Tag: Clinical-Nursing

Assessment and Interventions for Health Promotion

After completing this unit, you should be able to:

Assess determinants of health for individuals and families.

Develop a community health screening initiative based on a focused community need.

Course Outcome(s) practiced in this unit:

MN505-2: 
Apply theoretical and conceptual models of health related behavior and health promotion education to the individual, families and communities.

Interventions for Health Promotion

This unit focuses on the importance of interventions for health promotion, such as the use of preventative services consisting of screening tests. Screening tests detect health problems early and can enable the advance practice nurse to provide valuable preventative measures, health promotion, and health education to support the care of healthy individuals and populations.

Individual and Family Assessment for Health Promotion

One of the primary responsibility of master’s prepared registered nurse is to promote health, utilizing the processes and patterns that lead toward wellness. Understanding risk factors, exposures and the relationship to disease helps to determine cause effects and predictions. Masters prepared nurses use assessment strategies that address interactions among individuals’ biophysical, psychosocial, and spiritual states and patterns with the environment. The advanced nursing role requires data gathering through assessment. This data is relevant to the health promotion activity of the individual and their current health status. Assessment is key to identification of problems within the individual’s health and lifestyle pattern. Assessment is foundational to all other steps of diagnosing and planning of an individual or a family’s health status and in the promotion of health.

Community Interventions for Health Promotion

Evidence-based preventive services are effective in reducing death and disability, and are cost effective or even cost-saving. Preventative services consist of screening tests, counseling, immunizations, or medications used to prevent disease, detect health problems early, or provide people with the information they need to make good decisions about their health. Clinical and community preventive services are vital to health promotion and disease prevention. The master’s prepared registered nurse is an advocate for preventive services and equitable policies for at risk and vulnerable groups.

Screening is an important component of clinical preventative services because it helps the healthcare professional to identify chronic conditions and risk factors before the conditions become costly, both in financial terms and quality of life. Health education about screening is categorized as part of the rubric of primary prevention, but the actual process of screening is part of secondary prevention. The selection of a screenable population is as important as selection of a screenable disease, and is often based on incidence and prevalence. The main criterion used to define an appropriate population is the definitive presence of risk factors related to a disorder. This unit will require you perform a focused community health assessment and choose a condition or disease process for which to create a community health screening initiative, including why you have chosen the topic of screening.

Community Needs and Health Screening Initiative

Directions

For this Assignment you will pick one recommended screening from AHRQ section 2; an A or B Grade:

Agency for Healthcare Research and Quality [AHRQ]. (2014). Guide to clinical preventive services. Retrieved from https://www.ahrq.gov/professionals/clinicians-providers/guidelines-recommendations/guide/index.html

An initiative is a project, an event, so something in the community is ideal. Workplace location for employees is fine too. Please include the following suggested level one headings so content is clear and easily identified.

Conceptual Model

Choose a conceptual model that you think might work for your initiative and explain the model here.  Appendix 2 in the document at the link below will help you understand community approaches. Appendix 3 in this same document will help you with conceptual model selection. Note: This project is about screening, not physical activity evaluation. Use the appendix as a resource for models:

Physical Activity Evaluation Handbook. (2002). Retrieved from https://www.cdc.gov/nccdphp/dnpa/physical/handbook/pdf/handbook.pdf

You may choose to independently research your model to help you explain its application to your initiative. If you have found another model you will like to use, not listed, contact your instructor.

Screening Purpose

Discuss why it is important to screen for this condition. This is where you address your community assessment and the reason for this need in your community/ population choice. Support your stance with statistics and information, ideally related to the location and population.

Population

Clearly address the demographics that are being screened; where they live, state, county, ages, races included etc.

 

Screening Activity

This section is what you are doing at the screening and should completely align with the screening guideline above for the condition. Also all health promotion screenings include some brief prevention education component.

 

 Outcome Goals

Bullet a few specific goals here. What do you hope to accomplish with your screening?

 

Location

Briefly explain where you are doing this. It should be very specific. Senior Citizen Center in Monroe Co on Saturday. Local church- name, malls, fair etc. Think about what facility type, area you will need. Add comments on why this location meets the needs of your target population and screening choice.

 

Cost

This is the cost for you to develop and conduct the initiative. It is best displayed as a brief Word table showing what it costs you do develop and conduct the screening; paper, equipment, rental s etc. Volunteers are fine, but everything is not free. Students must demonstrate they can develop a cost estimate for screenings that is realistic and takes into account financials. If there is a cost for the attendees that should go here as well.

 

Summary

Provide a summary of your screening, general benefit to the community and why it is important.

This should be a 3–4 page paper, excluding title page, and references. A person should be able to read your paper and understand fully what you are screening, where, when, the costs and how it is supported in the guideline. Ideally a person would be able to duplicate your screening initiative, based on the clarity you present. This paper should adhere to appropriate 6
th
 edition APA format. A minimum of 3-4 sources should be used.

 

How to Submit:

When you are ready to submit your Assignment, select the unit  Dropbox and then attach your file. Make sure to save a copy of the Assignment you submit.

Mucormycosis

Mucormycosis is a considered a life-threatening disease, that is an amalgamation of infections that come from the organism mucorales belonging to a group of fungi Mucoromycotina. It usually involves individuals with “uncontrolled diabetes; malignancy; hematopoietic stem cell transplant or solid organ transplant; persistent neutropenia; prolonged corticosteroid therapy; skin trauma, burns, or surgical wounds; iron overload; intravenous drug use; malnourishment; and premature infants” (Centers of Disease Control, 2011).  In terms of exposure, most often associated with inhalation from environments that contain fungal spores. Moreover, can involve sinus and brain infection involving rhinocerebral infection – a sinus infection that affects the brain stem nerves. In addition, it affects the lungs (pulmonary mucormycosis) which exacerbates the individuals condition of pneumonia that can distribute to other sections of the body which includes the chest cavity, brain, and heart (Medicine Plus, 2016).

 

The main signs and symptoms include the following for sinus infections (fever, headache, and sinus pain), skin (fever, and tenderness, pain, heat, excessive redness, or swelling around a wound) and lung infections (fever, cough) (Centers of Disease Control and Prevention, 2011).

Abnormal labs that are present HCO3 29 meq/L (22-26 meq/L) and pH 7.50 (7.35-7.45), which suggest metabolic alkalosis. Moreover, the patient has a decreased Pa02 of 59 mm Hg on room air (80-100), reduced oxygenation circulating and and is alkalotic and is partially compensated – PC02 of 25 mm Hg (35-45 mm Hg). Moreover, the individual also has an elevated WBC of 15,200/mm³ (5-10,000/mm³) and lymphocytes of 10%  which revolves the patient having an infection. Patient also has an elevated fasting blood sugar of 138 mg/dl (60-110 mg/dl) as the patient is fighting the infection and the body is trying to compensate.

Medication treatments involve two antifungal treatment which is “amphotericin B products and posaconazole, isavuconazole with activity against Mucorales…posaconazole in an oral formulation that can be administered safely for prolonged periods makes it an attractive agent for long-term primary and secondary prophylaxis” . These treatment is involved to reduce or halt the spreading to the disease whilst treating other comorbidities. Likewise, consultation for infectious disease specialist and surgeon should be seen as the patient may need surgery debridement or surgical resection to address the decaying of tissue and possible removal. These complications include the following which are “blindness, meningitis, brain abscesses, osteomyelitis, pulmonary hemorrhages, gastrointestinal hemorrhages, cavitary lesions in organs and eventually secondary bacterial infections, sepsis, and death may occur”

Mucor Definition and Infection

Explain what Mucor is and how a patient is likely to become infected with Mucor.

Mucormycosis or zygomycosis is a rare and serious fungal infection. It is caused by a group of molds called mucormycetes. Patients is likely to be infected by coming in contact with fungal spores found in the environment. People at risk are patients with a weak immune system. They may become infected by simply inhaling the spores or through any type of skin trauma.

Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.

Pulmonary mucormycosis happends when spores may reach all the way to the alveolar spaces, most stay in the nasal turbinates causing sinusitis. Two nursing interventions would be watching closely for respiratory problems, monitoring vital signs specially pulse oximetry levels, chest pains and fever.  Lastly, giving medications as prescribed by physician.

Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.

WBC’s are abnormally high due to infection; Lymph are abnormally low due to infection; HCO and PH suggests metabolic alkalosis. Decreased Pa02/PC02 suggests alkalotic and compensated. High glucose levels indicate that the body is trying to compensate due to the infection.

What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.

Mucor must be treated with antifungal medications. Amphotericin B,Posaconazole, Isavuconazole. Ibuprofen and Tylenol might be used for fever/pain. O2 per doctor’s orders might be needed as well.

Treatments: If needed, mucromycisis might require surgery to remove infected tissue. Educating the patient on how to prevent this infection from occurring again like wearing appropriate clothing when working outside with soil.

Aspects of Human Resources Management and Marketing Strategies

Appraise the key functions of Human Resources Management (HRM) and state your opinion as to whether or not HRM should be part of the strategic planning process for medical group practices. Support your rationale with specific examples.

Evaluate the importance of effective marketing for medical practices. Recommend three (3) specific factors that a practice administrator should consider when creating a marketing plan for a medical group practice. Justify your recommendations.

The Application of the Saul Alinsky

The Industrial Areas Foundation of Saul Alinsky has been referred to numerously in community organization.  Review the Saul Alinsky, Community Organizing and Rules for Radicals article, research the roots of this method, and then discuss its application of “the ends justify the means” in today’s economy.  Address whether this theory is still applicable.  Why or why not?  Under what circumstances?  Provide a specific example to illustrate your perspective.  Prepare a two- to- three page paper (excluding title and reference pages) with a minimum of two scholarly, peer-reviewed sources that were published within the last five years, in APA format.

Designing and Implementing an Effective Compliance Plan

The Office of Inspector General (OIG) has established a set of guidelines (e.g., auditing, monitoring, internal controls, sampling, due diligence, and standards of organizational and employee behavior, etc. Page 508 of the textbook) that physician practices should follow when creating a compliance plan. State your opinion as to which OIG guideline would be the single most significant aspect of a compliance plan for a small practice. Provide a rationale for your response. According the text, the fundamental purpose of a compliance plan is to create an organizational culture that promotes the prevention, identification, and resolution of issues associated with risk. Suggest two (2) main aspects of a management strategy necessary to create this type of culture. Support your recommendations with at least one (1) real-world example.

Health Screening and History of an Adolescent or Young Adult Client

In this assignment, you will be completing a comprehensive health screening and history on a young adult. To complete this assignment, do the following:

Select an adolescent or young adult client on whom to perform a health screening and history. Students who do not work in an acute setting may “practice” these skills with a patient, community member, neighbor, friend, colleague, or loved one.

Complete the “Health History and Screening of an Adolescent or Young Adult Client” worksheet.

Complete the assignment as outlined on the worksheet, including:

Biographical data Past health history Family history: Obstetrics history (if applicable) and well young adult behavioral health history screening Review of systems All components of the health history Three nursing diagnoses for this client based on the health history and screening (one actual nursing diagnosis, one wellness nursing diagnosis, and one “risk for” nursing diagnosis) Rationale for the choice of each nursing diagnosis. A wellness plan for the adolescent/young adult client, using the three nursing diagnoses you have identified.

Format the write-up in a manner that is easily read, computer-generated, neat, and without spelling errors. Use correct acronyms or abbreviations when indicated.

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.

Ethics and Pain Alleviation in Palliative Care

As a hospice nurse, you are involved with pain control on a regular basis. Many of the medications prescribed for the management of pain also depress respirations. Determine a protocol for the use of these medications, keeping in mind that the purpose of hospice is to promote comfort. Support your decisions with ethical theories and principles.

Interpreting Statistical Output for Data Analysis

PowerPoint Presentation

Purpose:

The purpose of this Assignment is to enable you to present the information that you gather from a systematic review on your PICOT topic. This activity will give you the experience to present what your research findings to others.

Directions:

Define the clinical key questions based on PICOT.

Briefly review the database selected for key clinical questions.

Identify the studies of the database search that are a Level I or II evidence.

Interpret the statistical results of the studies identified in Step 3.

Design a presentation.

Place results /overview of research in PowerPoint.

Length of the presentation should be 12–15 slides.

Follow APA format.

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:

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;

utilize spelling and grammar check to minimize errors; and

Your writing Assignment should:

follow the conventions of Standard American English(correct grammar, punctuation, etc.);

be well ordered, logical,and unified, as well as original and insightful;

display superior content, organization, style, andmechanics; and;

use APA 6th editionformat

How to Submit:

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

When you are ready to submit your Assignment, submit to the unit Dropbox. Make sure to save a copy of your work and be sure to confirm that your file uploaded correctly.