Category: Nursing Assignment Help

Inclusion of Nurses in the Systems Development Life Cycle

Discussion: The Inclusion of Nurses in the Systems Development Life Cycle
In the media introduction to this module, it was suggested that you as a nurse have an important role in the Systems Development Life Cycle (SDLC). With a focus on patient care and outcomes, nurses may not always see themselves as contributors to the development of new systems. However, as you may have observed in your own experience, exclusion of nurse contributions when implementing systems can have dire consequences.
In this Discussion, you will consider the role you might play in systems development and the ramifications of not being an active participant in
systems development.
To Prepare:
Review the steps of the Systems Development Life Cycle (SDLC) as presented in the Resources.
Reflect on your own healthcare organization and consider any steps your healthcare organization goes through when purchasing and implementing a new health information technology system.
Consider what a nurse might contribute to decisions made at each stage of the SDLC when planning for new health information technology.
By Day 3 of Week 9
Post a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and
planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. Be specific and provide examples.

Use of Clinical Systems to Improve Outcomes and Efficiencies

Assignment: Literature Review: The Use of Clinical Systems to Improve Outcomes and Efficiencies
New technology—and the application of existing technology—only appears in healthcare settings after careful and significant research. The stakes are high, and new clinical systems need to offer evidence of positive impact on outcomes or efficiencies.
Nurse informaticists and healthcare leaders formulate clinical system strategies. As these strategies are often based on technology trends, informaticists and others have then benefited from consulting existing research to inform their thinking.
In this Assignment, you will review existing research focused on the application of clinical systems. After reviewing, you will summarize your
findings.
To Prepare:
Review the Resources and reflect on the impact of clinical systems on outcomes and efficiencies within the context of nursing practice and healthcare delivery.
Conduct a search for recent (within the last 5 years) research focused on the application of clinical systems. The research should provide evidence to support the use of one type of clinical system to improve outcomes and/or efficiencies, such as “the use of personal health records or portals to support patients newly diagnosed with diabetes.”
Identify and select 4 peer-reviewed research articles from your research.
The Assignment: (4-5 pages)
In a 4- to 5-page paper, synthesize the peer-reviewed research you reviewed. Format your Assignment as an Annotated Bibliography. Be sure to address the following:
Identify the 4 peer-reviewed research articles you reviewed, citing each in APA format.
Summarize each study, explaining the improvement to outcomes, efficiencies, and lessons learned from the application of the clinical system each peer-reviewed article described. Be specific and provide examples.
In your conclusion, synthesize the findings from the 4 peer-reviewed research articles

 

Evidence-Based Practice

Instructions:
Go to MDC Medical Campus Library site http://www.mdc.edu/medical/library/default.asp, and read these two EBP articles:
SmithBattle, L. Diekemper, M., & Leander, S. (2004a). Getting your feet wet: Becoming a public health nurse, Part 1. Public Health Nursing, 21, 3-11.
SmithBattle, L. Diekemper, M., & Leander, S. (2004b). Moving upstream: Becoming a public health nurse, Part 2. Public Health Nursing, 21, 95-102.
Then answer the following questions:
How well do the findings of the research study described in these two articles reflect your experience clinical practice?
What interventions by your community health nursing faculty might make the transition to effective community health nursing practice easier for you?
Your response should be 50 – 100 word

Impacts of microplastic fibres on the marine mussel Mytilus galloprovinciallis

To be made PhD level.

Earlier recommendations for masters:
For future work in this field, solutions must be found to the methodological issue that was faced with fibres clustering and gathering. Also standardised material characterisation and toxicological test methodologies must be implemented so as to ensure the validity and comparability of studies on the toxicity of microplastics. Moreover, more characterisation work should be implemented in order to know what exactly is causing
these impacts.

PICOTS quantitative question Fingers Chart of Statistical Tests

Read and review all other materials listed, especially Dr. Finger’s Chart of Statistical Tests and the video walkthrough. Doing so will help tickle your memory of how the variable type determines the statistical test required to analyze the data.

Use scholarly and scientific writing

Post your 1.4 PICOTS quantitative question.

Keeping in mind that you must report on all data collected, what demographic data do you need from your participants?

What other questions do you need to ask your participants?

For each question, what type of data will the answers produce?

What statistical tests will you use on each data set and why?

Use Dr. Finger’s Chart of Statistical Tests to determine what statistical tests you would select to demonstrate the answer(s) to your problem, subproblems, and research question based on your variable types. Be sure to refer to the studies related to your topic found in OCLS. Post at least one test to use on your data along with your rationale.

What interpretive criteria would you use to give meaning and significance to your findings?

What if your findings do not support your hypothesis or hunch?

This discussion should be referenced with at least three references.

Analyzing and Summarizing Research Literature systematic reviews meta-syntheses meta-analyses abstracts

Instructions

Systematic reviews, meta-syntheses, meta-analyses or abstracts cannot be used in your review. Studies from Google, a .com or .net domain, or older than four years from today’s date cannot be used. Only peer reviewed, non-editorial, non-commentary, non-translated, evidence based sources are to be used. post your quantitative research question. This discussion has three components:
Could the proposed study/question be simplified or clarified? (If yes, suggest a possible rephrasing.)
Are the studies current, within four years?
Are the questions in the studies presented relevant to the proposed study? Why or why not?
Do you detect any bias in the synthesis?
Find in the OCLS and review one of the full text studies listed. Compare the spreadsheet information to the article. Is the information in the spreadsheets accurate and complete based on the article? Offer feedback regarding inconsistencies.
Offer any suggestions for the proposed research study you might have.
Review and Analysis of the Literature III: Complete the information requested on the spreadsheet entitled, 2.3, 3.3, 4.3 Spreadsheet for four new articles and attach it to this discussion. Please designate your attachments to open in a new window.
Summarizing Research Literature III: Use the template entitled, Synthesis Guide to compare and contrast this week’s studies/articles on the points of research question, variables, study design, use of a theory, sample population, statistics, findings, and other key points as pertinent to your study. The synthesis should use scholarly and scientific writing with use of APA style.

Roles of Healthcare Professionals APRN RN

This assignment will be at least 1500 words or more. Reflect on the roles of nurses, and other healthcare professionals as the roles of physicians in the healthcare system moves from one of working in silos to a more progressive value-based system. Write a paper that discusses in detail why a value-based system may improve health care in the U. S. and address the following questions:
How has current policy transformed the current practice of nurses, physicians, and other healthcare professionals?
What distinction can you make between physicians/healthcare providers working in a fee-for-service system and a value-based care system?
How do you view shared power between physicians and nurses in your healthcare system? How does it impact care?
Assignment Expectations
Length: 1500-2000 words in length
Structure: Include a title page and reference page in APA format. These do not count towards the minimal word amount for this assignment.
Your essay must include an introduction and a conclusion.
References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. A minimum of two (2) scholarly sources are required for this assignment.

Florence Nightingale Theory

Case Study: Florence Nightingale Theory
CASE STUDY
You are caring for an 82-year-old woman who has been hospitalized for several weeks for burns that she sustained on her lower legs during a cooking accident. Before the time of her admission, she lived alone in a small apartment. The patient reported on admission that she has no
surviving family. Her support system appears to be other elders who live in her neighborhood. Because of transportation difficulties, most of them are unable to visit frequently. One of her neighbors has reported that she is caring for the patient’s dog, a Yorkshire terrier. As you care for this woman, she begs you to let her friend bring her dog to the hospital. She says that none of the other nurses have listened to her about such
a visit. As she asks you about this, she begins to cry and tells you that they have never been separated. You recall that the staff discussed their concern about this woman’s well-being during report that morning. They said that she has been eating very little and seems to be depressed.
1. Based on Nightingale’s work, identify specific interventions that you would provide in caring for this patient.
2. Describe what action, if any, you would take regarding the patient’s request to see her dog. Discuss the theoretical basis of your decision and action based on your understanding of Nightingale’s work.
3. Describe and discuss what nursing diagnoses you would make and what interventions you would initiate to address the patient’s nutritional status and emotional well-being.
4. As the patient’s primary nurse, identify and discuss the planning you would undertake regarding her discharge from the hospital. Identify members of the discharge team and their roles in this process. Describe how you would advocate for the patient based on Nightingale’s observations and descriptions of the role of the nurse.

Nursing RUA Essay

Summarize the article to include how you apply the following in your professional endeavors:

Article to be reviewed is “Cognitive stacking: Strategies for the busy RN”

• Managing unplanned change
• Routinization
• Prioritization hierarchies
• Delegation
• Utilize your lifelines

Help Write Admission Essay for Nursing College

I am applying many colleges for nursing program. I want you to help me write an excellent admission essay because I have never written one. I Thank you.

 

Correlation between medication (carbidopa/ levodopa ) and disease process (Parkinson disease)

Pathophysiology Expected Symptoms Assessment Nursing Diagnosis Medications Patient Safety

Required Elements	Points Possible	Points Received	Comments
Pathophysiology: Admitting diagnosis and primary diagnosis of concern.  Is this diagnosis pertinent to course content? Did the student give a definition based on the textbook?	5
Expected Symptoms:  Were actual and potential symptoms listed and pertinent to this disorder?	5
Assessment: Targeted Physical Assessment: Were pertinent symptoms related to disorder identified? Were specific things listed that the student would assess for? System Assessment Findings:  Was a system specific targeted to diagnosis assessment listed? General Survey:  Was a general survey documented and covered all areas? (Head to Toe)	10
3 Nursing Diagnosis, meaningful to this patient.  Not more than one “at risk for”. Used Maslow’s Hierarchy & NANDA	10
Interventions: 3 for each of the three Nursing Diagnosis based on NANDA	10
Outcomes must be measurable.  Take off points if student uses “by end of shift” NANDA	5
Medications:  Were the medications listed, stating dose, timing, and purpose.  Were nursing considerations listed? Cite drug book	10
Lab Tests and Treatments:  Were lab values listed pertinent to patient’s diagnosis?  Did student list the actual value and normal range and state why they were abnormal?  Were the signs and symptoms listed appropriate to the abnormal lab value *If no labs have been drawn recently, student should say what labs should be drawn for the patients diagnosis. Cite Lab book or textbook	5
Resources:  Did student list who should be involved in the patient care, how interdisciplinary teamwork and collaboration promoted patient care and affect the outcome of care?  Did student state how this was communicated?	5
Interesting aspects of care:  Did student identify what they felt was the most interesting aspect of this patient related to their diagnosis and care?  Why they chose this patient as their case study?	5
Patient Safety: Did the student describe factors that create a culture of safety.  How were observations or concerns related to patient safety communicated to families and the health care team?  Discuss any potential and/or actual impact of National Patient Safety Goals, initiatives and regulations related to your patient and the care setting of your clinical rotation.	5
Teaching plan/Demonstration: Was the teaching plan specific to the patient’s diagnosis, patient-centered, and an appropriate choice to the course level student is currently in.	5
Verbal Report Given:  Did the student give a thorough verbal report.	5
Presentation & Professionalism:  Did student speak clearly, obtain eye contact with the audience?	5
APA Formatting	10
Total Grade	100		Final Score:

Case Study/Care Plan Grading Rubric 2018

Hypoglycemia and Impaired Renal Function

Case Study: An Elderly Patient With Hypoglycemia and Impaired Renal Function

—This case shows the importance of re-evaluating treatment regimens to address adverse effects without exacerbating other comorbidities.

This case presents an elderly man with type 2 diabetes and impaired renal function. He has recently been experiencing hypoglycemia with his current treatment regimen. The importance of re-evaluating treatment regimens to address adverse effects without exacerbating other comorbidities, such as renal dysfunction, is discussed.

Case presentation and patient assessment

An 84-year-old man with type 2 diabetes is admitted to the hospital with altered mental status and hypoglycemia. He had experienced recurring episodes of mild hypoglycemia over the previous week, which were managed with food. With this episode, however, he could not be aroused, so the family called EMS. His past medical history includes chronic lymphocytic leukemia, gout, hypertension, and atrial fibrillation. Approximately 6 weeks ago, his serum creatinine increased from 1.6 mg/dL to 2.4 mg/dL following a bout of pneumonia. He had been taking glimepiride 4 mg twice daily. He admitted that he sometimes skipped the dose entirely because of hypoglycemia, and when he did so, his glucose was >200 mg/dL. His glycosylated hemoglobin (HbA1c) is 6.9%. Information and laboratory values collected at the hospital are as follows:

• Height, 5’9”
• Weight, 198 lb
• BMI, 28
• BP, 114/73 mm Hg
• Current medications, glimepiride 4 mg BID and atorvastatin 10 mg QD
• HbA1c, 6.9%
• Lipids, LDL-C 45 mg/dL; HDL-C 55 mg/dL; Total-C 109 mg/dL; triglycerides 47 mg/dL
• Serum creatinine 1.94 mg/dL

Diagnosis

The patient is found to have acceptable glycemic control, but unacceptable episodes of severe hypoglycemia. His worsening renal dysfunction and poor overall health status were likely responsible for the hypoglycemia, since he had tolerated glimepiride in the past. Hypoglycemia with his current treatment regimen was a particular concern given his age, concomitant renal disease, and other comorbidities.

Treatment

While in the hospital, the patient required a small dose of insulin glargine to control his blood glucose, 16 units.

This patient is elderly and has other comorbidities, including moderate renal impairment. Developing a treatment plan that helps maintain normal glucose levels with little or no associated hypoglycemia as well as limited complexity is important for this elderly patient.¹Lastly, renal dysfunction and advanced age are two key risk factors for hypoglycemia.^1-3

At discharge, the decision was made to discontinue insulin glargine and initiate oral therapy with a dipeptidyl peptidase-4 inhibitor, given the low rates of hypoglycemia associated with this class and ease of use (ie, oral administration).¹

Linagliptin 5 mg/day was prescribed at hospital discharge, and a follow-up visit was scheduled in 2 weeks. At the follow-up appointment, the patient reported that he was feeling well and eating better. He stated that his glucose ranged from 140 mg/dL to 210 mg/dL. His serum creatinine had increased to 2.4 mg/dL. He has had no hypoglycemic episodes since leaving the hospital. At this time, a small dose of insulin glargine was added to his glucose-lowering regiment (8 units), with adjustments made on an outpatient basis.

At a 6-month follow-up, the patient’s HbA1c was 6.6%. He reported that his glucose ranges from 110 mg/dL to 155 mg/dL, and he had not experienced any hypoglycemia. His serum creatinine was 1.99 mg/dL. Information and laboratory values collected during the 6-month follow-up visit are summarized here:

• Weight, 186 lb
• BP, 112/70 mm Hg
• Current medications, linagliptin 5 mg/d; insulin glargine 10-14 units/day; atorvastatin 10 mg QD
• HbA1c, 6.6%
• Lipids, LDL-C 28 mg/dL; HDL-C 38 mg/dL; Total-C 103 mg/dL; triglycerides 73 mg/dL
• Serum creatinine 1.99 mg/dL

Over the next 2 years, the patient’s serum creatinine fluctuated from 1.7 mg/dL to 2.5 mg/dL. He required additional chemotherapy for chronic lymphocytic leukemia with small cell lymphoma. His diabetes remained stable on the same regimen of linagliptin 5 mg/day and insulin glargine 10 to 14 units/day.

 

 

Nursing Case Study Case Studies in Nursing

QUESTION 1

1. CC: “I have been having terrible chest and arm pain for the past 2 hours and I think I am having a heart attack.”

HPI: Mr. Hammond is a 57-year-old African American male who presents to the Emergency Department with a chief complaint of chest pain that radiates down his left arm. He states that he started having pain several hours ago and says the pain “it feels like an elephant is sitting on my chest”. He rates the pain as 8/10. Nothing has made the pain better or worse. He denies any previous episode of chest pain. Denies nausea, dyspnea, or lightheadedness. He was given 0.4 mg nitroglycerine tablet sublingual x 1 which decreased, but not stopped the pain.

Lipid panel reveals Total Cholesterol 324 mg/dl, high density lipoprotein (HDL) 31 mg/dl, Low Density Lipoprotein (LDL) 122 mg/dl, Triglycerides 402 mg/dl, Very Low-Density Lipoprotein (VLDL) 54 mg/dl

His diagnosis is an acute inferior wall myocardial infarction.

1 of 2 Questions:

Why is HDL considered the “good” cholesterol?

2 of 2 Questions:

Explain the role inflammation has in the development of atherosclerosis.

QUESTION 3

1. A 45-year-old woman with a history of systemic lupus erythematosus (SLE) presents to the Emergency Room (ER) with complaints of sharp retrosternal chest pain that worsens with deep breathing or lying down. She reports a 3-day history of low-grade fever, listlessness and says she feels like she had the flu. Physical exam reveals tachycardia and a pleural friction rub. She was diagnosed with acute pericarditis.

Question:

What does the Advanced Practice Registered Nurse (APRN) recognize as the result of the pleural friction rub?

QUESTION 4

1. A 15-year-old adolescent male comes to the clinic with his parents with a chief complaint of fever, nausea, vomiting, poorly localized abdominal pain, arthralgias, and “swollen lymph nodes”. States he has felt “lousy” for a couple weeks. The fevers have been as high as 102 F. His parents thought he had the flu and took him to an Urgent Care Center. He was given Tamiflu® and sent home. He says the Tamiflu didn’t seem to work. States had a slight sore throat a couple weeks ago and attributed it to the flu. Physical exam revealed thin young man who appears to be uncomfortable but not acutely ill. Posterior pharynx reddened and tonsils 3+ without exudate. + anterior and posterior cervical lymphadenopathy. Tachycardic and a new onset 2/6 high-pitched, crescendo-decrescendo systolic ejection murmur auscultated at the left sternal border. Rapid strep +. The patient was diagnosed with acute rheumatic heart disease (RHD).

Question:

Explain how a positive strep test has caused the patient’s symptoms.

QUESTION 5

1. The APRN sees a 74-year-old obese female patient who is 2 days post-op after undergoing left total hip replacement. The patient has had severe post op nausea and vomiting and has been unable to go to physical therapy. Her mucus membranes are dry. The patient says she feels like the skin on her left leg is too tight. Exam reveals a swollen, tense, and red colored calf. The patient has a duplex ultrasound which reveals the presence of a deep venous thrombosis (DVT).

Question:

Describe the factors that could have contributed to the development of a DVT in this patient explain how each of the factors could cause DVT.

QUESTION 6

1. A 45-year-old woman is 10 days status post partial small bowel resection for Crohn Disease and has been recuperating at home. She suddenly develops severe shortness of breath, becomes weak, and her blood pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse oximetry is 89% on room air. The APRN suspects the patient experienced a massive pulmonary embolus.

Question:

Explain why a large pulmonary embolus interferes with oxygenation.

QUESTION 7

1. A 45-year-old woman is 10 days status post partial small bowel resection for Crohn Disease and has been recuperating at home. She suddenly develops severe shortness of breath, becomes weak, and her blood pressure drops to 80/40 mmHg (previous readings ~130/80s mmHg). The pulse oximetry is 89% on room air. While waiting for the Emergency Medical Service (EMS) to arrive, the APRN places EKG leads and the EKG demonstrates right ventricular strain.

Question:

Explain why a large pulmonary embolism causes right ventricular strain.

QUESTION 8

1. A 12-year-old girl is brought to the Emergency Room (ER) by her mother with complaints of shortness of breath, wheezing, tachypnea, tachycardia, and a non-productive cough. The mother states they had just come from a fall festival where the entire family enjoyed a hayride. The symptoms began shortly after they left the festival but got better a couple hours after they returned home. The symptoms began again about 6 hours later and seem to be worse. The mother states there is no history of allergies or frequent respiratory infections. The child is up to date on all vaccinations. The child was diagnosed with asthma. The nurse practitioner explained to the mother that her child was exhibiting symptoms of asthma, and probably had an early asthmatic response and a late asthmatic response.

Question 1 of 2:

Explain early asthmatic responses and the cells responsible for the responses.

Question 2 of 2:

Explain late asthmatic responses and the cells responsible for the responses. 

QUESTION 10

1. A 64-year-old man with a 40 pack/year history of cigarette smoking has been diagnosed with emphysema.  He asks the APRN if this means he has COPD.

Question 1 of 2:

Explain the pathophysiology of emphysema and how it relates to COPD.

Question 2 of 2:

Explain the pathophysiology of chronic bronchitis and how it relates to COPD.

QUESTION 12

1. Jones is a 78-year-old gentleman who presents to the clinic with a chief complaint of fever, chills and cough. He also reports some dyspnea. He has a history of right sided CVA, COPD, dyslipidemia, and HTN. Current medications include atorvastatin 40 mg po qhs, lisinopril, and fluticasone/salmeterol. He reports more use of his albuterol rescue inhaler.

Vital signs Temp 101.8 F, pulse 108, respirations 21. PaO₂ on room air 86% and on O₂ 4 L nasal canula 94%. CMP WNL, WBC 18.4. Physical exam reveals thin, anxious gentleman with mild hemiparesis on left side due to CVA. HEENT WNL except for diminished gag reflex and uneven elevation of the uvula, CV-HR 108 RRR without murmurs, rubs, or click, no bruits. Resp-coarse rhonchi throughout lung fields. CXR reveals consolidation in right lower lobe. He was diagnosed with community acquired pneumonia (CAP).

Question:

Patient was hypoxic as evidenced by the low PaO₂. Explain the pathologic processes that caused this patient’s hypoxemia.

QUESTION 13

1. A 64-year-old woman with moderately severe COPD comes to the pulmonary clinic for her quarterly checkup. The APRN reviewing the chart notes that the patient has lost 5% of her body weight since her last visit. The APRN questions the patient and patient admits to not having much of an appetite and she also admits to missing some meals because it “takes too much work” to cook and consume dinner.

Question:

The APRN recognizes that COPD has a deleterious effect on patients. Explain why patients with COPD are at risk for malnutrition.