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

 

 

 

Eve Martinez 

 

1 posts

 

Re:Topic 4 DQ 1

 

Emotional tensions and conflict can affect the vision of the organization. It is the job of management to reorganize and implement policies that help carry out the mission of the organization. Leaders, however, are not necessarily managers thus have a different role in the work place. They have the ability to gain the respect and cooperation of their peers. Leaders may help to relieve tensions, harmonize misunderstandings, and deal with disruptive behaviors (Saeed, Almas, & Niazi, 2014). Leaders can show support by encouraging their peers. It is common to get resistance to change, especially when members don’t feel like they are a part of the process but a leader can serve as a bridge between management and staff. They can use their influence to manage conflict and enhance productivity by working together (Saeed, Almas, & Niazi, 2014). Communication is at the heart of conflict and resolution. Conflict often arises from ineffective communication; effective or assisted communication and positive collaboration promotes successful resolution of differences (Robson, 2005). The best way that a leader can both identify and manage conflict is to promote effective communication.

 

Robson, P. M. (2005, October 15). Preventing and Managing Conflict: Vital Pieces in the Patient Safety Puzzle. Retrieved July 17, 2017, from http://www.longwoods.com/content/17660

 

Saeed T., Shazia Almas, & GSK Niazi, (2014) “Leadership styles: relationship with conflict management styles”, International Journal of Conflict Management, Vol. 25 Issue: 3, pp.214-225, https://doi.org/10.1108/IJCMA-12-2012-0091

 


 

 

 

P6

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

 

Carolina Perez  

 

 

Explain what Mucor is and how a patient is likely to become infected with Mucor.

Mucormycosis or zygomycosis is a rare and serious fungal infection. It is caused by a group of molds called mucormycetes. Patients is likely to be infected by coming in contact with fungal spores found in the environment. People at risk are patients with a weak immune system. They may become infected by simply inhaling the spores or through any type of skin trauma.

 Describe the pathophysiologic progression of the infection into pneumonia and at least two medical/nursing interventions that would be helpful in treating the patient.

Pulmonary mucormycosis happends when spores may reach all the way to the alveolar spaces, most stay in the nasal turbinates causing sinusitis. Two nursing interventions would be watching closely for respiratory problems, monitoring vital signs specially pulse oximetry levels, chest pains and fever.  Lastly, giving medications as prescribed by physician.

Examine the laboratory blood test results and arterial blood gases provided in “Discussion Question Resource: Laboratory Blood Test Results.” What laboratory values are considered abnormal? Explain each abnormality and discuss the probable causes from a pathophysiologic perspective.

WBC’s are abnormally high due to infection; Lymph are abnormally low due to infection; HCO and PH suggests metabolic alkalosis. Decreased Pa02/PC02 suggests alkalotic and compensated. High glucose levels indicate that the body is trying to compensate due to the infection.

What medications and medical treatments are likely to be prescribed by the attending physician on this case? List at least three medications and three treatments. Provide rationale for each of the medications and treatments you suggest.

Mucor must be treated with antifungal medications. Amphotericin B,Posaconazole, Isavuconazole. Ibuprofen and Tylenol might be used for fever/pain. O2 per doctor’s orders might be needed as well.

Treatments: If needed, mucromycisis might require surgery to remove infected tissue. Educating the patient on how to prevent this infection from occurring again like wearing appropriate clothing when working outside with soil. 

 

 

 

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I NEED A POSTIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-10 WORDS

The two nursing provisions I would like to discuss would be Advanced Practice Registered Nurse’s (APRN’s) and under the Section Additional Nursing Provisions, the Nurse-Managed Health Centers (NMHCs). These two provisions will expand the opportunities I have as I further my education. 

Advanced practice nursing, nurse practitioner, clinical nurse specialist, certified registered nurse anesthetist, certified nurse-midwife, nurse administrator or nurse executive, this provision will allow for many new jobs, and continued growth in the nursing profession. It also allows nurses to work in direct patient care settings outside of a hospital, performing many highly skilled procedures that would have been done in a hospital setting in the past. “Wellness and disease prevention, historically fundamental to the nursing profession, are becoming more meaningful and revitalized concepts within the larger health care system” (Cherry & Jacob, 2016, p. 464). 

Nurse-managed health centers, research shows that nurse managed health centers can reduce health disparities and meet people’s primary care and wellness needs. NMHC have been successful, but many NMHC find themselves in financial struggles. NMHCs see a high percentage of uninsured patients, 30%-60%. A federal grant program released $14.8 million in support of NMHCs, to provide high quality primary care for thousands of patients in need (Hansen-Turton, 2012).

 

Cherry, B., & Jacob, S.R. (2016). Contemporary Nursing: Issues, trends, and management (7 th ed.). St. Louis, MO: Elsevier. ISBN-3: 9780323390224

Hansen-Turton, T. (2012). Nurse-Managed Health Clinics Provided Badly Needed Primary Care – But Without Funding, They and their Patients are at Risk. Retrieved from http://www.rwjf.org/en/culture-of-health/2012/01/nurse-managed-health-clinics-provided-badly-needed-primary-carebut-without-funding-they-and-their-patients-are-at-risk.html

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

 

 

Chinyere Ojiyi 

 

3 posts

 

Re:Topic 3 Mandatory Discussion Question

 

Acute decompensated heart failure (ADHF) is a common and potentially fatal cause of acute respiratory distress. The clinical syndrome is characterized by the development of dyspnea, generally associated with rapid accumulation of fluid within the lung’s interstitial and alveolar spaces, which is the result of acutely elevated cardiac filling pressures (cardiogenic pulmonary edema) [1].

 

ADHF can also present as elevated left ventricular filling pressures and dyspnea without pulmonary edema. Patients presenting with acute dyspnea from acute decompensated heart failure (ADHF) should be rapidly assessed and stabilized using the ABC criteria.

 

●Airway assessment and continuous pulse oximetry to assure adequate oxygenation and ventilation

 

●Supplemental oxygen and ventilatory support (noninvasive ventilation [NIV] or intubation) as indicated

 

●Vital signs assessment with attention to hypotension or hypertension

 

●Continuous cardiac monitoring

 

●Intravenous access

 

●Seated posture

 

●Diuretic therapy

 

●Early vasodilator therapy (for severe hypertension, acute mitral regurgitation, or acute aortic regurgitation); later vasodilator use for refractory cases is discussed below.

 

●Urine output monitoring (perhaps with urethral catheter placement)

 

Intra venous furosemide (Lasix) is given to help get rid of the extra fluid by increasing urination. To help the body rid itself of the extra fluid.

 

Enalapril (Vasotec) is a Blood vessel relaxing medication, it is given to make it easier for the heart to pump. Blocks the enzyme responsible to produce angiotensin II, resulting in a

 

decrease in blood pressure.

 

Metoprolol (Lopressor) Inhibits the strength of the heart’s contractions, as well as heart rate. This

 

results in a decrease in cardiac oxygen consumption.

 

IV morphine sulfate (Morphine) used for treatment of moderate to severe pain including chest pain associated with ACS, CHF, and pulmonary edema.

 

Four cardiovascular conditions that can lead to heart failure are, Coronary heart disease is a condition in which a waxy substance called plaque builds up inside the coronary arteries.

 

Diabetes is a disease in which the body’s blood glucose (sugar) level is too high. Over time, high blood sugar levels can damage and weaken the heart muscle and the blood vessels around the heart, leading to heart failure.

 

High Blood Pressure is the force of blood pushing against the walls of the arteries. If this pressure rises and stays high over time, it can weaken your heart and lead to plaque buildup. And Hyperlipidemia or high cholesterol causes atheresclerosis. In these four conditions,  Lifestyle changes, such as appropriate diet, exercise and seeking prompt medical attention will help to prevent the development of heart failure. 

 

 

 

Interventions that can help prevent drug interaction in elderly includes. Medication reconciliation, this will prevent taking different forms of one medication, like generic and brand name.  Providing medication card list. This lists every medication patient is taking and this can be shared with multiple providers. Taking brown bag of all patient’s medications to appointments. Finally educating patient and caregivers especially in the language they understand, utilizing pill box is also an effective way to keep track of older adults’ medication.

 

 

 

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Ijeoma Igbokwe   3 posts  Re:Topic 2 DQ 1   The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March of 2010. Identify the impact of this legislation on your nursing practice by choosing two key nursing provisions outlined in the American Nurses Association “Key Provisions Related to Nursing” summary at http://www.rnaction.org/site/DocServer/KeyProvisions_Nursing-PublicLaw.pdf?docID=1241&verID=1.

 Discuss how these two provisions have impacted, or will impact, your current practice of nursing. The Patient Protection and Affordable Care Act sometimes called “Affordable Care Act” or “Obamacare” is a law that provides numerous rights and protections making health coverages easier to understand and more accessible and affordable to people. 

This law provides a wider Medicaid coverage to people with low income (Health care.gov, n.d) According to the summary, nurses hold vital roles in health care system, in other to transform the health care services, the issues facing nursing profession must be addressed. The two key provisions related to nursing outlined in American Nurses Association summary are “Nursing Workforce” and “Nurse Home Visitation Services” Nursing Workforce Nursing like any other professions needs financial support to improve nursing training, education, and practice. T

he Nursing Workforce Development program helps in recruiting new nurses, encouraging nurses hired to advance in education by providing financial assistance in scholarships and grants to nurses, for advanced nursing education (American Nurses Association), so that nurses are better prepared to deliver high quality care to patients and to serve the community better.

 This program also helps to direct the registered nurses to areas of nursing needs to ensure nurses are adequately available to meet every need of the community members, whether in the hospitals, health centers, nursing homes or patients’ homes (American Nurses Association). This program will attract more people to nursing profession thereby solving the problem of nurses’ shortage and encourage nurses to go back to school for upgrade, without worrying about taking up more jobs to afford school fees, because they could qualify for grants or scholarships. Nurse Home Visitation Services.

 This program authorizes the federal and the states to provide financial supports to fund nurse home visitation coverages for maternal, infant, and early childhood interventions (American Nurses Association). This program would ensure continuity of patient’s care, follow-up, and more importantly provides opportunity for patients’ nursing needs to be met in the comfort of patient’s homes which is a familiar environment, and less stressful for the family members, who would have to commute to and from the hospital. This program not only benefits the patients, but also benefits nurses who have options of working outside healthcare facilities, where scheduling is more flexible. With the flexible of the schedule, nurses balance family, work, and

education.                                                                     

Reference 

American Nurses Association. “Key Provisions Related to Nursing”. Retrieved from http://www.rnaction.org/site/Docserver/KeyProvisions_Nursing-PublicLaw.pdf?doclD=1241&verID=

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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 

 

1 posts

 

Re:Topic 5 Mandatory Discussion Question

 

Health risks associated with obesity that Mr. C has is sleep apnea, high blood pressure, high blood glucose level, high cholesterol level, high triglyceride level, and a low HDL level which is considered a major risk factor for heart disease. Bariatric surgery may be a potential intervention for Mr. C. We would need to know if the patient has a history of multiple failed attempts with diet plans, behavioral changes, and medical therapy. The patient is in the right age group for bariatric surgery because he is between the ages of 14-75. The patient is a candidate because of his weight, high blood pressure, sleep apnea, and high cholesterol levels. The patient would need to understand the procedure and its implications, and have the commitment to follow post-surgery diet instructions, vitamin supplementation, exercise programs, and follow-up necessary for health and weight maintenance.  Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL: 1000, 1500, 2100. Ranitidine (Zantac): 2230. Sucralfate/Carafate 1 g or 10ml suspension: 0600, 1100, 1700, 2200. Health-Perception: The patient tries to maintain a low sodium diet and realizes that his weight is a health issue and wants to make changes with receiving bariatric surgery. This patient has good health-perception. Nutritional – Metabolic: Patient is trying to maintain a low sodium diet. Patient has high blood pressure, high cholesterol, and high glucose levels. Elimination: No information provided. Activity-exercise: Patient works at a catalog telephone center which could mean that he sits most of his day. Other than his job, there are no reports of activity or exercise. Sleep-rest: Patient has sleep apnea. Cognitive-perceptual: No abnormalities noted. Self-perception/Self-concept: Patient understands that he is overweight and is making efforts to help improve this. Role-relationship: No information provided. Sexuality – reproductive: No information provided. Coping – stress tolerance: No information provided. Five problems include high blood pressure, high cholesterol, high glucose levels, sleep apnea, and a potential for heart disease. The patients blood pressure is 172/96. This is an actual problem. The patients fasting glucose level is 146 which is high. This is an actual problem. The patient has sleep apnea which is an actual problem that could be potentially fatal if the patient does not treat it. The patient has a high cholesterol level of 250. This is an actual problem. The patient has a low HDL level of 30 which is considered a major risk factor for heart disease.

 

 

 

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

 

 

ChristineTarbox 

 

1 posts

 

Re:Topic 1 DQ 1

 

A nursing shortage has been shown to decrease patients access to care, decrease job satisfaction, and increase nurse turnover (Huber, 2010).  “The current nursing shortage is anticipated to become twice as large as any nursing shortage experienced since the 1960s” (O’Neil, 2009, p. 180, para 7).  Nurse shortage has been a significant focus of study and debate because of the enormous effect it has on all of us at every possible level of healthcare. Numerous research studies have been conducted to determine the main factors driving the nursing shortage.  “This shortage is not solely nursing’s issue and requires a collaborative effort among nursing leaders in practice and education, health care executives, government, and the media” (Nevidjon & Erickson, 2001).  Factors contributing to the nursing shortage include the following:  Nursing school enrollment is not growing fast enough to meet the projected demand for RN and APRN services, nursing school faculty shortage is restricting nursing program enrollments, a significant percentage of the current nursing workforce is nearing retirement age, there is an increased need for nursing care because of our aging population, and  insufficient staffing is intensifying nurses’ stress level which impacts job satisfaction and drives many nurses to leave the profession.

 

Although there has been a 3.6% increase in baccalaureate nursing program enrollment in 2016 according to the AACN (2017), this increase is not even close to sufficient enough to meet the projected demand for nursing faculty, researchers and primary care providers.  The AACN also reports that nursing schools in the U.S. turned away 64,067 qualified applicants in 2016 due to an insufficient number of faculty, clinical sites, clinical preceptors and budget limitations. Nevidjon & Erickson discuss multiple collaborative recruitment efforts happening currently:  

 

In San Diego, six hospital systems have committed $1.3 million to support a program called, “Nurses Now”, which will add faculty and additional student slots to San Diego University.  The American Hospital Association News reports that in Laredo, Texas, a hospital CEO worked with Texas A&M University to develop a four-year bachelor’s program and is providing $425,000 in scholarships to local students over the next five years.  In Morris County, New Jersey, the Board of Freeholders offered scholarships to students who agreed to work in a long term care facility.  The Dallas-Fort Worth Hospital Council raised $600,000 to expand student enrollment at local schools.  These are examples of various successful collaborative efforts among healthcare organizations, government, nursing associations and nursing schools. Many more are happening at the local level (2011).

 

Ineffective leadership and management continue to foster suboptimal work environments minimizing the rate of improvement in the nurse shortage and turnover rates.  According to Kleinman (2004), results from a study conducted by Volk and Lucas in 1991 revealed that “management style was the only predictor of anticipated turnover” (p. 129, para 4). This correlation further substantiates the amount of influence that nurse leaders have on healthcare organizations in a variety of ways including: decreased quality of care, loss of patients, increased nurse turnover, increased turnover of medical support staff, increased staffing costs, and increased accident and absenteeism rates (Hunt, 2009).  Work environment has also been cited as a significant predictor of nurse turnover.  Nurse autonomy, interactions with managers, compensation and workload are all factors that have been reported to facilitate job satisfaction or lack-there-of, ultimately determining staff retention and turnover (Huber, 2010).  Leaders need to be aware of and understand the current healthcare challenges and develop expertise in the skills and approaches requisite for effective leadership (O’Neill, 2013).  “People’s time and effort, as well as organizations’ money, facilities, and supplies, need to be directed in a coordinated effort to achieve best results and meet objectives” (Huber, 2010).

 

Over time, study results have been consistently indicative of the direct impact managers and leaders have on the quality of healthcare at every level.  The importance of highly qualified and effective nurse leaders is evident now more than ever and by improving the methods used to manage nurses, positive changes will be put into motion (Hunt, 2009). While the direct benefit would be decreasing the nurse shortage, this change would also significantly benefit the availability and quality of healthcare for everyone. Implementing enhanced methods of managing nurses would successfully result in improved staffing.  In fact, effective leadership and management may be the key to overcoming the nurse shortage and finally optimizing the quality of healthcare for all.

 

References:

 

AACN. Nursing shortage fact sheet.  Retrieved from http://www.aacn.nche.edu/media-relations/NrsgShortageFS.pdf 

 

Huber, D. (2010). Leadership and Nursing Care Management, 4th Edition. [Bookshelf Online]. Retrieved from https://bookshelf.vitalsource.com/#/books/9781416059844/

 

Hunt, S. T. (2009). Nursing turnover: costs, causes, & solutions.  Retrieved from

 

https://www.nmlegis.gov/lcs/handouts/LHHS%20081312

 

 

 

Response to nursing peer DB_ar

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Response 150 words 1 nursing reference within 5 yrs

 

Qualitative research is a strategy for systematic collection, organization, and interpretation of phenomena that are difficult to measure quantitatively. In health care, qualitative methodologies aim to explore complex phenomena encountered by nurses, other providers, policy makers, and patients (Vaismoradi, 2013). Qualitative research is a strategy for precise collection, organization and interpretation of written information. Qualitative research question thoughtful, deliberate and relies on a set of established well defined methodology. Qualitative research works from the ground up to generates novel insights into phenomena that are difficult to measure quantitatively. Such as preferences for end of life care. The goal of qualitative research is to achieve a depth of understanding, generating a hypothesis. Qualitative research occurs in a natural setting. The purpose of qualitative research is to explore the meaning of peoples experiences, cultures and how they view certain situations.

Discuss the different types of qualitative research design

The five different types of qualitative research designs are ethnographic, narrative,  phenomenological,  grounded theory, and case study. Ethnography focuses on context and culture and is obtained by interviews and observation. Perhaps the hardest part of ethnographic field research is to be able to see things from someone else’s point of view (Wilcox, 2012).  Narrative focuses on individual experiences and sequence and is obtained by stories from individuals and documents. Phenomenological focuses on  People who have experienced a phenomenon and are obtained by interviewing. Grounded theory focuses on  developing a theory from grounded in field data and obtained from interviews and open axial coding. Case study focuses on  organization, entity, individual, or event and the data is collected by interviews, documents, reports, and observations (Sauro, 2015.)

Identify and describe a minimum of two types of sampling techniques used in qualitative research. 

Two techniques that are used in qualitative research is purposeful sampling and convenience sampling. Convenience sampling is samples of  participants that were convenient for the researcher to recruit. This type is the least scientific and lacks credibility. Purposeful sampling is a sample of participants that were thoughtfully,purposely recruited by the researcher. There are several sub-groups of purposeful sampling: Snowball sample,opportunistic sample, and maximum variation sample. 

Describe methods for collecting data for qualitative research.

Methods for collecting data for qualitative research include focus group, observation, document review, and auto and visual materials. There are two types of interviews structured interview and informal interview. A structured interview has a predetermined set of questions. An informal interview goes with the flow of the conversation and creates questions as the researcher goes.

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Faith Muchiri 

 

3 posts

 

Re:Topic 2 DQ 1

 

According to Healthypeople.gov, (2017), social determinants of health are situations which involve social connection such as religious places, mosques, temples, work places, learning institutions, places of play, people are born, and age. All these social determinants contribute to the development of illnesses. Health begins with our immediate contact social/physical environment; churches, schools, communities, hospitals, and at home. The quality, safety, and cleanliness of these places contribute to our being healthy alongside staying active, and eating healthy. Patients who have respiratory illnesses may say they worked in environment where there was air pollution/contamination which they were exposed for a long time, if quality of food that people are ingesting is not healthy, then development of heart diseases, or diabetes is inevitable. A community that is exposed to crime, violence, and insecurity creates social disorder, if the quality of education, and training is poor, then the community members are not able to secure well-paying jobs, resulting in poor housing, for example people that live in shelters due to not being able to secure a well- paying job, own, or rent a house, would be at risk to being exposed to various illnesses that other people have.

 

The communicable disease chain is described by Center of Disease Prevention, and Control, (2017), as a chain of infection which includes; host called reservoir (infected agent), port of exit (through which the pathogen leaves the infected host), mode of transmission (direct or indirect), and port of entry (is how pathogen enters the susceptible host). So steps that a nurse can take to break a link within the communicable disease chain as documented by Health Department, (2011), on antibiotic resistance task force assignment on how to break the chain of infection in your outpatient clinic include; hand-washing, keeping nails short, using gloves for one patient only, wearing personal protective equipment as necessary, and disinfecting contact areas thoroughly.

 

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Kristie Keel 

 

1 posts

 

Re:Topic 5 DQ 2

 

When someone’s religious perspective is different than my own I try to focus on the positive aspects of the care. It is important for patients to have those things with them that are comfortable and supportive when they are ill or struggling. As long as the care does not harm myself or others I try to be respectful and non judgmental. I have Native American patients that refuse care until their shaman comes and blesses the treatment. This is difficult when you can see a diabetic struggling with DKA or a child with severe dehydration. I have gotten all the supplies ready and started lines making sure everything was ready. Then as soon as the shaman entered the room I would ask them to pray over the fluids or medications before they started their medicine dance, that way the medication could be going in while the patient was receiving their prayer/dance. We have had the shaman come in and bless the department so that the Native Americans know that the treatment rooms are sacred and can be used to give care.

 

            I think a weakness I have is when it comes to children as they cannot make their own decisions. Sometimes parents think they are making really good decisions regarding care and in reality it is really poor. I try and give good patient education making the information more scientific than religion based. I feel that after I have given them all the scientific evidence that I have about the decision they are left with the decision to make but it is hard when you feel like it is the wrong choice. I also have said, “If this was my child I would to do this, but you need to make the decision for what is right for you and your child.”

 

            If I was the patient my husband would have the final ethical decision making and interventions for me. We have had extensive conversations about different situations. I feel like him and my father understands my perspective on issues. My children are too young to understand the concepts but as they grow older I feel it is important to have these conversations with them as well.