Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

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Case Study: Mrs. J.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mrs. J., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.
Subjective Data
Is very anxious and asks whether she is going to die.
Denies pain but says she feels like she cannot get enough air.
Says her heart feels like it is “running away.”
Reports that she is exhausted and cannot eat or drink by herself.
Objective Data
Height 175 cm; Weight 95.5kg.
Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention
The following medications administered through drug therapy control her symptoms:
IV furosemide (Lasix)
Enalapril (Vasotec)
Metoprolol (Lopressor)
IV morphine sulphate (Morphine)
Inhaled short-acting bronchodilator (ProAir HFA)
Inhaled corticosteroid (Flovent HFA)
Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:
Describe the clinical manifestations present in Mrs. J.
Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

. Do we know whether the resident is capable to make his own health care decisions?

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Mr. Parker is an 88-year-old resident of your LTC home with end-stage Alzheimer’s. He is wheelchair-bound and spends most of his days sleeping in his wheelchair near a window facing the garden. He needs to be spoon-fed but has recently started to refuse to eat. Mr. Parker has three children, one of whom – his only daughter — is very involved in the care of her father. The team approaches the daughter about her father refusing to eat and feels that his refusal is legitimate. Thus, they propose changing the plan of care to palliation. The daughter absolutely refuses, claiming that “you cannot kill my father, I want everything done to keep him living!”

The director of nursing (DON) for the facility has turned to you, as the executive director, for guidance, asking these questions.

a. Do we know whether the resident is capable to make his own health care decisions?

b. Are there any known wishes from Mr. Parker? What would he want? What are his values?

c. Is his daughter the substitute decision-maker? Can she, in this role, demand treatment and expect that you comply?

Because of the potential legal and reputational liability, the corporate counsel has recommended you respond to the DON in writing. Prepare a 4-10 page writing, double spaced addressing the DON and daughter’s issues. Cite relevant academic sources.

Develop strategies to lead project planning, implementation, management, and evaluation to promote high value healthcare

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CO1: Examine the role of the DNP-prepared nurse in leading financial planning and management across healthcare settings (PO 2, 4, 9).

CO2: Formulate a needs-based organizational assessment to inform strategic leadership decision-making (PO 3, 5, 7).

CO3: Develop strategies to lead project planning, implementation, management, and evaluation to promote high value healthcare (PO 3, 5, 7).

What do you think the professional role of a nurse is when it comes to addressing equity in health care?

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In the US and around the world there are increasing concerns about inequity and a lack of fairness for many members in our society. What do you think the professional role of a nurse is when it comes to addressing equity in health care?

– discuss minority disparities

Identify perceived health care deficits for the population of Vietnam.

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Goal:

The goal of the Field Period is to learn about population health in Vietnam via research and cultural immersion experience, and to provide culturally competent service in Vietnam via daily direct interaction with members of the local population.

Student’s Personal Goal: My goal is to provide myself with a full diverse cultural experience while gaining the knowledge of Vietnam’s history and current state. I hope to gain a different perspective and knowledge of the Vietnamese culture as a whole.

Learning Objectives:

  1. Gain an overview of Vietnam, including culture, history, language, geography, climate, housing, socioeconomic concerns.
  2. Understand current systems and facilities for delivery of health care in the Vietnam
  3. Understand the education and role of the professional nurse within the health care system of Vietnam
  4. Assess community resources and deficits.
  5. Identify perceived health care deficits for the population of Vietnam.
  6. Provide culturally sensitive service to select members of the Vietnamese population.
  7. Practice and develop leadership skills within the context of a cultural immersion experience in a developing country.

Learning Activities:

  1. Research the culture and history of Vietnam including health care beliefs and practices.
  2. Research possible health risks for travelers to Vietnam.
  3. Prepare for oral communication using the Vietnamese language with an interpreter.
  4. Research and explain health care resources at the local and national level.
  5. Visit health care facilities serving the population of DaNang, Vietnam.
  6. Visit and observe at local health care facility and orphanage in DaNang, Vietnam.
  7. Visit local families in their homes and assess health care issues and needs.
  8. Visit local families in their homes and learn about long term impact of war on their health.
  9. Visit the local elementary school and interact with local children in the school setting.
  10. Participate in daily discussion group with Field Period supervisor and colleagues regarding cultural immersion experience.
  11. Collaborate with colleagues to prepare written summary of findings.
  12. Maintain a Reflective Journal throughout the Field Period.

Dates: January 1 through January 17, 2020

 

Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.

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Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment, making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening ones. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors.
One method that supports the clinical decision making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment.
To Prepare
• Reflect on drugs used to treat asthmatic patients, including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients, including adults and children.
• Consider how you might apply the stepwise approach to address the health needs of a patient in your practice.
• Reflect on how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

Create a 5- to 6-slide PowerPoint presentation that can be used in a staff development meeting on presenting different approaches for implementing the stepwise approach for asthma treatment. Be sure to address the following:
• Describe long-term control and quick relief treatment options for the asthma patient from your practice as well as the impact these drugs might have on your patient.
• Explain the stepwise approach to asthma treatment and management for your patient.
• Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Be specific.

During Week 3, the Respiratory System will be covered. In the United States, 12 million people suffer from chronic obstructive pulmonary disease (COPD) and about 25 million people suffer from asthma. Since various symptoms are associated with COPD, asthma and other common respiratory disorders, a single patient might be prescribed multiple drugs for treatment. Consider a pediatric asthmatic patient who frequently presents with acute asthma exacerbations that are triggered by seasonal allergies. As a result of her disorder, she might be prescribed albuterol to treat asthma attacks and loratidine to treat allergic reactions. This requires you, as the APN, to be aware of risks of polypharmacy and patient factors that impact the effects of drugs.

Describeyour experience of using or observing the use of health information system in your clinical placement

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College of Science, Health and Engineering School of Nursing and MidwiferyNSG3EPN Engagement in Professional Nursing Assessment 2Due: Tuesday 22nd September 0900hrs (9am)Percentage: 40%Word count: 2000 word (±10%) excluding in-text citations & reference list This assignment is divided into 3 parts:

1.Reflect on how organisational structure and organisational culturecan affect the safety of person-centred care delivery. (SILO3)

2.Reflect on the skills related tohealth information systems. (SILO5)

3.Develop awareness of the transition from students to registered nurses through critical self-reflection. (SILO6)You will be required to reflect upon your own clinical experience to date and to search for evidence from the literature to address questions regarding contemporary professional practice. This reflection follows the underlying principles of Gibbs’ reflective cycle (1988) on description, analysis and action. You do not need to explain or follow the specific questions of the Gibb’s cycle in yourwork.As this is reflective writing, it is appropriate to use a first-person writing style. However, you should support your opinion and arguments with current(unless it is seminal work)and peer reviewed evidence from the literature, especially in the analysis section.Please submit your completed assessments through the Turnitin portal in Word format.SILO 3 Organizational structure and culture (650 words)✓Rationale: As a graduate nurse, you may not always feel comfortable speaking up when there is a safety concern. It is important to reflect on systemic and personal factors that promote safetyculture.oDescribe a time in your clinical placement as a student nurse where there was a safety concern. How was this dealt with? Were you or other nurses able to speak up forsafety?[150 words]oAnalyse what kind of organisational culture makes it possible for you to speak up? What kinds of structure or systems exist in a workplace that makes it possible for you to speak up? E.g. Melbourne Health’s Safety Culture Program, Mildura Based Hospital’s ‘Speaking up for safety’ (can be foundin assessment resources folder).[300 words]oReflect on what role you have as a graduate nurse in speaking up to promote a safety culture? (action)[200 words]

SILO 5 Health Informatics (650 words)✓Rationale:The integration of informatics skills into nursing practice is fundamental for nurses at all levels and specialty in the contemporary health care system. It is importantfor graduate nurses to bea skilled, capable and ethicaluserof technology,in orderto deliver safe and effective care. oDescribeyour experience of using or observing the use of health information system in your clinical placement (e.g. patient browser, patient flow system, Electronic Medical Record [EMR] or other clinical documentation or storage system).[100 words]

oAnalyseone enabler orbarrier from your clinical experience that influences the effectiveuse of health informatics systemsin the nursingenvironment. Use literature to support your discussion. [350 words]

oReflecton what role you have as a graduate nurse in the ethical use ofhealth information systems? (action)[200 words]SILO 6 Transition to practice (700 words)✓Rationale: Working as a nurse comes with various challenges. Challenges can come from internal and external elements. While challenges are not necessarily negative, it is important for you to develop professional resilience to be able to have a sustainable and fulfilling nursingcareer.

oAnalyse one or twochallengesreported in literature that graduatenurses face in their transition into the professional workplace.[300 words]

oIdentify andReflect ontwo positive workplace behaviours or attitudes and two self-care strategies that you will employ to maintain your mentaland physical well-being in your new role as a registered nurse.(action)

Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values.

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When seeking to identify a patient’s health condition, advanced practice nurses can use a diverse selection of diagnostic tests and assessment tools; however, different factors affect the validity and reliability of the results produced by these tests or tools. Nurses must be aware of these factors in order to select the most appropriate test or tool and to accurately interpret the results.
Not only do these diagnostic tests affect adults, body measurements can provide a general picture of whether a child is receiving adequate nutrition or is at risk for health issues. These data, however, are just one aspect to be considered. Lifestyle, family history, and culture—among other factors—are also relevant. That said, gathering and communicating this information can be a delicate process.

For this Assignment, you will consider the validity and reliability of different assessment tools and diagnostic tests. You will explore issues such as sensitivity, specificity, and positive and negative predictive values. You will also consider examples of children with various weight issues. You will explore how you could effectively gather information and encourage parents and caregivers to be proactive about their children’s health and weight.
To Prepare
• Review this week’s Learning Resources and consider factors that impact the validity and reliability of various assessment tools and diagnostic tests. You also will review examples of pediatric patients and their families as it relates to BMI.
• By Day 1 of this week, you will be assigned to one of the following Assignment options by your Instructor: Adult Assessment Tools or Diagnostic Tests

Option 1 – Mammogram

• Search the Walden Library and credible sources for resources explaining the tool or test you were assigned. What is its purpose, how is it conducted, and what information does it gather?
• Also, as you search the Walden library and credible sources, consider what the literature discusses regarding the validity, reliability, sensitivity, specificity, predictive values, ethical dilemmas, and controversies related to the test or tool.

• The Assignment
Assignment (3–4 pages, not including title and reference pages):
Assignment Option 1: Adult Assessment Tools or Diagnostic Tests:
Include the following:
• A description of how the assessment tool or diagnostic test you were assigned is used in healthcare.
o What is its purpose?
o How is it conducted?
o What information does it gather?
• Based on your research, evaluate the test or the tool’s validity and reliability, and explain any issues with sensitivity, reliability, and predictive values. Include references in appropriate APA formatting.

What is a nursing diagnosis and how does the North American Nursing Diagnosis Association (NANDA) relate to forming a nursing diagnosis

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TOPIC: Dorothea Orem- Self Care theory
1. Summarizes nursing theory in own words.
2. How does your theorist view the individual in care and support with literature.
3. How does your theorist view nursing care and support with literature.
4. How can the theory be demonstrated in nursing practice? Provide 3 examples.
5. What is a nursing diagnosis and how does the North American Nursing Diagnosis Association (NANDA) relate to forming a nursing diagnosis
6. Write a complete nursing diagnosis and explain how it relates to your chosen theorist
*Minimum of 5 different sources are used
*Resources are referenced in correct APA format 7th edition
Thank you so much.

How do you feel about the use of life-sustaining measures in the face of terminal illness?

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Life-Sustaining Measures
Ticket to class:
The threaded discussions will provide the student with the opportunity to explore different topics, share what he/she is learning with classmates, and gain clarity about the content. This assignment reflects student-centered, independent learning.

The students will:
• Apply critical thinking through participation of selected topics
• Engage in thoughtful discourse with peers
• Incorporate topic discussion into clinical judgment and decision making within practice setting
Guidelines:
• For each posted discussion question, the student is expected to:
• Post an answer to the discussion question at least 24 hours before the discussion due date
• The original posts must be at least 200 words in length (100+ words for each question)
• Discussion responses should demonstrate critical thinking skills and be thoughtful and respectful
• Post two responses to the original posts of any other classmates (50+ words for each response)
• Posting should ask for clarification, challenge (respectfully) ideas, or describe a situation that illustrates the points being made. Simply agreeing or disagreeing with a post is not adequate
• Worth 15 points / 5%

Threaded Discussion:
1. How do you feel about the use of life-sustaining measures in the face of terminal illness? Examples: Permanent coma? Irreversible chronic illness, such as Alzheimer’s disease? Debilitating Stroke?
2. How do you feel about particular medical procedures? Examples: mechanical breathing (respirator), cardiopulmonary resuscitation (CPR), artificial nutrition and hydration, hospital intensive care, pain relief medication, chemo or radiation therapy, and surgery.

NOTE: Please it is discussion board and the paper are not complete without two responses. So, you will write and give me initial post I will post and get my two classmates write-up for you to read and respond to them, respectively.
Thank you.