Says her heart feels like it is “running away.” Reports that she is so exhausted she cannot eat or drink by herself. Objective Data

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Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.
Subjective Data
Is very anxious and asks whether she is going to die. Denies pain but says she feels like she cannot get enough air. Says her heart feels like it is “running away.” Reports that she is so exhausted she cannot eat or drink by herself. Objective Data
Height 175 cm; Weight 95.5 kg Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58 Cardiovascular: Distant S1, S2, S3, S4 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82% Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin Critical Thinking Questions
What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?
IV furosemide (Lasix) Enalapril (Vasotec) Metoprolol (Lopressor) IV morphine sulphate (Morphine) Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

 

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Using APA format write a six (6) to ten (10) page paper (excludes cover and reference page) that examines culturally sensitive nursing care. The paper consists of two (2) parts and must be submitted by the close of week six (6).

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Using APA format write a six (6) to ten (10) page paper (excludes cover and reference page) that examines culturally sensitive nursing care. The paper consists of two (2) parts and must be submitted by the close of week six (6).

A minimum of three (3) current professional references must be provided. Current references include professional publications and valid websites dated within five (5) years. Additionally a textbook that is no more than one (1) edition old may be used.
Part 1 Introduction
Address the following:
Using your own words define culturally competent nursing care. Support your definition with a professional literature citation.
Identify four (4) guidelines the registered professional nurse may use to enhance the ability to provide culturally competent nursing care. Provide one example the culturally competent nurse applies to each of the four (4) selected guidelines. At least one example must address care of patient(s) not occurring in an acute care hospital.
Describe how the registered professional nurse evaluates if the patients cultural needs have been met.
Describe whether cultural practices must be accommodated in all aspects of health care. Provide a specific example and rationale to support your response.
Part 2- Demonstrating Culturally Competent Nursing Care
Address the following:
Select one of the following cultures and focus on the direct caregiving role of the RN at the bedside:
Asian
Native American
Hispanic
Select four (4) cultural features associated with the selected culture that influence the provision of nursing care for patients with chronic illness and at the end of their lives. Describe how the four (4) cultural features influence the provision of care to the patients. At least one (1) feature must address chronic illness and at least one (1) feature must address end of life care.
Provide a total of four (4) nursing interventions that demonstrate nursing care which reflect the respect for the dignity and uniqueness of those cultural features for patients experiencing chronic illness (2 interventions) and at the end of their lives (2 interventions).

 

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examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.

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Examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.

Interprofessional practice requires that health care practitioners recognize that patient outcomes are better when there is a collaborative team approach in addressing patient health issues. Also, there are barriers to interprofessional practice that must be addressed among health care practitioners. The Interprofessional Education Collaborative (IPEC) is an initiative including multiple professions designed to advance interprofessional education so that students entering health care professions are able to view collaboration as the norm and seek collaborative relationships with other providers (IPEC, 2011).

This week your Discussion will focus on interprofessional practice. This Discussion is an opportunity for you to examine your perspective and experiences with interprofessional collaborative practice and to apply your knowledge to managing patient care.
To prepare:

Identify a professional nursing organization and review their position on inter-professional practice

Review the following case study:

Case Study:

Ms. Tuckerno has been diagnosed with multiple sclerosis (MS). The patient receives care at an internal medicine clinic. Her internist is not in the office today and she is being treated by the nurse practitioner. The patient is on two medications for her MS, three different blood pressure medications, one medication for thyroid disease, one diabetic pill daily, insulin injections twice a day, she uses medical cannabis, and uses eye drops for glaucoma. Upon assessing the patient, the nurse practitioner (NP) decides her treatment plan should be adjusted. The NP discontinues some of the patient’s meds and discontinues medical cannabis. She orders the patient to follow up in two weeks.

The patient returns and is seen by her internist. The internist speaks with the patient and reviews her medical chart. The internist states to the patient, “I am dissatisfied with the care you received from the nurse practitioner.” The internist places the patient back on originally prescribed medications and medical cannabis.

Post at least 250 words (no introduction or conclusion)

an explanation of your understanding of interprofessional practice.

2. Also, explain the position on interprofessional practice for (The American Association of College of Nursing)

3 Then, explain what you think is the best collaborative approach to manage Ms. Tuckerno’s care.

Resources

Bankston, K., Glazer, G., (November 4, 2013) “Legislative: Interprofessional Collaboration: What’s Taking So Long?” OJIN: The Online Journal of Issues in Nursing Vol. 19 No. 1.

DOI: 10.3912/OJIN.Vol18No01LegCol01

Hain, D., Fleck, L., (May 31, 2014) “Barriers to Nurse Practitioner Practice that Impact Healthcare Redesign” OJIN: The Online Journal of Issues in Nursing Vol. 19, No. 2, Manuscript 2.

DOI: 10.3912/OJIN.Vol19No02Man02

Interprofessional Education Collaborative Expert Panel. (2011). Core competencies for interprofessional collaborative practice: Report of an expert panel. Washington, D.C.: Interprofessional Education Collaborative

Buppert, C. (2015). Appendix 11-D: Sample Professional Services Agreement. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (417-422). Burlington, MA: Jones & Bartlett.

Buppert, C. (2015). Legal Scope of Nurse Practitioner Practice. In Nurse Practitioner’s Business Practice and Legal Guide (5th ed.) (37-78). Burlington, MA: Jones & Bartlett.

 

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Write a paper of 750 words that explains the relationship between finance and accounting, and how they operate to determine financial viability within a health care organization.

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Write a paper of 750 words that explains the relationship between finance and accounting, and how they operate to determine financial viability within a health care organization.

Write a paper of 750 words that explains the relationship between finance and accounting, and how they operate to determine financial viability within a health care organization.

Prepare this assignment according to the guidelines found in the APA Style Guide.

This assignment uses a rubric.

 

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