Physical Assessment DQ 12

 Please answer each question APA references and less than 20 % similarity. 

Week 12 

Chapter: 24.Putting it All Together   Examining the patient
Give examples of blockers and facilitators to communication. Outline the steps involved in building rapport before performing an examination. List cultural considerations when taking a history and performing a physical examination. Differentiate between the human and the scientific understanding of illness.

5 Name three observations that a human can make better than a machine. DiScuss the phrase “Deal with the total person.” Discuss comfort and privacy issues related to positioning during the examination. Review ways to maintain privacy during the examination process. Discuss methods to reduce anxiety in persons of various ages during the examination process.

10-  You overhear another student complaining about how frustrated she was during her first practice examination of an infant. “He was sleeping when it was time to begin the examination,” she explains. “I woke him up so I could get started, but then he started crying. He finally quit crying, but by then I’d already lost a lot of time.”

a)- What critique can you offer for the scenario? 

b)What advice do you have for this student examiner? 

c)When does the process of inspection begin with the patient? 

11-The physical examination of an older patient should include mental status evaluation with particular attention to which three areas?

12-For children who are small enough, where should they be examined?

13-The child’s ability at any age to react socially offers clues to which two types of well-being?

14-What does observing a child playing on the floor afford us?

15-KM is a 46-year-old male patient who presents for a routine physical examination. He presents today without complaints. He wants to be sure that he is on the right track to maintain his health because he is in his fourth decade of life.

a)- What components of the exam would be completed with the patient seated and the back exposed?

b)- You are preparing to complete a rectal examination. What are the possible positions for this examination?

c)- Describe the components of the rectal examination.

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ELIMINATION COMPLEXITIES

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg

2. BP: 172/98, HR 88, RR 26

3. 3+ pitting edema bilateral feet and ankles

4. Fasting blood glucose: 146 mg/dL

5. Total cholesterol: 250 mg/dL

6. Triglycerides: 312 mg/dL

7. HDL: 30 mg/dL

8. Serum creatinine 1.8 mg/dL

9. BUN 32 mg/dl

Critical Thinking Essay

In 900-words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.

2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.

3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)

4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.

5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.

6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to three sources to complete this assignment. Sources must be published within the last 5 years. Also, you must have an abstract and a conclusion with a minimum of 5 sentences to wrap up this case study. 

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PHARMACOLOGY ESSAY

READ TOPIC AND INSTRUCTIONS FOR ESSAY, APA FORMAT, TIMES ROMAN FT 12, ABSOLUTELY NO PLAGIARISM, ESSAY SHOUL BE APPROXIMATELY ONE PAGE IN LENGTH( NOT INCLUDING THE COVER AND REFERENCE SHEET) CITED AND REFERENCED.DUE ON DATE AND TIME REQUESTED. 

 

BOOK HAS TO BE ONE OF THE REFERENCE

Moini, J. (2013). Focus on pharmacology. Essential for health professionals (2nd ed). Upper Saddle River, NJ: Prentice Hall.

 

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Discussion board

Login as me and complete the discussion board for week 10. Class is medical terminology and an article is needed with 2 replies. DUE TODAY 

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Insider Trading at the Galleon Group case 12

Case 12, “Insider Trading at the Galleon Group,” beginning on page 517-524.  Your answers should total one to two paragraphs for each question.  Each paragraph should contain three to five complex sentences. Describe the events that led to the accusations of insider trading at Galleon. What could regulators, investors, and executives do to reduce the practices of information gathering described in this case? What are the implications of sharing confidential material information? How does this affect your decision to invest in the stock market? Do you believe the secret investigation and conviction of those in the Galleon network will deter other fund managers and investors from sharing non-public information? Why or why not? What lessons can be learned from the Galleon case? My book is Business Ethics: Ethical Decision Making and Cases; 10th ed, by O.C. Ferrell, J. Fraedrich, and L. Ferrell, 2015.

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VARK

 

Discuss the overall value of learning styles. Include the following: Provide a summary of your learning style according the VARK questionnaire. Describe your preferred learning strategies. Compare your current preferred learning strategies to the identified strategies for your preferred learning style. Describe how individual learning styles affect the degree to which a learner can understand or perform educational activities. Discuss the importance of an educator identifying individual learning styles and preferences when working with learners. Discuss why understanding the learning styles of individuals participating in health promotion is important to achieving the desired outcome. How do learning styles ultimately affect the possibility for a behavioral change? How would different learning styles be accommodated in health promotion?

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Position Paper – DUE 3/25/20

Research an article defending the position on the advancement of healthcare informatics and technology in healthcare. Be prepared to discuss in class. 

# of words: 750 words excluding title page, abstract, and references # of sources: PRN

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2 coments each one 150 words (CITATION AND REFERENCE). BY3/12

What is vulnerability? Merriam- Webster defines vulnerable as “capable of being physically or emotionally wounded.” In my opinion, we are all vulnerable by that definition. In healthcare, vulnerable populations are considered those who cannot advocate for their needs or well-being. For example, children, members of the LGBTQ community, prisoners, ethnic minorities, impoverished, and physically or mentally impaired would all be considered vulnerable. (Falkner, 2018). Children, in my opinion, are the most vulnerable because they lack decision making skills and autonomy to advocate for their needs or health care decisions. Children must count on the adults around them to make these decisions for them and unfortunately, some adults take advantage of this vulnerability. As healthcare providers, it is our responsibility to advocate for our patients even and especially when their caregivers are making decisions that will cause them harm. This is a slippery slope as choices such as refusal of vaccinations or life- saving blood products (because of religion) is a protected right. Ethics committees and judicial members are often tasked to intervene in life-saving decisions when the child’s best interest is at risk. So, I beg the very controversial question, how much longer will we continue to watch children die from vaccine- preventable illnesses until the government intervenes?

 

Reference

Falkner, A. (2018). Community as Client. In Community & public health: The future of health care. Retrieved from https://lc.gcumedia.com/nrs427vn/community-and-public-health-the-future-of-health-care/v1.1/

“Vulnerable.” Merriam-Webster.com Dictionary, Merriam-Webster, https://www.merriam-webster.com/dictionary/vulnerable.

There are many different groups of people who are categorized as vulnerable population such as racial and ethnic minorities, the economically disadvantaged, those with chronic health conditions, those who live in rural areas and the elderly (AMJC, 2018). These vulnerable populations health and healthcare problems are often worsened by social factors. They may experience greater risk factors, worse access to care, and increased morbidity and mortality with the general population.

The economically disadvantaged is one group of the vulnerable population as they are at risk for poor health status and access to healthcare. They experience significant disparities in life expectancy, access and utilization of healthcare, morbidity and mortality. In general, low-income individuals are more likely to have chronic illnesses, and the impact of these illnesses can be more severe, individuals with low incomes are also disproportionately racial and ethnic minorities. These low income people may be less like to have health insurance coverage or may be underinsured and as a result they have less interaction with the healthcare system as stated by Pamella Riley, MD, vice president of delivery system reform at The Commonwealth Fund (AJMC, 2018). These individuals are more likely to behavioral health issues such as depression, substance abuse problem and chronic medical conditions like obesity or diabetes.

Numerous efforts are been made to reduce the disparities in healthcare. Persons who are poorer often are stigmatized and not given the chance to express themselves and they are often unaware of the community healthcare resources available to them. The community health nurse comes in contact with these persons and he/she will assess these individuals and identify their needs, make necessary referrals, raise awareness, provide education and put guideline in place with the help of other health professionals and stakeholders (Waisel, 2013). Patients can be educated on how to prevent diseases and maintain the best possible health even if they are poor. The nurse should remain non-judgmental, be culturally aware, show respect to all patients when giving care regardless of race or social status.

Reference

Joszt, L. (2018). 5 Vulnerable populations in healthcare. American Journal of Management Care. Retrieved from https://www.ajmc.com/newsroom/5-vulnerable-populations-in-healthcare

Waisel, D. B. (2013). Vulnerable populations in healthcare. Current opinion in anesthesiology 26(2) p186-192.

Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/23385323/

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Quality Metrics for Chronic Disease Management

  

Quality Metrics for Chronic Disease Management

 According to the CDC, chronic diseases are the leading cause of death in the United States, with almost 50% of the population suffering from at least one chronic illness. As a result, almost 80% of health care spending is devoted to its management (CDC, 2010). To this end, the National Committee for Quality Assurance (NCQA) developed performance measures. These performance measures allow organizations to compare yearly quality improvement outcomes in the management of chronic diseases. As a nurse engaged in advanced practice, you may find yourself at the forefront of prevention and care management efforts.
 

To prepare:

Review      the National Committee for Quality Assurance report, presented in the      Learning Resources, and examine current trends and measures associated      with at least two chronic diseases. This information will form the basis      for this Discussion. Review      examples of measures that address the management of chronic diseases for      an inpatient setting that might not be relevant in an outpatient setting.      Be sure to explore the companion metrics that influence a patient’s      ability to manage chronic disease. Consider      how these metrics facilitate change and improve the management of chronic      disease. Examine      the efficiency of current automated trigger systems for managing patient safety.      Ask yourself: How do these automated trigger systems help improve quality      of health care, patient education, and management of chronic illnesses?

By tomorrow 12/27/2017, write a minimum of 550 words essay in APA format with 2 references from the list below. Include the level one headers as numbered below:

post a cohesive response that addresses the following:

1) Compare one quality metric for managing chronic disease that applies to your practice setting to a metric that applies in a different practice setting (i.e. hospital nurse compared to home health nurse).

2) Evaluate how these quality metrics facilitate change and improve the management of chronic disease.

3) Take a stance on the efficiency of current automated trigger systems to help manage patient safety. Do you believe these to be proactive or reactive responses when educating patients on disease management?

 Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

Chapter 9: “Measuring and Improving Patient Experiences of Care”

Frith, K. H., Anderson, F., & Sewell, J. P. (2010). Assessing and selecting data for a nursing services dashboard. Journal of Nursing Administration, 40(1), 10–16. doi:10.1097/NNA.0b013e3181c47d45

This article highlights the benefits of nurses using dashboards to help with staffing issues. It considers the sharing of data that dashboard can facilitate from the perspectives of nurses, units, hospitals, and patients.

Grossmeier, J., Terry, P. E., Cipriotti, A., & Burtaine, J. E. (2010). Best practices in evaluating worksite health promotion programs. American Journal of Health Promotion, 24(3), TAHP 1–9.

In this article, the authors discuss how to measure success when analyzing worksite health promotion (WHP). They then cover how to organize these measurements, assess WHP programs, and determine factors related to best-practice evaluation frameworks.

Stanley, R., Lillis, K. A., Zuspan, S. J., Lichenstein, R., Ruddy, R. M., Gerardi, M. J., & Dean, J. M. (2010). Development and implementation of a performance measure tool in an academic pediatric research network. Contemporary Clinical Trials, 31(5), 429–437.

The details of this article focus on a multi-center research network that initiated an evaluation method using balanced scorecards. The first three years of the measurement tool’s implementation are covered, and the achievements and challenges are discussed.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Benchmarking outcomes. Baltimore: Author.

Note: The approximate length of this media piece is 10 minutes.

In this program, Barbara Epke and Carrie Brady discuss methods that health care organizations use to gather data for measuring outcomes, and explain how data are used to measure key indicators of quality and safety.

   

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Interprof Org & Sys Leadership

Please check the attachment

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