Category: Nursing homework help

You are an advanced practice nurse in a hospital.
If you could whisper one thing to your organization’s leader about toxicity, what would it be?
How do you expect the leader to respond?
Will the toxicity be addressed?
Why or why not?
What is the role of the advanced practice nurse to address and prevent toxicity?

A 65-year-old patient is 8 days post op after a total knee replacement. Patient suddenly complains of shortness of breath, pleuritic chest pain, and palpitations. On arrival to the emergency department, an EKG revealed new onset atrial fibrillation and right ventricular strain pattern – T wave inversions in the right precordial leads (V1-4) ± the inferior leads (II, III, aVF)
In your Case Study Analysis related to the scenario provided, explain the following
The cardiovascular and cardiopulmonary pathophysiologic processes that result in the patient presenting these symptoms.
Any racial/ethnic variables that may impact physiological functioning.
How these processes interact to affect the patient.

CASE SCENARIO
IDENTIFYING DATA
LS is a 25-year-old Caucasian male who works as a lawyer at a top law firm in his state. He came to the clinic accompanied by his romantic partner. They are both worried about his condition since it has been affecting his social life and has caused a change in his professional environment.
CHIEF COMPLAINT: “I feel confused about how to act.”
HISTORY OF PRESENT ILLNESS
The patient’s overall life has been affected due to a limited ability to attain emotional stability. When he became aware of the initial diagnosis, he started getting affected by physical symptoms like pain, shortness of breath, or body weakness. All these indicate that the patient was impacted by a response to psychological distress, mainly discovered when a person is experiencing these symptoms. As LS progressed with his life and taking medication, he was asked to take some medical tests, but they did not always show a medical basis. The previous doctor diagnosed him with a personality disorder because psychological distress and physical symptoms were the main symptoms he displayed.
PERSONAL HISTORY
LS has had a rough time adjusting his life so that other people would be accommodative to his personality. He often changes moods quickly and can appear to be an impatient person, yet the issue is known to persons close to him. Career advancement has been a common outcome of LS’s life since he does not allow his personality issues to affect his sustenance.
PAST PSYCHIATRIC HISTORY
The patient got diagnosed with a personality disorder when he was 15 years old. It was imperative for him to receive the diagnosis since he had been frequently affected by emotional distress and unmanageable behavior when he joined high school.
MEDICAL HISTORY
The patient had been prescribed Serotonin reuptake inhibitors which is a type of antidepressant used in patients with personality disorders who get affected by severe physical and psychological symptoms. The medication is an anxiolytic agent who got prescribed to the patient by his physician. LS explained that he researched the medication he prescribed and discovered that patients could become dependent on them. Thus, he managed his medical history by communicating with his nurses since he started taking the medication 3 months ago.
REQUIREMENTS:
BASED ON THE CASE SCENARIO ABOVE, CREATE A POWERPOINT PRESENTATION WITH THE FOLLOWING DETAILS, NONE OF THEM CAN’T BE MISSED.
1- TOPIC PERSONALITY DISORDER ( As the CSE SCENARIO ABOVE)
2- Diagnosis definition/ SIGN AND Symptoms/Prevalence and Risk factors( *The diagnosis, prevalence, and risk factors descriptions are completely accurate and supported by evidence-based information.)
3- Patient presentation/Neurobiology/Related neurotransmitters
4-Evidence-based treatment plan:
Includes patient education,
prognosis, and potential side
effects and the role of the PMHNP.
5- References
Please adhere to the 5 points above, complete each section as requested b Instructor
8 SLIDES WITH SPEAKER NOTES REQUIRED
SLIDES NEED TO BE WITH PROPER INFORMATION, USE GOOD FORMAT WTH DETAILS
NO PLAGIARISM MORE THAN 10%
DUE DATE MARCH 30, 2023 NO LATER THANKS

Using Everyday use by Alicia Walker, respond to the following questions.
1. Explain the symbolism in the story.
2. How does the symbolism tie to the theme?
3. What is the greater message or lesson?
Use textual support

**ANSWER**
**Symbolism in Everyday Use**

The most prominent symbol in “Everyday Use” is the quilt. The quilts are made from scraps of fabric from different generations of Maggie and Dee’s family. They represent the family’s history and tradition. Dee wants to take the quilts to hang on the wall as art, but Maggie wants to use them for their everyday purpose. This symbolizes the conflict between Dee’s desire to preserve the family’s heritage and Maggie’s desire to use it in a practical way.

Other symbols in the story include:

* **The house:** The house is a symbol of the family’s roots and their connection to the land. It is also a symbol of the family’s poverty and struggle.
* **The yard:** The yard is a symbol of the family’s freedom and their connection to nature. It is also a symbol of the family’s struggle to survive.
* **The dasher:** The dasher is a symbol of Dee’s new identity and her desire to break away from her family’s past.

**How the symbolism ties to the theme**

The symbolism in “Everyday Use” ties to the theme of identity. The story is about the conflict between two sisters who have different views of their identity and their family’s heritage. Dee wants to define her identity on her own terms, while Maggie is more comfortable with her traditional identity. The symbols in the story represent the different choices that Dee and Maggie have made about their identities.

**Greater message or lesson**

The greater message of “Everyday Use” is that there is no right or wrong way to define your identity. It is important to be proud of your heritage, but it is also important to be your own person. You can choose to embrace or reject your family’s traditions, but it is important to be honest with yourself about who you are.

**Textual support**

The following passages from the story support the analysis of the symbolism:

* **Symbolism of the quilt:**

> “She had always wanted to have ‘some of Mama’s quilts’… Dee had already decided she would take the quilts with her. She had no doubt that Maggie would be delighted to have them.”

> “Maggie put the quilt around her shoulders. It was her favorite, and she had always slept with it.”

* **Symbolism of the house:**

> “The old house was drafty and cold, but it was home.”

> “The house was built of logs cut from the woods behind it, and it was surrounded by a yard full of pecan trees.”

* **Symbolism of the yard:**

> “Maggie loved the yard. She loved the smell of the pine needles and the feel of the soft dirt under her feet.”

> “Maggie sat on the porch and looked out at the yard. She could see the chickens pecking at the ground and the ducks swimming in the pond. She felt at peace.”

* **Symbolism of the dasher:**

> “Dee came out with a dasher. She held it up for us to admire. It was beautiful light yellow wood, from a tree that grew in the yard where Big Dee and Stash had lived.”

> “Dee put the dasher on the table. I don’t think I’ll be using that,” she said. “I can buy new things at the store.”

**Conclusion**

The symbolism in “Everyday Use” is complex and meaningful. It helps to convey the story’s theme of identity and the greater message that there is no right or wrong way to define who you are.

For this, you will take on the role of a clinician who is building a health history for the following case:
Chief Complaint
(CC) “I am here today due to frequent and watery bowel movements”
SubjectiveFever and chills, Lost appetite Flatulence No mucus or blood on stools
History of Present Illness (HPI)A 37-year-old European American female presents to your practice with “loose stools” for about three days. One event about every three hours
PSHAppendectomy at the age of 14
Drug Hx
No meds
AllergiesPenicillin
PE B/P 188/96; Pulse 89; RR 16; Temp 99.0; Ht 5,6; wt 110; BMI 17.8
General well-developed female in no acute distress, appears slightly fatigued
HEENT Atraumatic, normocephalic, PERRLA, EOMI, arcus senilus bilaterally, conjunctiva and sclera clear, nares patent, nasopharynx clear, edentulous.
NeckSupple
Cardiology S1S2 without rub or gallop
Abdomen positive bowel sounds (BS) in all four quadrants; no masses; no organomegaly noted; diffuse, mild, bilateral lower quadrant pain noted Mild diffuse tenderness.
Integumentary good skin turgor noted, moist mucous membranes

Once you received your case number, answer the following:
What other subjective data would you obtain?
What other objective findings would you look for?
What diagnostic examination do you want to order?
Name 3 differential diagnoses based on this patient presenting symptoms?
Give rationales for your each differential diagnosis.
Requirements:
at least 500 words ( 2 complete pages of content) formatted and cited in current APA style 7 ed with support from at least 3 academic sources which need to be journal articles or books from 2019 up to now. NO WEBSITES allowed for reference entry. Include doi, page numbers, etc. Plagiarism must be less than 10%.

Module 01 Content
Submit this assignment which compares and contrasts two mental health theories:
You may choose your theories from the textbook or from other sources.
Describe each theory, including some history about the person who developed the theory and the major ideas and applications of the theory.
Describe the ways in which the two theories are similar, and how they differ.
Include a statement of how each theory could be used in your nursing practice. Include specific patient examples if you have them. You may also critique the theory: Is there anything with which you disagree or are there any problems you can identify?
It is expected that this assignment will be 2-3 pages in length (not including the title page), double-spaced. Your assignment should include an introduction and conclusion and proper APA citations from any source material you use, including your text.

Week 4 Discussion
Chest Pain
CP is a 64-year-old male who presents to the emergency department (ED) via ambulance for chest pain. He was out shoveling snow from his driveway when he developed left anterior chest pain, pressure-type, radiating to his jaw and shoulder. Despite the cold weather, he was sweating. He also noted palpitations and shortness of breath, although he thought it was just because he was “a little out of shape.” He was afraid that something was wrong, so he asked his wife to call 911.
Past Medical History
• Hypertension
• Hyperlipidemia
• Diabetes mellitus
• Gout Medications
• Hydrochlorothiazide, 25 mg once daily
• Allopurinol, 300 mg once daily
Social History
• Retired factory worker
• Smokes one pack of cigarettes per day
• Drinks about six beers per day (sometimes more)
Physical Examination
• Well-developed obese man in moderate distress
• Height: 69 inches; weight: 252 lbs.; blood pressure: 172/110; pulse: 92; respiration rate: 16; temperature: 98.7 °F
• Lungs: Scattered bilateral wheezes
• Heart: Regular with grade II/VI systolic murmur
• Extremities: No edema
Labs and Imaging
• Complete blood count with mild leukocytosis (WBC 12.9k)
• Potassium: Low at 2.9 mEq/L
• Glucose: 252 mg/dL
• Troponin I: 1.7 ng/L
• Uric acid: 11.1 mg/dL
• EKG: ST segment depression with T-wave inversion over lateral leads; no pathologic Q waves Next Steps
• CP’s admitting diagnoses are non-ST segment elevation acute coronary syndrome, hypertension, diabetes mellitus, obesity, alcohol abuse, hyperuricemia, and smoker
Discussion Questions
1. What medications should be instituted for CP?
2. What medications should be continued after discharge?
3. What lifestyle modifications can be recommended for CP?

Reflection
Initial Post
Areas for reflection:
Describe how you achieved each course competency, including at least one example of new knowledge, gained related to that competency.
Describe how you achieved the transferable skills (listed below), including at least one example of new knowledge, gained related to the transferable skill.
Describe how this new knowledge will impact your nursing practice.
Course Competencies
Design relevant, multidimensional nursing care for optimal health inclusive of client preferences, values, and beliefs.
Select approaches to client care which incorporate care and comfort, risk reduction, health promotion, and disease management.
Prioritize evidence-based, client-centered nursing care as a foundation for emotional, mental, spiritual, and social well-being.
Utilize data-driven nursing care strategies inclusive of continuous quality improvement.
Synthesize components of clinical judgement, professional nursing identity, and reflective practice for lifelong learning.
Determine effective responses to clinical problems integrating information technology, evidence-based practice, quality improvement, and interprofessional collaboration.
Transferable Skills
Take a moment and review the Transferrable Skills Media from Module 02.
Communication
Critical Thinking
Digital Fluency
Diversity and Teamwork
Information Literacy
Ethics and Professional Responsibility

Describe a health promotion model used to initiate behavioral changes. How does this model help in teaching behavioral changes? What are some of the barriers that affect a patient’s ability to learn? How does a patient’s readiness to learn, or readiness to change, affect learning outcomes?
ANSWER
The Health Promotion Model (HPM) is a widely used model to initiate behavioral changes. It is based on the belief that people are motivated to make changes when they believe that the benefits of change outweigh the costs, and when they feel confident that they can make the change.
The HPM has six key components:
Perceived benefits of action: This refers to the person’s belief that the benefits of making a change outweigh the costs.
Perceived barriers to action: This refers to the person’s belief that there are barriers to making a change, such as lack of time, money, or support.
Perceived self-efficacy: This refers to the person’s confidence in their ability to make a change.
Activity-related affect: This refers to the person’s emotional response to the thought of making a change.
Motivational intentions: This refers to the person’s intention to make a change.
Behavioral outcomes: This refers to the person’s actual behavior.
The HPM can be used to teach behavioral changes by helping people to:
Identify and weigh the benefits and costs of change.
Identify and address barriers to change.
Develop self-efficacy.
Experience positive emotional responses to the thought of change.
Form intentions to change.
Make changes to their behavior.
Here are some examples of how the HPM can be used to teach behavioral changes:
A nurse educator might teach a patient about the benefits of quitting smoking, such as improved health, reduced risk of cancer, and saved money.
A dietitian might help a patient to identify and address barriers to eating healthy, such as lack of time or access to healthy foods.
A physical therapist might help a patient to develop self-efficacy for exercise by providing them with support and encouragement.
A counselor might help a patient to experience positive emotional responses to the thought of making a change, such as feeling more confident and in control of their health.
Barriers to Learning
There are a number of barriers that can affect a patient’s ability to learn, including:
Lack of motivation: Patients may not be motivated to learn about behavioral changes if they do not see the need for change, or if they believe that the change is too difficult.
Lack of knowledge: Patients may not have the knowledge or skills necessary to make a change. For example, a patient may not know how to cook healthy meals or how to exercise safely.
Language barriers: Patients may not be able to understand the information that is being taught if they do not speak English or if they have a limited understanding of medical terminology.
Cultural barriers: Patients’ cultural beliefs and values may conflict with the behavioral changes that are being taught.
Readiness to Learn
A patient’s readiness to learn, or readiness to change, can also affect learning outcomes. Patients who are more ready to change are more likely to be motivated to learn about behavioral changes and to make changes to their behavior.
There are a number of factors that can affect a patient’s readiness to change, including:
Awareness of the problem: Patients must be aware of the problem before they are ready to change.
Desire to change: Patients must want to change in order to be successful.
Ability to change: Patients must believe that they are able to change in order to be successful.
Social support: Patients who have social support are more likely to be successful in changing their behavior.
Conclusion
The Health Promotion Model is a useful model for teaching behavioral changes. It can be used to help people to identify and weigh the benefits and costs of change, to identify and address barriers to change, to develop self-efficacy, to experience positive emotional responses to the thought of change, to form intentions to change, and to make changes to their behavior.
When teaching behavioral changes, it is important to consider the barriers that can affect a patient’s ability to learn and their readiness to change. By understanding these factors, nurses and other healthcare professionals can develop more effective teaching strategies.

Assignment 3:
Individual assignment . one per student .
Assignment #3 Individual PowerPoint Presentations covering the following case study:
Aims and Objectives: To identify structure, process, and outcomes associated with the implementation of transitional community-based management of hospital readmission rates.
Background: Population health-based projects have previously been described (Chapters 10 and 13). Using a transitional community-based readmissions plan for patients with heart failure, categorize quality metrics into structure, process, and outcomes.
Questions/comments to be considered are as follows:
What are your data input, output, and measures of success?
Suggested response: The data input would be community health workers and patients with heart failure, the output would be readmission plans, and the measure of success would be surveying patient responses.
2, Explain how your devised model incorporates social context.
The community-based management program will ensure that social contexts such as social or familial support, income, or cultural norms are incorporated.
Patients will be treated within their social context and communities.
3.How will you assess your population or community?
Suggested response: The patient assessment instrument in Centers for Medicare & Medicaid Services (CMS) measure management programs can be used to assess the population or community.
Minimum 6 slides- Maximum 8 slides including reference page.
14 percent of total grade
Rubric
Content/Points
-The students answered the data input would be community health workers and patients with heart failure, the output would be readmission plans, and the measure of success would be surveying patient responses. (4 points)
-The student identify that the revised model incorporates social context are.
The community-based management program will ensure that social contexts such as social or familial support, income, or cultural norms are incorporated.
Patients will be treated within their social context and communities.
(4 points)
-The student discuss that to assess the population or community it can be used the patient assessment instrument in Centers for Medicare & Medicaid Services (CMS) measure management program (4 points)
– APA reference (2 points)