Category: Nursing homework help

Billions spent to fix VA didn’t solve problems, and made some issues worse.
http://www.cnn.com/2016/07/05/politics/veterans-administration-va/index.html
1. Critique the quality as this article states, Money isn’t an issue. What do you think is the problem?

Instructions
Using the client information provided, respond to the critical thinking questions. Each response should be original (in your own words) and a minimum of three sentences in length.
Client Information
Meet your client, Nicole Peterson.
Nicole Peterson is a very thin 80-year-old woman who is in the hospital after fracturing her hip. Her hip was surgically repaired four days ago, but her recovery is slower than usual because of her overall fragile health and some post-surgery confusion. One of her nursing diagnoses is self-care deficits related to weakness, pain, alteration in cognitive functioning, and impaired mobility. Her nursing orders (NIC) include self-care assistance: bathing/hygiene/toileting.
Nicole Peterson: 80-year-old female, fractured hip surgically repaired, nursing diagnosis: self-care deficits, pain, alteration in cognitive functioning, impaired mobility
As the nurse helps an unlicensed assistive personnel (UAP) with Mrs. Peterson’s bath, she notices a reddened area on her sacrum. Realizing that this may be the beginning of a pressure injury, the nurse examines the area carefully and notes a small skin excoriation in the area. She repositions Mrs. Peterson to prevent further pressure on her sacrum. After finishing the bath, the nurse records her findings and enters on Mrs. Peterson’s care plan a nursing diagnosis of impaired skin integrity related to mechanical forces (e.g., shearing forces, pressure, physical immobility), alteration in skin turgor, and pressure over a bony prominence as evidenced by reddened area on the skin. She writes nursing orders, including an order to observe skin over bony prominences every 4 hours, and then delegates to the UAP the task of turning and repositioning Mrs. Peterson every 2 hours. The nurse also places Mrs. Peterson on a pressure-relief mattress and obtains a foam cushion for her wheelchair.
Critical Thinking Questions
What facts and principles do you already know about the causes of pressure injury?
Do you have enough information to provide interventions for Mrs. Peterson’s actual impaired skin integrity? If not, what do you still need to find out?
What do you know about positioning clients? How would you explain to the UAP how to position Mrs. Peterson “to prevent further pressure on her sacrum”?
What reassessments would you make to evaluate Mrs. Peterson’s skin integrity problem? When evaluating the diagnosis of self-care deficit, what reassessments would you make? Who can or should evaluate the issues identified? How often, or when, would you reassess?
What is one problem not described in the scenario that might arise?

Perform and document an internet search (database, key words, top listings) of community resources for a specific mental health illness
Explain the resources available and include a local organization
Describe the purpose (Mission and Vision statement is a guide ONLY) and the efficacy of the organization (how many needs are met)
Express the role of APRN in telehealth care delivery and how students can monitor its usefulness in primary care
Submit as a discussion post – no responses are required for this activity
apa format, references within 5 years

Based on the readings, viewing on the Module 6: Lecture Materials & Resources page, and your own experience, what strategies would you recommend encouraging culturally competent care of African Americans?
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
All replies must be constructive and use literature where possible.

Bullying prevention is a growing research field that investigates the complexities and consequences of bullying. There is also a complex relationship between bullying and suicide.
Visit http://www.stopbullying.gov/resources/index.html and identify resources for preventing bullying
and assisting children who have been bullied.
Instructions:
Word limit 500 words. Please provide citations and references (in APA, 7th ed. format) for your work.

Case Study
Instructions: Read the following case study and answer the reflective questions. Please provide
evidence-based rationales for your answers.
Requirements:
– Formatted and cited in current APA 7
– Use at least 600 words (no included 1st page or references in the 600 words)
– Use 3 academic sources. Not older than 5 years
– Not Websites are allowed.
– Plagiarism is NOT allowed
CASE STUDY: An Older Immigrant Couple: Mr. and Mrs. Arahan
Mr. and Mrs. Arahan, an older couple in their seventies, have been living with their oldest daughter,
her husband of 15 years, and their two children, ages 12 and 14. They all live in a middle-income
neighborhood in a suburb of a metropolitan city. Mr. and Mrs. Arahan are both college educated and worked full-time while they were in their native country. In addition, Mr. Arahan, the only offspring of wealthy parents, inherited a substantial amount of money and real estate. Their daughter came to the United States as a registered nurse and met her husband, a drug company representative. The older couple moved to the United States when their daughter became a U.S. citizen and petitioned them as immigrants. Since the couple was facing retirement, they welcomed the opportunity to come to the United States.
The Arahans found life in the United States different from that in their home country, but their
adjustment was not as difficult because both were healthy and spoke English fluently. Most of their time was spent taking care of their two grandchildren and the house. As the grandchildren grew older, the older couple found that they had more spare time. The daughter and her husband advanced in their careers and spent a great deal more time at their jobs. There were few family dinners during the week. On weekends, the daughter, her husband, and their children socialized with their own friends. The couple began to feel isolated and longed for a more active life.
Mr. and Mrs. Arahan began to think that perhaps they should return to the home country, where
they still had relatives and friends. However, political and economic issues would have made it
difficult for them to live there. Besides, they had become accustomed to the way of life in the United States with all the modern conveniences and abundance of goods that were difficult to obtain in theircountry. However, they also became concerned that they might not be able to tolerate the winter months and that minor health problems might worsen as they aged. They wondered who would take care of them if they became very frail and where they would live, knowing that their daughter had only saved money for their grandchildren’s college education. They expressed their sentiments to their daughter, who became very concerned about how her parents were feeling.
This older couple had been attending church on a regular basis, but had never been active in other church-related activities. The church bulletin announced the establishment of parish nursing with two retired registered nurses as volunteers. The couple attended the first opening of the parish clinic.
Here, they met one of the registered nurses, who had a short discussion with them about the services offered. The registered nurse had spent a great deal of her working years as a community health nurse. She informed Mr. and Mrs. Arahan of her availability to help them resolve any health-related issues.
Reflective Questions
1. What strategies could be suggested for this older adult couple to enhance their quality of life?
2. What community resources can they utilize?
3. What can the daughter and her family do to address the feelings of isolation of the older couple?
4. What health promotion activities can ensure a healthy lifestyle for them?

Goal:
To assess a clinical issue that is the focus of your Quality Improvement Project.
Create a description of the clinical issue to be addressed in the project.
Content Requirements:
Identify the clinical issue that will be the focus of your Quality Improvement project.
Provide rationale for the need to change the status quo.
Identify best practices from the literature related to the issues.
Submission Instructions:
The work is to be clear and concise, and students will lose points for improper grammar, punctuation and misspelling.
The work is to be 2 – 3 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 (the library has a copy of the APA Manual).
Your work should be formatted per current APA and references should be current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions)
Note: this is first part of your Quality Improvement Project. You should revise/improve your work based on your professor’s feedback. In module 7, you will be putting all the parts together to complete and submit your final project.
Submission needs to have: title page, introduction, body, and conclusion, and references in APA style.

Due 6/20 7pm EST
250 word discussion not including title and 1 reference APA All posts should be supported by a minimum of one scholarly resource, ideally within the last 5 years. Journals and websites must be cited appropriately. Citations and references must adhere to APA format.

Consider the use of communication tools and checklists in your clinical area.
Identify areas for improvement in communicating critical patient information to the appropriate provider.
Discuss errors or near misses in your clinical area and how it was handled.
Identify education that would support improved teamwork and decrease the chance of near misses or errors.
Please be sure to validate your opinions and ideas with citations and references in APA format.

Watch this video below and respond to the improvements (or lack of improvements) you’ve noted to our nation’s Obesity Epidemic over the past 10 years. Use evidence to support your position.
https://www.cdc.gov/cdctv/diseaseandconditions/lifestyle/obesity-epidemic.html
Discussion Questions: Evaluation is based on the following three criteria 1) Substance of the posting or other media method 2) Regularity and consistency of the posting and 3) The degree to which postings expand the level of dialogue and analysis.

For this Case Study Discussion, you will once again review a case study scenario to obtain information related to a comprehensive well-woman eval and determine differential diagnoses, diagnostics, and develop treatment and management plans.
Include the additional questions (additional questions ONLY related to the HPI/CC) you would ask the patient and explain your reasons for asking the additional questions. Then, explain the types of symptoms you would ask. Be specific and provide examples. (Note: When asking questions, consider sociocultural factors that might influence your question decisions.)
Based on the preemptive diagnosis, explain which treatment options and diagnostic tests you might recommend. Use your Learning Resources and/or evidence from the literature to support your recommendations. Your primary diagnosis, additional questions, and types of symptoms are what this assignment and grading is focused on. Your critical thinking for this assignment
References MUST be scholarly!!! (Do not use WebMD, Clevelandclinic.org, mayoclinic.org, etc as these are public websites).
Case Study 2
Case Study: STI Investigation
Susan Lang is a 24-year-old Caucasian female presenting to the clinic for regular care. She
works full-time as an administrative assistant, and relates she loves her job. She has no medical
or surgical history, takes no medication, and has no allergies. Family history is non-
contributary. Social history is remarkable for cigarette smoking at a rate of ½ packs per day
(PPD) since age 14, / EtOH only on weekends, 6-8 hard liquor/ daily, and marijuana
smoking. Gyn history is onset of menses age 13, menses every 28-32 days, lasting 4-6 day and
using 3 tampons daily. She has some cramping during her menses for which she
takes otc Pamprin. She jogs 3-4 times a week, wears seatbelts when in the car, and
“occasionally” uses sunscreen. Susan relates she has been having some postcoital bleeding for
the past 6 weeks and has had a sore throat for past 3 weeks. She did have a fever for a day
or two, but Tylenol took care of it and she thought it was allergies.
Susan’s vital signs are taken and were temperature 97.8, pulse 68, BP 112/64, height 5’6” and
weight 118 lbs. (which was the same as last year). BMI 19.04
· HEENT: WNL except some anterior cervical adenopathy bilaterally, and throat
appears reddened.
· Lung: clear to auscultation
· CV: regular sinus rhythms without murmur or gallop
· Abd: soft, non-tender, liver normal,
· Breasts: fibrocystic changes bilaterally, no masses, dimpling, redness or discharge,
no adenopathy, and bilateral nipple piercings.
· VVBSU: wnl, slight frothy yellow discharge by cervix, clitoral piercing noted
· Cervix: friable, some petechia no cervical motion tenderness.
· Uterus: mid mobile, non-tender
· Adnexa: without masses or tenderness
· Perineum: wnl
· Rectum: wnl
· Extremities: full rom, skin clear, no edema, reflexes 1+.
· Neurological: CN II-12 grossly intact.