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What are the major positives that you see in the PPACA legislation?

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Nursing homework help
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Max Points: 5.0
Your hospital has been placed on alert for receiving patients from a local explosion at a large factory. Reports from the scene are spotty in terms of numbers killed or injured, and you do not know how many patients you may be getting. News reports are calling for casualties in the 100s, but local fire responders are sending in conflicting reports. You need to know what your ED will be receiving, so you can determine whether to close surgery to elective cases and to go on ED bypass for regular patients. Rumors are swirling inside the hospital and the chain of command about how severe the incident is and what it will do to your ability to function. What thoughts do you have about how to learn what you need to know in order to structure the hospital’s preparations and continue regular functioning at the same time? What resources can you tap in order to learn more accurately about the situation at the scene and what you can expect to come to your ED? How would you manage this situation to cause the minimum disruption to regular hospital functioning?
2.
When faced initially with a disaster situation in a health care setting, what do you think your first five steps need to be? Why?
3.
What are the major positives that you see in the PPACA legislation? What are the major negatives that you see in the PPACA legislation? Provide rationale for your answer.
4.
What are your thoughts about the emerging accountable care organizations? In what ways do you think they will affect the current health care delivery system? How do you think the practice patterns of primary care physicians will change under the new models of health care? What are the biggest problems that this could bring to primary care practices?
Include a scholarly apa reference and intext citation for each  .

For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes

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Nursing homework help
 
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.

Describe a department or unit within a health care organization using systems theory terminology

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Nursing homework help
 
For this Assignment, you apply systems theory to the examination of a problem in a department or a unit within a health care organization. (Note: You may use the same problem you identified for the Discussion as long as it meets the criteria for this assignment.)
To prepare:
· Review the Meyer article, “Nursing Services Delivery Theory: An Open System Approach,” in this week’s Learning Resources. Focus especially on the information presented in Table 1 (p. 2831) and Figure 2 (p. 2833).
· Reflect on your organization or one with which you are familiar. Within a particular department or unit in this organization, identify a problem the staff is encountering.
· Using Table 1 in the Meyer article as a guide, analyze the department or unit, identifying inputs, throughput, output, cycles of events, and negative feedback. Consider whether the problem you have selected relates to input, throughput, output, cycles of events, and/or negative feedback.
· Think about how you could address the problem: Consider what a desired outcome would be, then formulate related goals and objectives, and translate those goals into policies and procedures.
· Research professional standards that are pertinent to your identified problem.
· Reflect on the organization’s mission statement and values. In addition, consider how addressing this problem would uphold the mission and values, while improving the organizational culture and climate. (Depending on the organization you have selected, you may have explored these in the Week 1 Discussion.)
To complete:
Write a 3- to 5-page paper (page count does not include title and reference page) that addresses the following:
· Describe a department or unit within a health care organization using systems theory terminology. Include a description of inputs, throughput, output, cycles of events, and negative feedback.
· Describe the problem you identified within the department or unit using an open- systems approach, and state where the problem exists using the systems theory model (input, throughput, output, cycles of events, or negative feedback).
· Based on this information, explain how you would address the problem as follows:
o Formulate a desired outcome.
o Identify goals and objectives that would facilitate that outcome.
o Translate those goals and objectives into policies and procedures for the department or unit.
o Describe relevant professional standards.
· Explain how your proposed resolution to the problem would uphold the organization’s mission and values and improve the culture and climate.

Discuss a screening tool that can be used in the primary care setting that can help with the identification of patients with depression and or substance abuse

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Nursing homework help
No plagiarism please.
Will need minimum of 300 words, APA Style, double spaced, times new roman, font 12, and Include: (3 references within years 2015-2018) with intext citations.
Depression is a common psychiatric disorder in children, adolescents, adults, and the elderly. Primary care providers, not mental health professionals, treat the majority of patients with symptoms of depression. Persons who are depressed have feelings of sadness, loneliness, irritability, worthlessness, hopelessness, agitation, and guilt that may be accompanied by an array of physical symptoms as well as substance abuse.
Identifying patients with depression and substance abuse can be difficult in busy primary care settings where time is limited, but certain depression/substance abuse screening tools may help diagnose the disorder.
Discussion:
Discuss a screening tool that can be used in the primary care setting that can help with the identification of patients with depression and or substance abuse. What is your responsibility as a primary care provider to this patient once a disorder has been identified?