Ethical Dilemma On Confused Patient

Ethical Dilemma On Confused Patient

Criterion

Search minimum of a scholarly nursing journals or national newspaper for peer review articles or scholarly nursing journal article about health care involving ethical dilemma in nursing. Must be referenced in your paper. Ethical dilemma is consent from Confused patient for medical procedure of angiogram

  • The paper addresses the following, of What is the ethical dilemma? How does the dilemma affect nursing? What are the main moral issues raised in the situation? Discuss two bioethical principals as they relate to the ethical dilemma. Based on personal, group, and societal moralities, identifies a value of your own personal morality. Describe that value’s relationship with the morality of a group or society you are currently living.
  • The paper cites at least 8 references, two of which may be the course text, to support the paper’s position.

Organization/Development

  • The paper is 7 pages in length. Not including title page and reference page
  • The introduction provides sufficient background on the topic and previews major points.
  • The conclusion is logical, flows, and reviews the major points.

Mechanics

  • The paper—including the title page, reference page, tables, and any appendixes—is consistent with APA 6th edition guidelines as directed by the facilitator. The paper is laid out with effective use of headings, font styles, and space.
  • Rules of grammar, usage, and punctuation are followed; spelling is correct.
  • Evidence of critical thinking, synthesis, analysis throughout the paper.

consequences of short staffing in a hospital

Journal #2

What are the consequences of short staffing in a hospital. How can management help reduce the number of patient to nurse ratio, also explain how over working can negatively effect the nurse in their daily life.

Scenario

Discussion

Scenario: You have just mentored a group of medical-surgical nurses on your unit through an EBP project aimed at addressing Hospital Associated Pressure Injury Rates, and your results were astounding! You want to disseminate your results quickly to let the world know of your team’s successes. The nurses know the results need to be disseminated internally, but are torn between submitting an abstract for a state-level organization, a national conference, or submit a manuscript to a journal for publication

  • Describe your next steps to disseminate this evidence internally.
  • Discuss how a masters prepared nurse would determine the best place to disseminate this information outside of the organization (externally).

reference: 2 peer reviewed articles with 5 yrs.

kidney injury

Week 13/2

Assessment Description

Answer both of the following questions. Support your answer with two or three peer-reviewed resources.

  1. Differentiate acute renal insufficiency versus acute kidney injury (AKI). Explain the diagnosis, etiology, and treatment for both. Describe the types of AKI including prerenal, intrarenal, and postrenal etiologies. Include diagnostic criteria for each etiology.
  2. Define chronic kidney disease, including stages, diagnosis, treatment, and prevention. Explain the indications for dialysis as well as the differences in the forms of dialysis (Intermittent hemodialysis, CRRT, peritoneal dialysis).

Genetics/Human Project

Genetics/Human Project

350 words needed always for discussions.  1.   Research a genetic disorder of your choice. Pick any of the 3,000 – 5,000 genetic disorders. Discuss what the disorder is, the symptoms, and how it affects an individual.  2. Also, what is the Human Genome Project, and its goals? 3. What is your thoughts on “genetic engineering” of genetic disorders.  Add your own thoughts into the discussion as well. A good site is nih.gov.  You need at least 350 words,  and always two references listed. 4.  Would you possibly have genetic engineering/splicing done if it was “safe”  related to your child having a major genetic disorder?  Answer all 4 of the questions please.  Should be interesting.

calcium abnormalities

CAT 3

Cat 1

Chapters 240 and 241 in your Principles and Practice of Hospital Medicine text detail several electrolyte abnormalities. After completing your assigned readings, answer the following questions;

1. How is serum calcium regulated?

1. What body system dysfunctions would cause calcium abnormalities?

2. The GI tract, kidneys, and skeletal system are integral in regulating calcium.

2. What are potential causes of hypercalcemia? How can you differentiate the cause of hypercalcemia in your patient?

3. How is hypercalcemia diagnosed and managed?

4. What are potential causes of hypocalcemia?

5. What are potential causes of potassium and magnesium disorders?

1. What is pseudohypokalemia? What is the treatment for this?

6. What are the potential consequences of potassium and magnesium disorders?

7. How are potassium and magnesium disorders treated?

1. What is the function of Calcium Gluconate in lowering potassium?

8. How are potassium disorders treated in clinical situations with rapid potassium shifts, such as diabetic ketoacidosis, hyperglycemic hyperosmolar state, and periodic paralysis?

Theory

Theory

Go to the Nursing History page. Other historical sites include:

Military Nurse, Historical African American Nurses,  Mary BreckenridgeEdith CavellLillian WaldFamous Nurses, ANA Hall of Fame

View at least two sites, list the sites visited, and discuss how nursing history has influenced current nursing philosophy, theory, science, and ultimately practice, based upon the sites that you visited. Be specific by demonstrating the linkages. (The purpose of this exercise is to think about the links between nursing philosophy, theory, science, and practice – to see that these are not isolated entities but integral to each other

SOAP NOTE 4 PEDIATRICS/ ACNE

SOAP NOTE 4 PEDIATRICS/ ACNE

Faculty Comments:  MRU Soap Note Grading Rubric
This sheet is to help you understand what is required, and what the margin remarks might be about on your comments of patients. Since most of your comments that you hand in are uniform, this represents what MUST be included in every write-up.

Grading Rubric

Student______________________________________
This sheet is to help you understand what we are looking for, and what our margin remarks might be about on your write ups of patients. Since at all of the white-ups that you hand in are uniform, this represents what MUST be included in every write-up.

1) Identifying Data (___5pts): The opening list of the note. It contains age, sex, race, marital status, etc. The patient complaint should be given in quotes. If the patient has more than one complaint, each complaint should be listed separately (1, 2, etc.) and each addressed in the subjective and under the appropriate number.

2) Subjective Data (___30pts.): This is the historical part of the note. It contains the following:

a) Symptom analysis/HPI(Location, quality , quantity or severity, timing, setting, factors that make it better or worse, and associate manifestations.(10pts).
b) Review of systems of associated systems, reporting all pertinent positives and negatives (10pts).
c) Any PMH, family hx, social hx, allergies, medications related to the complaint/problem (10pts). If more than one chief complaint, each should be written u in this manner.

3) Objective Data(__25pt.): Vital signs need to be present. Height and Weight should be included where appropriate.

a) Appropriate systems are examined, listed in the note and consistent with those identified in 2b.(10pts).
b) Pertinent positives and negatives must be documented for each relevant system.
c) Any abnormalities must be fully described. Measure and record sizes of things (likes moles, scars). Avoid using “ok”, “clear”, “within normal limits”, positive/ negative, and normal/abnormal to describe things. (5pts).

4) Assessment (___10pts.): Diagnoses should be clearly listed and worded appropriately.

5) Plan (___15pts.): Be sure to include any teaching, health maintenance and counseling along with the pharmacological and non-pharmacological measures. If you have more than one diagnosis, it is helpful to have this section divided into separate numbered sections.

6) Subjective/ Objective, Assessment and Management and Consistent (___10pts.): Does the note support the appropriate differential diagnosis process? Is there evidence that you know what systems and what symptoms go with which complaints? The assessment/diagnoses should be consistent with the subjective section and then the assessment and plan. The management should be consistent with the assessment/ diagnoses identified.

7) Clarity of the Write-up(___5pts.): Is it literate, organized and complete?

Comments:

Total Score: ____________ Instructor: __________________________________

Guidelines for Focused SOAP Notes
• Label each section of the SOAP note (each body part and system).
• Do not use unnecessary words or complete sentences.
• Use Standard Abbreviations
S: SUBJECTIVE DATA (information the patient/caregiver tells you).
Chief Complaint (CC): a statement describing the patient’s symptoms, problems, condition, diagnosis, physician-recommended return(s) for this patient visit. The patient’s own words should be in quotes.
History of present illness (HPI): a chronological description of the development of the patient’s chief complaint from the first symptom or from the previous encounter to the present. Include the eight variables (Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, Severity-OLDCARTS), or an update on health status since the last patient encounter.
Past Medical History (PMH): Update current medications, allergies, prior illnesses and injuries, operations and hospitalizations allergies, age-appropriate immunization status.
Family History (FH): Update significant medical information about the patient’s family (parents, siblings, and children). Include specific diseases related to problems identified in CC, HPI or ROS.
Social History(SH): An age-appropriate review of significant activities that may include information such as marital status, living arrangements, occupation, history of use of drugs, alcohol or tobacco, extent of education and sexual history.
Review of Systems (ROS). There are 14 systems for review. List positive findings and pertinent negatives in systems directly related to the systems identified in the CC and symptoms which have occurred since last visit; (1) constitutional symptoms (e.g., fever, weight loss), (2) eyes, (3) ears, nose, mouth and throat, (4) cardiovascular, (5) respiratory, (6) gastrointestinal, (7) genitourinary, (8) musculoskeletal, (9-}.integument (skin and/or breast), (10) neurological, (11) psychiatric, (12) endocrine, (13) hematological/lymphatic, {14) allergic/immunologic. The ROS should mirror the PE findings section.
0: OBJECTIVE DATA (information you observe, assessment findings, lab results).
Sufficient physical exam should be performed to evaluate areas suggested by the history and patient’s progress since last visit. Document specific abnormal and relevant negative findings. Abnormal or unexpected findings should be described. You should include only the information which was provided in the case study, do not include additional data.
Record observations for the following systems if applicable to this patient encounter (there are 12 possible systems for examination): Constitutional (e.g. vita! signs, general appearance), Eyes, ENT/mouth, Cardiovascular, Respiratory, GI, GU, Musculoskeletal, Skin, Neurological, Psychiatric, Hematological/lymphatic/immunologic/lab testing. The focused PE should only include systems for which you have been given data.
NOTE: Cardiovascular and Respiratory systems should be assessed on every patient regardless of the chief complaint.
Testing Results: Results of any diagnostic or lab testing ordered during that patient visit.
A: ASSESSMENT: (this is your diagnosis (es) with the appropriate ICD 10 code)

List and number the possible diagnoses (problems) you have identified. These diagnoses are the conclusions you have drawn from the subjective and objective data.
Remember: Your subjective and objective data should support your diagnoses and your therapeutic plan.
Do not write that a diagnosis is to be “ruled out” rather state the working definitions of each differential or primary diagnosis (es).
For each diagnoses provide a cited rationale for choosing this diagnosis. This rationale includes a one sentence cited definition of the diagnosis (es) the pathophysiology, the common signs and symptoms, the patients presenting signs and symptoms and the focused PE findings and tests results that support the dx. Include the interpretation of all lab data given in the case study and explain how those results support your chosen diagnosis.
P: PLAN (this is your treatment plan specific to this patient). Each step of your plan must include an EBP citation.
1. Medications write out the prescription including dispensing information and provide EBP to support ordering each medication. Be sure to include both prescription and OTC medications.
2. Additional diagnostic tests include EBP citations to support ordering additional tests
3. Education this is part of the chart and should be brief, this is not a patient education sheet and needs to have a reference.
4. Referrals include citations to support a referral
5. Follow up. Patient follow-up should be specified with time or circumstances of return. You must provide a reference for your decision on when to follow up.

Concept Map

Concept Map – 2 Pages

This assignment incorporates knowledge of organizations and workplace culture. It also evaluates the ability to navigate a complex organization and recommend a change to a care process by involving stakeholders and reaching approval. This will incorporate systems theory, the influence of organizational structure, and the improvement of care delivery in this assignment.

Using the following elements as a guide, address your findings and the graphics listed below.

Introduce your concept map by identifying a process improvement in your department that includes economic, legal, and political factors that may influence the process.
Using systems theory, create a concept map for the improvement process of your project. Be sure to include all aspects as well as other disciplines that will be involved.
This assignment will be a 2-page document. The first page is a written introduction explaining your findings, which addresses the topics in 1) above. The second page is your Lucidchart concept map.
Use Lucidchart or another tool such as Word to create your concept map for your improvement process plan.

Deep Vein Thrombosis

Deep Vein Thrombosis

Case study:

Sandra is a 27-year-old female admitted with a possible Deep Vein Thrombosis (DVT). She smokes one pack per day and is on birth control. She has a history of hypertension and obesity. She is admitted to the hospital and placed on bedrest. Heparin drip is started per protocol. The Provider is anticipating on sending her home with Coumadin.

  1. Can Sandra be placed on Coumadin and Heparin at the same time? What is the reason she is on both medications at the same time? Use critical thinking skills and rationale along with data from your resource to support the reason.
  2. Develop 3 teaching points important for Sandra to know about her medications regimen.
  3. What 3 questions would you ask Sandra to verify that she understand the 3 teaching points?
  4. Please include at least 1 reference and provide appropriate citation of your reference(s), only time frame of 2019-2021 is to be used for your references