COMMENT EVE

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

The link between nurse education and patient outcomes was confirmed in 2011, when Aiken published a study in Medical Care that found that a 10 percent increase in the proportion of BSN-prepared nurses reduced the risk of death by 5 percent. In 2013, Aiken co-authored a study in Health Affairs that found that hospitals that hired more BSN-prepared nurses between 1999 and 2006 experienced greater declines in mortality than hospitals that did not add more BSN-prepared nurses. Patients in hospitals in which 60% of nurses had bachelor’s degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor’s degrees and nurses cared for an average of eight patients (Building the Case for More Highly Educated Nurses, 2017). There have been numerous studies that correlate higher education with better patient safety outcomes. However, studies like these do not account for other variables such as the number of patients each nurse had as mentioned above. In my personal experience, I have worked with many ADN prepared nurses and some LVNs that are outstanding nurses. The first code blue that I ever participated in was ran by an ADN nurse. She had many years of experience and it was amazing to watch her in action. She was calm and knew exactly what to do and how to lead the rest of the team. I believe that experience can in some way make up for lack of school education. However, I feel that even a nurse with years of experience must be willing to evolve with the health care system. Nursing is constantly changing due to evidence based practices and BSN nurses may have a better understanding of how to apply that to every day practice.

Building the Case for More Highly Educated Nurses. (2017, May 16). Retrieved September 17, 2017, from http://www.rwjf.org/en/library/articles-and-news/2014/04/building-the-case-for-more-highly-educated-nurses.html

 

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Tunesha Chambliss 

 

3 posts

 

Re:Topic 2 DQ 1

 

Emotional intelligence is the intersection of thinking and emotion. Skill building and training in positive thinking and a focus on positive emotions assist nurses to better listen, encourage, motivate, and create connections (Huber, 2014). Having self awareness simply means that you understand you. You have an awareness of what makes you tick as well as what makes your heart sing or sink.  When you know your strengths and weaknesses as a person, you can then start to understand why you feel the way you do and what makes you feel the way you feel. When you can learn to understand your own emotions, as well as how to control them, you can identify their impact to you and those in your team (Candy, 2016).  

 

I have a personal example of this from a current situation that I am facing on my job in which I am the program manager. In the last two months I have had two of my staff to move from our area.  Recently, one of the two Nurses I have left has decided to transfer to another clinic to “work less days”. She is fully aware that this will only leave our program with one nurse other than myself. This nurse shared this information to me openly in front other team members (Charge nurse, Social worker, dietician, secretary). It was so quiet you could hear a pin drop. I politely said ok, I want you to do what is going to make you happy and work for your family. Now the other team members didn’t take this news so calmly. What I have learned through the years from trial and error is that as the Leader I cannot allow my feelings to control my behavior. Deep down inside I wanted to scream because it takes 6 months for a new nurse to take call and train patients and I’m in school. To this day my staff are still not aware of how I really feel about the situation. As the leader of our program I could not afford to display the heart drop in my heart that I felt deep down inside because I didn’t want to envoke uneccessary anxiety on them. Surprisingly they have come to privately stating how surprised they were that  I was able to remain so calm after hearing that another nurse was leaving. Of course after hearing that I could only say “Thank you Lord” because that is an area that I have really had to seek God’s help with. 

 

 

 

Candy, L (2016). Emotional Intelligence Theory: Highlighting and Developing Leadership Skills. Retrieved 7/4/2017 from http://www.educational-business-articles.com/emotional-intelligence-theory/

 

Huber, D (2014). Leadership & Nursing Care Management, 5th Edition. Retrieved 7/4/2017 from https://pageburstls.elsevier.com/#/books/9781455740710/cfi/0!/4/2/2@0:51.6

 

 

 

 

 

P5

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

Katy Morris  

 

 

Mucormycosis is a rare infection caused by organisms that belong to a group of fungi (CDC, 2013). These fungi are typically found in the soil and in association with decaying organic matter, such as leaves, compost piles or rotten wood (CDC, 2013). The infection is more common among people with weakened immune systems, but it can occur, rarely, in people who are otherwise healthy (CDC, 2013). In the pulmonary or sinus form of infection, exposure occurs by inhaling fungal spores from the environment (CDC, 2013). Lung infection, or pulmonary mucormycosis, is pneumonia that gets worse quickly and may spread to the chest cavity, heart, and brain (CDC, 2013). Medical/nursing interventions that would be helpful in treating the patient include antifungal medications to slow or halt fungal spread (The New York Times, 2017). Amphotericin B, initially intravenous, is the usual drug of choice for antifungal treatment (The New York Times, 2017). In addition, placing the patient on supplemental oxygen would be helpful due to the patient having pneumonia and that causes it to be difficult to breathe. Laboratory values that are considered abnormal include the patients HCO3, PO4, fasting glucose, WBC, lymphocytes, pH, PaO2, PaCO2. Patients HCO3 is 29 and the normal value is 22-28. Patients PO4 is 2.9 and the normal value is 3.0-4.5. Patients fasting glucose is 138 and the normal value is less than 100. Patients WBC count is 15.2 and the normal value is 3,500-10,500. Patients lymphocytes are 10% and the normal value is 20-40%. Patients pH is 7.50 and the normal value is 7.35-7.45. Patients PaO2 is 59 and normal value is 75-100. Patients PaCO2 is 25 and normal value is 38-42. The abnormal ABG information means that the patient is in partially compensated respiratory alkalosis (McAuley, 2017). The patient has increased WBC count due to infection of the pneumonia. Patients lymphocytes are decreased due to an infection. The increased fasting blood glucose levels means that the patient is more susceptible to infection, in this case making the patient susceptible to pneumonia. Medications that are likely to be prescribed by the physician could be Amphotericin B-an antifungal medication to slow or halt fungal spread, Insulin due to an increased blood glucose level, and Prednisone to help with inflammation and improve breathing. Treatments likely to be prescribed by the physician could be Nebulizer breathing treatments to help improve breathing, supplemental O2 to improve breathing and increase oxygen saturation, and IV fluids to help ensure the patient is hydrated because if the patient becomes dehydrated more issues could arise.

 

P2

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Karan Kortlander 

 

1 posts

 

Re:Topic 1 DQ 1

 

The nursing shortage is not stopping.  Registered nurses are near the top of the list when it comes to employment growth (BLS 2012 Table 8 – RNs are #4). Additionally:

 

  • Over the past decade, the average age of employed RNs has increased by nearly two years, from 42.7 years in 2000 to 44.6 years in 2010.
  • America is seeing vast increases in the number of people over 65. This age group has many medical and health needs, and will put a strain on our health system.
  • Recent reforms in healthcare will give millions of people access to the healthcare system. More nurses and health professionals are needed in response.

 

These factors, combined with an anticipated strengthening of the economy, will create a renewed critical shortage for nurses.

 

According to the Nursing World, while nursing shortage affords opportunity, there are negative effects to the nursing shortage.  Nurses often need to work long hours under stressful conditions, which can result in fatigue, injury, and job dissatisfaction. Nurses suffering in these environments are more prone to making mistakes and medical errors. Patient quality can suffer. For these reasons, and more, ANA is dedicated to improving the workplace safety for nurses around the nation. 

 

Nursing Shortage Legislation and Strategies ANA lobbies both houses of congress, as well as the federal agencies, on policies and legislation to bolster the number of RNs and nurse faculty. 

 

 

 

Retrieved from http://www.nursingworld.org/nursingshortage

 

 

 

 

 

COMMENT KAREN

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I NEED A POSITIVE COMMENT BASED IThe Patient Protection and Affordable Care Act (PPACA) was signed into law in 2010; it has and will continue to have a dynamic impact upon the nursing profession. The PPACA has introduced many provisions applicable to nursing, but this discussion will focus on education and nurse-managed health clinics.
          The Institute of Medicine (IOM) recognizes that healthcare has become increasingly complex, intensive, and technical, and that nurses are given greater responsibilities. Consequently, it is imperative that nurses achieve advanced levels of training and education. In response to this need, the PPACA has increased the loan amount for nurses education to $17,000 and has also expanded the funding allotted to graduate nursing students for clinical education. It should be noted that although the cost of education has risen dramatically, the federal loan amounts have not been changed for over a decade. The government has authorized $338 million to develop programs that include advanced education grants for nurses. Furthermore, the Health Resources and Service Administration (HRSA) provides support programs for RNs who are pursuing careers as Advanced Practice Nurses.
          In the US today, we are currently experiencing a physician shortage problem (Stokowski, 2010); very often patients must wait over one month to see a specialist. On the contrary, Nurse Practitioner (NP) candidates and programs are increasing. The good news is that the PPACA is not only granting funds for NP training, but also for nurse-managed health clinics.  In 2014, HRSA estimated that nearly 60 million persons had limited access to healthcare. In 2013, Health Affairs published the results of a study conducted by the RAND Corporation; the committee recommended that nurse-managed care centers could relieve the current pressures experienced by the primary care staff.
          Because of the recommended provisions, educational opportunities for nurses will be less costly and burdensome. For example, at the hospital where I am employed, the tuition reimbursement amount has risen. Nurses will be more likely to pursue advanced degrees, and when they do achieve their goals, facilities will be available where they can practice advanced skills.
 
American Nurses Association, (2014). Health care reform. Retrieved from
          www.nursingworld.org
Health care reform law begins to have effect on nursing (2011). Retrieved from
          http://www.rwif.org/en/library
Hertel, R. (2011). Health care reform & issues in nursing. Matters.(2011).
Stokowski, L. (2010). Healthcare reform and nurses: challenges and opportunities.
          Retrieved from http://www.medscape.com
National Nursing Centers Consortium. Nurse-managed health clinics.N THIS ARGUMENT..BETWEEN 100-120 WORDS

The Patient Protection and Affordable Care Act (PPACA) was signed into law in 2010; it has and will continue to have a dynamic impact upon the nursing profession. The PPACA has introduced many provisions applicable to nursing, but this discussion will focus on education and nurse-managed health clinics.

          The Institute of Medicine (IOM) recognizes that healthcare has become increasingly complex, intensive, and technical, and that nurses are given greater responsibilities. Consequently, it is imperative that nurses achieve advanced levels of training and education. In response to this need, the PPACA has increased the loan amount for nurses education to $17,000 and has also expanded the funding allotted to graduate nursing students for clinical education. It should be noted that although the cost of education has risen dramatically, the federal loan amounts have not been changed for over a decade. The government has authorized $338 million to develop programs that include advanced education grants for nurses. Furthermore, the Health Resources and Service Administration (HRSA) provides support programs for RNs who are pursuing careers as Advanced Practice Nurses.

          In the US today, we are currently experiencing a physician shortage problem (Stokowski, 2010); very often patients must wait over one month to see a specialist. On the contrary, Nurse Practitioner (NP) candidates and programs are increasing. The good news is that the PPACA is not only granting funds for NP training, but also for nurse-managed health clinics.  In 2014, HRSA estimated that nearly 60 million persons had limited access to healthcare. In 2013, Health Affairs published the results of a study conducted by the RAND Corporation; the committee recommended that nurse-managed care centers could relieve the current pressures experienced by the primary care staff.

          Because of the recommended provisions, educational opportunities for nurses will be less costly and burdensome. For example, at the hospital where I am employed, the tuition reimbursement amount has risen. Nurses will be more likely to pursue advanced degrees, and when they do achieve their goals, facilities will be available where they can practice advanced skills.

 

American Nurses Association, (2014). Health care reform. Retrieved from

          www.nursingworld.org

Health care reform law begins to have effect on nursing (2011). Retrieved from

          http://www.rwif.org/en/library

Hertel, R. (2011). Health care reform & issues in nursing. Matters.(2011).

Stokowski, L. (2010). Healthcare reform and nurses: challenges and opportunities.

          Retrieved from http://www.medscape.com

National Nursing Centers Consortium. Nurse-managed health clinics.

COMMENT KAREN

/in /by

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

Current statistics show that at present, there are 1,048 Associate Degree Nursing (ADN) colleges and 696 Baccalaureate Degree Nursing (BSN) institutions in the United States (Cherry & Jacob, 2017). Recent studies show that a correlation exists between patient safety outcomes and whether a nurse has an ADN or BSN. Linda Aiken, PhD, RN, who is associated with the Robert Wood Johnson Foundation (RWFJ), believes that hospitals who employ more BSN-prepared nurses have better patient outcomes and lower mortality rates (RWJF, 2014).

          In 2003, Aikens reported on studies done in Pennsylvania hospitals showing a 5% decrease in patient deaths at hospitals that staffed a 10% increase in BSN-prepared nurses (RWJF, 2014). Challengers of Aikens note that these studies raise further questions (Sentinel Watch, 2014). For example, what were the actual causes of death of these patients, and were they related to the action of an ADN nurse? Could there be other factors or causal relationships that affected patient care in these circumstances?

          In defense of Aikens, the Sentinel (2014) states that no one is calling ADN nurses “bad nurses”. In fact, errors, infections, and adverse events are often due to process and system problems. Aikens maintains that by promoting evidence-based practice and leadership, the BSN curriculum will better prepare nurses to correct problems and implement solutions.

          I agree that it is advantageous for nurses to expand their knowledge by obtaining a BSN degree, but I do not feel that deaths and adverse outcomes are the result if ADNs care, or lack of. Many other factors need to be considered. For example, poor staffing, long shifts, poor communication, fatigue, documentation errors, etc. affect everyone no matter what type of degree they hold. I have been at the hospital where I am currently employed for almost 20 years and have seen no evidence that the care given by ADNs is substandard to the care given by BSN-prepared nurses.

References

Cherry, B. & Jacob, S. (2017).Contemporary nursing, issues, trends, & management. St. Louis: Elsevier

Robert Wood Johnson Foundation. (2014).  Building the case for more highly

          educated nurses. Retrieved from http://www.rwjf.org/en/library/articles

The Sentinel Watch. (2014). How does your nursing degree affect patient

          mortality rates? Retrieved from http://www.american sentinel.edu 

Statics help

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Please use the data, StatCrunch, and your knowledge of statistics to answer the questions below.. Download the provided CDC data into StatCrunch (located at the bottom of these directions). You will utilize this data in weeks 3 and 8 for your Healthcare Applications Assignment. 

Part I

  1. Calculate the correlation coefficient between each of the independent variables and the variable—diabetes. What does this value tell us about the relationship between each of the independent variables and diabetes?
  2. Run a regression using diabetes as the dependent variable and smoking as the independent variable.
    • Is there a statistically significant relationship between poverty rates and diabetes? (Use the T-stat or P-value.) Explain.
    • Write out the regression line calculated using the data.
    • Interpret b1 (the slope coefficient).
    • Suppose a state raises the tobacco tax and the rate of smoking in the state falls from 21% to 18%. What would the decrease be in the rate of diabetes based on the regression results?

Part II

Suppose you work for a local hospital. Your manager requests that you use the CDC data on diabetes and smoking, obesity rate, physical activity, and poverty rate to present a compelling argument to the board regarding the importance of creating state initiatives to reduce diabetes rates. You must present statistical data in a written report to the board. Write an APA formatted paper, double spaced, 2-4 pages in length, with a cover page and references page addressing the following:

  • Include a minimum of four types of statistical tests to make your case. Examples include hypothesis tests, confidence intervals, correlations, regressions, etc. You may use statistical tests that you have completed in weeks 3 and 8 or develop your own.
  • Include a minimum of three graphs with your report. Examples include scatter plots, histograms, regression lines, box-plots, etc. You may use graphs that you have completed in weeks 3 and 8 or develop your own.
  • Write an essay using these statistics and graphs to make a convincing argument for the need to create an initiative to reduce the rate of diabetes.  In your essay, explain the relationship between diabetes and obesity, smoking, physical activity, and poverty rates utilizing statistical data, tests, and graphs. Be sure to explain your results and how these results show there is a need to create an initiative to reduce the diabetes rates. 

p6

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Ashley Pittman 

 

1 posts

 

Re:Topic 1 Mandatory Discussion Question

 

Ms G. presents to the ED with cellulitis of the LLL.  She reports no improvement since applying heat for several days.  Miss G. also reports increased pain and has developed chills suggesting that she has a fever.  Assessment findings show an open wound on her LLL with drainage present and swelling of >3 cm in comparison to her RLL.  She has a temperature of 102.2 F and wound cultures are positive for Staph aureus.  Lab values show an elevated WBC with > 10% bands and 80% L shift in neutrophils.

 

My recommendation would be IVF, Abx, A1C, CMP, complete set of VS, head to toe assessment, CBG ac/hs (insulin if needed).  Miss G. would also benefit from evaluation by OT and PT as well as meeting with a Diabetic Educator.  Social work would also be beneficial as she lives alone and may have greater needs than we are aware of.  Imaging of the LLL can tell us if she is experiencing DVT or if there is damage beyond what we can see. 

 

It is essential that we treat the existing infection so that she can return to baseline, and it is equally important that we assess her knowledge of Diabetes as uncontrolled diabetes can have a serious impact on wound healing. 

 

Muscle groups that are likely to be affected by Miss G.’s infection include gastrocnemius, soleus, extensor hallucis longus, extensor digitorum longus, fibularis longus, vastus medialis, rectus femoris, and extensor hallucis brevis (ARC Resource Center, nd).

 

The data presented paints a picture of where Miss G may need assistance and/or education.  She needs to be evaluated on her understanding of Diabetes and management of the disease.  Many complications come from diabetes including delayed wound healing.  She will need labs drawn over the course of her stay to evaluate the effectiveness of the abx.  An A1C will tell us if Miss G manages her Diabetes well over time.  Evaluation by PT and OT are important for safe discharge home as she lives alone and was not able to perform ADLs independently upon admission.  She will need to follow up with her PCP after discharge to have the wound on her leg looked at. 

 

As mentioned above, delayed wound healing can be caused by diabetes and also poor nutrition. Miss G may also suffer from depression as she is managing a chronic condition and living alone; depression has also been linked to delayed wound healing. 

 

“The moment a person with diabetes suffers a break in the skin of their foot, they become at danger for amputation. Most commonly, patients have neuropathy, which could be causative. When coupled with an impaired ability to fight infection, these patients become largely unable to mount an adequate inflammatory response. Thus, the DFU that may look like a healing wound becomes a portal for infection that can lead to sepsis and require limb amputation” (Journal of Investigation, 2007).

 

 

 

 

 

comment stephanie

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

Discuss how two of the provisions related to nursing outlined by the ANA have impacted, or will impact, your current practice of nursing.

In regards to the Advanced Practice Registered Nurses (APRNs) provision, where they are proven providers of high quality and cost effective primary care (Health Care, 2010). This provision has and will continue to impact my current practice of nursing by having APRN available within the hospital or a phone call away to collaborate and assist with getting the necessary treatments needed for a patient. In surgery, our main cardiovascular surgeon, has a APRN that rounds on all his patients, initially sees consults in the hospital that are called into him, and then relays the status of the patient to him, and if surgery is needed, she makes sure the appropriate orders are placed, which in turn helps us in surgery immensely. She is available if we have questions regarding one of the patients or we see a particular test isn’t done, she can check on it or verify it. Having a dedicated and capable APRN in this case, allows for the surgeon to be able to devote more of his time with surgery and other duties necessary and relieves some of the burden from him, which in the long run, benefits the patient.

The second provision outlined by the ANA, which will impact my current practice, is the nurse education, practice, and retention provision. The section 5309, added 2 new grant programs specifically aimed at nurse retention. The first grant program would award grants to accredited nursing schools or health facilities to promote career advancement among nurses (Health Care, 2010). And the second grant program would award nursing schools and health facilities for exhibiting enhanced collaboration and communication among nurses and other health care professionals (Health Care, 2010). I think this provision would impact my nursing practice by first encouraging career advancement among nurses provides nurses with a goal or a commitment and gives them purpose. I think up until now in my practice I felt that I really had no purpose, with incentives to promote nurses and make them a vital part of the health care team provides worth to the health facility’s staff, therefore they strive to be the best they can be. I think this also contributes to nurse retention, as well, which in the long run helps with staffing and also helps the hospital to save money. And secondly, by encouraging enhanced collaboration and communication among nurses and other health care professions helps to provide quality continuum of care to patients and supports a team-approach to patient care, and a valued member of the health profession.  

Reference:

Health Care Reform, Key Provisions Related to Nursing. (2010). Retrieved September 11, 2017, from http://www.rnaction.org/site/DocServer/KeyProvisions_Nursing-PublicLaw.pdf?docID=1241&verID=1

Reply  |  Quote & Reply 

comment karan

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 I NEED APOSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 120-150 WORDS

 

What health risks associated with obesity does Mr. C. have?

Nearly one third of the adult population of the United States is overweight or obese (Centers of Disease Control and Prevention, 2015). Obesity and diabetes are major health problems that are rapidly getting worse in the United States. In addition, obese people have an increased risk for the development of cardiovascular disease because obesity is often accompanied by elevated serum lipid levels. Obesity is also associated with hypertension. Obesity places an increased workload on the heart, which increases oxygen demand. According to the Centers of Disease Control and Prevention “the estimated cost of obesity in the United States was 147 billion in 2008 and the medical costs of people who are obese were $1,429 higher than those of normal weight” (Centers of Disease Control and Prevention, 2015). Obese people are also more likely to have delayed wound healing and wound infection because adipose tissue impedes blood circulation and its delivery of nutrients, antibodies, and enzymes required for wound healing. Obese clients also have difficulty breathing when sedated (Orlando Sentinel, 2012).

Is bariatric surgery an appropriate intervention? Why or why not?

 

According to the American Nurses Association “bariatric surgery provides dramatic improvement” to obese people that suffer from chronic diseases such as heart disease, hypertension, sleep apnea, degenerative joint disease, gastroesophageal reflux disease, asthma, and depression (American Nurses Association, 2009).

 

Bariatric surgery can be very effective when combined with a comprehensive treatment plan according to the American Society for Metabolic and Bariatric Surgery (American Society for Metabolic and Bariatric Surgery, 2015). The combined treatment can be an effective tool to provide a client with a long term weight-loss and help the client increase the quality of their health. Bariatric surgery has shown to help improve or resolve many obesity-related conditions, such as type 2 diabetes, hypertension, and heart disease it also helps in reducing the need to continue taking so many medications for these co-morbidities.

 

According to the US National Library of Medicine National Institutes of Health the following are some pros and cons of bariatric surgery (US National Library of Medicine National Institutes of Health, 2012):

 

Pros

Cons

Initial and sustained weight loss

Initial failure to lose weight

Resolution of obesity-related comorbidities

Potential complication: preoperative, surgical, gastrointestinal, nutritional, and psychological

Improved mortality

Initial costs

Reduction in obesity-related health risks

Weight regain

Improved quality of life

Permanency

Psychosocial benefit

 

 

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered: (a) Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime; (b) Ranitidine (Zantac) 300 mg PO at bedtime; and (c) 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.

Carafate

Mylanta

Zantac

0600

 

 

 

1000

 

1100

 

 

 

1500

 

1700

 

 

 

2100

 

2300

 

2300

Assess each of Mr. C.’s functional health patterns using the information given (Hint: Functional health patterns include:

Health-perception – health management – Based on the information provided in the case study Mr. C has always been heavy since he was a child but has gained 100 pounds in the last 2-3 years. With the limited information and the increase weight in the last 2-3 years I can only presume that Mr. C might live a sedentary lifestyle that might be related to lack of motivation or lack of education or readiness.

           

Nutritional – metabolic – Mr. C  is 5 feet 5 inches and weighs 295.9 pounds. According to Premier Health, Mr. C has a BMI of 47.6 and is considered morbidly obese (Premier Health, 2015). He also claims that he has gain 100 pounds in the last 2-3 years.  Based on the information he falls under Nutrition, Imbalanced, More Than Body Requirements as evidenced by reported higher baseline weight.

Elimination – Mr. C has a peptic ulcer and symptoms include passing of bloody stools or black tarry stools. Possible nursing diagnoses can be constipation/diarrhea related to effects of medications on bowel function.

Activity-exercise – Mr. C has an office job and based on his increased weight of 100 pounds in the last 2-3 years lives a sedentary lifestyle. The case study does not specify if Mr. C performs any type of exercise activities but we can assume that he is able to perform activities of daily living.

Sleep-rest – Mr. C is morbidly obese and suffers from sleep apnea due to his overweight.

Cognitive-perceptual – Mr. C appears alert and oriented and able to make his needs known.

Self-perception – self-concept – Mr. C claims that he has been heavy all his life and has gained 100 pounds in the last 2-3 pounds.  Mr. C is looking into bariatric surgery as a solution to his morbid weight.

Role-relationship – Based on the case study Mr. C is a single man not involved in a relationship.

Sexuality – reproductive – is a young man but the case study doesn’t offer any other information.

Coping – stress tolerance – Mr. C is able to identify that he has a problem with his weight. He is taking initiative by reducing salt intake to control his hypertension and he is looking into bariatric surgery to reduce his weight problem.

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

 

1) Health maintenance ineffective related to sedentary lifestyle (Ackley & Ladwig, 2011).

2) Imbalanced nutrition more than body requirements related to lack of basic nutritional knowledge (Ackley & Ladwig, 2011).

3) Disturbed sleep pattern related to sleep apnea (Ackley & Ladwig, 2011).

4) Deficient knowledge related to his obesity, disturbed body image by verbalization of his weight gain (Ackley & Ladwig, 2011).

5) Ineffective coping related to lack of knowledge of weight gain resources (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 Nurses Association. (2009). Weight-loss surgery. Retrieved from

http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TasbleofContents/Vol142009/No1Jan09/Weight-Loss-Surgery.html

American Society for Metabolic and Bariatric Surgery. (2015). Benefits of bariatric surgery. Retrieved from https://asmbs.org/patients/benefits-of-bariatric-surgery

Centers of Disease Control and Prevention. (2015). Adult Obesity Facts. Retrieved from

            http://www.cdc.gov/obesity/data/adult.html

Orlando Sentinel. (2012). Obese patients create big problems for surgeons. Retrieved from

http://articles.orlandosentinel.com/2012-07-25/news/os-obese-patients-20120724_1_obese-patients-normal-weight-person-bmi

Premier Health. (2015). BMI calculator. Retrieved from

            http://www.premierhealthspecialists.org/phspractice.aspx?id=64848

US National Liberty of Medicine National Institutes of  Health. (2012). Quick fix or long-term cure? Pros and cons of bariatric surgery. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3470459/