Discuss the aetiology and pathophysiology of the patient’s presenting condition.Susan Summers is a 40 year old female who has 3 children under the age of 10yrs. Susan has casual employment stacking shelves in a supermarket at night.

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Discuss the aetiology and pathophysiology of the patient’s presenting condition.Susan Summers is a 40 year old female who has 3 children under the age of 10yrs. Susan has casual employment stacking shelves in a supermarket at night.

?
HISTORY:
Susan Summers is a 40 year old female who has 3 children under the age of 10yrs. Susan has casual employment stacking shelves in a supermarket at night. Susan is obese at 90kg (BMI 35kg/m2) and has been diagnosed with type 2 diabetes. Susan admits to drinking a bottle of wine or more per night after work to help her cope with her life. Susan was admitted to hospital for surgery following changes in her appearance due to Cushing’s syndrome caused by a benign tumour of her right adrenal gland. Susan is admitted to hospital for a laparoscopic right adrenalectomy under general-anaesthesia.
After 2 hours in the post-anaesthetic recovery room (PARU) and an uneventful recovery, Susan
was transferred to the ward, where you have been allocated to her care.
PRESENTATION TO THE WARD:
On return to the ward Susan’s observations are as follows:
• Respirations 30 breaths per minute ?
• BP 160/90mmHg ?
• Pulse 128bpm ?
• Temperature 35.0oC ?
• Pain score 0/10 ?
• Indwelling urinary catheter (IDC) 5mls in the last hour ?It is planned for Susan to be discharged after two days on the ward. ?

QUESTIONS TO BE ANSWERED In relation to Susan Summers:

?Q1. Discuss the aetiology and pathophysiology of the patient’s presenting condition
?Q2. Critically discuss the underlying pathophysiology of the patient’s post-operative deterioration. Prioritize, outline and justify the appropriate nursing management of the patient during this time

?Q3. Identify three (3) members of the interdisciplinary healthcare team, apart from the primary medical and nursing team, who you would involve in the care of the patient before their discharge and provide justification for their involvement.
?
I have identified 3 member of interdisciplinary team –

1. Dietician
2. Drug and alcohol counsellor
3. diabetic educator

 

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What psychosocial and cultural factors should you consider when assessing Mr. Lei?

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Healthy People Initiative (graded)
As the school nurse working in a college health clinic, you see many opportunities to promote health. Maria is a 40-year-old Hispanic woman who is in her second year of nursing school. She complains of a 14-pound weight gain since starting school and is afraid of what this will do to both her appearance and health if the trend continues. After doing her history, you learn that she is an excellent cook and she and her family love to eat foods that reflect their Hispanic heritage. She is married with two school-age children. She is in class a total of 15 hours per week, plus 12 hours of labs and clinical. She maintains the household essentially by herself and does all the shopping, cooking, cleaning, and chauffeuring of the children.She states that she is lucky to get 6 hours of sleep per night, but that is okay with her. She lives 1hour from campus and commutes each day.Using .healthypeople.gov/”>Healthy People 2020as a guide:
1. What additional information would you like to gather from Maria?
2. What are Maria’s real and potential health risks?
3. Pick one of Maria’s health risks. What would be one reasonable short-term goal for this risk?

Cultural Bias (graded)
Understanding cultural phenomena is essential to the completion of an accurate health assessment. Please choose a cultural group from Table 4.1 from your text and describe the cultural differences pertinent to that group. Remember, the table may not include all cultural groups. Let’s try to include all the groups listed in the discussion, so please do not choose a group that has already been done. To expedite this, please use the group name in the title of your post.

week 2

Pain Assessment (graded)
John, a 46-year-old African-American male presents for admission to your hospital for hemi-colectomy for colon polyps. He is complaining of chronic back pain. Patient is on disability from work related injury. History of two (2) previous back surgeries with relief of numbness in RLE but pain has not been relieved. His current medications include Methadone, Neurontin and Norco. John states he takes Benadryl PM every night in addition to his prescribed medications. John is a smoker and smokes 1 PPD. John confides in you that he is considering a spinal cord stimulator for the chronic pain.
• What risk factors does John have for risk of opioid withdrawal during this hospitalization?
• Is there a stigma connected to being disabled and or methadone?
• Does the nurse need to be concerned about acetaminophen use?
• What are the differences in acute and chronic pain?
•

Nutritional Assessment (graded)
Yulang Lei, an 82-year-old Vietnamese man, was admitted to your floor with dehydration and a urinary tract infection following a fall at home. He is alert and oriented, but weak. He appears frail. His admission history includes the following.
• He lives alone; his wife died 6 months ago.
• He states he ran a traditional Vietnamese family, unlike his children, who are married and have now moved away.
• His wife did all the cooking and he hasn’t had much of an appetite since she died. He eats rice and some vegetables, but rarely “bothers to cook meat for just one person.”
• Usual daily activity is reading the Vietnamese community newspaper with his morning tea for breakfast. He says he usually eats lunch, but can’t remember what he usually eats. He has rice and a few vegetables for dinner.
• You notice that his clothes fit very loosely. He states he weighed 140 pounds at his doctor’s office 5 months ago. When you weigh him, he weighs 123 pounds and is 5’8″ tall.
Look at the list of nursing diagnoses in Appendix A of your text. What nursing diagnoses would you choose for Mr. Lei?
• What additional questions would you ask to confirm your diagnosis?
• What physical examination and laboratory findings would you expect Mr. Lei to have?
• What psychosocial and cultural factors should you consider when assessing Mr. Lei?

General Survey and Health History (graded)
Casey is a 17-year-old high school student admitted to the ER with a compound fracture of the left leg obtained falling at the local skateboard park while practicing for a national competition. He has never been hospitalized before. His mother has been notified and is on her way. The EMTs gave him morphine and he reports his pain level as “okay.”
• What part of the interview and examination can be done prior to his mother’s arrival?
• As you enter the room for the first time, what should you observe as part of the general survey?
• As you complete his history, what areas are especially important?
• What are the important developmental considerations for Casey?

 

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Do you think therapists should focus on becoming an expert in one particular counseling approach or should they try to become proficient in more than one approach?

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Do you think therapists should focus on becoming an expert in one particular counseling approach or should they try to become proficient in more than one approach?

Integrating Theories

In this course, we have studied various approaches to therapy and explored the utility of each orientation with reference to the client. For this assignment, take the perspective of a therapist working with clients. This will help you honestly assess your own development and more objectively evaluate the advantages and disadvantages of using an integrative approach to counseling. Answer each of the following questions thoroughly and provide examples where requested to substantiate your points.

Do you think therapists should focus on becoming an expert in one particular counseling approach or should they try to become proficient in more than one approach? Provide an explanation for your answer and illustrate them with examples.
Identify what the three most important characteristics of a successful counselor you consider to be. Describe how these characteristics can be developed or strengthened?
Identify and describe some of the characteristics (from question 2) that are best developed in the counseling process with clients? Support your points with examples? Identify and describe some areas of personal or professional development that would potentially be unethical for the counselor to develop in the counseling process with clients? Explain your rationale in detail and give examples.
What are some of your own personal motivations and characteristics that may help or hinder you as a counselor (identify at least two)?
What areas of your own personal and professional development need the most development before you will feel prepared to be an effective counselor (identify at least three)?
What are two advantages and two disadvantages of practicing within the framework of one specific theory as opposed to developing a more integrative approach consisting of several therapies? Give a detailed description and rationale for both sides.
What are the advantages and disadvantages of practicing within an integrated framework?
Explain at least two techniques you would use in your treatment and describe how you would integrate these techniques in a therapy session.

***Your paper should be double-spaced and in 12 point, Times New Roman font with normal one-inch margins, written in APA style, and free of typographical and grammatical errors.

 

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Identify the appropriate chain of command for implementing a policy regarding the quality improvement process.

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Identify the appropriate chain of command for implementing a policy regarding the quality improvement process.

Demonstrate the ability to identify a quality improvement need.

2. Demonstrate the ability identify the appropriate target population for the need.

3. Assess the target populations needs regarding the identified quality improvement.

4. Discuss the appropriate process for developing the policy related to the quality improvement.

5. Identify the appropriate chain of command for implementing a policy regarding the quality improvement process.

6. Discuss the appropriate timeline and chain of command for evaluating and revising the policy related to the quality improvement process.

Look around your place of work. There are usually many procedures and policies regulating the actions of staff for patient safety. Polices attempt to standardize care and help drive positive outcomes for the organization and most importantly for the patients. Policies are stated in the absolute; shall or will. They are directives. Your organization will have several policies. In this course, you are to explore the process required in developing good policies and getting them implemented. This is similar to the process for developing laws as explained in your textbook. Think of the nursing process: Assess, Diagnose, Plan, Implement, and Evaluate. In developing a policy, nurses follow this pattern. In this assignment, you will delineate this process for a particular nursing topic.

Final Project Instructions:

Your assignment is to write a paper on how you would develop a policy (new or revised policy) to address an issue identified in a practice setting:

A)You may use as many references as you need to for this document to bring the best EBP to your project.

B)This writing assignment should adhere to APA style.

C)Project must be between 3-5 pages NOT including the title page and reference list.

1) You are to delineate processes for getting the policy adopted and implemented within that practice setting. Using these “steps” as headings for your paper elaborated on the required items listed here.

2) The introduction is to cover basic information about the topic supported by research and the need for such a policy. Consider and include, at a minimum, potential issues related to safety, culture, collaboration, finances, information management, and resource utilization, if applicable, when writing this assignment.

A. Who are the people directly addressed in the policy? Includes internal and external people:

Internal=within the organization.

External=Those coming into the organization such as vendors.

B. What are the needs/wants of the identified people? How will you identify their needs/wants?

C. How will the policy respond to their needs/wants? What does the policy and/or procedure provide for these people?

D. What processes and/or procedures will be needed to produce results to meet the need for the identified people.

E. Who will be responsible for implementing this policy – What is your institution’s process for policy development and revision?

 

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