COMMENT KAREN

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Because our government is playing an increasingly greater role in health decisions, it is necessary for nurses to become involved in policy and lawmaking. Governing bodies will enact laws regardless of whether nurses are present or not (Cherry & Jacob, 2017); consequently, it is advantageous for  the healthcare system to have nurse representatives in legislation.

          One such nurse is Lois Capps, a democrat from California. When Lois graduated from nursing school in 1959 with a BSN, she had no idea she would one day win the 1998 California 23rd District election to Congress! In 2001, Capps helped to introduce the Nurse Reinvestment Act (NRA). Among other things, the NRA helps fund educational scholarships, loans, and grants. Stipends that encourage the development of nursing school faculty are also included in this bill (McKean & Reed, 2001). Laws such as these have great impact on the upcoming nursing shortage and dwindling nursing faculty population.

          Capps is responsible for helping to pass legislation that prevents domestic violence, improves mental healthcare, and provides emergency defibrillators in community settings. Among her many accomplishments, Capps has also founded and co-chaired the Congressional Nursing Caucus (Jimenez, 2015). After the announcement of her retirement in 2015, the American Nurses Association presented Capps with the distinguished President’s Award. Capps’ leadership and commitment has truly impacted not only healthcare professionals, but patient care and the community as well.

 

References

Cherry, B., & Jacob, S. (2017). Contemporary nursing, issues, trends, &

          management. St. Louis: Elsevier.

Jiminez, S. (2015). ANA honors US Rep Lois Capps, RN. Retrieved from

          https://www.nurse.com/blog2015

Mayer, L. (2009). Lois Capps, nurse and legislator, gets dose of health pro

          funds. Retrieved from https://www.opensecrets.org/news/2009

McKeon, E., & Reed, S. (2001). Nurse education bills introduced: the ANA

          endorses bills designed to combat the nursing shortage. American Journal

          of Nursing(101)6.

150 word positive response no plagiarism with references due tomorrow October at 8:00 am est

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Maurer and Smith (2013) define a geopolitical community as a spatial designation, either a geographical or geopolitical area, that is formed by natural or human-made boundaries. I live in Phoenix, Arizona which does not have a distinct boundary such as a river or mountain.  However, it has the Salt River Project which helped develop canal systems to allow for millions of people to live in the desert with access to water.  It is my geopolitical community because it is a geographical location and is also the state capitol.  One example of a man-made boundary in my community are zones which dictate the specific school our children attend. 

A phenomenological community is another way of looking at the community in terms of the citizens’ feeling of belonging or awareness of membership rather than a spatial designation. (Maurer & Smith, 2013). My phenomenological community is a middle-class neighborhood where residents are like-minded but have diverse cultures, ethnicities, and religious backgrounds.  We share common interests such as an active home owner’s association and neighborhood block watch.  There are numerous religious institutions surrounding our community. 

Cultural diversity would be a challenge for community health nurses in providing care to different communities and populations.  This is where the nurse needs to be aware of their own biases and beliefs while ensuring they are providing culturally competent care.  It is important to stay up-to-date and educated by such means as taking CEU’s.  Some communities may have limited means and the nurse will have to adapt to working with what is available.  Benefits include bringing the nurses insight, experience, and ideas to the community that may not have been thought possible.  When working with a similar or same community to the nurse’s own background, the community must still begin with an assessment by using the nursing process.  Assumptions should not be made.  While working in the same community, benefits include the firsthand knowledge of what issues are present in the community and what has worked and failed in the past.  Understanding of culture and diversity is an asset.  Addressing challenges needs to be done while prioritizing needs. According to Maurer & Smith (2013), physical, psychological, social, cultural, economic, and political considerations affect the appropriateness of strategies to solve a problem in any given community.  Taking time to assess the culture and needs of the community while building trust is key to addressing the people and the issues identified. 

Reference

Maurer, F.A. & Smith, C.M.  (2013). Community/public health nursing practice (5th ed.)

150 word positive response with reference due tomorrow at 3:00 pm est

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Abuse does not discriminate againts age.  Children of all ages suffer abuse and some of the most fragile are at the younger end of the spectrum.  Shcool age children often suffer from  abuse and the abuse can come in a variety of different types ranging from sexual, physical, emotionaly, and from neglect.  The most common form of abuse within this age group is neglect.  Neglect occurs when the responsible party fails to provide basic needs for the child.  This may manifest in the form of malnutrition, lack of medical care, or lack of basic needs like clothing and hygiene.  “Neglect is dangerous and can cause serious, long-term damage – even death.”  (NSPCC, 2007).

 

Warning signs may be hard to detect.  Changes in the child behavior may be evident.  The child may also seem more paranoid or easily frightened.  Often neglected children may have poor hygiene, wear dirty clothes, and have poor nutrtitional and dental health. Difficulty concentrating may also be something the neglected child suffers from.  “Some children may directly disclose that they have experienced abuse or neglect.”  (Child Welfare Information Gateway, 2013).

 

When assessing a school age child a nurse should always assess for any signs and symptoms of abuse.  Physical abuse may be easily visable by bruises, broken bones, and injuruies healing at different levels.  However, many of these types of symptoms can be due to the active life of a school aged child.  Cultural practices may also be mistaken as abuse.  For example, some cultures believe in cupping and coining to ward off infection.  This can leave marks that look like abuse but are simply the cultural practices and beliefs of some people.  Often you will have to dig deeper and look for other clues and remain culturaly competent to not misdiagnose abuse.  Sexual abuse may be aparent with extreme fear and avoidance of assessment of the genitals where neglect may be aparent in the childs BMI and growth records.  

 

In California all healthcare providers are mandated reporters for any suspision of abuse at any level.  I work at a hospital and we have a resource binder we access when any abuse if suspected.  We would fill out a report and fax to the appropriate agency which would be child welfare or adult protective services.  As nurses it is our responsiblility to advocate for all patients, big and small.  

 

 

Reference:

 

NSPCC. Child Neglect. (2007).  Retrieved from:  

https://www.nspcc.org.uk/preventing-abuse/child-abuse-and-neglect/neglect/

 

Child Welfare Information Gateway. What is Child Abuse and Neglect: Recognizing Signs and Symptoms. (2013).  Retrieved from:  

https://www.childwelfare.gov/pubPDFs/whatiscan.pdf

Positive reply for the below 150 words with reference due October 21 at 10:00 am

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Adolescent pregnancy is viewed as a high-risk situation as there are serious health risks that are created for the mother, the baby, and society at large. “Early childbearing increases the risks for both mothers and their newborns.” (World Health Organization, 2014) There are many other health problems that can occur from these pregnancies along with the financial difficulties it places on the family and the community. Prevention starts with identifying risk factors and promoting education to the public. Risk factors for adolescent pregnancy can include lack of parental supervision or communication, sexual pressure from peers, friends or siblings who are sexually active, the belief that most peers are sexually active, lack of education, drug or alcohol use, dating someone who is at least three or more years older, living in poverty, and lack of goals for the future. (Southeastern Idaho Public Health, 2017) Through identification and early intervention progress can be made to help prevent adolescent pregnancies from occurring.

Within the community, there are resources available to the public to assist with adolescent pregnancies. One of the local resources in my community is Planned Parenthood which is an organization that provides sexual health care in the United States and around the world to help women and families. (Planned Parenthood, 2017) Another available resource for the prevention of teen pregnancy is the Teen Pregnancy Prevention Program (TPP) from the U.S. Department of Health & Human Services (HHS). “ The OAH TPP Program is a national, evidence-based program that funds diverse organizations that are working to prevent teen pregnancy across the United States. OAH invests in the implementation of evidence-based TPP programs, and provides funding to develop and evaluate new and innovative approaches to prevent teen pregnancy.” (HHS, 2017)

For Pennsylvania, the rates of teen pregnancy have decreased over the recent years. According to The National Campaign to Prevent Teen and Unplanned Pregnancy, “ the teen birth rate in Pennsylvania declined 62% between 1991 and 2015” and “the teen pregnancy rate, which includes all pregnancies rather than just those that resulted in a birth, has also fallen steeply, by 60% between 1988 and 2013.” (2017) Potential reasons for this improvement include better education to adolescents and the public on prevention of pregnancy and a higher use of birth control methods. Much more work still needs to be done to work on this problem but continued effort, education, and resources will make a difference.

Planned Parenthood. (2017).   About us. Retrieved from https://www.plannedparenthood.org/about-us

Southeastern Idaho Public Health. (2017). Risk factors for teenage pregnancy. Retrieved from http://www.siphidaho.org/rephealth/app_risk.php                    

The National Campaign to Prevent Teen and Unplanned Pregnancy. (2017). Pennsylvania data. Retrieved from https://thenationalcampaign.org/data/state/pennsylvania

U.S. Department of Health & Human Services. (2017). Teen pregnancy prevention program (TPP). Retrieved from https://www.hhs.gov/ash/oah/grant-programs/teen-pregnancy-prevention-program-tpp/index.html

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What aspects of the topic readings do you find the most interesting? What is your view of the analysis of disease and healing in the readings? Explain

 

150-250 words

NO FORMATTING!! this is a non formatted discussion question.

1-2 references utilized in text

 

READING MATERIAL:

also see attached lecture for the class

1. Bioethics: A Primer for Christians

Read the Introduction and Chapter 1 from Bioethics: A Primer for Christians.

http://gcumedia.com/digital-resources/wm-b-eerdmans-publishing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php

 

2. Called to Care: A Christian Worldview for Nursing

Read Chapters 1-3 from Called to Care: A Christian Worldview for Nursing.

http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php

 

Electronic Resource

1. The Role of Spirituality in Health Care

Read “The Role of Spirituality in Health Care” by Puchalski from Proceedings (Baylor University Medical Center) (2001).

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1305900/

COMMENT TANA

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 150-200 WORDS

 

 

Just as pain is a subjective feeling and we cannot attempt to define someone else’s pain, someone else’s suffering cannot be defined. “They too are autonomous, and, if autonomy is as important as the argument claims it is, then their autonomous requests for euthanasia should also be honored, even if they are not suffering greatly” (Meilaender, 2013, p. 63).  Therefore, I do not agree that suicide should be considered a sin.  If a patient decides that they do not want life- saving treatment, we would not consider that suicide, and why not?  Because we have the right to choose what is best for us based on our culture, beliefs, feelings, needs, and backgrounds.  Euthanasia can be considered similarly.  We make people comfortable at the end of life with prescribed medications, hence ultimately diminishing their respiratory drives leading to death, however; this is not considered euthanasia.  It is the patient’s choice to forgo suffering. Meilaender backhandedly writes, “Christians are, I suspect, more likely to be drawn to the argument that describes euthanasia as compassionate relief of suffering” (Meilaender, 2013, p. 65).  I do believe that no one can truly know the suffering of another person; the sufferer is not making his fate, but in fact living his fate.

As an oncology nurse, I see my patients suffer for months to years on end.  They suffer through chemotherapies, radiation, and surgeries to fight for their lives, or at the least prolonging them.  They have no intention of killing themselves willingly are unwillingly.  When there are no more options and death is inevitable, a comfortable ending should not be taken away from them.  It is their right they have earned.

Meilaender, G. (2013). Bioethics a Primer for Christians (3rd ed.). Retrieved from www.eerd

comment katarzyna

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

 

1) What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Health risks associated with obesity that Mr.C has are:

–          Elevated fasting blood glucose at 146/mg/dL (Mr. C. possibly might have diabetes)

–          Elevated 172/96 with RR at 26. Mr. C. has hypertension and his RR shows that his body has to work harder to breathe; sleep apnea               is another health risk.

–          elevated total cholesterol is 250mg/dL (desirable value is below 200mg/dl).

–          HDL is 30 mg/dL, which is low. Optimal value that protects ones heart is above 60 mg/dL.

–          Elevated triglycerides at 312mg/dl and the desirable value should be below 200 mg/dl (Cholesterolmenu, 2017).

“Consensus guidelines suggest that the surgical treatment of obesity should be reserved for patients with a body-mass index (BMI) >40 kg/m(2) or with BMI >35 kg/m(2) and 1 or more significant comorbid conditions, when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity and mortality “ (Pentin, Nashelsky, 2005). Mr. C.’s Height: 68 inches (170 cm); Weight 134.5 kg; BMI is 46.9 (BMI calculator, 2017). Mr. C. is considered obese and meets criteria for beriatric surgery with BMI of 46.9 and at least one comobordity that puts him at risk for heart disease and stroke.

 

2) Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

  1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
  2. Ranitidine (Zantac) 300 mg PO at bedtime.
  3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

 06:00: Carafate

10:00 Mylanta

11:00: Carafate

15:00 Mylanta

17:00 Carafate

21:00 Mylanta

21:00 Carafate

22:00 Mylanta and Zantac

22:30 (after snack) Carafate

 

3) Assess each of Mr. C.’s functional health patterns using the information given (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance).

What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

 

Health perception – health management: Mr.C.is obese. He seeks information about bariatric surgery. He was always heavy but within last 2-3 years gained about 100lb. Potential problem within health perception and management for this individual is knowledge deficit. Mr. C.’s labs reveal high cholesterol, triglycerides. Mr C.  knows he has high blood pressure but the only intervention is sodium restriction. Mr C. does not know how to manage his weight and needs to be aware about the risks he might be facing like heart disease, stroke. Even with surgery Mr C. still needs to know about what his daily nutrition should be.

nutritional – metabolic: Mr.C has imbalanced nutrition: more than body requirements. He consumes too much food and possibly not the healthy nutrients that his body needs (HDL is low). Sedentary lifestyle (working at a call center where he is sitting all day) is contributing to his obesity. Mr C. was diagnosed with peptic ulcer as well. According to a study by the National Institutes of Health [NIH], obesity can be a contributing factor to the development of gastric ulcers (2014).

 Elimination: there is not enough data to examine this pattern.

activity-exercise: Mr.C’s job requires him to sit most of the day at the call center. Physical activity deficit is consequitive problem. Lack of exercise is contributing to Mr. C.’s obesity. Intervention with safe exercise plan is needed for Mr. C.

sleep-rest: Sleep pattern is disturbed due Mr. C.’s sleep apnea. This problem can cause him to be tired and weak during the day. Body that is depleted from oxygen can suffer other negative consequences such as heart problems.

 self-perception – self-concept: Mr.C’s body image is disturbed due to his obesity. He knows that he is overweight and his self esteem is probably low. We can assume he is self aware and is looking for change since he is seeking information about surgery. He needs support, help and education

 

role-relationship: Mr. C. is single. Further assessment is needed for more information

References:

Cholesterolmenu. (2017). A comprehensive Guide on Ideal Cholesterol Levels. Retrieved from: http://www.cholesterolmenu.com/cholesterol-levels-chart/

National Institutes of Health [NIH]. (2014). Measures of adiposity are associated with increased risk of peptic ulcer. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/24681076

COMMENT SUSAN

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I NEED A POSITIVE COMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

The healthcare industry is constantly changing, with the advancement in technology there is the need for improvement in the quality care that is rendered by health care staff. The clinical nurse leader (CNL) role was developed to improve the outcome of patient care. The CNL act as the patient advocate by assessing  the patients and family members needs. Then through strategic planning and collaboration with the healthcare staff patient care is rendered in a more  timely and effective manner. The CNL is also the bridge for communication between the healthcare staff, from nursing assistant to physicians. They take on a role that empowers the healthcare staff to strive for excellence. There are many different types of leadership styles a CNL can acquire, from Democratic to Affiliative with the underlying goal of  having the healthcare team working together to bring the best outcome for the patient.

An example of how the CNL influence patient care:

CNL leaders at Baptist Hospital in Miami, Florida had conducted a evidenced based project on fall with injury and pressure ulcer  prevalence. After one year of implementation of their intervention, the study reveled a reduction rate of 67% in fall with injury and pressure ulcer ( Sacred Heart University, n.d) . Another way how CNL influences patient care is by  implementing alternative strategies for dealing with patients to prevent the use restraints.

In order to become a clinical nurse leader the individual must be good at problem solving and have strong critical thinking skills. This is essential for evaluating patient outcome and making strategic changes to improve the quality of care a patient receive (Registered Nursing.org, n.d). The individual must also be committed to engage in lifelong learning in order to stay abreast of the latest technologies and treatment innovation. In order to function at this high level, an advanced degree in education is needed. So the individual who aspires to become a clinical nurse leader must obtain a master’s degree in the clinical nurse leader program. The course of program varies by institution but the general program includes:

Advanced Pharmacology

Advanced Pathophysiology

Quality and Safety in Healthcare

Research Methods & Biostatistics

Advanced Health Assessment & Diagnostic Reasoning

Advanced Ethical Issues and Decision Making

The Business of Healthcare

Evaluation of Health Outcomes

Advanced Epidemiology: Tracking Health & Disease (Registered Nursing.org, n.d))

At the end of the course the individual must earn a clinical nurse leader certification from the American College of Colleges of Nursing’s Commission on Nurse Certification (Registered Nursing.org, n.d). After certification the CNL can seek employment in the hospital, private clinic, acute care institution and research facilities (Registered Nursing.org, n.d). CNLs can also work as a faculty member or develop educational programs to improve the outcome of patient care. The CNL salary varies by location, and experience. The pay ranges from $50,975 – $100,094, with an average pay of $75,000 (Registered Nursing.org, n.d).

Reference: 

Sacred Heart University. (n.d.) . The many roles of a Clinical Nurse Leader. Retrieved from, onlineprograms.cacredheart.edu

RegisteredNursing.org. (n.d). What is a Clinical Nurse Leader. Retrieved from registerednursing.org

comment karen

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

 In 2007, the American Association of Colleges of Nursing introduced the Clinical Nurse Leader (CNL) role as a response to the increasing concerns regarding the safety and quality of nursing care. The educational preparation of the CNL requires a Master’s Degree that encompasses both clinical and theoretical experiences and results in competencies that develop strong clinical leadership traits (Stavrianopoulos, 2012).

          The CNL influences and enhances patient care both at inpatient and outpatient healthcare environments. CNLs’ duties involve assuming a leadership role among team members, evaluating how the present system is working, and identifying changes that need to take place (University of San Francisco). In general, CNLs affect patient care in the following ways: as an interdisciplinary care team leader, as outcomes manager, as patient educator and advocate, as information manager, and as an advanced clinician (Stavrianopoulos, 2012).

          Strategies for Nurse Managers (2017) reports that currently there are an estimated 900 CNLs in the USA. Statistics show that hospitals who employ CNLs have fewer readmission rates, shorter “length of stays”, decreased infection rates, fewer falls, and less RN turnover. The Veterans Health Administration (VA) not only applauds CNLs, but initiated a plan to have at least three CNLs employed at each of its hospitals by 2016. Many organizations have offered scholarships to advance this much-needed nursing career.

References

Stavrianopoulos, T. (2012). The clinical nurse leader. Health Science Journal,6(3). Retrieved from https://www.hsj.gr/medicine/the-clinical-nurse

Strategies For Nurse Managers. (2017). Clinical nurse leaders improve patient care

          and quality. Retrieved from http://www.strategiesfornursemanagers.com/ce

University of San Francisco. The evolution of clinical nurse leaders.

          Retrieved from https://onlinemsn.usfce.edu/news-resources

 

Positive response with reference 150 words due October 19 at 10:00 am

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As described by Maurer and Smith, vulnerability can be characteristics, traits, or experiences that can increase a persons’ vulnerability to develop health related problems and have less access to care therefore likely leading to poor outcomes (Maurer & Smith, 2013).  As Maurer and Smith state, a person or group will ultimately be more vulnerable with increasing amounts of risk factors (Maurer & Smith, 2013).  For example, genetics can play a role in high blood pressure and heart disease however, just as important, the people within the family most likely share commonalities like food consumption, activities, and various other lifestyle choices that may contribute to hypertension (Centers for Disease Control and Prevention, 2014).  The family with a genetic predisposition to hypertension is at risk.  How each person in the family lives (diet, exercise, non-smoker) determines their vulnerabilities.

Members of the at-risk group I have mentioned may not be able to advocate for themselves due to lack of education. Culture and traditions play a large part in food, diet, and exercise.  Letting go of traditions and changing what makes a person a part of their family can be difficult.  As a nurse leader, I would advocate for the entire family/group by educating them on the risks and attempt to make them less vulnerable to the ill effects that can contribute to hypertension.  As mentioned in our readings, I would utilize the critical theory teaching the members of the at-risk group about hypertension and encouraging dialogue that would lead to education and hopefully change.

Another example that came to mind has to deal with low income families.  For example, many people will ask for a prescription for Tylenol or Motrin because their insurance (Medicaid) will pay for it.  Many times, I had wondered why they would want a prescription for it when they can just buy it for a few dollars.  I soon realized that some people cannot afford it.  Lack of income/money can put people in more vulnerable positions adding to their burdens and stress potentially worsening their health.

 

Centers for Disease Control and Prevention (CDC). (2014). High Blood Pressure. Family history and other characteristics that increase risk for high blood pressure. Retrieved from https://www.cdc.gov/bloodpressure/family_history.htm

 

Maurer, F. & Smith, C. (2013). Community/Public Health Nursing Practice (5th ed.). St. Louis, MO: Elsevier Saunders.

Con week 3 quest 1