Client Questions

I need a comment for each paragraph Paragraph 1   Health education plays a central role in health promotion. This is because in order to promote healthy living, it is important for individuals to understand why they are engaging in healthy behavior. For example, for an individual to go out of their way to become physically active and avoid junk food, they should have an incentive to do so. Health education provides this incentive as individuals learn of the association between a sedentary lifestyle/ junk food and diseases like diabetes and obesity.  The nursing process is inherently tied to patient health education. This is because part of the nursing duties is to fight for patient advocacy. This means that nurses should ensure that their patients are properly informed about their health in order to make health-centered decisions. A contemporary issue that a family may experience today is a family struggling with obesity. The nurse can address the issue by first meeting with the family together, and then with each member individually. The nurse should focus on health education and discuss the implications of obesity, such as diabetes, high blood pressure, and heart disease. They should inform the family about how much they can positively affect their lives through the addition of regular exercise and healthy eating habits. A critical role of the nurse is to develop realistic health goals for the family and to provide a real plan that can help the family to achieve these goals. Paragraph 2 According to the World Health Organization (WHO) (2018b), health promotion is “the process of enabling people to increase control over, and to improve their health” (para 1). Health education is defined as “any combination of learning experiences designed to help individuals and communities improve their health, by increasing their knowledge or influencing their attitudes” (World Health Organization [WHO], 2018a, para 1). Nurses are actively involved in both health promotion and health education, providing education that is necessary to help patients achieve control over the promotion of their own health. Similar to all other nursing functions, health education is provided by using the nursing process. The nurse will assess, diagnose, plan, implement, and evaluate to provide the proper health education to the patients. This process can vary from person to person, but the basic foundation stays the same. Some patients have to have revisions so it can get out of order. An acronym we learned in nursing school for the nursing process is ADPIE. It’s really stuck with me over the years, making it easy to remember. A Contemporary issue that many faces globally includes hurricane’s, and forest fires. Even though these can’t be prevented, there are plans that can be devised, resources that can be offered, and tools that can be used to assist with preparation and help to work toward achieving wellness goals. Some local issues some patients face can include, environmental issues like illicit drugs or a high crime neighborhood, lack of transportation making it hard to get to their appointments.

Review the Institute of Medicine’s 2010 report “The Future of   Nursing: Leading Change, Advancing Health.” Write a 750-1,000   word paper discussing the influence of the IOM report on nursing   practice. Include the following: Summarize the four messages outlined in the IOM report and     explain why these are significant to nursing practice. Discuss the direct influence the IOM report has on nursing     education and nursing leadership. Describe the benefits and     opportunities for BSN-prepared nurses. Explain why it is     important that a nurse’s role and education evolve to meet the needs     of an aging and increasingly diverse population. Discuss     the significance of professional development, or lifelong learning,     and its relevance in caring for diverse populations across the life     span and within the health-illness continuum. Discuss how     nurses can assist in effectively managing patient care within an     evolving health care system. Prepare this assignment according to the guidelines found in the APA   Style Guide, located in the Student Success Center. An abstract is not required. 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. Please   refer to the directions in the Student Success Center.

Cultural awareness and sensitivity has become a necessary tool in nursing because; given the diversity in the growth of different populations, it has become imperative for nurses to understand various cultures and also respect the different practices in order to ensure holistic patient care at all levels of management. One among other tools that have been developed to help gather cultural information is the Heritage Assessment Tool. Through the outcomes of the survey from this tool, a nurse is able to gather relevant information about a patient’s culture, beliefs, needs and practices that may affect their care and treatment. While the tool is useful in structuring individualized patient care plans, it is also helpful in educating nurses adequately on new cultures thereby expanding their cultural competency foundation (Falkner, 2018). Some of the other tools used include; CCCC model, ACCESS model, The Process of Cultural Competence in the Delivery of Healthcare Services Model among others (Higginbottom, Richter & Mollel, 2011). Regardless of the tool being used the relevance remains in how the data would be used in the caring for patients. Cultural competency is the act of being aware of different cultural practices that helps a nurse to adjust care plans appropriately and to constantly remain sensitive and respectful of the choices that patients make based on those practices. Cultural competency leans on cultural awareness through thorough assessment of patients and its relevance to patient care is emphasized on ensuring safety at all costs. The nurse therefore has the responsibility to understand that some cultural beliefs have health practices that are considered unsafe to other cultures that don’t share in the same beliefs. For example, the [practice of female genital mutilation seen in middle east countries, Africa and southeast Asia is a practice where the female genitalia is partially or totally removed for non-medical purposes (WHO, 2018). Because of the many risks this practice poses on women healthy, the nurse caring for such clients must remain sensitive especially in their choice of words. Furthermore, child protection issues should be taken into account and advocacy for [patient safety should be considered if a minor is to undergo this procedure. Hence, understanding a client’s cultural preferences if beneficial for effective patient care (Falkner, 2018). Even though various barriers to health exist among different cultures, nurses are to remain focused on enhancing quality patient care by ensuring safety. Some of the ways cultural competency can be demonstrated is first, through comprehensive assessment. It is from such gained information that the nurse is able to understand family dynamics from which a customized care plan can be formulated to accommodate the needs. Secondly, while addressing emerging populations of immigrants, the nurse should be aware that most individuals lack knowledge to navigate the complex healthcare system and thus through collaboration with other interdisciplinary members, interpretive services should be provided to ensure effective management and smooth transition of care. Lastly, through cultural competency, nurses are able to identify vulnerable populations such as pregnant women, human fetuses, cognitively impaired et cetera, and by working with other interdisciplinary members, that helps to ensure provision of resources that would enhance adequate health care. References Falkner, A. (2018). In GCU’s Health Promotion: Health and Wellness Across the Continuum. Retrieved from https://www.gcumedia.com/digital-resources/grand-canyon-university/2018/health-promotion_health-and-wellness-across-the-continuum_1e.php  Higginbottom, GMA., Richter, M., & Mollel, O., (2011). Cultural awareness and sensitivity has become a necessity. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3175445 World Health Organization. (2018). Female genital mutilation. Retrieved from http://www.who.int/mediacentre/factsheets/fs241/en/ A nurse gathers cultural information from patients with care that is self- reflecting and an open mind. Itsimportant for the nurse to remain sensitive and respectful as the goal of the therapeutic relationship is to eliminate health disparities. “A nurse must give high quality care regardless of ethnicity, social economic background, race or culture” (ANA ) Cultural competence is an evolving process and is a daily process. Our communities are a mix of Asians, African Americans/ blacks, Hispanics, Arabs who all deserve respect and culturally sensitive care. To be Culturally competent, it “requires continuous education, self-awareness, and evaluation in order to provide holistic, culturally competent nursing care” (Campinha-Bacote, 2011). Prior to this material review I was not aware such a framework existed for a cultural assessment. Leininger states that cultural assessment “is the systematic appraisal or examination of individuals, groups, and communities as to their cultural beliefs, values and practices to determine explicit needs and intervention practices within the context of the people being served” (Falkner, 2018). The Heritage Assessment tool is a great resource for helping the nurse determine cultural influences in managing cultural care focus in education. It surprised me that I was using it all along, mostly for my own exploration/ self-reflection. I am a very cultural curious nurse and learning about cultures helps navigate my care.  Culturally competent care has been linked to improved health outcomes and the elimination of health disparities. To demonstrate competency is to emerge yourself in it. Learn from them. Most importantly nurses must have an “acknowledgement of culture as a core nursing trait of caring” (Gillson & Cherian, 2019). I am culturallycompetent, and I ask these questions regularly:  Where you born? Where did you grow up? How old were you when you moved to the US? Tell me how religion is important to you?  Tell me about the foods you eat? How do you celebrate holidays, deaths?  References: American Nurses Association. (n.d.). Diversity awareness mission statement. Retrieved from http://www.nursingworld.org/MainMenuCategories/ThePracticeofProfessionalNursing/Improving-Your-Practice/Diversity-Awareness/Mission-Statement.html Campinha-Bacote, Josepha. (2002). The process of cultural competence in the delivery of healthcare services: A model of care. Journal of Transcultural Nursing, 13(3), 181-184. Retrieved from http:/ /ovidsp.ovid.com.ezp.twu.edu/ovidweb.cgi ?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&D=yrovftf& AN=00002045-200207000-00003l Falkner, A. (2018). Health promotion: Health & wellness across the continuum. Chapter 3. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/ Gillson, S., & Cherian, N. (2019). The Importance of Teaching Cultural Diversity in Baccalaureate Nursing Education. Journal of Cultural Diversity, 26(3), 85–88.

“Health 3.0: A Discussion about Medicine at the Cutting Edge with the Mayo Clinic’s Dr. Nicholas LaRusso” – Discuss your thoughts in 150 words or more. http://link.brightcove.com/services/player/bcpid1187410652001?bckey=AQ~~,AAAAGuNzXFE~,qu1BWJRU7c2zPXB5pnS6ytF42ALvFXD6&bctid=717207772001

250 WORDS, CITATION, REFERENCES,  Adolescent pregnancy is viewed as a high-risk situation because it poses serious health risks for the mother and the baby. Describe various risk factors or precursors to adolescent pregnancy. Research community and state resources devoted in adolescent pregnancy and describe at least two of these resources. Research the teen pregnancy rates for the last 10 years for your state and community. Has this rate increased or decreased? Discuss possible reasons for an increase or decrease.

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 120-150 WORDS   What nursing interventions are appropriate for Mrs. J. at the time of her admission? Mrs.  J. is being admitted to the ICU due to acute decompensated heart failure. The subjective and objective data obtained is the following: Mrs. J is overweight based on her height and weight (5 feet 9 inches and weighs 210.5 pounds). For three days she has been experiencing a low grade fever (99.68), pharyngitis, and malaise. She denies pain but feels that she cannot breathe due to dyspnea. She claims that her heart is running away which indicates tachycardia (HR 118 and irregular). Her heart rate is working harder to compensate for the low blood pressure of 90/58. Her peripheral pulses are +1, demonstrating jugular distention, and ventricular rate of 132 with atrial fibrillation. She has crackles at auscultation, decreased breath sounds on right lower lobe, coughing frothy blood-tinged sputum, with and a very low oxygen saturation level of 82%. This patient is having left sided heart failure based on the subjective and objective data obtained. Intervention: Place patient on continuous oxygen 2-4 LPM via n/c. Rationale: To alleviate dyspnea symptoms and allow patient not to work as hard breathing Intervention: Establish guidelines and goals of daily activity. Rationale: Patient will most likely be more willing to cooperate if she is included in the goals being set. Intervention:  Assess patient’s mentation regularly. Rationale: This is to determine if the patient is becoming more severe. Anxiety and confusion are late signs when a patient is having decreased cardiac output. Intervention: Keep patient semi to high-fowlers position. Rationale: This will help alleviate some of the shortness of breath. Intervention: Asses heart rate and blood pressure frequently. Rationale: Sinus tachycardia and increased arterial blood pressure are in the early stages and the blood pressure decreases as the condition worsens. Intervention: Assess peripheral pulses frequently. Rationale: weak pulses are indicators of low cardiac output. Intervention: Assess skin color and temperature. Rationale: Cold and clammy skin is an indicator of low cardiac output and desaturation. Intervention: Assess fluid balance and weight gain. Rationale: A compromised regulatory system can result in sodium and fluid retention. Intervention: Continuous assessment of lung sounds. Rationale:  Crackles are indicative of fluid accumulation and secondary to left ventricular failure. Intervention: Asses urine input and output. Rationale: Decreased urine output is an indicator of lack of renal perfusion. Intervention: Assess for chest pain. Rationale: Indicates lack of oxygen supply. (Ackley & Ladwig, 2011).   What is the rationale for the administration of each of the following medications? IV furosemide (Lasix) – Furosemide is a loop diuretic and used to decrease fluid volume (pre-load). Patient is demonstrating. It is also used as an adjunct therapy. Mrs. J has crackles and coughing frothy blood-tinged sputum that is indicative of pulmonary edema. Nurse must check patient’s urine input and output and electrolytes due to possible dehydration, depletion of potassium, and metabolic alkalosis. Enalapril (Vasotec) – is an angiotensin-converting enzyme (ACE) inhibitor. Enalapril is used for congestive heart failure which is a weakness of the heart that leads to buildup of fluid in the lungs and the surrounding tissues. Patient has crackles, and she is coughing frothy blood-tinged sputum (McKenry, 2006). Metoprolol (Lopressor) – Lopressor is a beta blocker and the standard use for heart failure. Beta blockers are used in patients with heart failure because it helps improve the hearts ability to relax, decrease the production of harmful substances produced by the body in response to heart failure, and slows down the heart rate. Mrs. J has a ventricular rate of 132 and atrial fibrillation (WebMD, 2015). IV morphine sulphate (Morphine)- Morphine is an opioid and it is used to alleviate Mrs. J’s dyspnea. Morphine lowers the breathing rate in the brains respiratory center. This will help Mrs. J’s heart not work so hard. Morphine does this by widening the blood vessels in the extremities which will allow the heart not to work hard and use less oxygen. It is also great use for anxiety. Mrs. J is experiencing anxiety due to dyspnea and fear of complications (McKenry, 2006). Describe four cardiovascular conditions that may lead to heart failure Obesity – Mrs. J is overweight (210.5 lb). Obesity can cause congestive heart failure. Left Ventricular hypertrophy is very common in patients with obesity. High Blood Pressure – Mrs. J has a history of high blood pressure. The history of years of high blood pressure probably caused damage to the artery walls. The constant pushing on the walls of the arteries probably weakened her heart. Atrial Fibrillation – Mrs. J is currently having atrial fibrillation. This means that the heart is not pumping enough blood to meet the needs of the body. This can lead to heart failure because the heart is beating so fast and working so hard that the heart doesn’t fill-up properly to pump blood to the body. The blood then can back up in the pulmonary veins which cause fluid buildup which Mrs. J is currently experiencing. Mrs. J is also has fatigue and dyspnea due to lack of rich oxygenated blood that is not being delivered to her body and brain (American Heart Association, 2015). Coronary Artery Disease – Coronary artery disease is the most common form of heart disease and heart failure. It is the accumulation of fatty deposits buildup that causes reduction in blood flow, weakening the heart, and causing permanent damage to the heart.  And what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition. Obesity Intervention – Establish short and long term goals, encourage calorie intake appropriate for body type and lifestyle, encourage Mrs. J to keep a daily log of food and liquid consumption. Encourage Mrs. J to be more aware of nutritional habits that may contribute to weight gain. Encourage Mrs. J to exercise and encourage consultation of a dietician for further assessment and recommendations regarding a weight loss program. Educate Mrs. J of the importance of routine follow-up MD visits. High Blood Pressure – Mrs. J has been smoking two packs of cigarettes daily for the last forty years. Smoking cause’s blood pressure to rise but the chemicals in the tobacco causes damage to the lining of the artery walls causing arteries to narrow, increasing the blood pressure. Educating the patient with the outcome of smoking is beneficial. Mrs. J needs to be educated on the importance of taking her blood pressure on daily and keeping a log of the blood pressure reading. Mrs. J should be placed on a low sodium cardiac diet. Educating Mrs. J on the importance of taking her medication on a daily basis as prescribed to prevent organ damage. Informing Mrs. J that lifestyle adjustment must be made to reduce the risk of cardiovascular morbidity. This is not a short term goal and it will take time for patients to get use to the lifestyle change and nursing follow is important for the patient to feel supported and follow the program. Atrial Fibrillation – Atrial fibrillation is the loss of synchrony between the atria and ventricles. The goal is to maintain adequate cardiac output and tissue perfusion to make sure Mrs. J does not develop a thromboembolism. Monitoring the heart rate is very important and making sure that the systolic rate does not go below 90mmHg. Mrs. J should be educated on reporting any chest discomfort in which oxygen therapy would be beneficial. Continuous cardiac monitoring is imperative. Also making sure Mrs. J receives education on medications such as Amiodarone or Digoxin to control the atrial fibrillation. Educate Mrs. J how to obtain her own pulse and recognize symptoms of toxicity. Coronary Artery Disease – is the accumulation of plaque buildup on the coronary arteries which leads to blockage. The heart is deprived of oxygen due to the blockage and is unable to pump efficiently. Very important to access patient level of consciousness, evaluate for chest pain, assess heart rate, blood pressure, peripheral pulses, and evaluate skin color and temperature. Provide oxygen in conjunction with medication therapy. Monitor fluid volume to prevent overloading the heart and lungs Reduce anxiety by providing Mrs. J to share her fears or concerns. Provide a quiet environment and uninterrupted sleep. Discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Intervention: Interview Mrs. J to obtain a complete drug history that includes prescribed, OTC, home remedies, herbals, vitamins, and any drug allergies (Ackley & Ladwig, 2011). Rationale: This will help the healthcare provider identify any potential side effects that might occur with the medications, OTC, home remedies, herbals, vitamins, or drug allergies (Ackley & Ladwig, 2011). Intervention: Teach Mrs. J how to make a list of each medication, including the name, strength, appearance, purpose, and effects (Ackley & Ladwig, 2011). Rationale: Educates the patient on the reason for taking the medication and what to look for(Ackley & Ladwig, 2011). Intervention: Question Mrs. J on her self-medication practices. How does Mrs. J remember to take her medication? Does she forget to take her medication and what does she do when she remembers (Ackley & Ladwig, 2011). Rationale: This allows the healthcare provider know if Mrs. J is over or under medicating herself (Ackley & Ladwig, 2011). Intervention: Determine if Mrs. J is capable of administering medications (Ackley & Ladwig, 2011). Rationale: There might be a physical impairment, memory loss, health, cultural beliefs, financial constraints, or social support lacking (Ackley & Ladwig, 2011). . References   Ackley, B., & Ladwig, G. (2011). Nursing diagnosis handbook: An evidence-based guide to planning care (9th ed.). St. Louis: Mosby, Elsevier.   American Heart Associatio. (2015). Why atrial fibrillation (af or afib) matters. Retrieved fromhttp://www.heart.org/HEARTORG/Conditions/Arrhythmia/AboutArrhythmia/Why-Atrial-Fibrillation-AF-or-AFib-Matters_UCM_423776_Article.jsp#.Vp151vkrLIU   Kozier, B. (2012). Kozier & Erb’s fundamentals of nursing: Concepts, process, and practice(9th ed.).   Boston: Pearson.   McKenry, L., & Tessier, E. (2006). Mosby’s pharmacology in nursing (22nd ed.). St. Louis, Mo.: Elsevier   Mosby.   WedMD. (2015). Heart failure health center. Retrieved fromhttp://www.webmd.com/heart-disease/heart-failure/heart-failure-beta-blocker

How often do you engage with or witness death in your work? How has this experience or the lack of it shaped your view of death? Has it gotten easier or harder for you to accept the fact of death? As you explain, include your clinical specialty.   I NEED YOU TO ANSWER THIS QUESTION, 350 WORDS NEEDED AND 2 REFERENCES PLEASE

To prepare for this assignment view the following brief video from the American Medical Association titled, “Health Literacy and Patient Safety: Help Patients Understand.” The video can be accessed through the following link:   https://youtu.be/cGtTZ_vxjyA   Part I: Pamphlet   Develop a pamphlet to inform parents and caregivers about environmental factors that can affect the health of infants. Use the “Pamphlet Template” document to help you create your pamphlet. Include the following: Select an environmental factor that poses a threat to the health or safety of infants. Explain how the environmental factor you selected can potentially affect the health or safety of infants. Offer recommendations on accident prevention and safety promotion as they relate to the selected environmental factor and the health or safety of infants. Offer examples, interventions, and suggestions from evidence-based research. A minimum of three scholarly resources are required. Provide readers with two community resources, a national resource, and a Web-based resource. Include a brief description and contact information for each resource. In developing your pamphlet, take into consideration the healthcare literacy level of your target audience.   Part II: Pamphlet Sharing Experience   Share the pamphlet you have developed with a parent of an infant child. The parent may be a person from your neighborhood, a parent of an infant from a child-care center in your community, or a parent from another organization, such as a church group with which you have an affiliation. Provide a written summary of the teaching / learning interaction. Include in your summary: Demographical information of the parent and child (age, gender, ethnicity, educational level). Description of parent response to teaching. Assessment of parent understanding. Your impressions of the experience; what went well, what can be improved.   Submit Part I and Part II of the Accident Prevention and Safety Promotion for Parents and Caregivers of Infants assignment by the end of Topic 1.   While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation 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.   You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center. NRS-434VN-R-Pamphlet-Template-Student.docx

Minimum of 300 words with at least 2 peer review reference in 6th edition APA style. Select two of the following discussion questions for your discussion response. Indicate which questions you have

9. Develop a plan of care addressing: (3 slides) A. Expected outcomes for an adult living with Juvenile Diabetes. B. Develop health screening, health promotion, health interventions and education for adults with Juvenile Diabetes. C. Identify a comprehensive set of relevant resources community and national for adults with Juvenile Diabetes.  Describe resources.   10. Reference slide (1 slide)