Compare and contrast two change theories, and determine which theory   makes the most sense for implementing your specific EBP project. Why?   Has your mentor used either theory, and to what result?

 

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How has nursing practice evolved over time? Discuss the key leaders and historical events that have influenced the advancement of nursing, nursing education, and nursing roles that are now part of the contemporary nursing profession.

 

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The case scenario provided will be used to answer the discussion questions that follow.

Case Scenario

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

1. Assess each of Mr. C.’s functional health patterns using the information given. (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance.)
2. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.

 

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Stakeholder support is necessary for a successful change proposal   project implementation. Consider your internal stakeholders, such as   the facility, unit or health care setting where the change process is   situated, and your external stakeholders, like an individual or group   outside the health care setting. Why is their support necessary to the   success of your project, and how you will go about securing that support?

 

 

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