Client Questions

L.N. is a 49-year-old white woman with a history of type 2 diabetes, obesity, hypertension, and migraine headaches. The patient was diagnosed with type 2 diabetes 9 years ago when she presented with mild polyuria and polydipsia. L.N. is 5?4? and has always been on the large side, with her weight fluctuating between 165 and 185 lb. Initial treatment for her diabetes consisted of an oral sulfonylurea with the rapid addition of metformin. Her diabetes has been under fair control with a most recent hemoglobin A1c of 7.4%. Hypertension was diagnosed 5 years ago when blood pressure (BP) measured in the office was noted to be consistently elevated in the range of 160/90 mmHg on three occasions. L.N. was initially treated with lisinopril, starting at 10 mg daily and increasing to 20 mg daily, yet her BP control has fluctuated. One year ago, microalbuminuria was detected on an annual urine screen, with 1,943 mg/dl of microalbumin identified on a spot urine sample. L.N. comes into the office today for her usual follow-up visit for diabetes. Physical examination reveals an obese woman with a BP of 154/86 mmHg and a pulse of 78 bpm. Questions What are the effects of controlling BP in people with diabetes? What is the target BP for patients with diabetes and hypertension? Which antihypertensive agents are recommended for patients with diabetes?

Assignment: Analysis of a Pertinent Healthcare Issue The Quadruple Aim provides broad categories of goals to pursue to maintain and improve healthcare. Within each goal are many issues that, if addressed successfully, may have a positive impact on outcomes. For example, healthcare leaders are being tasked to shift from an emphasis on disease management often provided in an acute care setting to health promotion and disease prevention delivered in primary care settings. Efforts in this area can have significant positive impacts by reducing the need for primary healthcare and by reducing the stress on the healthcare system. Changes in the industry only serve to stress what has always been true; namely, that the healthcare field has always faced significant challenges, and that goals to improve healthcare will always involve multiple stakeholders. This should not seem surprising given the circumstances. Indeed, when a growing population needs care, there are factors involved such as the demands of providing that care and the rising costs associated with healthcare. Generally, it is not surprising that the field of healthcare is an industry facing multifaceted issues that evolve over time. In this module’s Discussion, you reviewed some healthcare issues/stressors and selected one for further review. For this Assignment, you will consider in more detail the healthcare issue/stressor you selected. You will also review research that addresses the issue/stressor and write a white paper to your organization’s leadership that addresses the issue/stressor you selected. To Prepare: Review the national healthcare issues/stressors presented in the Resources and reflect on the national healthcare issue/stressor you selected for study. Reflect on the feedback you received from your colleagues on your Discussion post for the national healthcare issue/stressor you selected. Identify and review two additional scholarly resources (not included in the Resources for this module) that focus on change strategies implemented by healthcare organizations to address your selected national healthcare issue/stressor. The Assignment (3-4 Pages): Analysis of a Pertinent Healthcare Issue Develop a 3- to 4-page paper, written to your organization’s leadership team, addressing your selected national healthcare issue/stressor and how it is impacting your work setting. Be sure to address the following: Describe the national healthcare issue/stressor you selected and its impact on your organization. Use organizational data to quantify the impact (if necessary, seek assistance from leadership or appropriate stakeholders in your organization). Provide a brief summary of the two articles you reviewed from outside resources on the national healthcare issue/stressor. Explain how the healthcare issue/stressor is being addressed in other organizations. Summarize the strategies used to address the organizational impact of national healthcare issues/stressors presented in the scholarly resources you selected. Explain how they may impact your organization both positively and negatively. Be specific and provide examples.

Discussion: Data Analysis—Small Group Discussion As a nurse engaged in evidence-based practice, it is important to recognize how statistics and other data analysis tools are used to generate and assess evidence. Most nurses need only a foundational understanding of statistical tools and terminology to understand the majority of research studies. As a nurse, you should be able to recognize the most commonly used statistical tests, how and when they are used, and how significance is determined. Review the information in your assigned chapter Look for:  The key concepts of the chapter 19: Focus on the basic concepts that are important for nurses to understand as they review research studies. Note: the Book to use is  attache bellow ( CHAPTER 19) Place references

For this assignment you will continue to review current research from South’s Online Library and provide a critical evaluation on that research through an annotated bibliography. An annotated bibliography is a brief summary and analysis of the journal article reviewed. For more information on annotated bibliographies please visit Purdue’s OWL: Purdue Online Writing Lab A total of two annotated bibliographies are to be submitted (not to exceed one page each). The articles must come from nursing scholarly literature and may not be older than 5 years since publication. Please note that the articles must be research based and reflect a qualitative methodology (review our reading assignments). Web pages, magazines, textbooks, and other books are not acceptable. Each annotation must address the following critical elements: Explanation of the main purpose and scope of the cited work Brief description of the research conducted Value and significance of the work (e.g., study’s findings, scope of the research project) as a contribution to the subject under consideration Possible shortcomings or bias in the work Conclusions or observations reached by the author Summary as to why this research lends evidence to support the potential problem identified specific to your role specialization.   1- Articles 1-   Graham, G. (2014). Population-based approaches to understanding disparities in cardiovascular disease risk in the United States. Int J Gen Med., 7(1), 393-400. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4132228/ 2-   Saab, K., Kendrick, J., Yracheta, J., & Lanaspa, M. (2015). New insights on the risk for cardiovascular disease in African Americans: The role of added sugars. Journal of the American Society of Nephrology, 26(2), 247-257. Retrieved from http://jasn.asnjournals.org/content/26/2/247.full 3-Sharma, A., Colvin-Adams, M., & Yancy, C. (2014). Heart failure in African Americans: Disparities can be overcome. Cleveland Clinical Journal of Medicine, 81(5), 301-311. Retrieved from http://www.abcardio.org/pdf/Yancy_Colvin.pdf

Assignment 2.2: Drugs and Narcotics Drugs and Narcotics OBJECTIVE Discuss the role of drugs in hypnosis and altering consciousness ASSIGNMENT OVERVIEW This reaction and response assignment allows you to explore the use of drugs in hypnosis. DELIVERABLES A one-page (12-point font) paper Step 1 Find an article. Using the Internet or a library, find an article relating to the role of drugs in hypnosis and altering consciousness. Step 2 Summarize the article. Identify the main points in your chosen article about the role of drugs in hypnosis or in altering consciousness and summarize them in a one-pag

Attached is a word document that should be used as a template for this assignment. What is written on it is only an example, but use the same headings and format. Provide one nursing care plan for the older adult that targets prevention and health promotion. The patient is a 67 year old African American male named Erick Johnson that has a medical diagnosis of hypertension. The nursing diagnosis for this patient is ineffective coping related to fear of secondary effects of the medications. The patient reported to the emergency department after obtaining high blood pressure readings for the last 4 days.Patient states that he does not adhere to the drug regimen because he fears the medication will cause him to be impotent. Develop an abstract, a medical history, a medical assessment, a care plan with nursing interventions and a treatment goal. 5 pages. APA style 3 references required

Write 2-3 page report on any aspect of the connection to global health (title and reference page not included in page count). Be sure to include at least one reference to support your work (beyond the book itself). The reference can be one that was discussed during the course. Submit under the Course Materials tab in Blackboard. The book’s name:    Timmerman, K. (2009). Where am I wearing?  A global tour to the countries, factories, and people that make our clothes.  New Jersey: Wiley. ISBN 978-0-470-37654-6

Topic 1: Faith-Based Nursing Review Healthy People 2020. Identify objectives that are amenable to parish nurse intervention. Describe how faith communities can contribute to the accomplishment of these national health objectives and accomplish the goal of improving the health of the public. How can nurses working in the community form partnerships with parish nurses and faith communities? How would such partnerships be beneficial? Review the article Redirecting Innovation in U.S. Health Care. Based on your analysis and understanding of the article, answer the following questions: What are the two most important reasons for why technology is not adopted? What can be done about them? What are the ways these two issues can be resolved? Explain.

APA format 2 pages long 3 references 1 from walden university library Due 3/20/19 at 7pm    Impact of Internal Factors on Development and Approval of Curriculum Impact of Internal Factors      As a bone marrow transplant (BMT) coordinator, education of our patients and their caregivers is our most important role.  When we prepare a patient for their admission for their BMT, we plan a family conference that includes discussing and signing consents as well as going over general restrictions that will be required when the patient is discharged.  As the number of autologous transplants increased for Multiple Myeloma (MM) patients, we found we had less and less time to go over educational materials.  About two years ago, we decided to develop a MM school to help rectify this problem.  This would be a once a month class (in the beginning) and patients and their caregivers would attend. Internal Factors      We pitched it to administration as a need justified by the increasing patient population as well as the idea that a better prepared patient and caregiver could equate to a decreased length of stay (LOS) as an inpatient.  As our first internal factor, decreasing inpatient LOS is and had been a goal of the hospital related to initiatives by CMS (CMS.gov, 2017).  We were given the go-ahead by administration.      The second internal factor that affected if we could start the school was related to resources (Keating & DeBoor, 2018).  Having a conference room with AV equipment available once a month could be a struggle since there was always issues with lack of space.  We were able to find an appropriate room at an odd time that would be big enough for 20 or more patients and caregivers.  Having enough coordinators to teach the class was our third internal factor (Keating & DeBoor, 2018).  There were two coordinators who were willing to teach the class and I was the back-up.      The actual curriculum was a power point presentation adapted from our BMT patient manual.  Having the visual aid was important to us to encourage interest in the material and retention of the information by the patient and caregiver (Shabiralyani et al., 2015).  We presented it to our MM physicians for input and critique and it was enthusiastically accepted.  Having the class would help the physicians – they would not have to go over basic instructions and could focus on the more complicated information. Summary      Internal factors that impact starting a program can be daunting.  But if the need is justified without negative implications, it can be approved quicker than may be expected.  In the case of MM school, it would be good for the patients and caregivers, good for administration and their goal, and good for the providers in giving them more time to discuss other issues with their patients. Note:  MM school is going strong with good attendance.  It is now twice a month, with the second class being offered on Saturdays.  The curriculum is revised annually with input from patients, caregivers, social workers, and the inpatient staff.  We are now working on a poster presentation of how it was started and how well it has worked for a future nursing conference. References CMS.gov (2017).  Outcome Measures.  Retrieved from https://www.cms.gov/medicare/Quality-      Initiatives-Patient-Assessment-Instruments/HospitalQualityInits/outcomeMeasures.html Keating, S.B. & DeBoor, S.S. (Ed.). (2018).  Curriculum, Development, and Evaluation in  Nursing (4th Ed.).  New York, NY:  Springer.

Does anyone on this site have a good knowlegde of writing a research methodology paper with sound analytical statistical analysis? Proper ENGLISH, in text citation on reference is a MUST. All areas must be covered.Topic: education of staff on standardization of surgical count strategies to prevent retained foreign body  Introduction Statement of the Problem Clinical Question(s) Project Methodology Project Design Population and Sample Selection Instrumentation Validity Reliability Data Collection Procedures Data Analysis Procedures Ethical Considerations Limitations Summary