QUESTION
Can you share with the class what legislation was enacted in Florida to protect against harmful effects of second hand smoke and any subsequent legislation that followed?
Chapter: 20 Anus,Rectum,Prostate 
While you are examining a 1-year-old girl, the mother mentions how eager she is to begin toilet training her child. How should you respond? When is it best to begin toilet training?
What do the rectum and anus form?
Control of the external anal sphincter is gradually achieved at what age?
Differentiate between internal and external hemorrhoids.
You are observing an examiner take the history of a 70-year-old man as part of the musculoskeletal examination. You notice that the examiner asks the patient about exercise habits in his early years. Is this a relevant question to ask this patient? Why or why not?
A young woman is concerned about a 1-cm difference in the length of her legs. What is the best response to give this patient?
A 3-year-old boy has had anal itching that becomes worse at night. What do these symptoms indicate?
You are assessing a pregnant woman who has had a fourth-degree perineal laceration. Why is it necessary to assess this patient’s anal sphincter function?
You are about to perform a rectal examination of an older adult. What is the suggested position for this patient?
What is a clue to the diagnosis of Hirschsprung disease?
What do persistent, pencil-like stools suggest?
Distinguish between the stool of a formula-fed baby and a breastfed baby.
Create a chart or two-column list that compares the risk factors for colorectal cancer with those for prostatic cancer.
What are the risk factors for colorectal cancer?
What are the risk factors for prostate cancer?
What symptoms are associated with BPH?
JF is a 42-year-old patient who presents for an annual examination, but he complains that he has had a fever for the past few days and recently some “urinary symptoms.”
1- Describe the best method for a rectal examination during the physical assessment
2- What additional past medical history questions would you ask of JF since you suspect prostatitis?
3- During the rectal examination of JF with acute prostatitis, what findings would expect on physical examination? .
A, Correct procedure for introducing finger into rectum. Press pad of finger against the anal opening. B, As external sphincter relaxes, slip the fingertip into the anal canal. Note that patient is in the hips-flexed position.
Chapter: 20 Anus,Rectum,Prostate
While you are examining a 1-year-old girl, the mother mentions how eager she is to begin toilet training her child. How should you respond? When is it best to begin toilet training?
What do the rectum and anus form?
Control of the external anal sphincter is gradually achieved at what age?
Differentiate between internal and external hemorrhoids.
You are observing an examiner take the history of a 70-year-old man as part of the musculoskeletal examination. You notice that the examiner asks the patient about exercise habits in his early years. Is this a relevant question to ask this patient? Why or why not?
A young woman is concerned about a 1-cm difference in the length of her legs. What is the best response to give this patient?
A 3-year-old boy has had anal itching that becomes worse at night. What do these symptoms indicate?
You are assessing a pregnant woman who has had a fourth-degree perineal laceration. Why is it necessary to assess this patient’s anal sphincter function?
You are about to perform a rectal examination of an older adult. What is the suggested position for this patient?
What is a clue to the diagnosis of Hirschsprung disease?
What do persistent, pencil-like stools suggest?
Distinguish between the stool of a formula-fed baby and a breastfed baby.
Create a chart or two-column list that compares the risk factors for colorectal cancer with those for prostatic cancer.
What are the risk factors for colorectal cancer?
What are the risk factors for prostate cancer?
What symptoms are associated with BPH?
JF is a 42-year-old patient who presents for an annual examination, but he complains that he has had a fever for the past few days and recently some “urinary symptoms.”
1- Describe the best method for a rectal examination during the physical assessment
2- What additional past medical history questions would you ask of JF since you suspect prostatitis?
3- During the rectal examination of JF with acute prostatitis, what findings would expect on physical examination? .
A, Correct procedure for introducing finger into rectum. Press pad of finger against the anal opening. B, As external sphincter relaxes, slip the fingertip into the anal canal. Note that patient is in the hips-flexed position.
Antimicrobial agents are essential components in the treatment of various bacterial infections as they help to kill or prevent the growth of microbes such as bacteria, fungi, and protozoans. Prior to the discovery of antimicrobial agents, treatment options for patients with bacterial infections were limited. For many patients, treatment often resulted in the amputation of limbs or even death. Today, treatment options for bacterial infections typically have a more positive prognosis. Due to the various types of infections presented in patients, it is essential to be able to identify the underlying cause of the infection—whether bacterial or viral—before recommending drug treatments. This will help you identify whether or not an antimicrobial agent would be appropriate and which specific agent would target the infection. In this Assignment, you consider the appropriate use of antimicrobial agents for infections.
To prepare:
POST a 2- to 3- page paper that addresses the following:
This work should have Introduction and conclusion
– This work should have at 4 to 6 current references (Year 2012 and up)
– Use at least 3 references from class Learning Resources
The following Resources are not acceptable:
1. Wikipedia
2. Cdc.gov- nonhealthcare professionals section
3. Webmd.com
4. Mayoclinic.com
Required Readings
Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.
Krummenacher, I., Cavassini, M., Bugnon, O., & Schneider, M. (2011). An interdisciplinary HIV-adherence program combining motivational interviewing and electronic antiretroviral drug monitoring. AIDS Care, 23(5), 550–561.
This article analyzes medication adherence in HIV patients and examines factors that increase adherence as well as factors that contribute to termination or discontinuation of treatment.
Drugs.com. (2012). Retrieved from http://www.drugs.com/
This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.
Scourfield, A., Waters, L., & Nelson, M. (2011). Drug combinations for HIV: What’s new? Expert Review of Anti-Infective Therapy, 9(11), 1001–1011.
Note: Retrieved from the Walden Library databases.
This article examines current therapies and strategies for treating HIV patients. It also examines factors that impact selection of therapy, including drug interactions, personalization of therapy, costs, management of comorbidities, and patient response.
Required Media
Laureate Education, Inc. (Executive Producer). (2012). Antimicrobials. Baltimore, MD: Author.
This media presentation outlines principles of antimicrobial therapy
Note: The approximate length of this media piece is 7 minutes.
Mayer, K. H., & Krakower, D. (2012). Antiretroviral medication and HIV prevention: New steps forward and New Questions. Annals of Internal Medicine, 156(4), 312–314.
Examine how might nurses and nursing organizations improve policies to encourage the judicious use of antibiotics in humans? Identify the correlation between global disease surveillance and domestic disease surveillance, and the significant role the family nurse practitioner plays.
Directions:
1-APA style. ( at least 3 paragraph)
2-at least 3 scholarly sources are requested (No older than 5years). One of the sources is the following :
Examples of scholarly sources:
-Published journal articles, books and other works (encyclopedias & newspapers)
-Official websites ending in .gov, .org, .edu (CDC,NIH,ADA,WHO, HARVARD, FIU,FNU)
Do not use Sites such as Wikipedia, WebMD, Nursingworld, Allnurses they are NOT scholarly sources.
Please follow all instructions and I need it by 6pm EST on February 22, 2018. Please no plagiarism!!
Karel,
Practice
For effectivecare in end of life management, nurses or APRN need to operate within a standard platform when practisingprimary palliative care. This is also evident in a study by Ramanayake, Dilanka, and Premasiri, which reveals that establishing palliative care models, and encouraging doctors and nurses to learn informative palliative care principles through improved skills and opportunities need to possible in order to address the future challenges (Ramanayake, Dilanka, & Premasiri, 2016). Therefore, nurses or APRN need to have a standard knowledge on how best to conduct primary palliative care in order toensure effectivecare in end of life management. This is vital in establishing discipline and professional when practisingprimary palliative care to the patient that isin pain and face near death situations.
Education
Integration of primary palliative care into curricula in medical institutions and schools of nursing is essential in providing effective care in end of life management for APRN. By achieving this, nurses and practitioners are able to understand the scope of palliative care as well as the disease and its implications. Therefore, education through the integrationof primary palliative care into curriculaenables APRN to communicate effectivelyand professionally without compromising the integrity of their work. According to a studyby Zimmerman, “effective communication is the cornerstone of palliative care,”(Zimmerman, 2015). This means that by training nurses and practitioners on how to communicate effectively through the integrationof primary palliative care into curricula, they are able to understand the standard way of helping their patientswithout incurring any legal consequences. Practitioners and nurses need to understand the principles and knowledge required to successfully manage end of life care.
Research
In order to understand whether the standard practices and education approached used in primary palliative care are effective, nurses or APRN need to research and gather more evidence across all dimension of end-of-lifecare. Based on a studybyVisser, Hadley, and Wee, it is argued that starting a treatment simply on the basis of agreement among colleagues is no longer an acceptable practice(Visser, Hadley, & Wee, 2015). There is a needfor more evidence-based care in different angles of the endof life care to make an informed decision. This means that doctors, nurses or APRN need to sure that there hasbeen actual evidence that the primary palliative care practice actually works before engaging in it. This makes primary palliative care much safer; while at the same time provide effectivecare in end of life management across different dimensions.
Administration
Establishing a work environment where excellent standard care is extended through the patient’s death and into post-death care for families not only demonstrates compassion by the APRN or nursesbut also demonstrates respect to the patient and his or her families during and after death. A study by Parris and Halereveals that the exact role of physician or nurses during and after the death of a patientis not clearly defined in primary palliative care (Parris & Hale, 2017). Therefore, APRN needsto ensure that there is a standard guideline on how to handle patient’s death and post-death process, understand the basics of logistics after a patient has died, how to support their grieving families and the bestway to avoid adverse events in the care of the deceased.
References
Parris, J., & Hale, A. (2017). Death and Dignity: Exploring Physicians’ Responsibilities After a Patient’s Death. Alliance for Academic Internal Medicine, 1- 4. Retrieved from https://www.amjmed.com/article/S0002-9343(17)30483-7/pdf
Ramanayake, R. P., Dilanka, G. V., & Premasiri, L. W. (2016, April). Palliative care; role of family physicians. Retrieved from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5084539/
Visser, C., Hadley, G., & Wee, B. (2015, September). Reality of evidence-based practice in palliative care. Retrieved from National Center for Biotechnology Information: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4607825/
Zimmerman, C. T. (2015, July 27). The Importance of Palliative Medical Education in Fellowship. Retrieved from Amrican Society of Clinical Oncology: https://connection.asco.org/magazine/career/importance-palliative-medical-education-fellowship
Dianelys,
Palliative care is the ability to improve efficiency, coordination, and quality of healthcare outcomes for patients and their families (Payne et al., 2017). Patients can use their skills to manage and recognize symptoms. Nurses are required to have skills and knowledge to manage pain as well as other symptoms associated with terminal diseases. APRNs, therefore, work with patients and the patient’s family in end-of-life and palliative care decision making.
Specialist education and certification is essential to APRNs as it ensures that they have skills. One of the barriers to quality palliative care is lack of workforce (Meier, 2011). Certifications and education will ensure that there is adequate workforce to meet the needs of patients. Therefore, when a nurse gets education and certification, they will likely use palliative care to patients with terminal illness and who are at the end of their lives.
Evidence-based care involves use of scientific research as means of delivering patient care. The use of evidence-based care allows an APRN to care that is specific to a certain patient and as a result improving the outcome of health services (Duke University Medical Center, n.d.). This because it allows integration of a patient’s values and beliefs into the health care delivery. Therefore, given that it combines clinical expertise, best research evidence, and patient values and preferences, the best or optimal clinical outcomes are achieved (Duke University Medical Center, n.d.).
Promoting work environments where by standards for excellent care is adhered to is important in providing end-of-life care. Healthcare facilities have the capability of creating and enforcing policies that enhance palliative care among the workforce. This involves ensuring that from the time a patient is received in a facility to the moment he or she dies, there is accessible palliative care. Health care facilities can always insist on optimal care for patients with serious illness. This will help nurses to be aware that they always need to provide optimal care for patients at the end-of-life. Nurses can continue with caring for the family members even after death. This can include honoring cultural and religious requirements or wishes of the dead and his/her family (Henry & Wilson, 2012).
References
Duke University Medical Center. (n.d.). LibGuides: Introduction to Evidence-Based Practice : Overview. Retrieved from https://guides.mclibrary.duke.edu/c.php?g=158201&p=1036021
Henry, C., & Wilson, J. (2012, May 8). Personal care at the end of life and after death. Retrieved from https://www.nursingtimes.net/clinical-archive/end-of-life-and-palliative-care/personal-care-at-the-end-of-life-and-after-death/5044559.article
Meier, D. E. (2011). Increased Access to Palliative Care and Hospice Services: Opportunities to Improve Value in Health Care. Milbank Quarterly, 89(3), 343-380. doi:10.1111/j.1468-0009.2011.00632.x
Payne, S., Eastham, R., Hughes, S., Varey, S., Hasselaar, J., & Preston, N. (2017). Enhancing integrated palliative care: what models are appropriate? A cross-case analysis. BMC Palliative Care, 16(1). doi:10.1186/s12904-017-0250-8
Marie
The answer provided should not raise doubts about one ability to perform the job while the person should not seem sounding dishonest or arrogant by stating that they do not have weakness.
My answer: Being in the nursing profession, the ability to delegate tasks and promote team work is a necessity. But I find myself lacking the ability to delegate work between the team as better as I should. I am satisfied with the work I do and find it difficult to delegate. However, I am working on this weakness, and, during the last hours of my shift I practice the team work and cooperation.
People do not always get along with each other by fact due to personality differences. The employer asks the interviewee this question to hear how one can respond to cases of conflict diplomatically.
My answer: Conflicts do happen in a workplace and a professional attitude helps avoid the conflicts and minimize the damage they do to productivity. I was encountered with a same situation when in a meeting I proposed a plan and a coworker who was not really a supporter of my idea. I was taken aback by such harsh response, but I stayed calm and handled the situation. After a sober discussion I was able to deliver my point and my idea was accepted. After the meeting, that coworker apologized for misbehavior and admitted his wrong behavior.
This is one of the often asked first questions. The question is raised for the interviewee to make their first impression
My answer: I am motivated and compassionate person with a desire to contribute my services as a nursing practitioner. I am responsible of my actions and understand the demands of this field. I have around 10 years of experience in the nursing field and aim to promote the livelihood of people and be a nurturer and caregiver of the patients.
Reference
Hawkes, B. (2017). How to Land Your First Nursing Job: The ultimate guide to landing your
first nursing job…and your next!
Karel
What is your biggest Weakness?
I think that weakness is something that you need to have in mind all the time if you want to improve yourself as a worker. Sometimes I have the tendency of loosing the notion of time when I am working, but I am learning how prioritize duties and to delegate when is needed to avoid the delay of tasks.
Describe how you resolved conflict with a co-worker or patient?
The first thing I do is to really get the details off the problem. Once I know what is the motive of the problem I try to solve it. Getting to know why people react a certain way is sometimes difficult because sometimes people are not open to others especially if they are dealing with strong feelings such as despair or frustration in the case of a co-worker or just simply with a lethal disease in the case of a patient.
An example of this is a coworker that I noticed was getting late very often. So often that become a problem to give him the reports in time. In our work we have 30 minutes to give report and the time frame that he was giving me for doing so was 5 and sometimes no minutes at all. This situation was even frustrating for me because it was affecting my work and the care we were supposed to be giving to our patients. I realized that this nurse was a PHS and came all the way down to Miami from Nebraska. I realized that he was missing his family when he told me once that he had his family in that city. How he was a military nurse I asked him how military people use to solve their problems when needed. He told me that they were very quick to detect problems, point out he problems and give solutions. I acknowledge that I really liked the style so I explained to him how important of being in time for the night shift was for coworkers, patients and me. I address the family problem as the motive he was sad and feeling alone in a new town and job and emphasize how important for the whole team was to have him completely on board as far he was working in the institution. He understood what I was saying and corrected it immediately.
Tell me about yourself?
I have been a nurse for 12 years. I have had my professional career through each nursing step such as: LPN, RN, BSN and now ARNP. I consider myself a proactive person, so I am always trying to improve myself as a nurse in a reasonable period of time. I am a nurse aware of the importance of training and development to advance my career to higher levels and standards. I feel my vocation stronger than ever and I really look to become a Dr. in nursing in a not so far future. Every time that I choose a job I ask myself what I can offer to that particular job. In this case I have to offer you lots of commitment and working professionalism. I have had experience in home health, hospice and penitentiary setting. I am a nurse that likes to work as part of a team, where also leadership and proactivity are allowed.
Please answer this two post. APA FORMAT. do 100 to 150 world in each answer.
Suselle
As the population continues to grow in the USA it is becoming clear that In the near future there will be a shortage of primary care physician access or primary care physicians that will be overloaded with patients sacrificing patient centered care and possibly leading to less than favorable patient satisfaction. The next years the population in the USA is increasing and so is the number of elders. “In 2050, the population aged 65 and over is projected to be 83.7 million, almost double its estimated population of 43.1 million in 2012. The baby boomers are largely responsible for this increase in the older population, as they began turning 65 in 2011. “(Hogan, Ortman, Velkoff, 2014)
Due to the increase in aging population and lac of primary care physicians in the work force there might be a very big disparity in access to healthcare across the population. Nurse practitioners can fill this void if our practice can be standardized accross the nation and if NPs can be given more authority to attend to communities which are lacking in healthcare access and primary care. Randomized studies that compared patient services from NPs and GPs found that nurse practitioner spent more time with patients, billed more effectively and had patients follow up with more visits when necessary. Patients also reported higher satisfaction with nurse practitioner and outcomes were in par with GPs. There is no doubt that NPs will be able to fill this role in the coming future. Nurse practitioners can work together with GPs to soften their work load and work in an interdisciplinary setting to provide efficient and compassionate care to each individual. As nurse practitioners we should always work with the safety of each patient in mind and prepare ourselves to become the best practitioners we can be. (Durie, Roland, Roberts, Leese,Venning 2000).
Reference
Ortman, J. M., Velkoff, V. A., & Hogan, H. (2014). An aging nation: the older population in the United States (pp. 25-1140). United States Census Bureau, Economics and Statistics Administration, US Department of Commerce.
Sanny
Nurse practitioners (NP) play one of the most important in the health care system, this is based on the fact that they manage patients overall care; precisely they are entitled to prescrib treatment and medication. Furthermore, they also interpret and order diagnostic tests. Nurse practitioners can be highly considered when looking for primary care providers, this is because Nurses practitioners are found to be providing important health care education and meeting all the medical needs in a health care center. For Nurses practitioners to be strong in an organization, first they must have a higher and greater level of compassion, analytical skills, and self-confidence as some of their top most quality. The ability to properly communication can also be termed as one of the most valuable qualities of NP. (Sangster-Gormley, 2013) With such qualities being in place, institutions will find it easy to fix the gap with NP at the time when there is shortage in primary health care providers.
Nurse practitioners are very important in an organization, how to improve the understanding of the NP roles really matters a lot. First, institutions and other companies must understand that NP is the one who is responsible for reducing the entire patient’s visits across all the healthcare settings. Therefore, when there is a shortage of primary care providers, insurances and other companies should learn to deploy the great use of NP so that the patients can be kept out of the hospitals, bearing in mind that NP is the primary care provider’s profession that is growing rapidly. (Sangster-Gormley, 2013)
References
Sangster-Gormley, E. (2013). How case-study research can help to explain implementation of the nurse practitioner role. Nurse Researcher, 20(4).
Please see attachment in order to asnwer the two available posts. Minimum 150 words each. If using data please provide references if necessary.
Thanks
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