Nursing

Question: A 67-year-old Caucasian woman wasbrought to the clinic by her son who … that his mother had become slightly confused over the past several days. She had been stumbling at home and had fallen once but was able to ambulate with some difficulty. She had no other obvious problems and had been eating and drinking. The son became concerned when she forgot her son’s name, so he … he better bring her to the clinic.
PMH-Type II diabetes mellitus (DM) with peripheral neuropathy x 20 years. COPD. Depression after death of spouse several months ago
Social/family hx – non contributary except for 30 pack/year history tobacco use.
Meds: Metformin 500 mg po BID, ASA 81 mg po qam, escitalopram (Lexapro) 5 mg po q am started 2 months ago
Labs-CBC WNL; Chem 7- Glucose-92 mg/dl, BUN 18 mg/dl, Creatinine 1.1 mg/dl, Na+120 mmol/L,
K+4.2 mmol/L, CO237 m mol/L, Cl–97 mmol/L.
The APRN refers the patient to the ED and … endocrinology for a consult for diagnosis and management of syndrome of inappropriate antidiuretic hormone (SIADH).
Question: Define SIADH and identify any patient characteristics that may have … to the development of SIADH.
Question: A 43-year-old female presents to the clinic with a chief complaint of fever, chills, nausea and vomiting and weakness. She has been unable to keep any food, liquids or medications down. The symptoms began 3 days ago and have not responded to ibuprofen, acetaminophen, or Nyquil when she … to take them. The temperature has reached as high as 102?F.
Allergies: none known to drugs or food or environmental
Medications-20 mg prednisone po qd, omeprazole 10 po qam
PMH-significant for 20-year history of steroid dependent rheumatoid arthritis (RA). GERD. No other significant illnesses or surgeries.
Social-denies alcohol, illicit drugs, vaping, tobacco use
Physical exam
Thin, ill appearing woman who is sitting in exam room chair as she said she was too weak to climb on the exam table. VS Temp 101.2?F, BP 98/64, pulse 110, Resp 16, PaO2 96% on room air.
ROS negative other than GI symptoms.
Based on the patient’s clinical presentation, the APRN diagnoses the patient as having secondary hypocortisolism due to the lack of prednisone the patient was taking for her RA secondary to vomiting.
Question: Explain why the patient … these symptoms?
Question: A 64-year-old Caucasianfemale presents to the clinic with vague symptoms of non- specific abdominal pain, myalgias, constipation, polyuria, and says she feels “fuzzy headed” much of the time. She had about of kidney stones a few weeks ago and she fortunately was able to pass the small stones without requiring lithotripsy or other interventions. She was told by the urologist to follow up with her primary care provider after the kidney stones has … .
The APRN examining the patient orders a Chem 7 which … a serum Ca++ of 13.1 mg/dl. The APN believes the patient has primary hyperparathyroidism and refers the patient to an endocrinologist who does a complete work up and concurs with the APRN’s diagnosis.
Question: What is the role of parathyroid hormone in the development of primary hyperparathyroidism?
Question: A 64-year-old Caucasian female presents to the clinic with vague symptoms of non- specific abdominal pain, myalgias, constipation, polyuria, and says she feels “fuzzy headed” much of the time. She had a fracture of her right metatarsal without trauma and currently is wearing a walking boot. She also had a bout of kidney stones a few weeks ago and she fortunately was able to pass the small stones without requiring lithotripsy or other interventions. She was told by the urologist to follow up with her primary care provider after the kidney stones has ….
The APRN examining the patient orders a Chem 12 which … a serum Ca++ of 13.1 mg/dl. The APRN believes the patient has primary hyperparathyroidism and refers the patient to an endocrinologist who does a complete work up and concurs with the APRN’s diagnosis.
Question: Explain the processes involved in the formation of renal stones in patients with hyperparathyroidism.
Question: A 64-year-old Caucasian female presents to the clinic with vague symptoms of non- specific abdominal pain, myalgias, constipation, polyuria, and says she feels “fuzzy headed” much of the time. She had a fracture of her right metatarsal without trauma and currently is wearing a walking boot. She also had a bout of kidney stones a few weeks ago and she fortunately was able to pass the small stones without requiring lithotripsy or other interventions. She was told by the urologist to follow up with her primary care provider after the kidney stones has ….
The APRN examining the patient orders a Chem 12 which … a serum Ca++ of 13.1 mg/dl. The APRN believes the patient has primary hyperparathyroidism and refers the patient to an endocrinologist who does a complete work up and concurs with the APRN’s diagnosis.
Question: Explain how a patient with hyperparathyroidism is at risk for bone fractures.
Question: A 64-year-old Caucasianfemale who is 4 weeks status post total parathyroidectomy with forearm gland insertion presents to the general surgeon for her post-operative checkup. She states that her mouth feels numb and she feels “tingly all over. The surgeon suspects the patient has hypoparathyroidism secondary to the parathyroidectomy with delayed vascularization of the implanted gland. She orders a Chem 20 to determine what electrolyte abnormalities may … present. The labs reveal a serum Ca++ of 7.1 mg/dl (normal 8.5 mg/dl-10.5 mg/dl) and phosphorous level of 5.6 mg/dl (normal 2.4-4.1 mg/dl).
Question: What serious consequences of hypoparathyroidism occur and why?
Question: A 17-year-old boy is brought to the pediatrician’s office by his parents who are concerned about their son’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with his school/work activities. He had been seemingly healthy until about 3 months ago when his parents … noticing these symptoms but put these symptoms down to his busy schedule including a part time job. He admits to sleeping more and tires very easily. He denies any other symptoms.
PMH-noncontributory. No surgeries or major medical problems. Usual colds and ear infections as a child
Allergies-none know
Family history- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
Social-denies alcohol, tobacco or illicit drug use. Not sexually active. Junior at local high school and works in a fast food store after school and on weekends.
Labs in office: random glucose 220 mg/dl.
Based on his symptoms and the glucose level, the pediatrician makes a tentative diagnosis of Diabetes Mellitus type 1 and refers the boy and his parents to an endocrinologist for further work up and management plan.
Question: The patient exhibited classic signs of Type 1 diabetes. Explain the pathophysiology of “polydipsia.”
Question: A 17-year-old boy is brought to the pediatrician’s office by his parents who are concerned about their son’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with his school/work activities. He had been seemingly healthy until about 3 months ago when his parents … noticing these symptoms but put these symptoms down to his busy schedule including a part time job. He admits to sleeping more and tires very easily. He denies any other symptoms.
PMH-noncontributory. No surgeries or major medical problems. Usual colds and ear infections as a child
Allergies-none know
Family history- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
Social-denies alcohol, tobacco or illicit drug use. Not sexually active. Junior at local high school and works in a fast food store after school and on weekends.
Labs in office: random glucose 220 mg/dl.
Based on his symptoms and the glucose level, the pediatrician makes a tentative diagnosis of Diabetes Mellitus type 1 and refers the boy and his parents to an endocrinologist for further work up and management plan.
Question: The patient exhibited classic signs of Type 1 diabetes. Explain the pathophysiology of “polyuria.”
Question: A 17-year-old boy is … to the pediatrician’s office by his parents who are … about their son’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with his school/work activities. He had been seemingly healthy until about 3 months ago when his parents started noticing these symptoms but put these symptoms down to his busy schedule including a part time job. He admits to sleeping more and tires very easily. He denies any other symptoms.
PMH-noncontributory. No surgeries or major medical problems. Usual colds and ear infections as a child
Allergies-none know
Family history- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
Social-denies alcohol, tobacco or illicit drug use. Not sexually active. Junior at local high school and works in a fast food store after school and on weekends.
Labs in office: random glucose 220 mg/dl.
Based on his symptoms and the glucose level, the pediatrician makes a tentative diagnosis of Diabetes Mellitus type 1 and refers the boy and his parents to an endocrinologist for further work up and management plan.
Question: The patient exhibited classic signs of Type 1 diabetes. Explain the pathophysiology of “polyphagia.”
Question: A 17-year-old boy is brought to the pediatrician’s office by his parents who are concerned about their son’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with his school/work activities. He had been seemingly healthy until about 3 months ago when his parents … noticing these symptoms but put these symptoms down to his busy schedule including a part time job. He admits to sleeping more and tires very easily. He denies any other symptoms.
PMH-noncontributory. No surgeries or major medical problems. Usual colds and ear infections as a child
Allergies-none know
Family history- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
Social-denies alcohol, tobacco or illicit drug use. Not sexually active. Junior at local high school and works in a fast food store after school and on weekends.
Labs in office: random glucose 220 mg/dl.
Based on his symptoms and the glucose level, the pediatrician makes a tentative diagnosis of Diabetes Mellitus type 1 and refers the boy and his parents to an endocrinologist for further work up and management plan.
Question: The patient exhibited classic signs of Type 1 diabetes. Explain the pathophysiology of “weight loss.”
Question: A 17-year-old boy is brought to the pediatrician’s office by his parents who are … about their son’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with his school/work activities. He had been seemingly healthy until about 3 months ago when his parents … noticing these symptoms but put these symptoms down to his busy schedule including a part time job. He admits to sleeping more and tires very easily. He denies any other symptoms.
PMH-noncontributory. No surgeries or major medical problems. Usual colds and ear infections as a child
Allergies-none know
Family history- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
Social-denies alcohol, tobacco or illicit drug use. Not sexually active. Junior at local high school and works in a fast food store after school and on weekends.
Labs in office: random glucose 220 mg/dl.
Based on his symptoms and the glucose level, the pediatrician makes a tentative diagnosis of Diabetes Mellitus type 1 and refers the boy and his parents to an endocrinologist for further work up and management plan.
Question: The patient exhibited classic signs of Type 1 diabetes. Explain the pathophysiology of “fatigue.”
Question: A 17-year-old boy is … to the pediatrician’s office by his parents who are concerned about their son’s weight loss despite eating more, frequent urination, unquenchable thirst, and fatigue that is interfering with his school/work activities. He had been seemingly healthy until about 3 months ago when his parents … noticing these symptoms but put these symptoms down to his busy schedule including a part time job. He admits to sleeping more and tires very easily. He denies any other symptoms.
PMH-noncontributory. No surgeries or major medical problems. Usual colds and ear infections as a child
Allergies-none know
Family history- maternal uncle with “some kind of sugar diabetes problem” but parents unclear on the exact disease process
Social-denies alcohol, tobacco or illicit drug use. Not sexually active. Junior at local high school and works in a fast-food store after school and on weekends.
Labs in office: random glucose 220 mg/dl.
Based on his symptoms and the glucose level, the pediatrician makes a tentative diagnosis of Diabetes Mellitus type 1 and refers the boy and his parents to an endocrinologist for further work up and management plan.
Question: How do genetics and environmental factors contribute to the development of Type 1 diabetes?
Question: A 17-year-old boy recently … with Type I diabetes is brought to the pediatrician’soffice by his parents with a chief complaint of “having the flu”. His symptoms began 2 days ago, and he has vomited several times and has not eaten very much. He can’t remember if he took his … insulin for several days because he felt so sick. Random glucose in the office reveals glucose 560 mg/dl and the pediatrician made arrangements for the patient to … admitted to the hospitalist service with an endocrinology consult.
BP 124/80mmHg; HR 122bpm; Respirations 32 breaths/min; Temp 97.2?F; PaO297% on RA
Admission labs: Hgb 14.6 g/dl; Hct 58%
CMP- Na+ 122mmol/L; K+ 5.3mmol/L; Glucose 560mg/dl; BUN 52mg/dl; Creatinine 4.9mg/dl;
Cl- 95mmol/L; Ca++ 8.8mmol/L; AST (SGOT) 248U/L; ALT 198U/L; CK 34/35 IU/L; Cholesterol 198mg/dl;
Phosphorus 6.8mg/dl; Acetone Moderate; LDH38U/L; Alkaline Phosphatase 132U/L.
Arterial blood gas values were as follows: pH 7.09; Paco220mm Hg; Po2100mm Hg; Sao2 98% (room air)
HCO3-7.5mmol/L; anion gap 19.4
A diagnosis of diabetic ketoacidosis was made, and the patient was … to the Intensive Care Unit (ICU) for close monitoring.
Question:
The hormones involved in intermediary metabolism, exclusive of insulin, that can participate in the development of diabetic ketoacidosis (DKA) are epinephrine, glucagon, cortisol, growth hormone. Describe how they participate in the development of DKA.
Question: A 67-year-old AfricanAmerican male presents to the clinic with a chief complaint that he has to “go to the bathroom all the time and I feel really weak.” He states that this has been going on for about 3 days but couldn’t come to the clinic sooner as he went to the Wound Care clinic for a dressing change to his right great toe that has been chronically … , and he now has osteomyelitis. Patient with known Type II diabetes with poor control. His last HgA1C was 10.2 %. He says he can’t afford the insulin he was … and only takes half of the oral agent he was …. Random glucose in the office … glucose of 890 mg/dl. He was immediately referred to the ED by the APRN for evaluation of suspected hyperosmolar hyperglycemic non ketotic syndrome (HHNKS). Also called hyperglycemic hyperosmolar state (HHS).
Question: Explain the underlying processes that lead to HHNKS or HHS.
Question: A 32-year-old woman presented to the clinic complaining of weight gain, swelling in her legs and ankles and a puffy face. She also recently … hypertension and diabetes type 2. She … poor short-term memory, irritability, excess hair growth (women), red-ruddy face, extra fat around her neck, fatigue, poor concentration, and menstrual irregularity in addition to muscle weakness. Given her physical appearance and history, a tentative diagnosis of hypercortical function was Diagnostics included serum and urinary cortisol and serum adrenocorticotropic hormone (ACTH). MRI revealed a pituitary adenoma.
Question: How would you differentiate Cushing’s disease from Cushing’s syndrome?
Question: A 47-year-old female is … to the endocrinologist for evaluation of her chronically … blood pressure, hypokalemia, and hypervolemia. The patient’s hypertension has been refractory to the usual medications such as beta blockers, diuretics, and angiotensin-convertingenzyme (ACE) inhibitors. After a full work up including serum and urinary electrolyte levels, aldosterone suppression test, plasma aldosterone to renin ratio, and MRI which … an autonomous adenoma, the endocrinologist diagnoses the patient with primary hyper-aldosteronism.
Question: What is the pathogenesis of primary hyper-aldosteronism?
Question: A 47-year-old AfricanAmerican male presents to the clinic with chief complaints of polyuria, polydipsia, polyphagia, and weight He also said that his vison occasionally blurs and that his feet sometimes feel numb. He has increased hunger despite weight loss and admits to feeling unusually …. He also complains of “swelling” and enlargement of his abdomen.
Past Medical History (PMH) significant for HTN fairly well controlled with and ACE inhibitor; central obesity, and dyslipidemia treated with a statin, Review of systems negative except for chief complaint. Physical exam unremarkable except for … filament test both feet. Random glucose in office 290 mg/dl. The APRN diagnoses the patient with type II DM and prescribes oral medication to control the glucose level and also … the patient to a dietician for dietary teaching.
Question: What is the basic underlying pathophysiology of Type II DM?
Question: A 21-year-old male was … in a motorcycle accident and sustained a closed head injury. He is waking up and interacting with his family and medical team. He complained of thirst that doesn’t seem to go away no matter how much water he drinks. The nurses note that he has had 3500 cc of pale-yellow urinein the last 24 hours. Urine was sent for osmolality which was reported as 122 mOsm/L. A diagnosis of probable neurogenic diabetes insipidus was made.
Question: What causes diabetes insipidus (DI)?
Question: A 43-year-old female patient presents to the clinic with complaints of nervousness, racing heartbeat, anxiety, increasedperspiration, heat intolerance, hyperactivity and She states she … had the symptoms for several months but … the symptoms to beginning to care for her elderly mother who has Alzheimer’s Disease. She has lost 15 pounds in the last 3 months without dieting. Her past medical history is significant for rheumatoid arthritis that she has had for the last 10 years well controlled with methotrexate and prednisone. Physical exam is remarkable for periorbital edema, warm silky feeling skin, and palpable thyroid nodules in both lobes of the thyroid. Pending laboratory diagnostics, the APRN diagnoses the patient as having hyperthyroidism, also called Graves’ Disease.
Question: Explain how the negative feedback loop controls thyroid levels.
Question: A 43-year-old female patient with known Graves’ Disease presents to the clinic with complaints of nervousness, racing heartbeat, anxiety, increased perspiration, heat intolerance, hyperactivity and severe palpitations. She states she had been given a prescription for propylthiouracil, an antithyroid medication but she did not fill the prescription as she claims she lost it. She had been given the option of thyroidectomy which she declined. She also notes that she is having trouble with her vision and often has blurry eyes. She states that her eyes seem “to bug out of her face”. She has had recurrent outs of nausea and vomiting. She was recently . for … Physical exam is significant for obvious exophthalmos and pretibial myxedema. Vital signs are temp 101.2?F, HR 138 and irregular, BP 160/60 mmHg. Respirations 24. Electrocardiogram revealed atrial fibrillation with rapid ventricular response. The APRN recognizes the patient is experiencing symptoms of thyrotoxic crisis, also … thyroid storm. The patient was immediately transported to a hospital for critical care management.
Question: How did the patient develop thyroid storm? What were the patient factors that lead to the development of thyroid storm?
Question: A 44-year-old woman presents to the clinic with complaints of extreme fatigue, weight gain, decreased appetite, cold intolerance, dry skin, hair loss, and sleepiness. She also admits that she often bursts into tears without any reason and has been exceptionally forgetful. Her vision is occasionally blurry, and she admits to being … without any social or occupational triggers. Pastmedical history Physical exam Temp 96.2?F, pulse 62 and regular, BP 108/90, respirations. Dull facial expression with coarse facial features. Periorbital puffiness noted. Based on the clinical history and physical exam, and pending laboratory data, the ARNP diagnoses the patient with hypothyroidism.
Question: What causes hypothyroidism?
Question: A 44-year-old woman is … to the clinic by her husband who says his wife has had some mental status changes over the past few days. The patient had … previously … with hypothyroidism and had been … on thyroid replacement therapy but had been lost to follow-up due to moving to another city for the husband’s work approximately 4 months ago. The patient states she lost the prescription bottle during the move and didn’t bother to have the prescription … since she was feeling better. Physical exam revealed non-pitting, boggy edema around her eyes, hands and feet as well as the supraclavicular area. The APRN recognizes this patient had severe myxedema and … the patient to the hospital for medical management.
Question: What causes myxedema coma?
Question: A 53-year-old woman presents to the primary care clinic with complaints of severe headaches, palpitations, highblood pressure and diaphoresis. She relates that these symptoms come in clusters and when she has these “spells”, she also experiences, tremor, nausea, weakness, anxiety, and a sense of doom and dread, epigastric pain, and flank pain. She had one of these spells when she was at the pharmacy and the pharmacist took her blood pressure which was recorded as 200/118. The pharmacist … that she immediately … evaluated for these symptoms. Past medical history significant for a family history of neurofibromatosis type 1 (NF1). Based on the presenting symptoms and family history of NF1, the APRN suspects the patient has a pheochromocytoma. Laboratory data and computerized tomography of the abdomen confirms the diagnosis.
Question: What is a pheochromocytoma and how does it cause the classic symptoms the patient presented with?
Question: A 53-year-old woman presents to the primary care clinic with complaints of severe headaches, palpitations, highblood pressure and diaphoresis. She relates that these symptoms come in clusters and when she has these “spells”, she also experiences, tremor, nausea, weakness, anxiety, and a sense of doom and dread, epigastric pain, and flank pain. She had one of these spells when she was at the pharmacy and the pharmacist … her blood pressure which was … as 200/118. The pharmacist … that she immediately … evaluated for these symptoms. Past medical history significant for a family history of neurofibromatosis type 1 (NF1). … on the presenting symptoms and family history of NF1, the APRN suspects the patient has a pheochromocytoma. Laboratory data and computerized tomography of the abdomen confirms the diagnosis.
Question: What are the treatment goals for managing pheochromocytoma?

Workflow Design Analysis Paper
A workflow design is a diagram illustration of the actions and steps in a prescribed sequence. Workflow design is used to show steps of a process. In this project, we will analyze a scenario, create, and analyze a workflow design.
Scenario
A patient calls using the patient call system to request medication for nausea. The unit clerk communicates this request verbally to the nurse. The nurse remembers that the physician ordered Ondansetron (Zofran) IV PRN for nausea. The nurse goes to the medication dispensing system and enters the correct patient name. The nurse searches and locates Ondansetron (Zofran) in the system directory. The correct drawer opens with all of the medications in the drawer available in view. The nurse takes the medication from bin #2 thinking this is Ondansetron (Zofran) as that has always been the location for that medication. In reality, an incorrect medication was taken from the dispensing system. While in the medication room, the nurse receives a phone call from the unit clerk that another patient is requesting assistance with their IV site. The nurse closes the drawer of the medication dispensing system and logs out of the system. The nurse takes the medication to the patient and administers the medication IV for what is presumed to be Ondansetron (Zofran). Due to the urgent need of another patient, the nurse chooses to complete the documentation at a later time.
Instructions:
Read the Scenario and the assigned readings
Review the grading rubric
Review the literature and cite a minimum of 3 journal articles.Additional references may include the course textbook and other sources (such informatics websites)
Written paper submission to include:
Cover page (Use APA format)
Content of the paper with the following headings:
Scenario Analysis- Based on the scenario presented, include the following content.
(Note: Do not re-copy the scenario in your paper.)
– Describe the errors that occurred in this scenario
– How many people or departments contributed to the errors in this scenario? Explain
– Were the issues attributed to system or human error? Why?
– Explain the barriers to the human-technology interaction noted in the scenario
– Explain the importance of the human-technology interaction
Workflow Design Analysis- Based on your workflow design diagram form Appendix A, include the following content
– Describe the key areas of your workflow design diagram
– Describe the focus of your process- technology, clinical staff, patient, or a combination? Explain
– Identify and describe at least 2 barriers and/or challenges to making any workflow and system changes
– Discuss methods to address and overcome these barriers/challenges
References(separate page)
Appendix: Workflow Design Diagram
– Based on your practice in Module 1: Create a Workflow Design (process flow) diagram in Microsoft Word, Microsoft PowerPoint, Microsoft Visio or some other type of software showing the correct process for medication administration.
– You must include a variety of flowchart shapes, lines, arrows, and/or connectors as noted in the Flowchart Shapes document (see the link below). A sample workflow design is provided for you (see the link below).
– Show the points/locations (using color or symbols) in the process indicating where humans and technology intersect
– Include a legend or key to describe the colors and intersections
– Place the diagram after the references, as Appendix in your written paper (refer to the APA text). Your diagram must be included within the Word document. You may need to copy and paste your diagram into your paper. Papers are only accepted in word document format. Separate attachments are not accepted.
Max 5 pages (Not including cover page, reference page, or appendix with workflow diagram)
A workflow design is a diagram illustration of the actions and steps in a prescribed sequence. Workflow design is used to show steps of a process.
Note: If you create the workflow design in the same paper as your written content for the assignment, then you may not need to practice these steps.
Flow sheet example:
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Solution
Errors that occurred in the Scenario
There are numerous errors made in the scenario by the health professionals involved. The professionals failed to follow the necessary steps taken in drug administration for the safety of the patient. The first error was a lack of documentation. The request by the patient is communicated verbally to the nurse making proper follow-up and accountability difficult. The nurse also failed to update the prescription after administering medication to the patient. Another error was the failure to communicate or consult the physician about the patient. The nurse administered a drug previously prescribed by the physician to another patient. Ondansetron (Zofran) IV PRN is linked to initial or repeated emetogenic cancer therapy. The nurse did not review the medical records of the patient. The prescription may not fit the patient in the scenario. The third error is the failure of the nurse to confirm the drug taken from bin #2 as they assume that the drug is correct given that is the location of the prescription. The errors led to nurses administering wrong medication and no proper record of facilitating error identification.
People Or Departments Contributed to The Errors in This Scenario
Two people and three departments contributed to the errors in the scenario. The clerk contributed to the error first by relaying information verbally rather than communicating through proper channels such as an email. The nurse also contributed to the error by failing to consult the physician in charge of the patient’s care. The nurse failed to follow the appropriate steps in prescribing and administering drugs. The pharmacy department is also at fault as the drugs were labeled incorrectly. The labeling of the drawer did not match the contents of the drawer. The administrative department and the human resource department also contributed to the errors in the scenario due to the high workload, which can be linked to staff shortages. According to Ahmed et al. (2019), perceived causes of medical errors include miscommunication, high workload, low adherence to safety guidelines, and poor collaboration. The nurse is overwhelmed and postpones documentation to offer care to other patients. Poor collaboration is evident in the failure of the nurse to consult the physician. If every party had played their role effectively, the errors would have been avoided.
Whether the Issues Attributed to System or Human Error
The errors in the scenario were attributed to both system and human errors. The system of the facility seems inadequate to provide errors. For example, the nurse prescribed medication without consulting the physician. The mode of communication is also faulty as the clerk made patient requests verbally. This can be attributed to the lack of proper policies and procedures to guide the actions of the health professionals working in the facility. The issues can also be attributed to human error as the professionals involved lack accountability at the individual level. In the scenario, the nurse fails to document the drug administered to the patient and decides to do it later. They also fail to confirm the drug or make consultations before making the decision on the choice of the drug and administration mode. One of the goals of the Joint Commission is to achieve correct and safe use of medication through double-checking the labeling of drugs (Rodziewicz, Houseman, & Hipskind, 2021). This was not the case in the scenario.
The Barriers to The Human-Technology Interaction Noted in The Scenario
Human-technology interaction can be described as a multidisciplinary field of study that focuses on the design of computer technology and particularly the interaction between computers and users, who are human beings. In the scenario, there are various barriers to human-technology interaction. If the technology is not user-friendly, the risk of errors increases. This is the case in the scenario. The nurse searches for a drug in the system directory and successfully locates it, but the system opens with all the drugs available in the view. The nurse picks a drug from bin #2, thinking it is the correct drug since that has always been the location of the drug. It is challenging for the nurse to identify the correct drug. It would have been more effective if each drawer had a particular drug and opened at a particular tie, reducing any confusion. The design of the system is also a challenge. The nurse is able to log out of the system without documenting any information related to drug administration to the patient. A more efficient system should not make the log-out possible with proper documentation.
The Importance of The Human-Technology Interaction
Human-computer interaction entails designing, evaluating, and implementing interactive computer systems for the usage of human beings. Human-technology interaction in healthcare is important in the delivery of safe and effective care. It allows the storage of medical information and record of each patient. It promotes faster retrieval of all necessary information. Current trends in healthcare, including robotic surgery, implementation of computers in patient tracking, and the mandates that surround electronic health record, has resulted in a need to examine the systems as part of the larger social-technical system (Stowers & Mouloua, 2018). The study of human technology facilitates the establishment of a user-friendly system customized according to the needs of a practice and facility.
The Key Areas of Your Workflow Design Diagram
The workflow design diagram below shows the correct process that the nurse in the scenario should have utilized to prevent errors.
Workflow Design Diagram
Yes
No
Review patient’s med box
Are Meds Available?
No
Yes
Yes
Legend
Interaction between human and technology
Optional steps depending on circumstances
Key areas of the process
Key areas of my workflow include scanning the patient ID, determining the need for further assessments, scanning the meds, administering, and documenting the drug administration. Scanning the patient ID is important as it provides essential information such as the name of the patient, previous conditions, any allergies, recommended medicine, and the dosage to be given. Scanning the availability of the med is also crucial. It is also important to determine the need for further assessment. This requires collaboration between the team members involved in patient care, including the physician. The need for assessment is determined by the progress of the patient. Other key areas include administering and documenting the administration of the drugs. This ensures that the medical records of the patient are up to date. The key areas ensure adherence to rights that include the right patient, drug, administration route, dose, time, indication for prescription, documentation, and right patient response (Hanson & Haddad, 2021). Key areas of documentation and scanning of the patient ID is an interaction point between technology and human needs. The system must be user-friendly, and humans should be accountable enough to execute their responsibility.
The focus of My Process
The focus of the process is a combination of clinical staff, technology, and the patient. Each has a role to play in promoting safety. A major focus is, however, on the clinical staff and the technology. This is especially where technology and human being interact. Such points include scanning of the patient ID and documentation. Clinical staff must be accountable and follow the right procedures and processes at all stages of drug administration. Technology plays a critical role in making the relevant information readily available. The information must be accurate. Interaction between technology and human beings minimizes errors when characterized by user-friendly designs on the part of technology and accountability of the clinical staff.
Barriers or Challenges in Making any Workflow and System Changes
One of the major challenges is skipping important steps. It is difficult to decide on the steps that are most important in the workflow. Leaving a step that may seem unimportant may result in a flaw in the workflow affecting the strength of the workflow, which may result in undesired outcomes. Another challenge is setting the steps in the proper order. There is a high likelihood of mixing priorities, and it may be hard to follow and understand the workflow resulting in misunderstanding. The workflow becomes less effective in achieving intended goals.
Methods to Address and Overcome the Barriers or Challenges
The barrier or challenge of skipping important steps can be overcome by mapping the previous workflow to ensure that all steps are involved and included. The previous or current workflow can be used as a draft in developing a new one. Outlining the steps in proper order can be achieved by outlining all the activities first and placing them in the proper order depending on how the activities are arranged.
Conclusion
The scenario is a good representation of how medication errors occur and common errors that occur in healthcare facilities. The errors can result from the system or human errors. Healthcare professionals, however, have a major role in preventing errors. Human-technology interaction is a key aspect in ensuring the safety of care. The workflow design diagram developed depicts crucial steps that should be taken by health professionals when administering drugs. Key areas include scanning patient ID, determining the need for assessment, and documenting drug administration. It was challenging to develop the workflow, particularly determining the steps involved in drug administration in their respective order. The challenge was, however, addressed by using previous workflows and outlining all activities involved in the process.
References
Ahmed, Z., Saada, M., Jones, A. M., & Al-Hamid, A. M. (2019). Medical Errors: Healthcare Professionals’ Perspective at A Tertiary Hospital in Kuwait. Plus One, 14(5), e0217023. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0217023
Hanson, A., & Haddad, L. M. (2021). Nursing Rights of Medication Administration. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560654/
Rodziewicz, T. L., Houseman, B., & Hipskind, J. E. (2021). Medical Error Reduction and Prevention. In-Stat Pearls [Internet]. Stat Pearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK499956/
Stowers, K., & Mouloua, M. (2018). Human-Computer Interaction Trends in Healthcare: An Update. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 7, No. 1, pp. 88-91). Sage CA: Los Angeles, CA: SAGE Publications. https://journals.sagepub.com/doi/abs/10.1177/2327857918071019
Appendix 1: Workflow Design Diagram
Yes
No
No
Yes
Yes
Legend
Interaction between human and technology
Optional steps depending on circumstances
Key areas of the process

Assignment 1: Practicum Journal: Voluntary and Involuntary Commitment
PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.
In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.
Scenario for Week 7 Case:
You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?
Learning Objectives
Students will:
• Evaluate clients for voluntary commitment
• Evaluate clients for involuntary commitment based on state laws
• Recommend actions for supporting parents of clients not eligible for involuntary commitment
• Recommend actions for treating clients not eligible for involuntary commitment
To Prepare for this Practicum:
• Review the Learning Resources concerning voluntary and involuntary commitment.
• Read the Week 7 Scenario in your Learning Resources.
• Research your state’s laws concerning voluntary and involuntary commitment.
The Assignment:
• Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
• Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
• Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
• If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
• If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.
By Day 7

Nursing Case Study
CASE STUDY BK is a 16-year-old Caucasian female who comes in with her grandmother for an annual exam. The grandmother reports BK has been “acting strange, staying in her room all the time and refusing to do all the things she used to enjoy like singing in the youth choir”. Grandmother shares that BK’s mother is a drug addict is currently incarcerated so she is worried BK is using drugs and wants her tested for drugs. BK is not on any medications. She is obese and does not make eye contact when you enter the room.
In this Casestudy, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds.
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
Post an explanation of the specific socioeconomic, spiritual, lifestyle, and other cultural factors associated with the patient you were assigned. Explain the issues that you would need to be sensitive to when interacting with the patient, and why. Provide at least five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
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Solution
Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
Several factors can affect a patient influencing how they behave and respond to stress. Some of the factors that I would consider about the patient’s health include social interaction and participation in exercises. The patient is 16 years old, and she is obese; it is therefore to understand her social life, such as friends that she used to hang out with and her involvement in physical activities since bullying might have contributed to the behavior. Socioeconomic factors would include education; it would be essential to focus on her experiences in school, including her performance, relationship with classmates, and instructors. Spiritual factors would include the patient’s belief about religion and its role in her life. The grandmother had noted that she previously enjoyed singing in the choir, but her interest had decreased (Odgers & Jensen, 2020).
What questions would you ask?
To be culturally sensitive to the patient, it is essential to avoid questions that are suggestive of wrongdoing since, at this age, adolescents tend to be more sensitive to issues. Therefore, I would prefer open-ended questions, and I would observe privacy to allow the patient to be comfortable opening up. Some of the questions that I would ask the patient include How is school? What do you enjoy most at the school? Do you have friends, and what activities do you do together? Have you ever tried any drug? How would you describe the thoughts you have been experiencing over the past two days? (Farley, 2020).
What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
Some of the strategies that nurses can apply to be culturally sensitive include practicing active listening to the patient, avoiding assumptions about the patient, and ensuring that there are no language barriers. Learning about different cultures increases their knowledge, establishes a rapport with the patients, and increases their situational awareness (Ahmed et al., 2018).
References
Ahmed, S., Siad, F. M., Manalili, K., Lorenzetti, D. L., Barbosa, T., Lantion, V., … & Santana, M. J. (2018). How to measure cultural competence when evaluating patient-centred care: a scoping review. BMJ open, 8(7), e021525. https://bmjopen.bmj.com/content/8/7/e021525.abstract
Farley, H. R. (2020). Assessing mental health in vulnerable adolescents. Nursing2020, 50(10), 48-53. https://journals.lww.com/nursing/Fulltext/2020/10000/Assessing_mental_health_in_vulnerable_adolescents.12.aspx
Odgers, C. L., & Jensen, M. R. (2020). Annual research review: Adolescent mental health in the digital age: Facts, fears, and future directions. Journal of Child Psychology and Psychiatry, 61(3), 336-348. https://acamh.onlinelibrary.wiley.com/doi/abs/10.1111/jcpp.13190

Post a description of a group therapy session with older adults, including the stage of the group, any resistances or issues that were present, and therapeutic techniques used by the facilitator. Explain any challenges that may occur when working with this group. Support your recommendations with evidence-based literature.
The following are resources.
1. Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.
Chapter 18, “Psychotherapy with Older Adults” (pp. 62–660)
2. Krishna, M., Jauhari, A., Lepping, P., Turner, J., Crossley, D., & Krishnamoorthy, A. (2011). Is group psychotherapy effective in older adults with depression? A systematic review. International Journal of Geriatric Psychiatry, 26(4), 331–340. doi:10.1002/gps.2546
3. Krishna, M., Honagodu, A., Rajendra, R., Sundarachar, R., Lane, S., & Lepping, P. (2013). A systematic review and meta-analysis of group psychotherapy for sub-clinical depression in older adults. International Journal of Geriatric Psychiatry, 28(9), 881–888. doi:10.1002/gps.3905
Thanks

Evidence-Based Practice Project Proposal Presentation
The dissemination of an evidence-based practice project proposal is an important part of the final project. Dissemination of your project to a local association or clinical site/practice informs important stakeholders of evidence-based interventions that can improve clinical practice and ultimately patient outcomes.
For this assignment, develop a professional presentation that could be disseminated to a professional group of your peers.
Develop a 12-15 slide PowerPoint detailing your evidence-based practice project proposal. Create speaker notes of 100-250 words for each slide. For the presentation of your PowerPoint, use Loom to create a voice-over or a video. Refer to the topic Resources for additional guidance on recording your presentation with Loom. Include an additional slide for the Loom link at the beginning and an additional slide for References at the end. Be sure to consider your personal demeanor and tone during the recorded presentation.
Include the following in your presentation:
Introduction (include PICOT statement)
Organizational Culture and Readiness
Problem Statement and Literature Review
Change Model, or Framework
Implementation Plan
Evaluation Plan
Conclusion
You are required to cite a minimum of six peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Assignment: Personal Leadership Philosophies
Many of us can think of leaders we have come to admire, be they historical figures, pillars of the industry we work in, or leaders we know personally. The leadership of individuals such as Abraham Lincoln and Margaret Thatcher has been studied and discussed repeatedly. However, you may have interacted with leaders you feel demonstrated equally competent leadership without ever having a book written about their approaches.
What makes great leaders great? Every leader is different, of course, but one area of commonality is the leadership philosophy that great leaders develop and practice. A leadership philosophy is basically an attitude held by leaders that acts as a guiding principle for their behavior. While formal theories on leadership continue to evolve over time, great leaders seem to adhere to an overarching philosophy that steers their actions.
What is your leadership philosophy? In this Assignment, you will explore what guides your own leadership.
To Prepare:
Identify two to three scholarly resources, in addition to this Module’s readings, that evaluate the impact of leadership behaviors in creating healthy work environments.
Reflect on the leadership behaviors presented in the three resources that you selected for review.
Reflect on your results of the CliftonStrengths Assessment, and consider how the results relate to your leadership traits.
Download your Signature Theme Report to submit for this Assignment.
The Assignment (2-3 pages):
Personal Leadership Philosophies
Develop and submit a personal leadership philosophy that reflects what you think are characteristics of a good leader. Use the scholarly resources on leadership you selected to support your philosophy statement. Your personal leadership philosophy should include the following:
A description of your core values.
A personal mission/vision statement.
An analysis of your CliftonStrengths Assessment summarizing the results of your profile
A description of two key behaviors that you wish to strengthen.
A development plan that explains how you plan to improve upon the two key behaviors you selected and an explanation of how you plan to achieve your personal vision. Be specific and provide examples.
Be sure to incorporate your colleagues’ feedback on your CliftonStrengths Assessment from this Module’s Discussion 2.
Note: Be sure to attach your Signature Theme Report to your Assignment submission.
By Day 7 of Week 6
Submit your personal leadership philosophy.
Submission and Grading Information
To submit your completed Assignment for review and grading, do the following:
Please save your Assignment using the naming convention “WK6Assgn+last name+first initial.(extension)” as the name.
Click the Week 6 Assignment Rubric to review the Grading Criteria for the Assignment.
Click the Week 6 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK6Assgn+last name+first initial.(extension)” and click Open.
If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
Click on the Submit button to complete your submission.
Due to the nature of this assignment, your instructor may require more than 7 days to provide you with quality feedback

Course Project: Part 3—Translating Evidence Into Practice
In Part 3 of the Course Project, you consider how the evidence you gathered during Part 2 can be translated into nursing practice.
Now that you have located available research on your PICOT question, you will examine what the research indicates about nursing practices. Connecting research evidence and findings to actual decisions and tasks that nurses complete in their daily practice is essentially what evidence-based practice is all about. This final component of the Course Project asks you to translate the evidence and data from your literature review into authentic practices that can be adopted to improve health care outcomes. In addition, you will also consider possible methods and strategies for disseminating evidence-based practices to your colleagues and to the broader health care field.
To prepare:
Consider Parts 1 and 2 of your Course Project. How does the research address your PICOT question?
With your PICOT question in mind, identify at least one nursing practice that is supported by the evidence in two or more of the articles from your literature review. Consider what the evidence indicates about how this practice contributes to better outcomes.
Explore possible consequences of failing to adopt the evidence-based practice that you identified.
Consider how you would disseminate information about this evidence-based practice throughout your organization or practice setting. How would you communicate the importance of the practice?
To complete:
In a 3- to 4-page paper:
Restate your PICOT question and its significance to nursing practice.
Summarize the findings from the articles you selected for your literature review. Describe at least one nursing practice that is supported by the evidence in the articles. Justify your response with specific references to at least 2 of the articles.
Explain how the evidence-based practice that you identified contributes to better outcomes. In addition, identify potential negative outcomes that could result from failing to use the evidence-based practice.
Outline the strategy for disseminating the evidence-based practice that you identified throughout your practice setting. Explain how you would communicate the importance of the practice to your colleagues. Describe how you would move from disseminating the information to implementing the evidence-based practice within your organization. How would you address concerns and opposition to the change in practice?

Describe both the exocrine and endocrine functions of the pancreas.
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Solution
The Exocrine and Endocrine Functions of the Pancreas
The pancreas is an exocrine and endocrine organ located in the upper-left abdomen, behind the stomach. It is surrounded by the spleen, small intestine, and liver. It is a flat spongy spear-shaped organ, measuring between six and ten inches in length. The pancreas performs exocrine and endocrine functions by secreting and releasing digestive ions, water, and enzymes to the gastrointestinal tract and vital hormones to the bloodstream.
As an exocrine organ, the pancreas produces digestive enzymes that work together with the bile from the gallbladder to assist in the breakdown of food. The organ has exocrine glands that secret crucial digestive enzymes: chymotrypsin, trypsin, lipase, and amylase (Atkinson et al., 2020). When the food enters the stomach, the pancreas secretes these enzymes, releasing them to the duodenum through the pancreatic duct. These enzymes mix with the bile at the ampulla of Vater, which is located in the upper part of the small intestine. The lipase is responsible for breaking down fats, the amylase enzyme for breaking down carbohydrates, and chymotrypsin and trypsin enzymes for breaking down proteins (Atkinson et al., 2020). Thus, the exocrine function of the pancreas is the production of enzymes that break down foods for effective digestion.
As an endocrine organ, the pancreas secretes and releases vital hormones responsible for regulating blood sugar into the bloodstream. The endocrine section of the pancreas has dedicated islet cells, referred to as islets of Langerhans, which secretes and releases blood sugar-regulating hormones into the bloodstream (Walling, 2018). The two hormones are insulin and glucagon. Insulin helps lower blood sugar levels, while glucagon increases blood sugar when it falls below the required levels (Walling, 2018). Organs such as the kidney, brain, and liver require proper blood sugar levels to function effectively. Thus, the endocrine function of the pancreas ensures that the sugar level remains at the optimal level.
Overall, the pancreas is considered both an exocrine and endocrine organ because it plays both roles. The exocrine functions involve secreting and releasing digestive enzymes that break down foods for proper digestion. In contrast, the endocrine function involves secreting and releasing blood sugar-regulating hormones into the bloodstream.
References
Atkinson, M. A., Campbell-Thompson, M., Kusmartseva, I., & Kaestner, K. H. (2020). Organization of the human pancreas in health and in diabetes. Diabetologia, 63(10), 1966-1973.
Walling, M. (2018). Endocrine System. In Fundamentals of Toxicologic Pathology (Third Edition). Elsevier Inc.

NUR-631 Discussion
Discussion Forum Sample
Discussion questions in NUR-631 are presented with a range of options.
Read the questions carefully and follow directions regarding whether to select one, two or answer multiple questions for the response. Present responses using the sample format provided below and include at least two citations from peer-reviewed journals published within the last 5 years or from the textbooks. References must be in proper APA format. A substantive responses must be at least 150 words in length and pertain to the topic as it relates to pathophysiology.
Sample DQ
NUR-631 Discussion
Select one of the following discussion questions for your discussion response.
What did Mark Twain mean when he said, “the difference between the right word and the almost right word is the difference between lightning and the lightning bug”? Demonstrate your answer by providing an example from your own life when “almost the right word” created confusion, misunderstanding, or adversity.
How can knowing your fellow students and fostering a sense of community benefit your educational experience?
Part of effective communication involves knowing how to respond rather than react to something someone has said or written. In the online classroom format, why is it important to read a classmate’s post and assess that person’s intended message before you offer a response? How can this skill of responding help you in your career?
Sample Student DQ Response Format
What did Mark Twain mean when he said, “the difference between the right word and the almost right word is the difference between lightning and the lightning bug”? Demonstrate your answer by providing an example from your own life when “almost the right word” created confusion, misunderstanding, or adversity.
It is very important to use the right words when communicating. If you do not select your words carefully you can end up not getting your point across or miss a great opportunity. Using the right word makes sure you are understood correctly. If you are not careful about the words you use, it is easier for people to misinterpret them. This can have a negative impact in the medical field, as miscommunication affects “patients’ quality of care, health outcomes, adherence to treatment and satisfaction” and is also cited as the “most common reason for patient medical complaints” (Morgan, 2013, p. 123).
I have experienced what the difference between the “right word” and the “almost right word” can do. A couple years ago I was having a tough time. I was really busy with a lot of different things and my family could tell it was wearing me down. One day my daughter came up and handed me a picture she drew of the two of us. I was in the middle of something and just took it and said, “Oh, that’s nice, thanks.” Later, I could see she was sad. I felt terrible and thought about how much work she put into the picture for me, and how she was trying so hard to make me happy. I used almost the right words, but not the right words. We both felt much better after I took the time to express how I really felt.
Reference:
Morgan, S. (2013). Miscommunication between patients and general practitioners: Implications
for clinical practice. Journal of Primary Health Care, 5(2), 123-128.