk for ongoing poor health status than other at-risk persons. For example, a middle-aged obese man with a sedentary lifestyle and hypertension would be considered at risk for cardiac problems. If that man also had an income below the poverty level, no health insurance, and stressors related to living conditions, he would be more likely to be vulnerable to ongoing poor health status than a man with similar risk factors but with an adequate income and health insurance (Maurer & Smith, 2013).

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     Children, pregnant women, elderly people, malnourished people, and people who are ill or immunocompromised, are particularly vulnerable.  Poverty – and its common consequences such as malnutrition, homelessness, poor housing and destitution – is a major contributor to vulnerability (WHO, 2017). Vulnerability may arise from individual, community, or larger population challenges and requires different types of policy interventions—from social and economic development of neighborhoods and communities, and educational and income policies, to individual medical interventions (Health Affairs).

Children and the elderly must have someone to advocate for them and as I nurse I am honored to be able to stand in the gap to assist this population of my community. For both groups due to the lack of knowledge when it comes to medical termination, procedures, and making sense of the medical language, we as nurses need to make sure that the families of these individual have the full picture of what is going on in terms of their health care. Break down information in laymen’s terms to where individuals can understand so that they can make informed decisions about their health care.

I would advocate for more affordable health care and easier access to health care for children and the elderly to help reduce the co-morbidity and mortality rates. Because it has shown that early access to quality medical care can help reduce an individual’s susceptibility illness, which will in turn reduce the mortality rate. For example, children one of our more vulnerable populations, providing early vaccination and screening for children can reduce and or prevent certain illnesses.

 

References

Health Affairs. Vulnerable People, Groups, And Populations: Societal View. (October 18, 2017). http://content.healthaffairs.org/content/26/5/1220.full

 

Maurer, F.A. & Smith, C.M.  (2013). Community/public health nursing practice (5th ed.). St. Louis, MO: Elsevier Saunders.

 

World Health Organization. (October 18, 2017). http://www.who.int/environmental_health_emergencies/vulnerable_groups/en/

Culture in Nursing Essay Assignment

1.  Discuss the cultural beliefs related to delivery of health care from the Haitian and Iranian population.

2.  Discuss any differences and/or similarities in the delivery of health care in both culture.

3.  How religious beliefs influence the delivery of health care in both.  Give at least one example.

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As stated in the syllabus and instructed here, please present the assignment in a 
word document Arial 12 font attached to the threat in the discussion tab of the blackboard under week 8. 
 A minimum of 2 evidence based references and 2 replies to any of your peers sustained with the proper references are required.  Please follow the example of the APA page that was sent via email and posted in the announcement tab of the blackboard at the beginning of the course.  A minimum of 500 words excluding the first and references page are required.  If you are unable to present the assignment in the due date please let me know at least 2 days before the due date.  Time after the due date have passed will not be granted.

Cultural group and socio-cultural group PowerPoint presentation

Population Presentation:

Each student will choose no later than Week 2 of class, one cultural group and one socio-cultural group from the list provided below and set up a PowerPoint presentation (APA style) Minimum of 16 slides.

Preparation for the presentation will include synthesizing the information from assigned readings, the scientific literature, Internet resources, and other sources. Students will provide a minimum of 5 references.

The presentation will address the following:

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A brief history of the cultural/socio-cultural group

Values

Worldview

Language and communication patterns

Art and other expressive forms

Norms and rules

Lifestyle characteristics

Relationship patterns

Common rituals

Degree of assimilation or marginalization from mainstream society

Health behaviors and practices.

 

The presentation must include a comparative and contrast analysis of common characteristics and distinguishing traits between the cultural group and the socio-cultural group. As well as a brief explanation of differential approaches needed by health care professionals.

Grades will also be based on overall quality of the professional presentation including handouts and references. The Cultural group and socio-cultural group PowerPoint presentation is due by the end of Week 8.

 

Cultural Groups:

Socio-cultural group

African American & African

African American Heritage, Haitian Heritage

Asian American, Asian, & Pacific Islander

Chinese Heritage, Japanese Heritage, Korean Heritage, Filipino Heritage, Russian Heritage, Thai Heritage, Indian Heritage, Vietnamese Heritage

Native American

Apache Heritage, Navajo Heritage, Yakama Heritage, Cherokee Heritage

Hispanic & Latino Americans

Mexican Heritage, Brazilian Heritage, Cuban Heritage, Puerto Rico Heritage, Guatemala Heritage

European  American

Jewish Heritage, Polish Heritage, Baltic Heritage, Greek Heritage, Turkish Heritage, Irish Heritage, Italian Heritage

Congestive Heart Failure Case Study Questions

APA format.

One to two paragraphs each question.

Cite references

No plagiarism.

 

 

Listening to the patient’s heart with stethoscope reveals a high pitched, blowing systolic murmur heard directly under the left nipple. The patient has no prior history of heart murmur. Explain what is causing this new murmur.

high-pitched, blowing heart murmur suggests that the patient has regurgitant heart valve – i.e. blood flows backward through the valve due to inadequate closure of valve; the fact that it’s under the left nipple suggests its the bicuspid valve is not closing appropriately

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From this location, Roger’s systolic murmur is most likely from the mitral valve.  During systole, the mitral valve should be closed, therefore if we are hearing a murmur, the valve must be insufficient, or not closing properly.  If we were viewing this valve via Doppler echo, we would see a large blue plume of color moving from the left ventricle into the left atrium.

 

Is the cause of murmur in anyway related to the patient’s heart attack?

the anterior intraventricular artery is also blocked; this causes ischemia and ultimately infarction of the the left ventricular wall

 

From this location, Roger’s systolic murmur is most likely from the mitral valve.  During systole, the mitral valve should be closed, therefore if we are hearing a murmur, the valve must be insufficient, or not closing properly.  If we were viewing this valve via Doppler echo, we would see a large blue plume of color moving from the left ventricle into the left atrium.

 

 

While listening to the patient’s breathing with a stethoscope, you hear some wheezing and inspiratory rales(crackling noises). Explain these findings.

               
the patient has a 40-pack-year smoking history that puts him at increased risk of developing chronic bronchitis and emphysema; both which alters the breath sounds heard w/ stethoscope; left ventricular heart failure slows rate of venous return of blood from pulmonary vein to left atrium

 

A chest X-ray taken two weeks after his collapse showed markedly enlarged cardiac silhouette and generalized haziness at the bases of the lungs. Explain why the heart  is enlarged and lungs “hazy” on the chest X-ray.

in order to stabilize cardiac output, left ventricle must fill with more blood during ventricular diastole to make up for all the blood that is being pumped backwards into the left atrium

hazy appearance is due to the fluid/pulmonary edema in the lungs; fluid appears lighter on Xray

 

The patient is stabilized and ultimately discharged from the hospital. Three months after the heart attack, he comes back to his physician for a checkup. He complains of dyspnea (shortness of breath) at rest and difficulty breathing while lying down (orthopnea). He says he can only sleep when he is propped up by two large pillows. Congestive Heart Failure Case Study. Explain why is the patient having these symptoms.

               
The heart is still performing at sub optimal level; when lying down blood rushes to lungs and makes his heart failure worse; patient is also experiencing poroxysmal nocturnal dyspnea which involves shortness of breath when laying down asleep; elevating the head with pillows helps the patient sleep

 

When Roger lays down at night, he eliminates the effect of gravity.

rate of venous blood flow returning to right atrium increases.

rate of venous blood flow returning to the left atrium is also increased.

increases the pre-load placed upon left ventricle.

Fluid begins to collect in lungs – difficulty breathing

Raises heart above the majority of his systemic circulation

Lowers rate of venous return

Relieves shortness of breath

Congestive Heart Failure Case Study. Discuss what other organs were affected by Roger’s illness, and how these organs are interconnected with each other.

Health care reform – Disease-oriented to wellness and prevention system

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What is the role of health care reform in shifting the focus from a disease-oriented health care system toward one of wellness and prevention, and how does nursing fit into this shift?

Citation

(Write citation using APA format, just as you would in a reference list. Put articles in alphabetical order by the first author’s last name)

Purpose Statement (quote directly from the study), Sample, and Setting

Research Question or Hypothesis

(If the study doesn’t list one, write what the implied RQ or Hypothesis is and label as “implied.”)

Variables

(State independent and dependent variables using bullet points.
Note: Participants are not variables)

Design

(Include study design (i.e. meta-analysis, RCT), level of evidence (See the Evidence Hierarchy in Polit & Beck (2014)), other key design features such as use of placebo, blinding, etc.

Outcomes (meaning what the researchers were trying to measure) with Measures and Time Administered (meaning how the data was collected/recorded)

(Do not put the actual data here. That belongs in the Findings column.)

Findings

(Include quantitative data. What are the researchers’ final conclusions based on the outcomes?)

Casiday, R. E., Wright, C. M., Panter-Brick, C., & Parkinson, K. N. (2004). Do early infant feeding patterns relate to breastfeeding continuation and weight gain? Data from a longitudinal cohort study.
European Journal Of Clinical Nutrition, 58(9), 1290-1296
.

 

Purpose:

Sample:

Setting:

 

 

 

 

Research Question/Hypothesis:

Independent variable(s):

 

Dependent variable(s):

Study design:

 

Level of evidence:

 

Key design features:

Outcomes:

 

Findings:

 

Conclusions:

Ferguson, M., & Molfese, P. (2007). Breast-fed infants process speech differently from bottle-fed infants: evidence from neuroelectrophysiology. Developmental Neuropsychology, 31(3), 337-347

Purpose:

 

Sample:

 

Setting:

 

Research Question/Hypothesis:

Independent variable(s):

 

 

Dependent variable(s):

Study design:

Level of evidence:

 

Key design features:

 

Outcomes:

 

Findings:

 

Conclusions:

Kim, T., Lee, H., Park, J., Jang, S., and Kim, M. (2013). Effects of early breastfeeding education on maintenance of breastfeeding practice: A prospective observational study.
Open Journal of Nursing
,
3
, 209-213.

 

 

 

 

 

Purpose:

 

Sample:

 

Setting:

 

 

 

 

Research Question/Hypothesis:
Implied

Independent variable(s):

 

Dependent variable(s):

 

Study design:

 

Level of evidence:

 

Key design features:

Outcomes:

 

 

Findings:

 

Conclusions:

 

Singhal, A., Cole, T., Lucas, A., Singhal, A., Cole, T. J., & Lucas, A. (2001). Early nutrition in preterm infants and later blood pressure: two cohorts after randomized trials.
Lancet, 357
North American Edition (9254), 413-419.

 

Purpose:

Sample:

Setting:

 

Research Question/Hypothesis:

Hypothesis:

Independent variable(s):

Operational definition:

Conceptual definition:

Dependent variable(s):

Operational definition:

Conceptual definition:

Study design:

 

Level of evidence:

 

Key design features:

Outcomes:           

 

 

Findings:

Conclusions:

Advanced practice nurse and quality healthcare essay

Across the world access to quality healthcare and the cost of said care is a major concern. In the United States escalating costs of healthcare due to chronic diseases has led to a merger of technology and health as it relates to data management (Newhouse, et al., 2011). Working for a health insurance company in a clinical division, most of the patient data that is used to make decisions is delivered through an electronic clinical exchange. As a health plan, we are contracted with the Agency for Healthcare Administration (AHCA) and therefore, must adhere to very specific criteria related to the management of patient data and expected patient outcomes. Within our work process we report on information specific to performance benchmarks, clinical dashboards, disease management, quality indicators, evidence-based practices and outcomes(Hamric, Hanson, Tracy, & O’Grady, 2014). In my current role as a Clinical Leader for Medicaid disease management, I review electronic reports related to the above data and feel comfortable in applying the reported information to make decisions about how to engage the patient in their care. Some examples of the type of information that is collected are high ER utilization, frequent inpatient admissions, compliance with primary care physician (PCP) appointments, medication utilization and compliance, patient access to care complaints, diagnosis and compliance with HEDIS measures. Advanced practice nurse and quality healthcare essay.

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While, my organization does have accountability for successfully meeting these expectations, as an APRN my personal accountability increases. The direct proximity of the interactions between practitioners and their patients places them in the best position to deliver quality care. Therefore, practitioners are held most accountable for the discrepancies in the care patients are receiving (Baker & Hopkins, 2010). Practitioners receive the same reports as the health plan regarding patient data. Utilizing the report from the aspect of the provider will be a change for me. Currently, it is frustrating to me when I see patients that have never established with their PCP. However, they are utilizing the ER for all their needs. The PCP looks to the health plan to make an impact in the patient’s utilization because it directly impacts their payment based on their contract. As an NP my focus would not be to look for the health plan to resolve my issue with my patient’s non-compliance. I feel that it would be my responsibility as the provider to engage my member by utilizing the patient data that is readily available to me. It is the interpretation of this data by the practitioner and subsequent application that would make the biggest impact in patient outcomes. Advanced practice nurse and quality healthcare essay.

 

References

Baker, L. C., & Hopkins, D. P. (2010). The contribution of health plans and provider organizations to variations in measured plan quality.
International Journal For Quality In Health Care: Journal Of The International Society For Quality In Health Care, 22
(3), 210-218. doi:10.1093/intqhc/mzq011

Hamric, A., Hanson, T., Tracy, C., & O’Grady, E. (2014).
Advanced practice nursing: an integrative approach.
St Louis, MO: Elsevier.

Newhouse, R. P., Stanik-Hutt, J., White, K. M., Johantgen, M., Bass, E. B., Zangaro, G., & Weiner, J. P. (2011). Advanced practice nurse outcomes 1990-2008: a systematic review.
Nursing Economics
, 230.

Benefits of joining a nursing union essay assignment

Unions are essential tools in ensuring safe working environments. Unions ensure a collective bargaining power for the workers hence ensuring nurses get their dues in time and reasonable wages are paid. Nurses work hard to ensure safe and quality healthcare. However, the management cannot be trusted in creating an enabling environment for nurses who work tirelessly in our health care facilities. With unions, nurses use their numbers to demand for a pay rise or allowances which might be difficult without the union (Silver, 2013).  Although there are claims that the unions represent unprofessionalism in healthcare, it is not possible to leave a facility just because your demands are not met like in most cases. Therefore unionized nurses need to be allowed and nurses must be willing to join the unions so that their voice can be heard by the management.

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An organizational culture that supports safety is paramount in ensuring safety at workplace. Safety culture is therefore the way an organization does things and how they collectively value safety at workplace. Unions affect the way in which nurses interact with the management. Most unions are focused on ensuring that employees or the union members receive fair wages and safe working environment. A unionized nurse therefore promotes a workforce culture of safety by ensuring that the management offers good working conditions for the nurses. The most appropriate MSN Essential is Essential III: Quality Improvement and Safety. The essential requires that the nurse performance be related to quality by ensuring safety of the patients. Also, the nurses need a safe working environment so that they can be able to execute their duties. Benefits of joining a nursing union essay assignment.

References

Silver, J. (2013). 
Just a union– of nurses
. Winter Park, FL: Legacy Book Publishing.