characteristics of fecal matter from a colonoscopy and an ileostomy

Fundamentals Of Nursing Clinical

1.  Explain the characteristics of fecal matter from a colonoscopy and an ileostomy.

2.  When performing ostomy care the nurse knows that the device should be changed based on what factor?

3.  When giving a large volume enema the nurse knows that instilling the solution is done through gravity.  Explain the procedure.

4.  Changing a wound dressing the main goal is to prevent what?

5.  Collecting a wound culture requires that the nurse does what?

6.  Your patient is discharged home with a Jackson-Pratt drain.  The drain is emptied when and how often and what is noted about the characteristics of the drainage?

7.  What are the steps in wound irrigation?

8.  What are the signs of proper tube placement and appropriate absorption of tube feeding?

9.  After bolus tube feeding the nurse should follow with how much water and what position should the patient be in when he/she is done, and why?

10.  When doing tube feedings the nurse knows that the feeding tube is in the abdomen, when he/she hears what sound or aspirates content. What range is the PH in for gastric content?

11.  The nurse needs to prepare a diet that will promote wound healing and tissue repair. What types of food would be on it?

12.  When calculating urinary output the nurse knows that the intake should equal the output and that he/she should provide what items for urine collection?

13.  If a patient is on 24 hour urine collection, when does it start and when does it stop? How is the urine stored? When does urine go to the lab?

14.  If a patient is on 24 hour urine collection, when does it start and when does it stop? How is the urine stored? When does urine go to the lab?

15.  When inserting an indwelling Foley catheter, the nurse uses strict sterile technique. Under what conditions would a nurse stop the procedure and start
over?

16.  What safety measures should the nurse employ prior to moving, transferring, or assisting a patient from the bed?

17.  A patient that is confined to bed should be turned. How often and what other measures should you use to prevent pressure injuries?

18.  To move a patient up in bed what is it that the nurse does to prevent injuries to her and others?

19.  To shave a patient you should check this chart for the use of what medications and why?

20.  Oral care for a dependent person is not the same as for an independent person. What are the deferences and similarities?

21.  When would you give a full bed bath to your patient?

22.  How would you identify the stages of pressure injuries?

23.  What are observable signs and symptoms of infection?

24.  Conduct a physical assessment in a systematic manner.

25.  What is the order in which you would auscultate a patients abdomen?

26.  What is the order for abdominal assessment?

27.  Hair, skin, and nails are observed by the nurse to assist in determining a persons overall health status. What signs and symptoms would you observe if these things were not healthy?

28.  Describe the sequence and give the rationale for putting on and taking off PPE.

29.  State the conditions when a sterile field will no longer be sterile.

30.  Compare and contrast factors that increase or decrease body temperature, pulse, respiration, and blood pressure.

31.  Before a patient can go to surgery the nursery is responsible for patient teaching. What things will you teach your patient prior to surgery?

32.  When applying a mummy restraint who does it best serve and why?

33.  What are the advantages or disadvantages of using a safety waist restraints?

34.  When should you place a patient in restraints and what are the rules for use of physical restraints (i.e. documentation, time, and site for tying).

35.  What things appear on a fall prevention list?

36.  When a patient is confined to bed what type of aids can help with circulation?

37.  When suctioning a tracheostomy tube, the patient is observed or assessed for what signs and symptoms?

38.  A patient needs to be taught how to use an incentive spirometer.  What information would you provide?

39.  When is a nasal gastric tube used?

40.  Conduct a physical assessment in a systematic manner. (Head-to-toe)

Note: The questions must be completed no less than 75 words each.

QUANTITATIVE Research

QUANTITATIVE Research

Discussion Question:

Outline the following steps for conducting QUANTITATIVE Research:

Describe the Research Problem and Questions
Describe the Review of Literature
Explain the design
Outline the sample selection
350 words
Outline the following steps for conducting QUANTITATIVE Research:

Describe the Research Problem and Questions
Describe the Review of Literature
Explain the design
Outline the sample selection
350 words

Infectious Disease And Cancer

Infectious Disease And Cancer

1. How is the Gram stain used to classify bacteria? How do antibiotics inhibit the growth of bacteria? Explain how carriers play an important role in the transmission of pathogens. Jan acquired a MRSA infection during a stay at a rehabilitation facility. Jan’s physician tells her that her MRSA was caused by S. aureus. How would you explain to Jan what S. aureus is and how it can cause diseases?

2. Lou had abdominal surgery. During his stay at the hospital a catheter was inserted into his bladder. After returning home Lou was diagnosed with a nosocomial infection. What are the principle routes of transmission of nosocomial infections? What can be done to prevent nosocomial infections? What are three reasons why rates of nosocomial infections are markedly higher in developing countries? What are five things that increase the risk of nosocomial infection?

3. What is the difference between a neoplasm, benign tumor, and malignant tumor? Identify four chronic infections that may cause cancer, and what cancer the infection might cause. Mr. Brown age 63 and Mrs. Brown age 61, are being seen in for a routine check-up. What cancer screenings should Mr. and Mrs. Brown receive (name at least 3 and why)?

4. In Western societies, why is colorectal cancer the most common cancer, but yet there has been a decline in the incidence and mortality of cervical cancer over the last 40 years? Identify and discuss four nonspecific warning signs of cancer and which cancer the warning sign is linked to. Aaron is a 28-year-old who had an EBV infection during high school. He noticed one of his lymph nodes in his neck is swollen but is not painful. He is also experiencing night sweats. What is a possible diagnosis? Give some possible treatments for this diagnosis?

Drug Use In Pediatrics

Off-Label Drug Use In Pediatrics

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of the safety implications of the off-label use of drugs with this patient group.

To Prepare
Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
Reflect on situations in which children should be prescribed drugs for off-label use.
Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics

THE QUESTION

Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics.

Concepts Of Health

6 Concepts Of Health

APA FORMAT 2 PAGES & 3-4 REFERENCES

In this assignment, you will explore the six concepts of health (physical, intellectual, emotional, professional, social, and spiritual) in a formal APA-formatted assignment. First-person is acceptable for this assignment.

For each of the six concepts, you are asked to include:

  1. A description of the concept (DESCRIBE EACH ONE!)
  2. How important you consider the component to be in your daily life (i.e., percentage totaling 100 for all six concepts) (NOTE: There is no right or wrong answer here; this is your opinion.)
  3. Describe a minimum of two ways you currently use to maintain (or plan to use to improve) this type of health. (Describe a minimum of two ways you currently use to maintain or plan to use to improve your top rated aspect of health. Two or more methods for maintaining or improving the top rated health concept were fully described. )
  4. As a leader, how do you plan to instill the importance of self-care in those you lead? Explain.  (A thoughtful and well developed discussion of prospective plans with specific examples are provided.)
  5. What are the signs that a nurse isn’t properly caring for themself? (Five or more signs are described including the concept(s) of health they relate to.)
  6. How would you approach that person and assist?  (Clear and well developed description of at least one plan of action for addressing a person exhibiting at least one of the signs previously addressed with specific examples or action steps. )
  7. How can you make health (including all concepts) a part of the organizational culture? (At least two ways to incorporate the six concepts of health into the organizational culture within an institution are addressed from a management perspective. )

Identifying A Framework

Identifying A Framework

Discussion Prompt

In the lecture for the week, a theory was identified. “Knowledge as a component of the socio-cultural orientation basic conditioning factor enhances the prevention of hazards” is a theory from a major nursing framework. Identify the framework and provide an example of how other applications of this theory may occur in nursing practice. For example, you may say that education may enhance the reduction of free-throw rugs in an elderly person’s home which will prevent falls. Tie the concepts together by clearly defining them and how they could be measured. Find an instrument, survey, or tool in the literature that could be used to measure the concept. For example, if you are measuring pain, you might use the Faces Pain Scale-Revised, at the following link: https://www.iasp-pain.org/Education/Content.aspx?ItemNumber=1519

Expectations

Initial Post:

APA format with intext citations

Word count minimum of 250

References: 2 high-level scholarly references within the last 5 years in APA format.

Plagiarism free.

Turnitin receipt.

Capstone Project Change Proposal Plan

Capstone Project Change Proposal Plan

Topic 9 DQ 1

One of my strengths regarding professional presentations is organization and thourough research. One way that I can continue to build this strength is to prepare ahead of time and avoid procrastination. This will allow plenty of time to edit and re-edit in order to be even more organized. One of my weaknesses regarding professional presentations is being able to get my entire thought presented in a way that is not confusing. One way that I can work on this includes preparation and running through the presentation before hand and either recording it and watching it back or in front of colleagues to obtain construtive criticism that I can apply to the presentation to make changes that will enhance the delivery (Swathi, 2015). Being able to present professionally is essential for projects such as our capstone project for this class.

The focus of my change proposal focuses on improving nursing work satisfaction to improve patient outcomes. There is much to be said on this topic, however, a challenge will be elaborating on key points without losing focus. “Communication gaps and dissatisfaction often described in terms of contradictory instructions, lack of clarity on self-care expectations, uncertainty” (Wheatley et al., 2017) are one of the problems I need to avoid.

Discuss one personal strength and one weakness you have regarding professional presentations. Name one method for improvement for each of these and discuss why it is important for you to work on these skills if you want to present your findings in a more formal setting.

 

Using 200-300 words APA format with at least two references. Sources must be published within the last 5 years. There should be a mix between research and your reflections. Add critical thinking in the posts along with research. Apply the material in a substantial way.

Hospice Social Work

Discussion 1: Hospice Social Work

Hospice is a concept of care that does not accelerate death or prolong life. It provides support and comfort to patients and caregivers in the face of a terminal illness that is no longer responding to standard medical treatment. Hospice services are delivered by a specialized team of health care professionals to provide comfort and dignity to patients in their last days of life. Social workers are an integral part of any hospice team. The burden of working with individuals at the end of life can be significant for members of a hospice team who are confronted with death on a daily basis. Hospice social workers in particular must be mindful of issues of secondary trauma and self-care.

To prepare for this Discussion:

Review this week’s resources. Consider hospice care at the end of life and the different programs providing hospice service. Examine the quality of each program. Think about the emotional burden experienced by a hospice social worker.

Post an explanation of the importance of an interdisciplinary team in end-of-life care.
Briefly describe different programs providing hospice care with regard to team structure and scope of services.
Compare the roles of a social worker on a hospice team in a hospital-based program and in a home hospice program.
Explain your feelings about the emotionally intense work of hospice care.
Finally, explain the strategies you might consider to cope with your emotions.

Be sure to support your postings and responses with specific references to the resources and the current literature using appropriate APA format and style.

Writing assessment

Writing Help

Write a 5-page analysis of your care setting that supports the development of a strategic plan and includes both the discovery and dream phases of an appreciative inquiry (AI) project and a strengths, weaknesses, opportunities, and threats (SWOT) analysis of the care setting.

Introduction

Identifying analysis techniques for assessing competitive advantage is important for building health care strategy. Sustaining health care competitive advantage requires that leaders understand environmental demands to assist with minimizing weakness and threats from the external environment. This assessment provides you with an opportunity to examine your health care environment to determine whether what is being accomplished in your organization, department, team, community project, or other care setting is making a positive difference.

Note: You will use the results of this analysis to develop a strategic plan in Assessment 2.

Preparation

You have been asked to conduct an analysis of your care setting that will result in two potential pathways toward a strategic plan to improve health care quality and safety in your organization, department, team, community project, or other care settings. To accomplish this, you will take two approaches to the analysis:

1. Complete the discovery and dream phases of an appreciative inquiry (AI) project.

2. Conduct a strengths, weaknesses, opportunities, and threats (SWOT) analysis.

To help ensure that your analysis is well-received, the requester has suggested that you:

· Present your analysis results in four parts:

. Part 1: Appreciative Inquiry Discovery and Dream.

. Part 2: SWOT Analysis.

. Part 3: Comparison of Approaches.

. Part 4: Analysis of Relevant Leadership Characteristics and Skills.

· Your analysis should be 5-pages in length. APA format, 3-5 scholarly source

 

Part 1: Appreciative Inquiry Discovery and Dream

· Synthesize stories and evidence about times when a care setting performed at its best with regard to quality and safety goals.

. Collect stories from your care setting. You may collect stories through interviews or conversations with colleagues or provide your own.

. Explain how your stories are related to quality and safety goals.

. Describe the evidence you have that substantiates your stories.

. Identify the positive themes reflected in your stories.

. Describe other evidence (for example data, awards, accreditations) that validates your care setting’s positive core.

· Propose positive, yet attainable, quality and safety improvement goals for your care setting.

. Explain how accomplishing these goals will lead to ethical and culturally sensitive improvements in quality and safety.

. Explain how your proposed goals align with your care setting’s mission, vision, and values.

Part 2: SWOT Analysis

· Conduct a SWOT analysis of your care setting, with respect to quality and safety goals.

. Provide a narrative description of your analysis.

. Identify the assessment tool you used as the basis of your analysis.

. Describe your key findings and their relationships to quality and safety goals.

· Describe one area of concern that you identified in your SWOT analysis—relevant to your care setting’s mission, vision, and values—for which you would propose pursuing improvements.

. Explain how this area of concern relates to your care setting’s mission, vision, and values.

. Explain why you believe it will be necessary and valuable to pursue improvements related to this area of concern.

Part 3: Comparison of Approaches

Compare the AI and SWOT approaches to analysis and reflect on the results.

· Describe your mindset when examining your care setting from an AI perspective and from a SWOT perspective.

· Describe the types of data and evidence you searched for when taking an AI approach and a SWOT approach.

· Describe the similarities and differences between the two approaches when communicating and interacting with colleagues.

Part 4: Analysis of Relevant Leadership Characteristics and Skills

Analyze the leadership characteristics and skills most desired in the person leading potential performance improvement projects, taking both an AI and SWOT approach.

· Explain how these characteristics and skills would help a leader facilitate a successful AI-based project and a successful SWOT-based project.

· Comment on any shared characteristics or skills you identified as helpful for both AI and SWOT approaches.

Writing, Supporting Evidence, and APA Style

· Communicate professionally when conducting interviews and collecting data.

· Write clearly, with professionalism and respect for stakeholders and colleagues.

· Integrate relevant sources of evidence to support your assertions.

. Cite at least 3–5 sources of scholarly or professional evidence.

. Include relevant interview information.

· Format your document using APA style. Use the APA style. Be sure to include:

. A title page and reference page. An abstract is not required.

. A running head on all pages.

. Appropriate section headings.

. Properly formatted citations and references.

· Proofread your writing to minimize errors that could distract readers and make it more difficult to focus on the substance of your analysis.

Evidence Based Responds

Evidence Based Responds

Discussion 1

I have experienced patient involvement in treatment and healthcare decisions for a patient with diabetes who wanted more information on patient education and self-management. Still, there is a challenge to prioritize patients’ preferences and professional when patients lack information and knowledge.  The diabetic patient wished to be involved in shared decision-making. Preferences are one of the considerations in shared decision-making, including treatment and management decisions. Trust in physicians and nurses likely influenced the patient’s willingness to participate in shared decision-making.

Evaluating what influences patient preferences for participating in healthcare decisions is helpful to promote informed decision-making as there would be a focus on facilitating shared decision-making. Meeting patients’ needs and evaluating their preferences should be a top priority, and promoting patient engagement makes it easier to determine patient preferences. In decision-making, it is necessary to consider the benefits and risks of decisions and patient preferences to inform patient decisions and involvement (Friedrichs et al., 2016). Patient preferences are increasingly prominent in shared decision-making about care and treatments, and getting informed is necessary to reduce knowledge deficit and make decisions based on the best evidence.

Even if patients engage in active decision-making, using the best evidence to support clinical decisions is necessary. Thus, in the case of the diabetic patient, it was necessary to respect the patient’s autonomy preferences while exercising professional judgment. Patient preferences can influence treatment choice, and in patient-centered care, there is a focus on supporting patients and families to make informed decisions (Lindsay et al., 2020). Patient-centered communication, patient education, and empowerment facilitate shared decision-making. Hence, patients and families make informed health care decisions, and patient-centeredness is essential for promoting high-quality health care.

The Ottawa Hospital Research Institute inventory of decision aids is one tool that facilitates clarifying patient choices and using the best evidence to support decisions. Personalizing patient decisions and enabling patient involvement is one of the benefits when using the decision aid. Diabetes is one of the specific conditions in the decision aid, and the type of decision aid is treatment, and the target audience is adults with diabetes type 2 (Ottawa Hospital Research Institute). Patient decision aids present individualized information and interventions tailored to the patients’ needs.

References

Friedrichs, A., Spies, M., Haerter, M., & Buchholz, A. (2016). Patient preferences and shared decision making in the treatment of substance use disorders: a systematic review of the literature. PloS one11(1), e0145817.

Lindsay, S. E., Alokozai, A., Eppler, S. L., Fox, P., Curtin, C., Gardner, M., … & VOICES Health Policy Research Investigators. (2020). Patient preferences for shared decision making: not all decisions should be shared. The Journal of the American Academy of Orthopaedic Surgeons28(10), 419.

Ottawa Hospital Research Institute. Decision Aids Inventory. Retrieved from

https://decisionaid.ohri.ca/

Discussion 2

Important Factors of Patient Education

Patient health outcomes should be a joint decision making process in which healthcare teams and patients collaborate to reach a common outcome.  Joint decision making offers a structured method to incorporate evidence as well as patient values and preferences into medical decision making (Grad et al., 2017).  As an acute care nurse on a surgical floor,  I strongly believe in collaborating with my patients to ensure the patients are discharged with all the resources they need and understand their current health conditions to improve their health.

I consider many of my patients to be the best source of information about their health conditions.  They know their diets, physical capabilities, living environments, and daily life styles that the healthcare teams need to understand and develop plans to reach desirable patient outcomes.  Although many patients collaborate with their healthcare team, there are several that choose not to follow given directions to improve their lives.  For some, it takes a serious medical condition to change their habits.

One situation in which a patient and the interdisciplinary team attempted to collaborate with was a diabetic patient who was admitted for osteomyelitis associated with diabetic vascular disease.  The patient underwent right foot amputation due to osteomyelitis.  The vascular surgery team, diabetic educator, and I educated the patient on following his diabetes regimen and controlling his diet at home or his vascular disease will advance, leading to further amputations.  Several months after his discharge, he was readmitted for a below the knee amputation (BKA).  When I spoke to the patient, he stated that he did not follow the teams instructions and did not change his diet, but now that he had his BKA, he stated that he will now follow the guidelines provided by his team.

After this patient’s outcomes, I thought about why the patient did not follow the team’s instructions on controlling his diabetes.  I thought that maybe our educational methods did not suit his life style and his needs at home.  I spoke with our diabetes nurse educator and asked her if we should have approached the patient’s treatment plan in a different way compared to other diabetic patients.  I thought maybe if we listened to his daily routines and diet, we could have formulated a patient specific diet plan, including the patient’s preferences and life values (Chester et al., 2018).  After my experiences with this patient, I decided to listen more about my patients’ daily life styles and preferences rather than teaching them about basic diabetes guidelines.

References

Bae, J. M. (2017).  Shared decision making: relevant concepts and facilitating strategies.  Epidemiology and

            Health, South Korea, 39, e2017048.  Doi: 10.4178/epih.e2017048

Chester, B., Stanley, W. G., & Geetha, T. (2018).  Quick guide to type 2 diabetes self-management education:

creating an interdisciplinary diabetes management team.  Diabetes, Metabolic Syndrome and Obesity:

            Target and Therapy, 11, 641-645.  Doi: 10.2147/DMSO.S178556

Grad, R., Legare, F., Bell, N. R., Dickinson, J. A., Singh, H., Moore, A. E., Kasperavicius, D., & Kretschmer, K.

L. (2017).  Shared decision making in preventative health care: what it is; what it is not.  The Official

           Journal of the College of Family Physicians of Canada, 63(9), 682-684.  Retrieved from

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5597010/