Monthly Archives: May 2023

Write a paper (2,000-2,500 words) in which you apply the concepts of epidemiology and nursing research to a communicable disease. Refer to “Communicable Disease Chain,” “Chain of Infection,” and the CDC website for assistance when completing this assignment.

Communicable Disease Selection

1. Chickenpox
2. Tuberculosis
3. Influenza
4. Mononucleosis
5. Hepatitis B
6. HIV
7. Ebola
8. Measles
9. Polio
10. Influenza

Epidemiology Paper Requirements

1. Describe the chosen communicable disease, including causes, symptoms, mode of transmission, complications, treatment, and the demographic of interest (mortality, morbidity, incidence, and prevalence). Is this a reportable disease? If so, provide details about reporting time, whom to report to, etc.
2. Describe the social determinants of health and explain how those factors contribute to the development of this disease.
3. Discuss the epidemiologic triangle as it relates to the communicable disease you have selected. Include the host factors, agent factors (presence or absence), and environmental factors. Are there any special considerations or notifications for the community, schools, or general population?
4. Explain the role of the community health nurse (case finding, reporting, data collection, data analysis, and follow-up) and why demographic data are necessary to the health of the community.
5. Identify at least one national agency or organization that addresses the communicable disease chosen and describe how the organizations contribute to resolving or reducing the impact of disease.
6. Discuss a global implication of the disease. How is this addressed in other countries or cultures? Is this disease endemic to a particular area? Provide an example.

A minimum of three peer-reviewed or professional references is required.

 APA Style. An abstract is not required.

 1-Which level of measurement would you prefer to utilize for quantitative research? Defend your answer. 

2- APA style

3- 3 paragraphs of 3 sentences each

4- 2 references

As the Administrator of a Medicare certified home health agency you are responsible for analyzing and controlling cost variances to maintain agency viability. Identify three metrics you would use to analyze agency financial performance on a daily basis. Discuss why you have selected these metrics.

250-350 words

N492 Assignment Mod 4:

Assignment:

Write a scholarly paper in which you apply the concepts of epidemiology and nursing research to a communicable disease. Choose one communicable disease.

Epidemiology Paper Requirements

Include the following in your assignment:

1. A      thorough description of the disease including causes, mode of      transmission, symptoms, treatment and complications. Discuss the      demographic most affected-incidence, prevalence, morbidity and mortality.
2. What      are the determinants of health affecting this disease? https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health.
3. Identify      the epidemiologic triad including host, agent and environmental factors as      related to this disease.
4. Discuss      the role of the public health nurse in relation to this disease. How is      the public health nurse involved in finding, reporting, collection and      analysis of data and follow up?

A minimum of three references is required. The written essay should be at least 1250 words in length.

APA format is required.

Patricia Brenner theory

“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.

Academic Clinical History and Physical Note 1

Academic clinical history and physical notes provide a unique opportunity to practice and demonstrate advanced practice documentation skills, to develop and demonstrate critical thinking and clinical reasoning skills, and to practice identifying acute and chronic problems and formulating evidence-based plans of care.

Complete an academic clinical history and physical note based on a patient seen during clinical. In your assessment, provide the following.

History and Physical Note

1. Chief complaint/reason for admission/visit/consult.

2. HPI for the H&P or consult notes.

3. Medical, surgical, family, social, and allergy history.

4. Home medications, including dosages, route, frequency, and current medications, if a consultation note

5. Review of systems with all body systems for H&P or consult notes. Review of systems is what the patient or family/friends tell you (by body system).

6. Vital signs and weight.

7. Physical exam with a complete head-to-toe evaluation. Include pertinent positives and negatives based on findings from head-to-toe exam.

8. Lab/Imaging/Diagnostic test results (including date).

Assessment and Clinical Impressions

1. Identify at least three differential diagnoses based upon the chief complaint, ROS, assessment, or abnormal diagnostic tools with rationale.

2. Include a complete list of all diagnoses that are both acute and chronic.

3. List the differential diagnoses and chronic conditions in order of priority.

Plan Component Management and Plan Criteria Incorporation

1. Select appropriate diagnostic and therapeutic interventions based on efficacy, safety, cost, and acceptability. Provide rationale.

2. Discuss disposition and expected outcomes.

3. Identify and address health education, health promotion, and disease prevention.

4. Provide case summary with ethical, legal, and geriatric considerations. Consider potential issues, even if they are not evident.

General Requirements

Incorporate at least three to Five peer-reviewed articles in the assessment or plan. Words count should be between 1000-1500.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

 Consider the “Four Topics Approach” (or Four Box method) to ethical decision making on page 61, Table 2.1 in Butts (below).  Apply this model to a challenging situation in your nursing career that required you to consider the ethical dimensions of the patient case and the role you played in providing care. Specifically apply and address the questions within each topic area as they pertain to your situation.

In your conclusion, discuss the impact of the Four Topics process. Did applying these principles shape your decision making in any way?  Does this seem like a valid process for you to apply in your practice? 

Your paper should be 1-2 pages. Adhere to APA formatting throughout, and cite any outside sources you may use.

Review the rubric for further information on how your assignment will be graded.

Due: Sunday, 11:59 p.m. (Pacific time)

Points: 60

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence

1. What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

2.  What are the goals of treatment?

3.  In what circumstances are medical treatments not indicated?

4.  What are the probabilities of success of various treatment options?

5.  In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

Patient Preferences:  The Principle of Respect for Autonomy

1. Has the patient been informed of benefits and risks, understood this information, and given consent?

2.  Is the patient mentally capable and legally competent, and is there evidence of incapacity?

3.  If mentally capable, what preferences about treatment is the patient stating?

4.  If incapacitated, has the patient expressed prior preferences?

5.  Who is the appropriate surrogate to make decisions for the incapacitated patient?

6.  Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

Quality of Life: The Principles of Beneficence and Nonmaleficence and Respect for Autonomy

1.  What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

2.  On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

3.  Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

4.  What ethical issues arise concerning improving or enhancing a patient’s quality of life?

5.  Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

6.  What are plans and rationale to forgo life-sustaining treatment?

7.  What is the legal and ethical status of suicide?

Contextual Features: The Principles of Justice and Fairness

1.  Are there professional, interprofessional, or business interests that might create conflicts of interest in the clinical treatment of patients?

2.  Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

3.  What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

4.  Are there financial factors that create conflicts of interest in clinical decisions?

5.  Are there problems of allocation of scarce health resources that might affect clinical decisions?

6.  Are there religious issues that might influence clinical decisions?

7.  What are the legal issues that might affect clinical decisions?

8.  Are there considerations of clinical research and education that might affect clinical decisions?

9.  Are there issues of public health and safety that affect clinical decisions?

10.  Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

Question 1

In 200-250 words,  Discuss what resources are often necessary for nonacute care for cardiorespiratory issues. Explain how they support patient independence and decrease readmission. 

Question 2  

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.

2. Denies pain but says she feels like she cannot get enough air.

3. Says her heart feels like it is “running away.”

4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.

2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.

3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.

4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.

5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)

2. Enalapril (Vasotec)

3. Metoprolol (Lopressor)

4. IV morphine sulphate (Morphine)

5. Inhaled short-acting bronchodilator (ProAir HFA)

6. Inhaled corticosteroid (Flovent HFA)

7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.

2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.

3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.

5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.

6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.

7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of TWO sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. 

New practice approaches 

Reply 1

According to Schmidt (2018), validity and reliability are crucial components to a well-developed research study. Validity refers to how much a concept relates to real life, whereas reliability is how much an experiment yields the same results when repeated. Qualitative and quantitative studies, though different in approach, still draw validity and reliability. Quantitative research is structured and objective, relying on data and measurements. Qualitative research is less structured and more subjective, relying on text, in depth information, and can include focus groups or interviews (UTA, 2020). Benefits to utilizing both qualitative and quantitative research in point towards each method filling in the gaps of where the other seems to lack. “Quantitative data can give baseline information to aid researchers in selections of patients to interview, while qualitative data can provide researchers understanding of barriers and factors to patient recruitment and retention” (Doorenbos, 2014). However, if a study is utilizing both methods of research, there might be a mix of data collection leading to inconsistencies in objective collection and issues with validity (McNiff and Petrick, 2018).

Doorenbos A. Z. (2014). Mixed Methods in Nursing Research : An Overview and Practical Examples. Kango kenkyu. The Japanese journal of nursing research, 47(3), 207–217.

McNiff, P. and Petrick, M. (2018). Quantitative research: ethics, theory, and research. In Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

Schmidt, M. (2018). Measurement, statistics and appraisal. In Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

University of Texas Arlington. (2020). Qualitative vs quantitative research. https://libguides.uta.edu/nursingresearch

Reply 2

Nursing research is conducted by using different types of methods such as qualitative, quantitative, experimental, quasi-experimental, correlation, and descriptive method. Qualitative research is considered as exploratory research for the deep understanding of the research problem and provides a way for quantitative research. In some studies, both qualitative and quantitative methods used in the studies are called Mixed methods of study.

Advantages of Mixed Method:

• Using both qualitative and quantitative method minimizes the weakness of the study. It increases the exploration and statistical analysis of the study.
• Mixed method increases the availability of research tools that helps to collect more comprehensive data.
• The results are validated more accurately and show additional evidence for supporting.
• Mixed methods combine thinking as well as reasoning.
• The findings are illustrated in both words as well as number.
• Mixed method reduces personal biases.

Disadvantages of Mixed method:

• Using both qualitative and quantitative method is time-consuming.
• Researchers need to be well-versed in both the data.
• More resources to be used for collecting both types of data.
• The result findings should be illustrated clearly for the better understanding of the audience.

References:

Rahman, M. S. (2020). The advantages and disadvantages of using qualitative and quantitative approaches and methods in language “testing and assessment” research: A literature review.

Queirós, A., Faria, D., & Almeida, F. (2017). Strengths and limitations of qualitative and quantitative research methods. European Journal of Education Studies.

Driscoll, D. L., Appiah-Yeboah, A., Salib, P., & Rupert, D. J. (2007). Merging qualitative and quantitative data in mixed methods research: How to and why not

Reply 3

To start, when both qualitative and quantitative research methods are used together, they make up what is referred to as mixed methods (Helbig, 2018). “This type of research study is common in health care because emotions and feelings may play a part in the study being performed: love, anger, or pain cannot easily be quantified” (Helbig, 2018, para 54).

A major benefit of using the mixed method in combination of the qualitative and quantitative method is that when using all three, or triangulation design, is its efficiency because you kill two birds with one stone, collecting both sets of data simultaneously, which can also be a disadvantage (Doorenbos, 2014). Afterwards, when the data has been collected, a team of researchers including those with expertise in qualitative and quantitative data can have access to the data and interpret it in a more efficient manner (Doorenbos, 2014).

Disadvantages of using mixed methods for research include the great amount of effort needed as well as the expertise of the researcher to collect both qualitative and quantitative data simultaneously (Doorenbos, 2014). At the same time of the data collection, the difficulty of giving each kind of data an equal amount of importance when collecting it provides another disadvantage or difficulty for the researcher.

References

Doorenbos, A. Z. (2014). Mixed Methods in Nursing Research : An Overview and Practical Examples. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287271/.

Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. In Grand Canyon University (Ed.)., Nursing research: Understanding methods for best practice.. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1