As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

· Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

· Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.

· Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

· Review the Application Assignment Rubric found under Course Information

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

· For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

· Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

 

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Assignment: Application: Leadership Concept
Analysis Group Paper

This week you will begin a group paper that you will develop over the next few weeks. By Day 3 of this week, you will be placed in a collaborative group and provided with a work area for your group (See the Groups area below Week 11 in the left-hand navigation bar. If you do not see your team area by the end of Day 3, contact your Instructor.)

Before you begin to work with your group, read the information below describing the paper. Then join your group, introduce yourself, and begin work on selecting a topic.

To prepare:

· Review the Peer Evaluation Form for important information on how this assignment is graded.

· Identify a group facilitator.

· Within your group, select a topic relevant to interprofessional leadership and the health care field on which to focus your group paper. The following are some potential topics for your group to consider: 

o Matrix organizations

o Accountable care organizations

o Horizontal and vertical organizations

o Role conflict and ambiguity

o Employee recruitment and selection

o Interpersonal relationships in the C-suite of organizations (the relationships between the CEO, CFO, and CNO)

o Resistance to change

o Succession planning

o Whistle blowing

o “Just” culture

o Team Stepps

· When your group has selected a topic, the group facilitator will submit the topic to the Instructor for approval on the Discussion Board in the Week 5 Group Project Topic Forum.

· Conduct research on your topic using the Walden Library and other credible sources.

To complete:

As a group, write a 3- to 5 (page count does not include title and reference page) page paper that includes the following:

· Section 1: Introduction

· Section 2: Significance of the topic (based on literature that speaks to the relevancy of the concept selected in terms of interprofessional leadership)

· Section 3: Review of the literature related to the concept that the group selects (current best practices, positive or negative impact on leadership or health care organizations, etc.)

· Section 4: Application to nursing (e.g., implications or consequences for nursing leaders)

· Section 5: Conclusion

All group members are expected to collaborate fully on this project, and your group paper should demonstrate an original and thoughtful application of the ideas presented in the Learning Resources and the research literature.

 

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This week’s Learning Resources classify management and leadership (which are often confused in everyday discussion) and explain their significance for health care organizations. As you advance professionally, it is critical to understand the distinctions between management and leadership and how you can apply this knowledge for increasing effectiveness in your workplace.

To prepare:

· Review the information in the Learning Resources.

· Conduct additional research on your own and select at least two current, credible sources that contribute to your understanding of management and leadership.

· Reflect on how the roles of management and leadership differ in supporting the organization to set and achieve goals.

· Drawing upon specific examples from a current or previous practice setting, bring to mind someone who seemed to be a leader but not a manager and someone who seemed to be a manager but not a leader (generally speaking, or within a specific circumstance). Be prepared to support your assessment with specific behavioral descriptions found in the literature.

Post an analysis of how management and leadership roles differ in terms of supporting an organization to set and achieve goals. In addition, post  descriptions of an individual who demonstrates leadership behaviors but not management behaviors and an individual who demonstrates management behaviors but not leadership behaviors. Provide your rationale, identifying specific characteristics of effective managers and leaders. (Note: Do not identify these individuals by name, position, or location.)

 

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Your experiences working with groups—whether you perceive them as positive, negative, or neutral—can be used to facilitate insight and development. Health care, with its focus on interprofessional teamwork and collaboration, offers ample opportunities and an imperative for continuous learning.

For this Discussion, you focus on strategies for facilitating the group process.

To prepare:

· Review the information in this week’s Learning Resources regarding the stages of group formation, problematic roles individuals play in groups, and strategies for facilitating and maintaining positive group collaboration. In particular, review Learning Exercise 19.14 of the course text.

· Reflect on various groups with which you have been or are currently involved. Select one specific group to analyze for the purposes of this Discussion. Identify the purpose or task that the group is or was meant to perform.

· Consider the four stages of group formation (forming, storming, norming, and performing). How would you describe the progression between stages? Is there a stage in which you believe your group is or was “stuck”?

· Consider the task or group-building role you normally play in a group setting. How could you apply the information from the Learning Resources to improve your group participation and facilitation, as well as the functioning of the group as a whole?

· In addition, think about which individuals within your group (including yourself) may fall into problematic roles such as the Dominator, the Aggressor, or the Blocker. How have you and your group members addressed the enactment of these roles and its impact on interactions? With information from the Learning Resources in mind, what strategies would you apply now or going forward?

Post a description of a group with which you have been or are currently involved. Assess where the group is in terms of the four stages of group formation. If you are reflecting on a past experience, explain if your group moved through all four stages. Describe the task or group-building role you typically play, or played, in this group. Then, explain what strategies you, as a leader, can apply to better facilitate the group process and address any problematic individual roles in the group.

Resources Given:

https://www.tablegroup.com 

https://www.mindtools.com/pages/article/newTMM_95.htm

https://www.mindtools.com/pages/article/newLDR_86.htm

 

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Discussion: Cardiovascular Disorders

Veins and arteries are vital elements of the cardiovascular system. They carry the blood supply through the body and are essential for proper function. Sometimes veins and arteries malfunction, resulting in cardiovascular disorders. Malfunctions of arteries and veins are similar to malfunctions of a water hose. Consider the structure and function of a hose. A tap releases water, which then travels through the hose and comes out the other end. If the hose has been dormant for several months, dirt and rusty particles might build up inside, resulting in a restricted flow of water. Similarly, buildup of plaque inside the coronary arteries restricts blood flow and leads to disorders such as coronary heart disease. This disease is one of the most common cardiovascular disorders, and according to the National Heart, Lung and Blood Institute (2011), is the leading cause of death for men and women in the United States. In this Discussion, you examine the pathophysiology of cardiovascular disorders such as coronary heart disease.

To Prepare

• Review this week’s media presentation on alterations of cardiovascular functions, as well as Chapter 24 in the Huether and McCance text. Identify the pathophysiology of cardiovascular disorders.
• Select one patient factor: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of cardiovascular disorders.
• Select one of the following alterations of cardiovascular disorders: peripheral arterial disease, myocardial infarction, coronary artery disease, congestive heart failure, or dysrhythmia. Think about how hypertension or dyslipidemia can lead to the alteration you selected. 

Post a description of the pathophysiology of cardiovascular disorders, including how the factor you selected might impact the pathophysiology. Then, explain how hypertension or dyslipidemia can lead to the alteration you selected for patients with the factor you identified.

Pick any that you want.

 

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