Nursing

For this assignment you will be given a case study about a young lady named Sarah Smith. Review the information provided and answer the questions following. Be sure to cite your references. Look at Sarah as if she is a patient in your office seeking care. What are your immediate concerns? What needs to be done for her? Be thorough and succinct in your responses. Case Study: Sarah Smith is a 28 y/o African American female who presents to the office with c/o wound to her left foot for the past few days. States she had tripped and fell while barefoot scraping the top of her foot on the pavement. She denies any other injury from the incident. Over the past 24 hours the wound has had “smelly” drainage. Has been experiencing generalized achiness, but denies fever and chills. Did not seek medical attention at the time of injury. Has been using hydrogen peroxide to clean her wound. Is unclear of her last tetanus vaccination. Patient PMHx significant for DM II. States that she takes her medications when she remembers, and does not always check her blood sugar. PMHx: Asthma: no hospitalizations for exacerbation. DM II PSHx: Denies SHx: Former tobacco user: ceased smoking 2 years ago. Had smoked 1ppd x 5 years ETOH: socially Illicit drugs: denies FHx: Significant for paternal DM, otherwise unremarkable Medications: Metformin: 500mg BID po – did not take the last few days Albuterol MDI: 2 puffs every 6 hours prn – last use just PTA Singulair: 10mg po daily Trinessa: 1 tab po daily – last taken this am Allergies: PCN: hives LNMP: 2 weeks ago. G0p0 ROS: General: denies any weight changes, fatigue or fever; + body aches Skin: denies any rashes; + wound to left foot HEENT: denies headache, head injury, dizziness, lightheadedness;             Denies any vision changes             Denies any hearing changes, tinnitus, vertigo, earache             Denies any nasal congestion, discharge, nose bleeds or sinus tenderness             Denies any sore throat, difficulty swallowing Neck: denies any swollen glands, pain Breasts: denies any pain, discharge Respiratory: denies any dyspnea; positive cough and wheezing CV: denies any chest pain, edema GI: denies any nausea/vomiting/diarrhea/constipation; denies bloody stools PV: denies claudication, swelling to LE GU: denies frequency, urgency, burning;             Denies vaginal discharge, itching, sores             Denies penile discharge, itching or sores MS: positive pain to left foot Psych: denies nervousness, depression Neuro: denies Headache, dizziness, vertigo, syncope, weakness; + numbness to right LE Heme: denies any easy bruising Physical Exam: Vital signs: 100.5 (tympanic), 162/88, 118, 22, O2 sat 95% on RA                         Height: 5’5”     Weight: 250 lbs.             Blood glucose: 230 (Fasting; states has not eaten yet today) patient awake, alert, oriented x 4 in NAD Skin: warm, dry, color WNL. 4 cm lesion noted to anterior left foot with crusting and purulent drng; + surrounding erythema extending up 7 cm proximally HEENT: head nontraumatic, normocephalic Pupils PERRLA, EOMs intact; disc margins sharp, without hemorrhages, exudates; no AV nicking noted Ears: bilateral TM with good cone of light and intact Nose: mucosa pink, septum midline; no sinus tenderness appreciated Mouth: mucosa pink, moist; tongue midline; tonsils 1+ without exudate Neck: supple; trachea midline; no LAD Resp: regular and unlabored; lungs with end expiratory wheezing throughout CV: RRR, S1 and S2 noted; no s3, s4 or murmur appreciated Abdomen: soft, non-distended; Bs + x 4; no tenderness with palpation; no CVA tenderness with percussion Genitalia: deferred Rectal: deferred Extremities: warm and without edema; calves supple, non-tender PV: no LE edema MS: + swelling to left foot; + tenderness of 2-4th left metatarsals; + left pedal pulse; CMS intact; Cap refill < 2 sec. Neuro: alert, cooperative; thought coherent; oriented x 4; cranial nerves II-XII intact Questions: 1. List your differentials for her current problems. Remember you should have at least three different differentials for each problem. Include rationale for each differential. 2. At this time what medical diagnoses are you most concerned about? Do they impact other diagnoses? If so, how? 3. What diagnostic images would you order? Provide your rationale. What are you trying to rule in or out? 4. What laboratory work would you order? What would you anticipate to be abnormal? Provide your rationale for each. 5. What is your comprehensive plan of care? Include your rationales. To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Resources. Assignment Requirements Before finalizing your work, you should: be sure to read the Assignment description carefully (as displayed above) consult the Grading Rubric to make sure you have included everything necessary; and utilize spelling and grammar check to minimize errors. Your writing Assignment should: follow the conventions of Standard English (correct grammar, punctuation, etc.); be well ordered, logical, and unified, as well as original and insightful; display superior content, organization, style, and mechanics; and  How to Submit Submit your Assignment to the unit Dropbox before midnight on the last day of the unit. When you are ready to submit your Assignment, select the unit Dropbox then attach your file. Save with your name in the title. Make sure to save a copy of the Assignment you submit.

To prepare: ·        Briefly summarize your policy analysis, focusing on the implications for clinical practice that may be most relevant or interesting for your colleagues. Include how evidence-based practice influenced the policy, policy options, or solutions.   Write 1- to 2-paragraph succinct summary of your policy analysis paper. Include at least two of the options or solutions for addressing the policy and the resulting implications for nursing practice and health care consumers.

Reflection on the Doctor of Nursing Practice (DNP): In approximately 500 words, reflect on the Doctor of Nursing Practice (DNP) degree.  Using at least 5 evidenced-based articles found through an academic library search that are no older than 5 years, analyze (1) the history and purpose of the DNP,(2) the current state of the DNP,(3) the future state of the DNP, (4) how DNP-prepared APNs will assist with transformative healthcare and help solve complex health problems, and (5) the advantages of having the DNP and reflect on your own thoughts on why (or why not) the degree would be appropriate for your career path in family practice setting and emergency department as a family nurse practitioner.

Please write a 2-3 paper addressing the following topics based on the case study of Mr. Martinez Please address the following topics: 1. Articulate the moral issues associated with limiting life support. 2. Demonstrate sound ethical thinking and relevant ethical principles when considering limiting life support. 3. Explain important considerations that arise when contemplating limiting life support. CASE STUDY: “Mr. Martinez was a seventy-five-year-old chronic obstructive pulmonary disease patient. He was in the hospital because of an upper respiratory tract infection. He and his wife had requested that CPR not be performed should he require it. A DNR order was written in the charts. In his room on the third floor, he was being maintained with antibiotics, fluids, and oxygen and seemed to be doing better. However, Mr. Martinez’s oxygen was inadvertently turned up, and this caused him to go into respiratory failure. When found by the therapist, he was in terrible distress and lay gasping in his bed.” In a 2–3 page analysis of the case study, address the following: The patient’s directives. The patient’s quality of life. The family’s stated preferences. The moral issues associated with limiting life support. The ethical principles most relevant to reaching an ethically sound decision. Important considerations such as implications, justifications, and any conflicts of interest that might arise because of the patient’s respiratory failure.

Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. Post an explanation of your choice of a nursing specialty within the program( please specialty is in Psychiatry). Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

Patient-Centered Care Objective Explain the concept of patient-centered care Discussion Overview This discussion forum explores the concept of patient-centered care. Deliverables Your participation in the discussion forum, including the following: A response to the initial questions below Responses to at least two other students’ posts Step 1 Post your response to the discussion board. Respond to the following questions and, if appropriate, include personal experience as part of your answers. In your nursing experience, what initiatives have you seen carried out to incorporate patient-centered care? If you were the nurse manager of your unit, what changes would you implement to better meet the needs of your patients and their families?

This is a research study including a PowerPoint, about a real-life nursing error. The presentation should include a description of the nursing error and where/when it occurred. Include research into the incident report and the legal procedures. Put particular focus on what could have been done to prevent the error from happening and how the staff would need to be educated to enhance client safety and prevent the type of error/incident from reoccurring. Instead of pages, I need 3-6 slides for the PowerPoint including the citations page.

An example of a multivariate procedure is analysis of covariance (ANCOVA). Explain what is meant by the following statement: ANCOVA offers post hoc statistical control. Provide an example.

Reliability, Validity, and Integrity in Action Objectives Describe reliability and validity in quantitative research studies Describe measures to ensure integrity within qualitative research studies Discussion Overview In this discussion forum, you will describe reliability and validity in quantitative research studies and measures to ensure integrity within qualitative research studies. Deliverables Your participation in the discussion forum, including the following: A response to the initial questions below Responses to at least two other students’ posts Step 1 Reflect on your research. Reflect on your proposed research question or problem of interest. Step 2 Post a response to the discussion board. Address the following questions in your response: How would you describe the concepts of reliability and validity as they pertain to quantitative research studies? What are measures the researcher can take to ensure integrity in qualitative research studies? Describe how you could maintain reliability and validity in your study.  Describe what measures you could take to ensure integrity in your study.

Discuss the current public image of nursing and how events in history have formed that image.