Monthly Archives: May 2023

Are there differences in the responsibility related to informed consent for the nurse and physician? If so, what are the differences?

INSTRUCTIONS

minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

APA format according to Publication Manual American Psychological Association (APA) , in text citations and references required.

·  Minimum of two references, not older than 2015.

Scenario 3: 11-year-old boy complains of wheezing and difficulty “getting enough air.” Notices it more when he is playing baseball and symptoms improve when exercise activity stops. He says that the symptoms are getting worse and the symptoms are even occurring at rest. Mother says the child is allergic to cat dander and his next-door neighbor in their apartment building recently began sheltering cats for the local humane society. Auscultation demonstrates wheezes on forced expiration throughout all lung fields. ( must be included in paper) 

Assignment (1- to 2-page case study analysis)

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.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The sample paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates). All papers submitted must use this formatting.

 Term Paper Instructions

In this course, you will write a term paper on a current medical ethics issue of your choice. Give this some thought, this will be the topic you will be using for the outline, rough draft, and final term paper assignments. Make sure you can find articles for support of your topic. Read the term paper requirements before you select your medical ethics issue topic to insure it is what you want to research.

Your term paper should:

• Discuss the technical aspects of your topic in general terms.
• Discuss the public policy debates relevant to the topic you choose. This section should cover arguments that are in favor of and opposed to the use of the techniques or products.
• Express your personal opinion regarding the importance of the topic and the validity of the pro and con arguments. 

Week 6 Term Paper: Rough Draft

This week, you will submit a rough draft of your term paper.

A rough draft is not expected to be polished, and as such, this assignment will be graded on a completion basis. However, in order to receive full credit for the assignment, the following components must be met:

• The rough draft includes an introduction, a minimum of four body paragraphs, and a conclusion.
• A minimum of three references are incorporated as supporting evidence.
• Use the outline you posted as a guide. As you draft you may find that changing some pieces is necessary for the paper to make sense.
• Be sure to follow APA style formatting for your paper and cite your sources.

 * Need PLAG report 

Help with this using Davis drug guide amd Dewit textbook. 

Instructions:

Try your own experiment by choosing a challenging online article to read, and listen to 4 different types of music while trying to read and comprehend the article. List the challenging passage in APA format, and answer the following questions for every piece of music:

• Make a note of the genre of music, (Vivaldi, death metal, jazz, gospel, hip hop, blues, rap, country).
• Was it easy or difficult to understand the challenging paragraphs?
• Why do you think it was easier to understand what you were reading while listening to some music and not to others?
• What impact do you think having certain music in schools or on the job would have on the people in those environments?

Please be sure to validate your opinions and ideas with citations and references in APA format

Musical Challenge

Instructions:

Please post 1 peer response

In the response post, include the following:

• How do your results from the experiment differ from the original post of this student?
• In what ways do you agree, and disagree, with your peer’s responses?

Please be sure to validate your opinions and ideas with citations and references in APA format.

Choose a common diagnosis resulting in neurological deficit in the older adult (i.e. Parkinson’s disease, transient ischemic attacks (TIA), or cerebrovascular accidents (CVA)) and identify the risk factors, symptom presentation, and nursing care for patients with these deficits. Also, search the Internet and locate Web sites that provide information about maintaining independence and limiting further injury in older adults with neurological deficits.

• Paper should be in APA format
• Length: 2-3 pages in length EXCLUDING the title and reference pages

reply1

The Haitian culture is a mixture of African, Spanish, and French influence from the colonization of Haiti and the transport of African slaves to the Caribbean island. Many Haitians sought asylum in the US in the 1970s when large-scale refugees migrated to the US in an attempt to escape Jean-Claude Duvalier’s dictatorship and the economic hardships that resulted. (Girault,2020). Many Haitians have settled in the United States blending in the cacophony of American life; many occupying jobs in varying positions of life including leadership positions in Healthcare, industry, and journalism. I have worked with many Haitian health care providers and have interacted with many of them as patients. Their culture is fascinating with the majority practicing Catholics with a mixture of spiritism called Voodoo a religious cult with roots from West African religions. (Girault, 2020). The major language spoken is French Creole and although the younger Haitians endeavor to learn English and get an education in this country, many of their elderly parents retain their unique traditions. Many individuals who migrate to the United States from other countries cling tenaciously to their traditional cultural practices and languages resulting in a phenomenon called multiculturalism. (Catalano, 2006).

Effective communication with the Haitian patient means assessing the patient’s ability to communicate fluently in English and may require using a professional interpreter preferably a health professional. I remember trying to teach an elderly Haitian woman deep breathing exercises to relieve stress because she was demonstrating symptoms of anxiety that were exacerbating her Chronic obstructive Pulmonary Disease (COPD) and although I used an interpreter she refused to follow the instructions. After speaking extensively with one of her family members I realized that the patient believed that her anxiety and depression was caused by an evil spirit that she thought could not be treated by modern medicine and her condition could only be improved with the help of a voodoo priest. A family member was allowed to bring a voodoo priest and the nursing staff gave them the privacy to carry out their rituals. Family is very important to the Haitian Culture and should be a part of the decision making process. As clinicians, we need to be sensitive to the root causes of health problems from the patient’s and family’s perspective and accommodate their religious beliefs as long as it does not interfere with medical treatment or cause harm to the patient. What was surprising to me and the other nurses was that she appeared calm a long time post ritual and did not appear to need her prn anxiety medications. Instead, she had several sacred items positioned around her bed which appear to provide her with comfort.

Lack of knowledge or understanding of cultural differences or unwillingness to accept the patient’s alternative beliefs, values or attitudes can lead to the inability to empathize or to respect the patient’s point of view and can jeopardize the nurse-patient relationship. Falvo, 2011). Open communication with the patient and the family members can cue the health professional to potential barriers to learning and assist in developing appropriate strategies to deal with them. For the elderly patient, health teaching materials should be in large print, colorful, and written in the patient’s language in simple layman’s terms.

References

Cataldo, J. (2006). Nursing now! Today’s issues, tomorrow’s trends. Philadelphia PA: FA Davis Company.

Falvo, D. (2011). Effective patient education. A guide to increased adherence. https://viewer.gcu.edu/RQBKXW

Girault, C. (2020). Haiti. Retrieved from. https://britannica.com.com/place/Haiti

reply2

I have personal experience with being a part of a culture that has specific values and beliefs. I am Russian and Armenian and can speak fluent Russian. I always took pride in that, however, it was difficult to balance the “American culture” and staying true to my roots. During nursing school, I had the experience of caring for a Russian patient and witnessed the importance of acknowledging the patients culture, values ad beliefs while caring for them. Russians highly respect and trust health care professionals. Health care professionals can present patient education by making direct eye contact, being firm and respectful and using “Mr.”, “Mrs.”, or “Ms.”. Russians are very big on respect, so there must be mutual respect from the patient and the health care professionals. One thing to remember is that Russian patients tend to have a high pain threshold and can present stoic regarding pain and care. Health care professionals can address this by using any evidence that presents the patient is in pain and reminding them the importance of staying comfortable during their stay. The Russian language, from an outside perspective, can sound very harsh and loud, so health care professionals should remember that this doesn’t necessarily mean that the patient is not happy or in distress, it is just a part of the Russian language. Lastly, Russian culture is all about family. Health care professionals should involve family members in the patients care and all patient education.

When I had the Russian patient, we were able to communicate very well because I happened to speak Russian and practice the culture. My preceptor, however, did not have the same experience. I think it was difficult for my preceptor to understand the culture at first because the patient heavily relied on her daughter for everything during her hospitalization. As well as not eating the hospital food and solely eating the food her daughter brought her. My preceptor made a comment how the patient was “harsh and rude”. It was a good learning experience for her because I explained the Russian culture to her. I reminded her that children are expected to care for their elderly parents, which is why the patient was so heavily dependent on her daughter for everything. Elderly Russian women are very stuck in their ways and are not good with change, which is why she requested meals from home. Lastly, I reassured my preceptor that her tone may seem harsh and rude, but that is just the culture and the accent. After giving my preceptor insight on the Russian culture, it made her day much easier because she had more understanding of why the patient was the way she was. Ultimately, as nurses we must remember culture defines an individual and working in health care we are responsible caring for all types of individuals, which is why assessing our patient thoroughly and educating ourselves are essential in treatment.

For  each Barrier to Patient Centered Care, identify facilitators that could  be introduced to balance/offset the barrier. Provide rationale for your  response based on (text books, articles,  practice guidelines, etc) as appropriate:

Barriers:

1. Competing care obligations (patient–load) interfere with prioritizing discussions of discharge planning with patient/planning.
2. Discharge communication ranged from simple one-sided instruction to shared decision making.
3. Patients did not feel prepared for discharge and post-discharge care was not individualized.
4. Discharge process/decisions affected by pressure for available beds.

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks.
The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status.
One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life.
The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families.
She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care.
When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines”
Critical thinking activities
1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).
2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?
3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.

WEEK 4

Select the state where you plan to practice as a nurse practitioner and/or nurse leader and investigate the state’s policies on access to maternal health resources such as contraceptive care including abortion for women with and without health insurance coverage. Identify what are the state’s infant and maternal mortality rates and discuss the possible relationship between these factors. 

Florida, I live in Miami. APA format, 250 words except references.