How has nursing practice evolved over time?

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1. How has nursing practice evolved over time? Discuss the key leaders and historical events that have influenced the advancement of nursing, nursing education, and nursing roles that are now part of the contemporary nursing profession.

2. Discuss the difference between a nursing conceptual model and a nursing theory.

Select a nursing theory and provide a concise summary of it. Provide an example in nursing practice where the nursing theory you selected would be effective in managing patient care.

Identify two weaknesses of the organizations utilization management plan and describe “why” you consider them to be weaknesses.

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Utilization Review Committee – Resource Management Operations:
https://www.youtube.com/watch?v=6vpUB6HCnrM

The value of utilization management and review has been debated among the leaders in health care since its inception. For this module’s case assignment, you are going to engage in the review of a utilization management plan for a health care organization.

Search the Internet for a hospital or other health care organization’s utilization management plan.

  • Identify the organization you researched and include the URL for the page of the utilization management plan that you examined.
  • Provide an overview of the organizations utilization management plan- specifically, discuss each of the elements of the plan and describe how each of the elements contributes to health care quality.
  • Identify two weaknesses of the organizations utilization management plan and describe “why” you consider them to be weaknesses. Postulate ways in which the weaknesses can be overcome.

How would your communication and interview techniques for building a health history differ with each patient?

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Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.

For this Discussion, you will take on the role of a clinician who is building a health history for one of the following new patients:

· 76-year-old Black/African-American male with disabilities living in an urban setting

· Adolescent Hispanic/Latino boy living in a middle-class suburb

· 55-year-old Asian female living in a high-density poverty housing complex

· Pre-school aged white female living in a rural community

· 16-year-old white pregnant teenager living in an inner-city neighborhood

To prepare:

With the information presented in Chapter 1 in mind, consider the following:

· How would your communication and interview techniques for building a health history differ with each patient?

· How might you target your questions for building a health history based on the patient’s age, gender, ethnicity, or environment?

· What risk assessment instruments would be appropriate to use with each patient?

· What questions would you ask each patient to assess his or her health risks?

· Select one patient from the list above on which to focus for this Discussion.

· Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.

· Select one of the risk assessment instruments presented in Chapter 1 or Chapter 26 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.

· Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.

Post a description of the interview and communication techniques you would use with your selected patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.

describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient

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As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics. Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body. When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharamcodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease. In this Discussion, you reflect on a case from your past clinical experiences and consider how a particular patient’s pharmacokinetic and pharmacodynamic processes altered his or her response to a drug.

To prepare:

· Review this week’s media presentation with Dr. Terry Buttaro, as well as Chapter 2 of the Arcangelo and Peterson text, and the Scott article in the Learning Resources. Consider the principles of pharmacokinetics and pharmacodynamics.

· Reflect on your experiences, observations, and/or clinical practices from the last five years. Select a case from the last five years that involves a patient whose individual differences in pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug. When referring to your patient, make sure to use a pseudonym or other false form of identification. This is to ensure the privacy and protection of the patient.

· Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.

· Think about a personalized plan of care based on these influencing factors and patient history in your case study.

With these thoughts in mind:

Post a description of the case you selected. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient from the case you selected. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case.

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