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  • [Solved] Nursing NUR 601 Assignment #1

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    – ## NUR601Assignment1.docx **## NUR601Assignment1.docx** **_Therapeutic Relationship_** | | | | — | — | | | **Case** | | **Cases** | J.J is a nurse practitioner who works in a primary care facility. He believes that one of the most important aspects of his work is to foster a therapeutic relati…

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    – ## NUR601Assignment1.docx

    **## NUR601Assignment1.docx**

    **_Therapeutic Relationship_**

    | | |
    | — | — |
    | | **Case** |
    | **Cases** | J.J is a nurse practitioner who works in a primary care facility. He believes that one of the most important aspects of his work is to foster a therapeutic relationship with his clients. He is using effective communication techniques.<br>Many of his clients have altered sensory perception such as blindness and deafness. Because of these conditions, He has to be extremely patient with his clients. J.J. also finds that the use of respect and humor help him bond more readily with his clients. |
    | **Questions for the case** | For better results with his clients, J.J must secure trust with his patients. Discuss strategies that promote trust between patients and health care providers. |

    Answer its respective question(s). And then, compose the items below for your case:

    1. Moral distress is a frequent situation where health care providers should face. Please define and articulate a personal experience where you have faced Moral distress in your practice.

    2. Explain how health promotion relates to morality.

    3. Describe your insights about your own communication strengths and weaknesses. Identify situations in which it may be difficult for you to establish or terminate a therapeutic relationship.

    **Submission Instructions:**

    · The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.

    · The paper is to be formatted per current APA, be clear, concise and students will lose points for improper grammar, punctuation and misspelling.

    · The paper is to be 3-4 pages in length, excluding the title, abstract and references page.

    · Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

    · Journal articles and books should be referenced according to current APA style.

    · Your assignment will be reviewed for plagiarism with Turnitin.

    **## NUR601Assignment1.docx**

    **_Therapeutic Relationship_**

    | | |
    | — | — |
    | | **Case** |
    | **Cases** | J.J is a nurse practitioner who works in a primary care facility. He believes that one of the most important aspects of his work is to foster a therapeutic relationship with his clients. He is using effective communication techniques.<br>Many of his clients have altered sensory perception such as blindness and deafness. Because of these conditions, He has to be extremely patient with his clients. J.J. also finds that the use of respect and humor help him bond more readily with his clients. |
    | **Questions for the case** | For better results with his clients, J.J must secure trust with his patients. Discuss strategies that promote trust between patients and health care providers. |

    Answer its respective question(s). And then, compose the items below for your case:

    1. Moral distress is a frequent situation where health care providers should face. Please define and articulate a personal experience where you have faced Moral distress in your practice.

    2. Explain how health promotion relates to morality.

    3. Describe your insights about your own communication strengths and weaknesses. Identify situations in which it may be difficult for you to establish or terminate a therapeutic relationship.

    **Submission Instructions:**

    · The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.

    · The paper is to be formatted per current APA, be clear, concise and students will lose points for improper grammar, punctuation and misspelling.

    · The paper is to be 3-4 pages in length, excluding the title, abstract and references page.

    · Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.

    · Journal articles and books should be referenced according to current APA style.

    · Your assignment will be reviewed for plagiarism with Turnitin.

  • [Solved] episode#2

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    – ## EpisodicVisit2.docx **## EpisodicVisit2.docx** Episodic Visit: Dermatology Focused Note Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused Notes, such as the ones required in this pra…

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    – ## EpisodicVisit2.docx

    **## EpisodicVisit2.docx**

    Episodic Visit: Dermatology Focused Note

    Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused Notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

    For this Assignment, you will work with an adolescent patient that you examined during the last 3 weeks and complete a Focused Note Template in which you will gather patient information, relevant diagnostic and treatment information, and reflect on health promotion and disease prevention in light of patient factors, such as age, ethnic group, past medical history (PMH), socio-economic status, cultural background, etc. In this week’s Learning Resources, please refer to the Focused Note resources for guidance on writing Focused Notes.

    Note: All Focused Notes must be signed, and each page must be initialed by your preceptor. When you submit your Focused Notes, you should include the complete Focused Note as a Word document and PDFimages of each page that is initialed and signed by your preceptor. You must submit your Focused Notes using Turnitin.

    Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/172095/modules/items/6936799)

    **To prepare:**

    · Review the Focused Note Checklist provided in this week’s Learning Resources and consider how you will develop your Focused Note for this week’s Assignment.

    · Use the Focused SOAP Note Template and the example found in the Learning Resources for this week to complete this Assignment.

    · Select an adolescent patient that you examined during the last 3 weeks. With this patient in mind, address the following in a Focused Note.

    **Assignment**

    · Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent as well as possible reasons for these discrepancies.

    · Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.

    · Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority and include their ICD-10 code for the diagnosis. What was your primary diagnosis and why?

    · Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.

    · Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

    **Note**: Your Focused Note Assignment must be signed by Day 7 of Week 6.

    By Day 7

    Submit your Focused Note Assignment. (Note: You will submit two files, your Focused Note Assignment, and a Word document of pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 6.)

    submission information

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the
    **Turnitin Drafts** from the
    **Start Here** area.

    1. To submit your completed assignment, save your Assignment as
    **WK6Assgn2+last name+first initial.**

    2. Then, click on
    **Start Assignment** near the top of the page.

    3. Next, click on
    **Upload File** and select
    **Submit Assignment** for review.

    Rubric

    **PRAC_6541_Week6_Assignment2_Rubric**

    | | | |
    | — | — | — |
    | PRAC_6541_Week6_Assignment2_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeOrganization of Write-up | **10 to >6.0 ptsExcellent** All information organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**6 to >3.0 ptsGood** Information generally organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**3 to >0.0 ptsFair** Errors in format; information intermittently organized. Headings are used some of the time.<br> <br>**0 ptsPoor** Errors in format; information disorganized. Headings are not used appropriately. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of History | **20 to >15.0 ptsExcellent** Thoroughly documents all pertinent history components for type of note; includes critical as well as supportive information.<br> <br>**15 to >11.0 ptsGood** Documents most pertinent examination components.<br> <br>**11 to >7.0 ptsFair** Documents some pertinent examination components.<br> <br>**7 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 20 pts |
    | This criterion is linked to a Learning OutcomeHistory of Present Illness | **10 to >6.0 ptsExcellent** Thoroughly documents all 8 aspects of HPI and pertinent other data relevant to chief complaint. Includes critical as well as supportive information.<br> <br>**6 to >4.0 ptsGood** Documents at least 6 aspects of the HPI and pertinent other data relevant to chief complaint. Includes critical information.<br> <br>**4 to >2.0 ptsFair** Documents at least 4 aspects of HPI and some data pertinent to chief complaint. Lacks some critical information or rambling in history.<br> <br>**2 to >0 ptsPoor** Missing many aspects of HPI and pertinent data. Critical information missing. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of Physical Exam | **10 to >7.0 ptsExcellent** Thoroughly documents all pertinent examination components for type of note.<br> <br>**7 to >4.0 ptsGood** Documents most pertinent examination components.<br> <br>**4 to >2.0 ptsFair** Documents some pertinent examination components.<br> <br>**2 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 10 pts |
    | This criterion is linked to a Learning OutcomeDiagnostic Reasoning | **10 to >7.0 ptsExcellent** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes all secondary problems. Cost effective when ordering diagnostic tests.<br> <br>**7 to >4.0 ptsGood** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes most secondary problems.<br> <br>**4 to >2.0 ptsFair** Assessment mostly consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests.<br> <br>**2 to >0 ptsPoor** Assessment not consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests. | 10 pts |
    | This criterion is linked to a Learning OutcomeTreatment Plan/Patient Education | **20 to >15.0 ptsExcellent** Treatment plan addresses all issues raised by diagnoses, excellent insight into patient’s needs. Medications prescribed are appropriate and full prescription is included. Evidence based decisions. Cost effective treatment.<br> <br>**15 to >10.0 ptsGood** Treatment plan addresses most issues raised by diagnoses. Medications prescribed are appropriate but include 1 or 2 error in writing prescription.<br> <br>**10 to >5.0 ptsFair** Treatment plan fails to address most issues raised by diagnoses. Medications are inappropriate or include 3 or more errors in writing prescription.<br> <br>**5 to >0 ptsPoor** Minimal treatment plan addressed. Medications are inappropriate or poorly written prescription. | 20 pts |
    | This criterion is linked to a Learning OutcomePatient Education / Follow Up / Reflection | **10 to >8.0 ptsExcellent** Patient education addresses all issues raised by diagnoses, excellent insight into patient’s needs. Follow up plan in appropriate and reflects acuity of illness. Reflection is thoughtful and in depth.<br> <br>**8 to >5.0 ptsGood** Patient education addresses most issues raised by diagnoses. Follow up plan is appropriate but lacks specifics Reflection is thoughtful and in depth.<br> <br>**5 to >3.0 ptsFair** Patient education fails to address most issues raised by diagnoses. Follow up plan is lacking specifics or is inappropriate for patient acuity. Reflection is brief, vague. and does not discuss anything that would have been done in addition to or differently.<br> <br>**3 to >0 ptsPoor** Minimal patient education addressed. Follow up plan is inappropriate Reflection is absent. | 10 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation. Professional language utilized | **5 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors. Professional language utilized.<br> <br>**4 ptsGood** Contains a few (1-2) grammar, spelling, and punctuation errors. Contains a few errors (1 or 2) in professional language use.<br> <br>**2 ptsFair** Contains several (3-4) grammar, spelling, and punctuation errors. Contains several errors (3 -4) in professional language use.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Contains many errors in professional language use. | 5 pts |
    | This criterion is linked to a Learning OutcomeScholarly References and Clinical Practice Guidelines. The assignment includes a minimum of 3 scholarly references that are not older than 5 years. Clinical practice guidelines are included if applicable. | **5 ptsExcellent** Contains parenthetical/in-text citations and at least 3 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**4 ptsGood** Contains parenthetical/in-text citations and at least 2 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**2 ptsFair** Contains parenthetical/in-text citations and at least 1 evidenced based reference less than 5 years old is listed. Clinical practice guidelines are not cited if applicable.<br> <br>**0 ptsPoor** Contains no parenthetical/in-text citations and 0 evidenced based references listed. Clinical practice guidelines are not cited if applicable. | 5 pts |

    Total Points: 100

    **## EpisodicVisit2.docx**

    Episodic Visit: Dermatology Focused Note

    Focused Notes are a way to reflect on your practicum experiences and connect the experiences to the learning you gain from your weekly Learning Resources. Focused Notes, such as the ones required in this practicum course, are often used in clinical settings to document patient care.

    For this Assignment, you will work with an adolescent patient that you examined during the last 3 weeks and complete a Focused Note Template in which you will gather patient information, relevant diagnostic and treatment information, and reflect on health promotion and disease prevention in light of patient factors, such as age, ethnic group, past medical history (PMH), socio-economic status, cultural background, etc. In this week’s Learning Resources, please refer to the Focused Note resources for guidance on writing Focused Notes.

    Note: All Focused Notes must be signed, and each page must be initialed by your preceptor. When you submit your Focused Notes, you should include the complete Focused Note as a Word document and PDFimages of each page that is initialed and signed by your preceptor. You must submit your Focused Notes using Turnitin.

    Note: Electronic signatures are not accepted. If both files are not received by the due date, faculty will deduct points per the Walden Late Policies.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/172095/modules/items/6936799)

    **To prepare:**

    · Review the Focused Note Checklist provided in this week’s Learning Resources and consider how you will develop your Focused Note for this week’s Assignment.

    · Use the Focused SOAP Note Template and the example found in the Learning Resources for this week to complete this Assignment.

    · Select an adolescent patient that you examined during the last 3 weeks. With this patient in mind, address the following in a Focused Note.

    **Assignment**

    · Subjective: What details did the patient or parent provide regarding the personal and medical history? Include any discrepancies between the details provided by the child and details provided by the parent as well as possible reasons for these discrepancies.

    · Objective: What observations did you make during the physical assessment? Include pertinent positive and negative physical exam findings. Describe whether the patient presented with any growth and development or psychosocial issues.

    · Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority and include their ICD-10 code for the diagnosis. What was your primary diagnosis and why?

    · Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management? Include pharmacologic and non-pharmacologic treatments, alternative therapies, and follow-up parameters as well as a rationale for this treatment and management plan.

    · Reflection notes: What was your “aha” moment? What would you do differently in a similar patient evaluation?

    **Note**: Your Focused Note Assignment must be signed by Day 7 of Week 6.

    By Day 7

    Submit your Focused Note Assignment. (Note: You will submit two files, your Focused Note Assignment, and a Word document of pdf/images of each page that is initialed and signed by your preceptor by Day 7 of Week 6.)

    submission information

    Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the
    **Turnitin Drafts** from the
    **Start Here** area.

    1. To submit your completed assignment, save your Assignment as
    **WK6Assgn2+last name+first initial.**

    2. Then, click on
    **Start Assignment** near the top of the page.

    3. Next, click on
    **Upload File** and select
    **Submit Assignment** for review.

    Rubric

    **PRAC_6541_Week6_Assignment2_Rubric**

    | | | |
    | — | — | — |
    | PRAC_6541_Week6_Assignment2_Rubric |
    | **Criteria** | **Ratings** | **Pts** |
    | This criterion is linked to a Learning OutcomeOrganization of Write-up | **10 to >6.0 ptsExcellent** All information organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**6 to >3.0 ptsGood** Information generally organized in logical sequence; follows acceptable format and utilizes expected headings.<br> <br>**3 to >0.0 ptsFair** Errors in format; information intermittently organized. Headings are used some of the time.<br> <br>**0 ptsPoor** Errors in format; information disorganized. Headings are not used appropriately. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of History | **20 to >15.0 ptsExcellent** Thoroughly documents all pertinent history components for type of note; includes critical as well as supportive information.<br> <br>**15 to >11.0 ptsGood** Documents most pertinent examination components.<br> <br>**11 to >7.0 ptsFair** Documents some pertinent examination components.<br> <br>**7 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 20 pts |
    | This criterion is linked to a Learning OutcomeHistory of Present Illness | **10 to >6.0 ptsExcellent** Thoroughly documents all 8 aspects of HPI and pertinent other data relevant to chief complaint. Includes critical as well as supportive information.<br> <br>**6 to >4.0 ptsGood** Documents at least 6 aspects of the HPI and pertinent other data relevant to chief complaint. Includes critical information.<br> <br>**4 to >2.0 ptsFair** Documents at least 4 aspects of HPI and some data pertinent to chief complaint. Lacks some critical information or rambling in history.<br> <br>**2 to >0 ptsPoor** Missing many aspects of HPI and pertinent data. Critical information missing. | 10 pts |
    | This criterion is linked to a Learning OutcomeThoroughness of Physical Exam | **10 to >7.0 ptsExcellent** Thoroughly documents all pertinent examination components for type of note.<br> <br>**7 to >4.0 ptsGood** Documents most pertinent examination components.<br> <br>**4 to >2.0 ptsFair** Documents some pertinent examination components.<br> <br>**2 to >0 ptsPoor** Physical examination cursory; misses several pertinent components. | 10 pts |
    | This criterion is linked to a Learning OutcomeDiagnostic Reasoning | **10 to >7.0 ptsExcellent** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes all secondary problems. Cost effective when ordering diagnostic tests.<br> <br>**7 to >4.0 ptsGood** Assessment consistent with prior documentation. Clear justification for diagnosis. Notes most secondary problems.<br> <br>**4 to >2.0 ptsFair** Assessment mostly consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests.<br> <br>**2 to >0 ptsPoor** Assessment not consistent with prior documentation. Fails to clearly justify diagnosis or note secondary problems or orders inappropriate diagnostic tests. | 10 pts |
    | This criterion is linked to a Learning OutcomeTreatment Plan/Patient Education | **20 to >15.0 ptsExcellent** Treatment plan addresses all issues raised by diagnoses, excellent insight into patient’s needs. Medications prescribed are appropriate and full prescription is included. Evidence based decisions. Cost effective treatment.<br> <br>**15 to >10.0 ptsGood** Treatment plan addresses most issues raised by diagnoses. Medications prescribed are appropriate but include 1 or 2 error in writing prescription.<br> <br>**10 to >5.0 ptsFair** Treatment plan fails to address most issues raised by diagnoses. Medications are inappropriate or include 3 or more errors in writing prescription.<br> <br>**5 to >0 ptsPoor** Minimal treatment plan addressed. Medications are inappropriate or poorly written prescription. | 20 pts |
    | This criterion is linked to a Learning OutcomePatient Education / Follow Up / Reflection | **10 to >8.0 ptsExcellent** Patient education addresses all issues raised by diagnoses, excellent insight into patient’s needs. Follow up plan in appropriate and reflects acuity of illness. Reflection is thoughtful and in depth.<br> <br>**8 to >5.0 ptsGood** Patient education addresses most issues raised by diagnoses. Follow up plan is appropriate but lacks specifics Reflection is thoughtful and in depth.<br> <br>**5 to >3.0 ptsFair** Patient education fails to address most issues raised by diagnoses. Follow up plan is lacking specifics or is inappropriate for patient acuity. Reflection is brief, vague. and does not discuss anything that would have been done in addition to or differently.<br> <br>**3 to >0 ptsPoor** Minimal patient education addressed. Follow up plan is inappropriate Reflection is absent. | 10 pts |
    | This criterion is linked to a Learning OutcomeWritten Expression and Formatting English writing standards: Correct grammar, mechanics, and proper punctuation. Professional language utilized | **5 ptsExcellent** Uses correct grammar, spelling, and punctuation with no errors. Professional language utilized.<br> <br>**4 ptsGood** Contains a few (1-2) grammar, spelling, and punctuation errors. Contains a few errors (1 or 2) in professional language use.<br> <br>**2 ptsFair** Contains several (3-4) grammar, spelling, and punctuation errors. Contains several errors (3 -4) in professional language use.<br> <br>**0 ptsPoor** Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. Contains many errors in professional language use. | 5 pts |
    | This criterion is linked to a Learning OutcomeScholarly References and Clinical Practice Guidelines. The assignment includes a minimum of 3 scholarly references that are not older than 5 years. Clinical practice guidelines are included if applicable. | **5 ptsExcellent** Contains parenthetical/in-text citations and at least 3 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**4 ptsGood** Contains parenthetical/in-text citations and at least 2 evidenced based references less than 5 years old are listed. Clinical practice guidelines are cited if applicable.<br> <br>**2 ptsFair** Contains parenthetical/in-text citations and at least 1 evidenced based reference less than 5 years old is listed. Clinical practice guidelines are not cited if applicable.<br> <br>**0 ptsPoor** Contains no parenthetical/in-text citations and 0 evidenced based references listed. Clinical practice guidelines are not cited if applicable. | 5 pts |

    Total Points: 100

  • [Solved] 23

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    In-depth study guidance and analytical solution covering 23.

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  • [Solved] week 3 discussion 1

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    “As demographics change, so too does our need to understand children and families from diverse cultures” (Kaiser & Rasminsky, 2016, p. 89). Even if we don’t realize it, our culture and the cultural viewpoints we possess influences our behavior. In order to be able to truly understand the influence t…

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    “As demographics change, so too does our need to understand children and families from diverse cultures” (Kaiser & Rasminsky, 2016, p. 89).
    Even if we don’t realize it, our culture and the cultural viewpoints we possess influences our behavior. In order to be able to truly understand the influence that culture has on behavior, we must first understand our own cultural competence, and then use this knowledge to implement culturally responsive teaching.
    To prepare for this discussion,
    – Refer to the Week 3 Instructor Guidance for tips and examples that will support your success on this discussion.
    – Read Chapter 6: Opening the Culture Door.
    – Watch the video [_How Culture Drives Behaviours | Julien S. Bourelle | TedXTrondheim_Links to an external site.](https://youtu.be/l-Yy6poJ2zs).
    – Complete the IRIS Center Cultural Responsiveness [Double-Check Self-Assessment: Reflective Thinking About the Children and Their “Group Membership.”Links to an external site.](https://iris.peabody.vanderbilt.edu/mcontent/activity_parent/actividad-double-check-self-assessment-beh1-p03-beh2-both-p02/)
    In your initial post,
    – Explain the cultural assumptions that underlie your discipline or behavior expectation practices. Refer to at least two specific examples from your IRIS Center Cultural Responsiveness [Double-Check Self-Assessment: Reflective Thinking About the Children and Their “Group Membership”Links to an external site.](https://iris.peabody.vanderbilt.edu/mcontent/activity-double-check-self-assessment/).
    – Explain how understanding this children’s cultural needs would influence how you support their behavior.
    \
    Double-CheckSelf-Assessment1.docx](https://www.sweetstudy.com/files/double-checkself-assessment1-docx "Double-CheckSelf-Assessment1.docx")

  • [Solved] HRM 300 Mod 1 Journal

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    In-depth study guidance and analytical solution covering HRM 300 Mod 1 Journal.

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  • [Solved] home

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    In-depth study guidance and analytical solution covering home.

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  • [Solved] Create a Reply for a discussion using APA 7 format, and scholarly references no older than 5 years.

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    **Please ensure that the Reply includes more than 200 words with scholarly articles, and the plagiarism level must remain below 20%.** **Cultural Factors That Directly Impact Health** The shift in focus in modern healthcare systems toward promoting healthy lifestyles and disease prevention as the co…

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    **Please ensure that the Reply includes more than 200 words with scholarly articles, and the plagiarism level must remain below 20%.**
    **Cultural Factors That Directly Impact Health**
    The shift in focus in modern healthcare systems toward promoting healthy lifestyles and disease prevention as the core of population health reflects the importance of lifestyle and health habits in individual health (Cho et al., 2022). Humans are advanced animals with social and cultural characteristics that no other species on Earth possesses, making this phenomenon an imminent health objective. Within the cultural characteristics of any society, elements such as diet, physical exercise, inherited hygiene habits, psychological patterns and predominant forms of behavior, and religious practices can directly impact the health of the individual and the community (Cho et al., 2022).
    **Eating Habits**
                Nutrition is one of the most decisive factors in an individual's health. Food is the way the human body obtains energy and resources, and poor nutrition is often accompanied by health problems (Da Costa, 2023). Some populations, such as those in Asia, have generally healthy eating patterns, with a high consumption of fish, brown rice, vegetables, and fruits, which results in populations with low body mass indexes and good physical condition (Da Costa, 2023). At the other extreme, we have societies such as the American one, with a significant predominance of fast food and oversaturated meals, generating high rates of childhood and adult obesity, leading to significant complications and chronic diseases (Da Costa, 2023).
    **Physical Exercise**
    Physical exercise provides recognized benefits for cardiovascular health, mobility, and autonomy at all ages (Da Costa, 2023). Populations such as Latinos and Africans, where exercise and sports are part of their culture, tend to reap the benefits of these practices compared to populations such as Americans and Europeans, where forms of entertainment that are more dependent on technology and screen time have displaced traditional sports (Da Costa, 2023).
    **Inherited Hygienic Habits**
    The benefits of systematic hygienic habits were learned by society several centuries ago, however, these are not practiced similarly in all populations, influenced by factors such as water availability, temperature, and religious practices (Cho et al., 2023). It is clear that populations that, for one reason or another, fail to comply with basic hygiene standards are more prone to disease and poor health (Da Costa, 2023).
    **Psychological Behaviors and Patterns**
    Advances in medicine have led to mental health becoming increasingly important. In this context, certain behaviors and patterns are becoming increasingly alarming in societies such as those in Asia, where idiosyncrasy, lack of individuality, and cultural protectionism often lead to the emergence of mental disorders such as depression, as evidenced by suicide rates that are much higher than in Western societies (Da Costa, 2023). In contrast, populations such as Latinos tend to have more open and communicative personalities, facilitating communication in healthcare settings and reducing the risk of mental disorders (Da Costa, 2023).
    **Religious Practices**
    Some religious practices can be potentially dangerous to the health of their practitioners, especially those disciplines that include extreme fasting, ingestion of toxic substances, self-flagellation, rejection of medical treatment, and social isolation (Verbunt et al., 2021).
    **References**
    Cho, M. K., & Kim, M. Y. (2022). Factors cultural factors that directly impact health. _International Journal of Environmental Research and Public Health_, _19_(7), 4109. [https://doi.org/10.3390/ijerph19074109](https://doi.org/10.3390/ijerph19074109)
    Da Costa M. (2023). How culture impacts health: The hispanic narrative. _Creative Nursing_, _29_(3), 273–280. [https://doi.org/10.1177/10784535231211695](https://doi.org/10.1177/10784535231211695)
    Verbunt, E., Luke, J., Paradies, Y., Bamblett, M., Salamone, C., Jones, A., & Kelaher, M. (2021). Cultural determinants of health for Aboriginal and Torres Strait Islander people – a narrative overview of reviews. _International Journal for Equity in Health_, _20_(1), 181. [https://doi.org/10.1186/s12939-021-01514-2](https://doi.org/10.1186/s12939-021-01514-2)

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    In your role as controller of a division of TransGlobal Airlines, you are responsible for assessing the possible acquisition of the two identified small airlines in the Caribbean specializing in chartered flights for luxury vacations using light aircraft (60 passengers or less). One of the important…

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    In your role as controller of a division of TransGlobal Airlines, you are responsible for assessing the possible acquisition of the two identified small airlines in the Caribbean specializing in chartered flights for luxury vacations using light aircraft (60 passengers or less).
    One of the important steps in this acquisition process is analyzing, understanding, and identifying all the external and internal elements that can affect the organization’s performance, and, as businesses are greatly influenced by their environment, all the situational factors that determine how day-to-day circumstances impact firms. You can assess situational factors by performing a business environment analysis. The analysis entails assessing the level of threat or opportunity these situational factors might present. These evaluations are later translated into the decision-making process. The analysis helps align strategies with the firm’s environment. You will use the PESTEL method to perform this analysis.
    ## Prompt
    Use the information provided to you in the [TransGlobal Airlines Information](https://learn.snhu.edu/content/enforced/1958807-MBA-620-10916.202557-1/Course%20Documents/MBA%20620%20TransGlobal%20Airlines%20Information.pdf?ou=1958807) document to perform a business environment analysis using the PESTEL method. Your task is to analyze the internal and external business environment of TransGlobal Airlines by identifying the impact of each PESTEL factor on the business environment.
    Specifically, you must address the following rubric criteria:
    1. Identify one **political** factor that can affect the company’s business environment and explain any potential impact on acquisition strategy.
    2. Identify one **economic** factor that can affect the company’s business environment and explain any potential impact on acquisition strategy.
    3. Identify one **sociological** factor that can affect the company’s business environment and explain any potential impact on acquisition strategy.
    4. Identify one **technological** factor that can affect the company’s business environment and explain any potential impact on acquisition strategy.
    5. Identify one **environmental** factor that can affect the company’s business environment and explain any potential impact on acquisition strategy.
    6. Identify one **legal** factor that can affect the company’s business environment and explain any potential impact on acquisition strategy.
    1 PAGE

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    – ## PsychosocialAssignment.docx – ## Chapter31OlderAdults1.pptx – Chapter33ForensicNursing12.pptx – Chapter32SeriousMentalIllness1.pptx – Chapter30DyingDeathandGrieving1.pptx **## PsychosocialAssignment.docx** Directions: Find something that interests you from each of the four chapters (use PowerPo…

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    – ## PsychosocialAssignment.docx

    – ## Chapter31OlderAdults1.pptx

    – Chapter33ForensicNursing12.pptx
    – Chapter32SeriousMentalIllness1.pptx
    – Chapter30DyingDeathandGrieving1.pptx

    **## PsychosocialAssignment.docx**

    Directions:

    Find something that interests you from each of the four chapters (use PowerPoints or textbook). Post a brief share from each chapter that will add to your classmates' understanding, insight, or future nursing practice. Your post should look approximately like this:

    Chapter 30: Here is an experience I've had with [insert topic here]. Followed by a few supporting sentences that illustrate your experience.

    Chapter 31: I was curious about [insert topic here]. I found this short video on YouTube that talks about [very brief summary]. Insert hyperlink here.

    Chapter 32: This is something in my community that I would (or have) recommended as a resource. They do X, Y, Z. Insert hyperlink here.

    Chapter 33: I researched this [insert job description]. Here's what I found about the required education, job opportunities, and potential wages.

    *The examples above are NOT prescriptive and can be used in any order if you choose these prompts. These are just some formats that I think might be interesting. Please choose whatever catches your interest and write up a little something about it for the sake of discussion. You will write one post (4 points) with a few sentences of information about each of the four chapters.

    **## Chapter31OlderAdults1.pptx**

    Chapter 31

    Older Adults

    1

    Objectives

    3

    Identify statistics related to aging in the United States.

    01

    Describe mental health disorders that may occur in older adults.

    02

    Discuss the importance of pain assessment and tools used to assess pain in older adults.

    03

    Explain the negative impact of ageism that is evident in discriminatory labels, public policy, and research.

    04

    Case Study

    Mr. Nixon is being admitted to a short-term care facility because his wife, who had been his only caretaker, has recently died. His son, who lives about 250 miles away, has been staying with him for the past 4 weeks, but has to go home now to go back to work.

    Mr. Nixon has COPD and has trouble getting around because he gets short of breath. He is still grieving, of course, but his son shares that he feels his dad has been depressed over his health “off and on” as well.
    You will be doing an intake assessment with Mr. Nixon.

    4

    Statistics on Aging

    5

    Life expectancy and number of older adults growing

    Common classifications for older adults:

    Young-old: 65 to 74 years

    Middle-old: 75 to 84 years

    Old-old: 85 to 100 years

    Centenarians: 100 to 104 years

    Mental Health and Aging

    6

    Late-life Mental Illness

    Major Depressive Disorder

    Suicide

    Anxiety disorders

    Delirium—secondary to general medical condition

    Neurocognitive disorders

    Alcohol use disorder

    Pain

    Pain

    [This Photo](https://www.aliem.com/2018/06/trigger-point-injection-musculoskeletal-pain/) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    Nonpharmacological treatments for pain include physical therapy, vagal nerve stimulation, exercise, hydrotherapy, heat and cold packs, chiropractic, and transcutaneous electrical nerve stimulation (TENS).

    Yoga, biofeedback, hypnosis, acupuncture, massage, Reiki, guided imagery, reflexology, and therapeutic touch are integrative therapies for managing pain.

    Herbal remedies include cayenne, capsaicin, ginger extract, echinacea, kava, and willow bark.

    7

    Barriers to accurate pain assessment

    Assessment tools

    Wong-Baker FACES Pain Rating Scale

    Pain Assessment in Advanced Dementia (PAINAD) scale

    Pain management

    Pharmacotherapy

    Non-opioids

    Opioids

    Nonpharmacological pain treatments

    Healthcare Concerns
    of Older Adults

    Financial burden

    Medicare Part D for help with medications

    Caregiver burden

    Ageism

    Language

    Public policy

    Research

    [This Photo](http://jobsanger.blogspot.com/2011/06/right-wing-attacks-medicare-in-tv-ads.html) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    8

    Discussion Topic

    Ageism sometimes affects the care of older adult patients. The best way to help prevent this is to do a self-assessment and discuss your feelings and attitudes with others:

    What kinds of feelings, assumptions, or hesitations do you have when you think about working with an older adult?

    9

    Healthcare Decision-Making

    Advance Directives and Portable Medical Orders

    Advance Directives and Portable Medical Orders

    Guardianship

    Court-ordered relationship in which the selected guardian acts on behalf of another individual (the ward)

    The ward must be proven to lack capacity to manage personal and/or financial affairs

    [This Photo](https://betterhealthwhileaging.net/end-of-life-planning-easy-advance-directives-through-prepare/) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    10

    Objectives

    11

    Explain the importance of a comprehensive assessment in older adults.

    1

    Recognize the significance of healthcare costs for older adults.

    2

    Compare the facts and myths about aging.

    3

    Analyze how ageism may affect attitudes and willingness to care for older adults.

    4

    Apply the nursing process to the care of older adults.

    5

    Objectives

    12

    Identify at least four priority nursing diagnoses in the care of older adults.

    1

    Discuss basic nursing interventions in the care of older adults.

    2

    Identify psychological therapies used in the treatment of older adults.

    3

    Identify treatment settings for the care of older adults.

    4

    Application of the Nursing Process

    Assessment

    Private interview space

    Adequate lighting & low-level noise

    Establish rapport & convey warmth

    Physical Assessment

    Medication reconciliation

    Polypharmacy & prescribing cascades

    Mental Status exam

    Older adult drivers

    Older adult abuse

    [This Photo](https://wtcs.pressbooks.pub/nursingfundamentals/chapter/4-3-assessment/) by Unknown author is licensed under
    [CC BY](https://creativecommons.org/licenses/by/3.0/).

    Assessing the use of multiple medications for the same condition (polypharmacy) includes prescription, over-the-counter drugs, and herbal agents. Adverse drug reactions or negative responses to drugs are common among the older adult.

    Prescribing cascades happen when drug-induced symptoms are treated with another drug. The provider may assess the side effect of the first drug as part of the original medical problem or a new one.

    13

    Case Study
    Discussion Question

    You are preparing to interview Mr. Nixon. What are some techniques the nurse could use to help the patient feel more comfortable?

    Conducting the interview in a private area

    Introducing oneself and asking the patient what he or she would like to be called (use of the first name is rarely appropriate unless one is invited to do so)

    Establishing rapport and putting the patient at ease by sitting or standing at the same level as the patient

    Ensuring that lighting is adequate and noise level is low, in recognition of the fact that hearing and vision may be impaired

    Using touch (with permission) to convey warmth, while at the same time respecting the patient's comfort level with personal touch

    Summarizing the interaction, inviting feedback and questions, and thanking the patient for giving his or her time and information

    14

    Quick Quiz

    Mr. Nixon, who has difficulty walking because of shortness of breath secondary to COPD says, “Every day is a struggle when you get old. No one cares about old people.” Select the best response.

    “Rest periods are important. Don’t try to overexert yourself.”

    “It sounds like you’re having a difficult time. Tell me about it.”

    “Let’s not focus on the negative. Tell me something good.”

    “You are still able to get around, and your mind is alert.”

    ANS: B

    15

    Nursing Diagnosis

    The International Classification for Nursing Practice (ICNP) (International Council of Nurses)

    Provides useful nursing diagnoses for older adults

    Acute/chronic pain, impaired low nutrition intake, impaired fluid intake, constipation, and impaired sleep

    Safety needs

    Higher level needs

    Caregiver stress/impaired family process

    Outcomes Identification

    Shared decision making; realistic goals

    [This Photo](http://researchoutreach.org/articles/patient-compliance-modern-medicine/) by Unknown author is licensed under
    [CC BY](https://creativecommons.org/licenses/by/3.0/).

    Some essential safety diagnoses include risk for injury, risk for falls, impaired ability to manage medication regime, victim of older adult abuse, and confusion.

    Higher level needs fall under Maslow’s categories of love and belonging needs, and esteem. Specific (ICNP) nursing diagnoses address those higher-level needs such as loneliness, hopelessness, impaired role performance, chronic low self-esteem, and disturbed personal identity.

    16

    Implementation

    Psychotherapeutic Methods

    Empathetic, active listening to encourage ventilation of feelings & reestablish emotional equilibrium

    Provide health education & alternatives

    Assist in problem solving

    Group counseling to help build relationships and reduce isolation

    Pharmacotherapy skills & psychotherapy

    Treatment Modalities

    Psychological Therapies

    [This Photo](http://hackingchristianity.net/2018/08/who-will-have-power-of-attorney-to-care-for-an-ailing-umc.html) by Unknown author is licensed under
    [CC BY-SA](https://creativecommons.org/licenses/by-sa/3.0/).

    Reminiscence is a cognitive stimulation activity that engages individuals in socialization and rapport building. Assisting to evoke pleasant feelings or memories is an effective method to improve mood, particularly in those with memory impairment.

    17

    Case Study

    Mr. Nixon’s son drives back down the next weekend so they can meet to talk about his options for a more permanent living situation. As part of this process, the son has made an appointment for the two of them to meet with the nurse, who can help them explore their options.

    His son asks, “So what kinds of choices does Dad have at this point?”

    18

    Treatment Settings for Older Adults

    [This Photo](https://blog.ssmgrp.com/blog/what-is-caregiver-role-strain-like-and-how-do-you-defeat-it) by Unknown author is licensed under
    [CC BY-SA](https://creativecommons.org/licenses/by-sa/3.0/).

    19

    Hospital-Based Care

    Partial hospitalization versus Inpatient

    Home-Based Services

    Day care programs

    Home healthcare

    Community support services

    Respite care

    Residential Care

    Assisted living

    Skilled nursing facilities

    Case Study

    Mr. Nixon’s son heads for home again and says, “I’ll be back again next weekend, Dad. Keep thinking about what sounds good to you. You can call me any time.”
    Mr. Nixon feels a little better about his future, but says, “It’s just a lot to think about. The nurse suggests that Mr. Nixon might benefit from group sessions with others who are trying to make similar plans. This may not only aid in decision making but help him to feel less alone in this big next step.

    20

    Quick Quiz

    A community mental health nurse plans an educational program for the staff of a home health agency specializing in care of the elderly. A topic of high priority should be

    identifying clinical depression in older adults.

    identifying nutritional deficiencies in the elderly.

    providing cost-effective foot care for the elderly.

    psychosocial stimulation for those who live alone.

    ANS: A

    21

    Case Study &
    Quick Quiz

    Mr. Nixon needs help with his prescription ordering. Which component of Medicare assists seniors to pay for prescription drugs?

    Part A

    Part B

    Part C

    Part D

    ANS: D

    22

    Quick Quiz

    A family member of a patient with advanced dementia says to the nurse, “I will sign the consent for my mother’s surgery.” What is the nurse’s best response?

    “This should be a family decision. When will your siblings arrive?”

    “Can you please show me the Court order designating you as guardian?”

    “Thank you. Please use a black ballpoint pen to sign.”

    “The patient is able to sign her own consent.”

    ANS: B

    A guardianship is a court-ordered relationship in which one party, the guardian, acts on behalf of an individual, the ward. Many people with mental illness, mental retardation, traumatic brain injuries, and organic brain disorders, such as dementia, have guardians. It is important that health care workers identify patients who have guardians and communicate with the guardians when health care decisions are being made.

    23

    ## image2.jpg

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    ## image4.jpeg

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    ## image6.jpeg

    ## image7.jpeg

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    ## image9.jpeg

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    **Chapter33ForensicNursing12.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter33forensicnursing12-pptx)

    **Chapter32SeriousMentalIllness1.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter32seriousmentalillness1-pptx-10337669)

    **Chapter30DyingDeathandGrieving1.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter30dyingdeathandgrieving1-pptx-10337673)

    **Chapter30DyingDeathandGrieving1.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter30dyingdeathandgrieving1-pptx-10337673)

    **## PsychosocialAssignment.docx**

    Directions:

    Find something that interests you from each of the four chapters (use PowerPoints or textbook). Post a brief share from each chapter that will add to your classmates' understanding, insight, or future nursing practice. Your post should look approximately like this:

    Chapter 30: Here is an experience I've had with [insert topic here]. Followed by a few supporting sentences that illustrate your experience.

    Chapter 31: I was curious about [insert topic here]. I found this short video on YouTube that talks about [very brief summary]. Insert hyperlink here.

    Chapter 32: This is something in my community that I would (or have) recommended as a resource. They do X, Y, Z. Insert hyperlink here.

    Chapter 33: I researched this [insert job description]. Here's what I found about the required education, job opportunities, and potential wages.

    *The examples above are NOT prescriptive and can be used in any order if you choose these prompts. These are just some formats that I think might be interesting. Please choose whatever catches your interest and write up a little something about it for the sake of discussion. You will write one post (4 points) with a few sentences of information about each of the four chapters.

    **## Chapter31OlderAdults1.pptx**

    Chapter 31

    Older Adults

    1

    Objectives

    3

    Identify statistics related to aging in the United States.

    01

    Describe mental health disorders that may occur in older adults.

    02

    Discuss the importance of pain assessment and tools used to assess pain in older adults.

    03

    Explain the negative impact of ageism that is evident in discriminatory labels, public policy, and research.

    04

    Case Study

    Mr. Nixon is being admitted to a short-term care facility because his wife, who had been his only caretaker, has recently died. His son, who lives about 250 miles away, has been staying with him for the past 4 weeks, but has to go home now to go back to work.

    Mr. Nixon has COPD and has trouble getting around because he gets short of breath. He is still grieving, of course, but his son shares that he feels his dad has been depressed over his health “off and on” as well.
    You will be doing an intake assessment with Mr. Nixon.

    4

    Statistics on Aging

    5

    Life expectancy and number of older adults growing

    Common classifications for older adults:

    Young-old: 65 to 74 years

    Middle-old: 75 to 84 years

    Old-old: 85 to 100 years

    Centenarians: 100 to 104 years

    Mental Health and Aging

    6

    Late-life Mental Illness

    Major Depressive Disorder

    Suicide

    Anxiety disorders

    Delirium—secondary to general medical condition

    Neurocognitive disorders

    Alcohol use disorder

    Pain

    Pain

    [This Photo](https://www.aliem.com/2018/06/trigger-point-injection-musculoskeletal-pain/) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    Nonpharmacological treatments for pain include physical therapy, vagal nerve stimulation, exercise, hydrotherapy, heat and cold packs, chiropractic, and transcutaneous electrical nerve stimulation (TENS).

    Yoga, biofeedback, hypnosis, acupuncture, massage, Reiki, guided imagery, reflexology, and therapeutic touch are integrative therapies for managing pain.

    Herbal remedies include cayenne, capsaicin, ginger extract, echinacea, kava, and willow bark.

    7

    Barriers to accurate pain assessment

    Assessment tools

    Wong-Baker FACES Pain Rating Scale

    Pain Assessment in Advanced Dementia (PAINAD) scale

    Pain management

    Pharmacotherapy

    Non-opioids

    Opioids

    Nonpharmacological pain treatments

    Healthcare Concerns
    of Older Adults

    Financial burden

    Medicare Part D for help with medications

    Caregiver burden

    Ageism

    Language

    Public policy

    Research

    [This Photo](http://jobsanger.blogspot.com/2011/06/right-wing-attacks-medicare-in-tv-ads.html) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    8

    Discussion Topic

    Ageism sometimes affects the care of older adult patients. The best way to help prevent this is to do a self-assessment and discuss your feelings and attitudes with others:

    What kinds of feelings, assumptions, or hesitations do you have when you think about working with an older adult?

    9

    Healthcare Decision-Making

    Advance Directives and Portable Medical Orders

    Advance Directives and Portable Medical Orders

    Guardianship

    Court-ordered relationship in which the selected guardian acts on behalf of another individual (the ward)

    The ward must be proven to lack capacity to manage personal and/or financial affairs

    [This Photo](https://betterhealthwhileaging.net/end-of-life-planning-easy-advance-directives-through-prepare/) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    10

    Objectives

    11

    Explain the importance of a comprehensive assessment in older adults.

    1

    Recognize the significance of healthcare costs for older adults.

    2

    Compare the facts and myths about aging.

    3

    Analyze how ageism may affect attitudes and willingness to care for older adults.

    4

    Apply the nursing process to the care of older adults.

    5

    Objectives

    12

    Identify at least four priority nursing diagnoses in the care of older adults.

    1

    Discuss basic nursing interventions in the care of older adults.

    2

    Identify psychological therapies used in the treatment of older adults.

    3

    Identify treatment settings for the care of older adults.

    4

    Application of the Nursing Process

    Assessment

    Private interview space

    Adequate lighting & low-level noise

    Establish rapport & convey warmth

    Physical Assessment

    Medication reconciliation

    Polypharmacy & prescribing cascades

    Mental Status exam

    Older adult drivers

    Older adult abuse

    [This Photo](https://wtcs.pressbooks.pub/nursingfundamentals/chapter/4-3-assessment/) by Unknown author is licensed under
    [CC BY](https://creativecommons.org/licenses/by/3.0/).

    Assessing the use of multiple medications for the same condition (polypharmacy) includes prescription, over-the-counter drugs, and herbal agents. Adverse drug reactions or negative responses to drugs are common among the older adult.

    Prescribing cascades happen when drug-induced symptoms are treated with another drug. The provider may assess the side effect of the first drug as part of the original medical problem or a new one.

    13

    Case Study
    Discussion Question

    You are preparing to interview Mr. Nixon. What are some techniques the nurse could use to help the patient feel more comfortable?

    Conducting the interview in a private area

    Introducing oneself and asking the patient what he or she would like to be called (use of the first name is rarely appropriate unless one is invited to do so)

    Establishing rapport and putting the patient at ease by sitting or standing at the same level as the patient

    Ensuring that lighting is adequate and noise level is low, in recognition of the fact that hearing and vision may be impaired

    Using touch (with permission) to convey warmth, while at the same time respecting the patient's comfort level with personal touch

    Summarizing the interaction, inviting feedback and questions, and thanking the patient for giving his or her time and information

    14

    Quick Quiz

    Mr. Nixon, who has difficulty walking because of shortness of breath secondary to COPD says, “Every day is a struggle when you get old. No one cares about old people.” Select the best response.

    “Rest periods are important. Don’t try to overexert yourself.”

    “It sounds like you’re having a difficult time. Tell me about it.”

    “Let’s not focus on the negative. Tell me something good.”

    “You are still able to get around, and your mind is alert.”

    ANS: B

    15

    Nursing Diagnosis

    The International Classification for Nursing Practice (ICNP) (International Council of Nurses)

    Provides useful nursing diagnoses for older adults

    Acute/chronic pain, impaired low nutrition intake, impaired fluid intake, constipation, and impaired sleep

    Safety needs

    Higher level needs

    Caregiver stress/impaired family process

    Outcomes Identification

    Shared decision making; realistic goals

    [This Photo](http://researchoutreach.org/articles/patient-compliance-modern-medicine/) by Unknown author is licensed under
    [CC BY](https://creativecommons.org/licenses/by/3.0/).

    Some essential safety diagnoses include risk for injury, risk for falls, impaired ability to manage medication regime, victim of older adult abuse, and confusion.

    Higher level needs fall under Maslow’s categories of love and belonging needs, and esteem. Specific (ICNP) nursing diagnoses address those higher-level needs such as loneliness, hopelessness, impaired role performance, chronic low self-esteem, and disturbed personal identity.

    16

    Implementation

    Psychotherapeutic Methods

    Empathetic, active listening to encourage ventilation of feelings & reestablish emotional equilibrium

    Provide health education & alternatives

    Assist in problem solving

    Group counseling to help build relationships and reduce isolation

    Pharmacotherapy skills & psychotherapy

    Treatment Modalities

    Psychological Therapies

    [This Photo](http://hackingchristianity.net/2018/08/who-will-have-power-of-attorney-to-care-for-an-ailing-umc.html) by Unknown author is licensed under
    [CC BY-SA](https://creativecommons.org/licenses/by-sa/3.0/).

    Reminiscence is a cognitive stimulation activity that engages individuals in socialization and rapport building. Assisting to evoke pleasant feelings or memories is an effective method to improve mood, particularly in those with memory impairment.

    17

    Case Study

    Mr. Nixon’s son drives back down the next weekend so they can meet to talk about his options for a more permanent living situation. As part of this process, the son has made an appointment for the two of them to meet with the nurse, who can help them explore their options.

    His son asks, “So what kinds of choices does Dad have at this point?”

    18

    Treatment Settings for Older Adults

    [This Photo](https://blog.ssmgrp.com/blog/what-is-caregiver-role-strain-like-and-how-do-you-defeat-it) by Unknown author is licensed under
    [CC BY-SA](https://creativecommons.org/licenses/by-sa/3.0/).

    19

    Hospital-Based Care

    Partial hospitalization versus Inpatient

    Home-Based Services

    Day care programs

    Home healthcare

    Community support services

    Respite care

    Residential Care

    Assisted living

    Skilled nursing facilities

    Case Study

    Mr. Nixon’s son heads for home again and says, “I’ll be back again next weekend, Dad. Keep thinking about what sounds good to you. You can call me any time.”
    Mr. Nixon feels a little better about his future, but says, “It’s just a lot to think about. The nurse suggests that Mr. Nixon might benefit from group sessions with others who are trying to make similar plans. This may not only aid in decision making but help him to feel less alone in this big next step.

    20

    Quick Quiz

    A community mental health nurse plans an educational program for the staff of a home health agency specializing in care of the elderly. A topic of high priority should be

    identifying clinical depression in older adults.

    identifying nutritional deficiencies in the elderly.

    providing cost-effective foot care for the elderly.

    psychosocial stimulation for those who live alone.

    ANS: A

    21

    Case Study &
    Quick Quiz

    Mr. Nixon needs help with his prescription ordering. Which component of Medicare assists seniors to pay for prescription drugs?

    Part A

    Part B

    Part C

    Part D

    ANS: D

    22

    Quick Quiz

    A family member of a patient with advanced dementia says to the nurse, “I will sign the consent for my mother’s surgery.” What is the nurse’s best response?

    “This should be a family decision. When will your siblings arrive?”

    “Can you please show me the Court order designating you as guardian?”

    “Thank you. Please use a black ballpoint pen to sign.”

    “The patient is able to sign her own consent.”

    ANS: B

    A guardianship is a court-ordered relationship in which one party, the guardian, acts on behalf of an individual, the ward. Many people with mental illness, mental retardation, traumatic brain injuries, and organic brain disorders, such as dementia, have guardians. It is important that health care workers identify patients who have guardians and communicate with the guardians when health care decisions are being made.

    23

    ## image2.jpg

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    **Chapter33ForensicNursing12.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter33forensicnursing12-pptx)

    **Chapter32SeriousMentalIllness1.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter32seriousmentalillness1-pptx-10337669)

    **Chapter30DyingDeathandGrieving1.pptx**

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    **## PsychosocialAssignment.docx**

    Directions:

    Find something that interests you from each of the four chapters (use PowerPoints or textbook). Post a brief share from each chapter that will add to your classmates' understanding, insight, or future nursing practice. Your post should look approximately like this:

    Chapter 30: Here is an experience I've had with [insert topic here]. Followed by a few supporting sentences that illustrate your experience.

    Chapter 31: I was curious about [insert topic here]. I found this short video on YouTube that talks about [very brief summary]. Insert hyperlink here.

    Chapter 32: This is something in my community that I would (or have) recommended as a resource. They do X, Y, Z. Insert hyperlink here.

    Chapter 33: I researched this [insert job description]. Here's what I found about the required education, job opportunities, and potential wages.

    *The examples above are NOT prescriptive and can be used in any order if you choose these prompts. These are just some formats that I think might be interesting. Please choose whatever catches your interest and write up a little something about it for the sake of discussion. You will write one post (4 points) with a few sentences of information about each of the four chapters.

    **## Chapter31OlderAdults1.pptx**

    Chapter 31

    Older Adults

    1

    Objectives

    3

    Identify statistics related to aging in the United States.

    01

    Describe mental health disorders that may occur in older adults.

    02

    Discuss the importance of pain assessment and tools used to assess pain in older adults.

    03

    Explain the negative impact of ageism that is evident in discriminatory labels, public policy, and research.

    04

    Case Study

    Mr. Nixon is being admitted to a short-term care facility because his wife, who had been his only caretaker, has recently died. His son, who lives about 250 miles away, has been staying with him for the past 4 weeks, but has to go home now to go back to work.

    Mr. Nixon has COPD and has trouble getting around because he gets short of breath. He is still grieving, of course, but his son shares that he feels his dad has been depressed over his health “off and on” as well.
    You will be doing an intake assessment with Mr. Nixon.

    4

    Statistics on Aging

    5

    Life expectancy and number of older adults growing

    Common classifications for older adults:

    Young-old: 65 to 74 years

    Middle-old: 75 to 84 years

    Old-old: 85 to 100 years

    Centenarians: 100 to 104 years

    Mental Health and Aging

    6

    Late-life Mental Illness

    Major Depressive Disorder

    Suicide

    Anxiety disorders

    Delirium—secondary to general medical condition

    Neurocognitive disorders

    Alcohol use disorder

    Pain

    Pain

    [This Photo](https://www.aliem.com/2018/06/trigger-point-injection-musculoskeletal-pain/) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    Nonpharmacological treatments for pain include physical therapy, vagal nerve stimulation, exercise, hydrotherapy, heat and cold packs, chiropractic, and transcutaneous electrical nerve stimulation (TENS).

    Yoga, biofeedback, hypnosis, acupuncture, massage, Reiki, guided imagery, reflexology, and therapeutic touch are integrative therapies for managing pain.

    Herbal remedies include cayenne, capsaicin, ginger extract, echinacea, kava, and willow bark.

    7

    Barriers to accurate pain assessment

    Assessment tools

    Wong-Baker FACES Pain Rating Scale

    Pain Assessment in Advanced Dementia (PAINAD) scale

    Pain management

    Pharmacotherapy

    Non-opioids

    Opioids

    Nonpharmacological pain treatments

    Healthcare Concerns
    of Older Adults

    Financial burden

    Medicare Part D for help with medications

    Caregiver burden

    Ageism

    Language

    Public policy

    Research

    [This Photo](http://jobsanger.blogspot.com/2011/06/right-wing-attacks-medicare-in-tv-ads.html) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    8

    Discussion Topic

    Ageism sometimes affects the care of older adult patients. The best way to help prevent this is to do a self-assessment and discuss your feelings and attitudes with others:

    What kinds of feelings, assumptions, or hesitations do you have when you think about working with an older adult?

    9

    Healthcare Decision-Making

    Advance Directives and Portable Medical Orders

    Advance Directives and Portable Medical Orders

    Guardianship

    Court-ordered relationship in which the selected guardian acts on behalf of another individual (the ward)

    The ward must be proven to lack capacity to manage personal and/or financial affairs

    [This Photo](https://betterhealthwhileaging.net/end-of-life-planning-easy-advance-directives-through-prepare/) by Unknown author is licensed under
    [CC BY-NC-ND](https://creativecommons.org/licenses/by-nc-nd/3.0/).

    10

    Objectives

    11

    Explain the importance of a comprehensive assessment in older adults.

    1

    Recognize the significance of healthcare costs for older adults.

    2

    Compare the facts and myths about aging.

    3

    Analyze how ageism may affect attitudes and willingness to care for older adults.

    4

    Apply the nursing process to the care of older adults.

    5

    Objectives

    12

    Identify at least four priority nursing diagnoses in the care of older adults.

    1

    Discuss basic nursing interventions in the care of older adults.

    2

    Identify psychological therapies used in the treatment of older adults.

    3

    Identify treatment settings for the care of older adults.

    4

    Application of the Nursing Process

    Assessment

    Private interview space

    Adequate lighting & low-level noise

    Establish rapport & convey warmth

    Physical Assessment

    Medication reconciliation

    Polypharmacy & prescribing cascades

    Mental Status exam

    Older adult drivers

    Older adult abuse

    [This Photo](https://wtcs.pressbooks.pub/nursingfundamentals/chapter/4-3-assessment/) by Unknown author is licensed under
    [CC BY](https://creativecommons.org/licenses/by/3.0/).

    Assessing the use of multiple medications for the same condition (polypharmacy) includes prescription, over-the-counter drugs, and herbal agents. Adverse drug reactions or negative responses to drugs are common among the older adult.

    Prescribing cascades happen when drug-induced symptoms are treated with another drug. The provider may assess the side effect of the first drug as part of the original medical problem or a new one.

    13

    Case Study
    Discussion Question

    You are preparing to interview Mr. Nixon. What are some techniques the nurse could use to help the patient feel more comfortable?

    Conducting the interview in a private area

    Introducing oneself and asking the patient what he or she would like to be called (use of the first name is rarely appropriate unless one is invited to do so)

    Establishing rapport and putting the patient at ease by sitting or standing at the same level as the patient

    Ensuring that lighting is adequate and noise level is low, in recognition of the fact that hearing and vision may be impaired

    Using touch (with permission) to convey warmth, while at the same time respecting the patient's comfort level with personal touch

    Summarizing the interaction, inviting feedback and questions, and thanking the patient for giving his or her time and information

    14

    Quick Quiz

    Mr. Nixon, who has difficulty walking because of shortness of breath secondary to COPD says, “Every day is a struggle when you get old. No one cares about old people.” Select the best response.

    “Rest periods are important. Don’t try to overexert yourself.”

    “It sounds like you’re having a difficult time. Tell me about it.”

    “Let’s not focus on the negative. Tell me something good.”

    “You are still able to get around, and your mind is alert.”

    ANS: B

    15

    Nursing Diagnosis

    The International Classification for Nursing Practice (ICNP) (International Council of Nurses)

    Provides useful nursing diagnoses for older adults

    Acute/chronic pain, impaired low nutrition intake, impaired fluid intake, constipation, and impaired sleep

    Safety needs

    Higher level needs

    Caregiver stress/impaired family process

    Outcomes Identification

    Shared decision making; realistic goals

    [This Photo](http://researchoutreach.org/articles/patient-compliance-modern-medicine/) by Unknown author is licensed under
    [CC BY](https://creativecommons.org/licenses/by/3.0/).

    Some essential safety diagnoses include risk for injury, risk for falls, impaired ability to manage medication regime, victim of older adult abuse, and confusion.

    Higher level needs fall under Maslow’s categories of love and belonging needs, and esteem. Specific (ICNP) nursing diagnoses address those higher-level needs such as loneliness, hopelessness, impaired role performance, chronic low self-esteem, and disturbed personal identity.

    16

    Implementation

    Psychotherapeutic Methods

    Empathetic, active listening to encourage ventilation of feelings & reestablish emotional equilibrium

    Provide health education & alternatives

    Assist in problem solving

    Group counseling to help build relationships and reduce isolation

    Pharmacotherapy skills & psychotherapy

    Treatment Modalities

    Psychological Therapies

    [This Photo](http://hackingchristianity.net/2018/08/who-will-have-power-of-attorney-to-care-for-an-ailing-umc.html) by Unknown author is licensed under
    [CC BY-SA](https://creativecommons.org/licenses/by-sa/3.0/).

    Reminiscence is a cognitive stimulation activity that engages individuals in socialization and rapport building. Assisting to evoke pleasant feelings or memories is an effective method to improve mood, particularly in those with memory impairment.

    17

    Case Study

    Mr. Nixon’s son drives back down the next weekend so they can meet to talk about his options for a more permanent living situation. As part of this process, the son has made an appointment for the two of them to meet with the nurse, who can help them explore their options.

    His son asks, “So what kinds of choices does Dad have at this point?”

    18

    Treatment Settings for Older Adults

    [This Photo](https://blog.ssmgrp.com/blog/what-is-caregiver-role-strain-like-and-how-do-you-defeat-it) by Unknown author is licensed under
    [CC BY-SA](https://creativecommons.org/licenses/by-sa/3.0/).

    19

    Hospital-Based Care

    Partial hospitalization versus Inpatient

    Home-Based Services

    Day care programs

    Home healthcare

    Community support services

    Respite care

    Residential Care

    Assisted living

    Skilled nursing facilities

    Case Study

    Mr. Nixon’s son heads for home again and says, “I’ll be back again next weekend, Dad. Keep thinking about what sounds good to you. You can call me any time.”
    Mr. Nixon feels a little better about his future, but says, “It’s just a lot to think about. The nurse suggests that Mr. Nixon might benefit from group sessions with others who are trying to make similar plans. This may not only aid in decision making but help him to feel less alone in this big next step.

    20

    Quick Quiz

    A community mental health nurse plans an educational program for the staff of a home health agency specializing in care of the elderly. A topic of high priority should be

    identifying clinical depression in older adults.

    identifying nutritional deficiencies in the elderly.

    providing cost-effective foot care for the elderly.

    psychosocial stimulation for those who live alone.

    ANS: A

    21

    Case Study &
    Quick Quiz

    Mr. Nixon needs help with his prescription ordering. Which component of Medicare assists seniors to pay for prescription drugs?

    Part A

    Part B

    Part C

    Part D

    ANS: D

    22

    Quick Quiz

    A family member of a patient with advanced dementia says to the nurse, “I will sign the consent for my mother’s surgery.” What is the nurse’s best response?

    “This should be a family decision. When will your siblings arrive?”

    “Can you please show me the Court order designating you as guardian?”

    “Thank you. Please use a black ballpoint pen to sign.”

    “The patient is able to sign her own consent.”

    ANS: B

    A guardianship is a court-ordered relationship in which one party, the guardian, acts on behalf of an individual, the ward. Many people with mental illness, mental retardation, traumatic brain injuries, and organic brain disorders, such as dementia, have guardians. It is important that health care workers identify patients who have guardians and communicate with the guardians when health care decisions are being made.

    23

    ## image2.jpg

    ## image3.png

    ## image4.jpeg

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    ## image6.jpeg

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    ## image1.jpg

    **Chapter33ForensicNursing12.pptx**

    This file is too large to display. [View in new window](https://www.sweetstudy.com/files/chapter33forensicnursing12-pptx)

    **Chapter32SeriousMentalIllness1.pptx**

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    **Chapter30DyingDeathandGrieving1.pptx**

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