Client Questions

As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic woman who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After doing her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She is in class a total of 15 hours per week, plus 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children. She states that she is lucky to get six hours of sleep per night, but that is okay with her. She lives one hour from campus and commutes each day. Using Healthy People 2020 and your text as a guide: What additional information would you like to gather from Maria? What are Maria’s real and potential health risks? Why is Maria’s culture important when obtaining the health assessment? Pick one of Maria’s health risks. Would you classify Maria’s problem as first-level priority, second-level priority, third-level priority, or a collaborative problem? What would be one reasonable short-term goal for this risk?   APA FORMAT REQUIRED

The American Cancer Society (ACS) is a nationwide, community-based, voluntary health organization dedicated to eliminating cancer as a major health problem. Together with its supporters, ACS is committed to helping people stay well and get well by finding cures and by fighting back. Critical Thinking Questions: Imagine that a family friend or colleague has just been diagnosed with cancer. Explain how the American Cancer Society might provide education and support. What ACS services would you recommend and why? According to statistics published by the American Cancer Society, there will be an estimated 1.5 million new cancer cases diagnosed each year over the next decade. What factors contribute to the yearly incidence and mortality rates of various cancers in Americans? What changes in policy and practice are most likely to affect these figures over time Select a research program from among those funded by the American Cancer Society. Describe the program and discuss what impact the research will have on the prevention or treatment of cancer.

Select two of the following discussion questions for your discussion response. Indicate which questions you have chosen using the format displayed in the “Discussion Forum Sample.” Explain Bell’s palsy by providing treatment options and the physiologic disorder on presentation. Explain the neurotransmitter dysfunction in a patient with schizophrenia and bipolar disorders. Include your resources in your response. In pediatric patients, the initial assessment is similar with bacterial and viral meningitis. What are the different considerations in treatment and stabilization of neurologic deficits? Embolic and bleed cerebrovascular accidents are managed differently based on the causative factor for the stroke. Provide a discussion of the difference in pathophysiology of the two types of strokes. Detail the different types of cerebral palsies. Explain the potential origin associated with cellular malfunction and environmental influences. Differentiate between Alzheimer’s disease, Parkinson’s disease, and vascular dementia. at least 250 words with reference no older than 5 years and intext citations.

Assignment Details The purpose of this assignment is to practice the skills you have learned and demonstrate your ability to assess the abdomen and neurological system. For this assignment you will need to videotape yourself examining the abdomen on a volunteer of your choosing. This should take you between 30-45 minutes. When you are done you will document your findings. You will need to submit both your video and your documentation. Below are the required pieces in your assessment.  Abdomen: Inspect the skin and contour of the abdomen Observe for peristalsis and pulsations Auscultate the abdomen Auscultate for bruits over the aorta, renal arteries, iliac arteries and femoral arteries Percuss the abdomen Palpate the abdomen (light then deep) Assess for peritoneal inflammation Rebound tenderness Murphy’s sign Rovsing’s sign Psoas sign Obturator sign Cutaneous hyperesthesia Percuss liver Palpate liver Percuss spleen Palpate spleen Palpate bilateral kidneys Assess for CVA tenderness Palpate width of the aorta  Nervous system Assess mental status Cranial nerves 1-12 Motor system: muscle bulk, tone strength, coordination, gait and stance Sensory system: pain/temp, vibration, light touch, discrimination Deep tendon reflexes  Next, you will need to document your findings.  To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources. Assignment Requirements Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above) consult the Grading Rubric to make sure you have included everything necessary; and utilize spelling and grammar check to minimize errors. Your writing Assignment should: follow the conventions of Standard English (correct grammar, punctuation, etc.); be well ordered, logical, and unified, as well as original and insightful; display superior content, organization, style, and mechanics; and

For this assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. Please remember to pretend that this is an actual patient and gives as much detail as possible! Week 10: Special Examinations—Breast, Genital, Prostate, and Rectal GENITALIA ASSESSMENT Subjective: • CC: “I have bumps on my bottom that I want to have checked out.” • HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner during the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed. • PMH: Asthma • Medications: Symbicort 160/4.5mcg • Allergies: NKDA • FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD • Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys) Objective: • VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs • Heart: RRR, no murmurs • Lungs: CTA, chest wall symmetrical • Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia • Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, negMcBurney • Diagnostics: HSV specimen obtained Assessment: • Chancre   Patients are frequently uncomfortable discussing with healthcare professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas. In this Lab Assignment, you will analyze an Episodic note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions. To Prepare Review the Episodic note case study your instructor provides you for this week’s Assignment. Please see the “Course Announcements” section of the classroom for your Episodic note case study. Based on the Episodic note case study: Review this week’s Learning Resources, and consider the insights they provide about the case study. Refer to Chapter 3 of the Sullivan resource to guide you as you complete your Lab Assignment. Search the Walden library or the Internet for evidence-based resources to support your answers to the questions provided. Consider what history would be necessary to collect from the patient in the case study. Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis? Identify at least five possible conditions that may be considered in a differential diagnosis for the patient. The Lab Assignment Using evidence-based resources from your search, answer the following questions and support your answers using current evidence from the literature. Analyze the subjective portion of the note. List additional information that should be included in the documentation. Analyze the objective portion of the note. List additional information that should be included in the documentation. Is the assessment supported by the subjective and objective information? Why or why not? Would diagnostics be appropriate for this case, and how would the results be used to make a diagnosis? Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least three different references from current evidence-based literature. ZERO PLAGIARISM FIVE REFERENCES NOT MORE THAN FIVE YEARS PLEASE PAY ATTENTION TO THE CASE STUDY ON THE TOP

Case Study, Chapter 10, Mandatory Minimum Staffing Ratios  A nurse manager is attending a national convention and is attending a concurrent session on staffing ratios. Minimum staffing ratios are being discussed in the nurse manager’s own state. The nurse manager has a number of questions about staffing ratios that the session is covering. The nurse manager knows that evidence exists that increasing the number of RNs in the staffing mix leads to safer workplaces for nurses and higher quality of care for patients. 1. What are the three general approaches recommended by the American Nurses Association (2017) to maintain sufficient staffing? 2. Summarize the findings that are often cited as the seminal work in support of establishing minimum staffing ratio legislation at the federal or state level. 3. Analyze what proponents and critics say about whether mandatory minimum staffing ratios are needed. Needs citations with minimum 2 peer reviewed references. No minimum word count

Go to the following website by clicking on the provided link, http://www.countyhealthrankings.org/ , and select a county and a state (this may be the county/state in which you reside, attend school, or plan to live and work). After reviewing the website and the health outcomes in the County Health Rankings for the area, answer the following questions in a few short sentences as part of your discussion. Select one area in need of improvement and list the general statistics pertaining to the specific problem. How does the creation of the community health center program help to address this public health problem and what can you as a nurse practitioner and/or nurse leader do to influence policy innovation to resolve the problem?

In this assignment, you will be creating a PowerPoint presentation based on the application of the functional health assessment of a movie character. To complete this assignment, choose a movie from the following list and identify a character from the movie on whom you would like to do a health assessment. If you wish to use a character from a movie not included on the following list, get the approval of your instructor. Films: Away From Her Lorenzo’s Oil Mask My Sister’s Keeper Philadelphia Rain Man Steel Magnolias Stepmom The Elephant Man The Mighty The Tic Code Directions: Create a PowerPoint presentation of 10-12 slides using the template “Movie Character Presentation.” Provide an introduction and background overview of the movie character (client). Assess the client using the “Functional Health Pattern Assessment.” Based on your “observations” and thoughts, document your assessment, providing examples from the movie. Describe any observed or potential cultural, geographic, religious, ethnic, or spiritual considerations of this client. Describe two normal health patterns of the client as well as two abnormal health patterns that you observe, and provide examples. Develop an appropriate nursing diagnosis for the client based on your assessment. Identify and describe three interventions for the client: health promotion, health prevention, and maintenance. Identify at least two possible resources or community services to which you would refer this client and provide rationale for your choices. In addition to submitting the presentation to the instructor, post your assignment to the Movie Character Health Assessment Presentation Main Forum as directed by instructor. Respond to other students’ posts in a manner that initiates or contributes to discussion. Each person should make at least three substantive comments. 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 not required to submit this assignment to Turnitin. NRS-434VN-R-MovieCharacterPresentationSamplePPT-Student.pptx

Choose two issues or challenges that the leaders of today’s health care organizations face. Select from among the following topics: Staff Shortage (Physicians, Nurses, Allied Health Providers, Ancillary Services) Reorganization in Response to Merger or Consolidation of Services Layoffs as a Result of Declining Revenues Influx of Registry, Part-Time, and Temporary Contract Staff Poor Performance Outcomes Leading to a Reduction in Medicare Reimbursement Dollars Poor Job Satisfaction Rates Resulting in Turnover You are the manager of an ancillary service department at a large, 500+ bed hospital. Develop a proposal (750-1,200 words) that is directed toward your staff, in which you address the following: Inform the staff of the two issues (from the topics provided) your organization is facing. Describe the impact of these issues on your department. Describe how improved communication, collaboration, and teamwork can improve conditions in your department. Identify at least two examples from the required or recommended readings of techniques found to foster inclusion and improve communication and collaboration. A minimum of three academic references from credible sources are required for this assignment.

Assignment Objectives   Demonstrate the integration and utilization of key concepts and knowledge from prior courses to solve the selected problem Apply critical thinking and relevant concepts to the final project Prepare a formal research report of the in-depth research and application of prior course concepts ASSIGNMENT DETAILS: The discussion assignment for this week includes a review of the Key Assignment Outline completed by one of your classmates, as well as a substantial response to at least one other student. Primary Task Response: Your first task is to post your own Key Assignment Outline to the discussion area so that other students are able to review your plan. Attach your document to the main discussion post, and include any notes you feel are appropriate. The purpose of this assignment is to help improve the quality of the Key Assignment Draft you will complete next week. Please include at least 4 references in APA format