Palliative care is an immensely important topic for nurses and there are plenty of jobs available.  there is a great demand that far exceeds supply which means that the salaries are high and getting better all the time.  this is a special kind of nursing also where the connection with the patient is very personal and patients need an enormous amount of empathy to get through this difficult stage of life.  there are many companies locally that hire nurses, both small and large.  Vista is an example of a large company and they cover all three countries. 

Instructions:

1. Review the Ethical Practices in EOL Care module.
2. Read the first few pages describing the content
3. On page 5 are a series of short Case Studies (10 total). Each case study has multiple questions after it. Answer each question after reading the case study. You can utilize Chapter 27 in your textbook to answer the questions.
4. When you are finished answering all 10 case study questions, check your answers at the end of the document.
5. You may probably miss a couple of questions. Go back, read the case study again and correct your answer.
6. Write your reflection(s) about why you answered incorrectly. Do this with at least two questions that you answered incorrectly. You can do more if you feel so inclined.
7. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.
8. Upload your file by clicking “Browse My Computer” for Attach File.
9. View rubric for grading. 

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T.J. is a 76-year-old man that recently lost his wife.  He lives alone now in an ALF where he has some friends that he associates with.  They are “good for his overall well-being” claims the administrators of the facility who befriended T.J. when he lost his wife six months ago.  The facility that T.J. lives in is convenient for many aspects of his life, including entertainment and even some of the healthcare associates from neighboring clinics that have partnered with the facility to allow visits with the residents.  

Over the years, the associates from the neighboring clinic have grown close to some residents and have followed them during some of their crisis, both emotional and physical.  Christine, a nurse practitioner from a neighboring clinic, has followed T.J. for many years and is now assessing his fall risk through a tool called the “Hendrick Fall Risk Tool II” a popular means of assessing the fall risk that may exist for an elderly person. 

An entry by the ARNP recently on T.J. demonstrated that there was enough information, recognizing previous and present knowledge to utilize the tool to give T.J. a score representing his fall risk.  the entry reads: “T.J. is a 76-year-old that is evaluated today for his fall risk. He has a MedHx of BPH, COPD, seizures, eczema, and anxiety.  He has been seen monthly and he described some episodes of nocturia that still persists.  A list of his recent mediation includes Alprazolam, Phenytoin, Dutasteride, and ibuprofen prn.  By administering the Get Up and Go Test, we find that he only had a brief episode of not being able to rise but he performed well after that completing it in 12 seconds.  He demonstrates an improvement in his depression experienced in the past exhibited for several months after the loss of his spouse.  His friends at the facility keep him busy and he is much improved in his outlook for the future.”  C. Miller ARNP

Instructions:

1. Read the Fall Risk Assessment for Older Adults article. 
2. Complete the Hendrich II Fall Risk Model tool form completely.
   • Assign the correct scores for the Fall Risk Tool.
   • Summarize the scores derived as per fall risk.
3. Develop a summary of the risks for T.J., so that the facility can respond to those risks and provide a safe environment.
4. Describe the level of safety that the facility should plan to give T.J.
5. Finally, explain whether you feel like the score from the Fall Risk Tool is accurate and if the tool is worth the effort to develop.
6. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.
7. Upload your file by clicking “Browse My Computer” for Attach File.

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1. Elder Abuse and Neglect
   You are a charge nurse in the emergency department. An elderly woman arrives with bruises all over the upper torso of her body and down her left arm. She was brought in by her grandson who resides with her, and the grandson shares that he brought her in to be checked out because he thinks she may have fractured her wrist when she fell on the last step going down in the cellar to do laundry. He appears extremely stressed and states that his grandmother suffers from Alzheimer disease. When you put the patient’s name and demographic information into the electronic medical record it indicates that this patient was in 2 weeks prior with a concussion. 

   Instructions:

   1. Read the scenario above and answer the following question:
      1. How would you assess the situation?
      2. What nursing interventions would you utilize to help both the elderly woman and the grandson?
   2. Your paper should be:
      • One (1) page or more.
      • Use factual information from the textbook and/or appropriate articles and websites.
      • Cite your sources – type references according to the APA Style Guide.

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nstructions:

1. Read the Case Study 11-2: Go to the Hospital and Come Back with Four More Medications in Chapter 11 of the textbook. 
2. Once you have read the Case Study thoroughly, answer the following questions:
   1. What does the administration of antibiotics have to do with a Clostridium difficile (C. diff infection) infection?
   2. List all the inappropriate medications prescribed for K.L. and describe the reason why they are inappropriate.
   3. What kind of treatment regimen is utilized for a patient with a C. diff infection?
   4. Do any of these treatments regimens raise suspicion as being inappropriate for K.L.?
   5. List the therapy and if contraindicated, give a reason why it is inappropriate.  
3. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.
4. Upload your file by clicking “Browse My Computer” for Attach File.
5. View rubric for grading. 

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Several years ago, researchers discovered a part of the nuclear chromosome called a telomere.  The telomere is found at the end of chromosomes and they fall off at regular intervals of a year or two. Since they are just a segment of chromosomes of 4-6 base pairs it appears to be insignificant except for their reliability over time of the organism or person’s life.  Researchers were fascinated by these small segments and the apparent correlation with the aging of the person.  In addition, these segments accelerated their action of dropping off when the person was diagnosed with cancer or a disease that was categorized as eventually fatal.  Review the Telomeres video below.

Watch VideoTelomeres and Aging | IsagenixDuration: 3:13
User: n/a – Added: 10/22/13YouTube URL: http://www.youtube.com/watch?v=de0aSMxeYmg

Instructions:

1. Reread Chapter 3 and answer the following questions.
   
   1. Would you classify telomere-based aging as stochastic or non-stochastic?
   2. What theory would you classify this under considering those listed in the chapter?
   3. How would you, if you were a gerontological researcher, manipulate the telomeres through telomerase to assist persons to live longer? Be specific about each step. 
2. Your paper should be:
   • One (1) page or more.
   • Use factual information from the textbook and/or appropriate articles and websites.
   • Cite your sources – type references according to the APA Style Guide.

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