Nursing 18919035

  

Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit.

Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive. She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness. Patient is alert and oriented but does have periods of forgetfulness during the overnight hours. Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs).

Medications:

Lopressor

Lisinopril

Plavix

Metformin

Novolin R per sliding scale *NEW* 

Multivitamin

Colace

Zithromax *NEW* 

Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog. Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch.

Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home.

What, if any, concerns related to Millie’s skin and nutritional status do you have?

What nursing interventions will you include in the plan of care to address these concerns?

What teaching strategies will you use to educate Millie and Fred on the new medications?

Using the SBAR, please include the information that you will communicate to the physician’s office at the completion of the visit.

2.  

During a follow up visit, a strong smell of urine is apparent when assessing Millie and you notice that she seems a bit more restless than usual. When questioned, Millie reports feeling discomfort in her tailbone area. You suspect that Millie may be experiencing some skin breakdown.

What would you do next?

What additions/revisions would you anticipate making to your plan of care?

   

 
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Nursing 18916521

   

For this Assignment, as you examine the client case study in this week’s Learning Resources, consider how you might assess and treat adult and older adult clients presenting symptoms of a mental health disorder.

Learning Objectives

Students will:

  • Evaluate      clients for treatment of mental health disorders
  • Analyze      decisions made throughout diagnosis      and treatment of clients with mental health disorders

Examine Case 2: You will be asked to make three decisions concerning the diagnosis and treatment for this client. Be sure to consider co-morbid physical, as well as mental factors that might impact the client’s diagnosis and treatment.

At each Decision Point stop to complete the following:

  • Decision #1: Differential      Diagnosis
    • Which Decision did you select?
    • Why did you select this Decision?       Support your response with evidence and references to the Learning       Resources.
    • What were you hoping to achieve       by making this Decision? Support your response with evidence and       references to the Learning Resources.
    • Explain any difference between       what you expected to achieve with Decision #1 and the results of the       Decision. Why were they different?
  • Decision #2: Treatment Plan for      Psychotherapy
    • Why did you select this Decision?       Support your response with evidence and references to the Learning       Resources.
    • What were you hoping to achieve       by making this Decision? Support your response with evidence and       references to the Learning Resources.
    • Explain any difference between       what you expected to achieve with Decision #2 and the results of the       Decision. Why were they different?
  • Decision #3: Treatment Plan for      Psychopharmacology
    • Why did you select this Decision?       Support your response with evidence and references to the Learning       Resources.
    • What were you hoping to achieve       by making this Decision? Support your response with evidence and       references to the Learning Resources.
    • Explain any difference between       what you expected to achieve with Decision #3 and the results of the       decision. Why were they different?

Also include how ethical considerations might impact your treatment plan and communication with clients and their family. ( please see attachment).

 
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Nursing 18915073

 

You have to create an E-Poster on what you see as the future of nursing practice and the role of nursing in the emerging health-care environment. You need to predict the future based on present evidence.

The E-Poster needs to include the following:

1. Introduction

2. Statement of the issue

3. Evidence supporting the issue

4. Prediction of the future role of the nurse

5. Conclusion

6. References: minimum of three references from peer-reviewed nursing journals (encourage the use of international journals). Articles need to be within the last 3 years unless historical.

 
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Nursing 18915069

 

You have to create an E-Poster on what you see as the future of nursing practice and the role of nursing in the emerging health-care environment. You need to predict the future based on present evidence.

The E-Poster needs to include the following:

1. Introduction

2. Statement of the issue

3. Evidence supporting the issue

4. Prediction of the future role of the nurse

5. Conclusion

6. References: minimum of three references from peer-reviewed nursing journals (encourage the use of international journals). Articles need to be within the last 3 years unless historical.

 
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Nursing 18936617

  Health History Form and Family assessment 

 
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Nursing 18932813

  

Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.

Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.

Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”

Please address the following questions related to the scenario.

What do you suspect is the cause of the patient’s symptoms?

Describe the course of action that you will take to confirm this suspicion and prevent further decline.

What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.

While you are caring for this patient, how will you ensure that the needs of your other patients are being met?

 
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Nursing 18925427

  

Randy Adams is a 38-year-old male patient of Dr. Joseph Reynolds who was admitted yesterday morning for 24-hour observation for mild concussion following a motor vehicle accident. Randy lost consciousness during the accident and was very confused when he arrived in the ER after EMS transport. He is an Iraq war veteran and he seemed to think after the accident that this all happened in Iraq. Dr. Reynolds is concerned that Randy has some residual problems from a couple of explosive incidents that occurred while he was in Iraq. The physician is unsure whether Randy’s current symptoms are from the car accident or from prior injuries so he has referred him for consultations to both a neurologist and to a behavioral health specialist.

Based on the above please discuss the following.

Pathophysiology of concussive injuries and treatment

Neurological assessment tools used in your current practice setting (if not presently working, please describe one used during prior employment or schooling)

Current best practices associated with post-traumatic stress disorder (PTSD)

Nursing interventions you would include in this patient’s plan of care

How can changes in nervous system functioning affect an individual’s psychosocial health status?

What resources are available at the local, state, and federal levels to assist those suffering from PTSD?

While reviewing Randy’s discharge instructions with him, you notice that he is having difficulty holding the pen in his hand and appears to be unable to sign his name. You ask him if he is okay. He looks at you and attempts to smile but only the right side of his face appears to move—the left side is fixed. You fear he may be having a stroke. What would your next steps be?

 
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Nursing 18925301

 Briefly describe the practice agreements for PMHNPs in Texas State.

Explain the two physician collaboration issues that you identified.

Explain what you think are the barriers to PMHNPs practicing independently in Texas State.

Outline a plan for how you might address PMHNP practice issues in Texas State

 
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Nursing 18924931

11 page paper on transformational 

 
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Nursing 18923721

  

Family Genetic History Form please see attached

 
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