Posts

 Post an explanation of the differential diagnosis for the patient in the case study you selected.

/in /by

Nursing homework help
Discussion: Breast Conditions

Throughout a woman’s life, her breasts go through many normal, healthy changes. However, patients do not always understand these changes and often visit health care providers for treatment. When examining these patients, you must be able to identify when a breast condition is the result of a safe and normal physiological change and when it is the result of an abnormal change requiring treatment and management. A diagnosis of a breast condition resulting from an abnormal change can be devastating for women, making emotional support as vital to women’s well-being as proper assessment, diagnosis, and management. For this Discussion, consider how you might diagnose, manage, and support the following two patients presenting with breast conditions:

Case Study 1:

You are seeing a 60-year-old Latina female, Gravida 4 Para 3104, who is concerned about a thick greenish discharge from her left breast for the past month. The discharge is spontaneous and associated with dull pain and burning. Upon questioning, she also tells you that she breastfed all her children and is currently not on any medications except for occasional Tylenol for arthritis. Her last mammogram, 14 months ago, was within normal limits. On exam, her left breast around the areola is slightly reddened and edematous. Upon palpation of the right quadrant, a greenish-black discharge exudes from the nipple. You note an ovoid, smooth, very mobile, non-tender 1 cm nodule in the RUIQ at 11:00 5 cm from the nipple. No adenopathy, dimpling, nipple discharge, or other associated findings. Her right breast is unremarkable. The patient expresses her desire to proactively decrease her risk for developing breast cancer.
Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Then, based on the appropriate clinical guidelines, explain a treatment and management plan for the patient, including proper dosages for any recommended treatments. Finally, explain strategies for educating patients on the disorder.

How will you address each area and improve understanding, collaboration, motivation, and positive attitude?

/in /by

 
Nursing homework help
Stress and Conflict Management
Conflict may occur in any work environment, whether it is in the clinical setting, another department, or another organization. It is important to understand how conflict arises and how conflict is managed through effective communication.
The behavior of a leader has a direct impact on the motivation of his or her team. It is crucial for a leader to understand how his or her behavior and conflict-handling ability impact the care of patients.
Here is a scenario of a leader who is willing to handle conflicts in his or her workplace.
You are promoted to a management position in a small organization. There are four full-time members and three part-time members. You have a department manager currently overseeing the operations. You are excited to begin with your new assignment and have completed orientation. You heard some rumblings from the staff development team, “You have your work cut out for you in this department!” It does not sound promising, yet you are filled with energy, a positive attitude but a bit concerned as you do not want to appear bossy. You lack a bit of confidence since they are seasoned team members and you are new to the organization.
Once you begin your first day, you decide to meet with everyone as a group and individually over the next few days. What you are uncovering is disturbing and you quickly realize that the team members have lots of conflicts within the department. In a nutshell, this is what you have discovered:
The department manager thinks she is in charge since clients, customers, or patients have specialized needs. She is stern faced and does not seem to smile, yet she does not admit it is her or her department’s fault if there is an error. She seems to enjoy the increasing conflict among the unit as it takes any “pressure” off her and she can continue to “tell people what to do.”
Two full-time administrative staff members do not like each other and refuse to work together. One feels the other cooks “strange food” and cannot understand her when she speaks, and she is too quiet. The other staff member feels the first one is too outspoken and not gracious and hurries through her assignments. They share a small office and their work is critical to the success of the organization as they oversee all billing, accounts payable and receivable, and schedule the large projects and services to other organizations. The rest of the staff members avoid going to this office as the tension is clearly increased in this room.
The part-time staff feel they are not being offered any extra shifts and sometimes they are asked not to come to work if the day is slow. They feel they are not valued and are demotivated by less pay. This is a critical time for them due to the economy crisis. When they are at work, they often bring their home problems with them and seem stressed when they have to work with the other team members.
Answer the following questions:
How will you address each area and improve understanding, collaboration, motivation, and positive attitude?
How does emotional intelligence play a role in encouraging the staff to cooperate and to be willing to make behavior changes?
What behavior theory will you research to develop your thoughts when you speak to each staff member?
How important is decreasing overall conflict in the workplace?
How can you develop a win-win approach?
Note: Substantive comments should be included in your thoughts and responses for all class participation.

Select a potential natural or man-made disaster that could happen in your community.

/in /by

 
Nursing homework help
Assignment: Disaster Planning for Public Health
By Day 7 of Week 5
Select a potential natural or man-made disaster that could happen in your community. Then, write a 3- to 4-page paper about the disaster from the community nurse’s perspective.
Section 1: The Disaster, Man-Made or Natural
What disasters may strike your community and why? For example, do you live in “Tornado Alley,” or has climate change resulted in unusual cold weather snaps or blizzards in your community? Are you located in a flood plain? Include possible diseases that may result from a natural disaster, such as tetanus or cholera.
Section 2: The Nursing Response
Formulate responses to the disaster, considering systems and community levels of intervention.
Review websites where a disaster plan may be available for the public, or if one is not currently available, call public health department to see if a disaster plan exists for your community and what the plan contains.
In addition to reviewing websites for information about your local disaster plan, you will need to locate best practice/evidence-based practice guidelines in professional literature to determine whether your community’s disaster plan is as sound as it might be or if there is room for improvement.
Section 3: Is My Community Prepared for a Disaster?
What conclusions can you draw about your community’s preparedness plan from having completed this evaluation?
Week 4: Evidence-Based Practice in Disaster Planning: Nurses as Leaders
Public health surveillance is one way that public health officials target intervention strategies (Turlock, 2016). Often, it is through prompt recognition of and reporting of incidents of communicable disease that a disaster can be averted (Turlock, 2016). Surveillance activities often prompt questions such as, What is causing the disease? How is it spreading? And who is at risk (Turlock, 2016)? While it is true that preparedness planning cannot eliminate all traces of threat to a community, planning assures that medical services and treatment are deployed in an effective, efficient, and rapid manner (Turlock, 2016). Public health plays a vital role in coordination of providers, assurance of supplies particularly when the Strategic National Stockpile pharmaceuticals and supplies are required, and mobilization of state and national response systems. Public health officials may also provide health care services when required (Turlock, 2016).
Stanhope (2016) noted that evidence-based practice (EBP) has become more important in health care for many reasons: increased expectations of consumers, increased availability of information through the Internet, increased accountability for results, health care economic changes, and growing numbers of lawsuits, among other reasons. EBP is a lifelong problem-solving approach that regularly produces excellent results and often provides the theoretical underpinnings for programs to mitigate problems in the community. Once programs are in place, evaluation of their effectiveness should be conducted to determine whether they are worth the continued expenditure of resources. Use of EBP is vital to assure safe outcomes for populations during disasters, such as massive communicable disease outbreaks, and should be the foundation of disaster-planning strategies.
Required Readings
Stanhope, M., & Lancaster, J. (2016). Public health nursing: Population-centered health care in the community (9th ed.). St. Louis, MO: Elsevier.
Chapter 15, “Evidence-Based Practice” (pp. 342–354)
Chapter 23, “Public Health Nursing Practice and the Disaster Management Cycle” (pp. 503–528)
Chapter 24, “Public Health Surveillance and Outbreak Investigation” (pp. 529–544)
Chapter 25, “Program Management” (pp. 545–567)
Required Media
Laureate Education (Producer). (2009a). Family, community and population-based care: Emergency preparedness and disaster response in community health nursing [Video file]. Baltimore, MD: Author.
TED. (2012). How to step up in the face of disaster [Video file]. Retrieved from https://www.ted.com/talks/caitria_and_morgan_o_neill_how_to_step_up_in_the_face_of_disaster
This Ted Talk describes the actions of two sisters who step up as leaders during a tornado disaster in their community.

Describe the key players (stakeholders) who should be members of your implementation team and explain why teamwork is an important factor in implementing a quality improvement program

/in /by

Nursing homework help
Assignment 1: LASA 2: Implementing Six Sigma at Wishmewell Hospital
Emergency departments (ED) at many hospitals have been overwhelmed in the past year, as more patients without health insurance use the ED as a primary care solution. Wait times in the ED are increasing as more and more Americans are using the Emergency Department for their general health concerns. Across the country, the average ED wait time is now 222 minutes (approximately 3 hours, 42 minutes).
Wishmewell Hospital’s average wait time in the ED is more than five hours, and the board of directors is concerned about this long wait time. The danger is that a patient’s condition may escalate during his/her waiting time in Wishmewell’s ED.
The board has tasked you to take on a new quality improvement initiative to decrease wait time in the ED using the Six Sigma approach.
Develop a quality improvement program using the Six Sigma approach to decrease waiting time in Wishmewell’s emergency department.
The quality improvement program must include the following elements in an approximately 10-page MS Word document:
Describe the goals and objectives of your plan to decrease ER wait times at Wishmewell.
Describe each step of the Six Sigma (DMAIC) process:
Define the problem
Measure the process; what Six Sigma tools will you use?
Analyze the data; what tools will you use to analyze the data?
Improve the process; explain your improvement plan
Control; how will you continue to monitor the results and adjust as necessary?
 
Describe the key players (stakeholders) who should be members of your implementation team and explain why teamwork is an important factor in implementing a quality improvement program.
Explain at least three factors that might inhibit the implementation of your decreased wait time program.