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Prophylactic Hysterectomy Essay assignment papers

This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered. For this assignment, make sure you post your initial response to the 
Discussion Area
 by 
the due date assigned
.

To support your work, use your course textbook readings and the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

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Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates’ initial postings. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Cite resources in your responses to other classmates. Complete your participation for this assignment by the end of the week.

For this assignment, you will review and reflect on the Prophylactic Hysterectomy article. This article can be applied to healthcare providers in the primary care and specialty settings.  Discussion of the article is based on the course objectives and weekly content, which emphasize the core learning objectives for an evidence-based primary care curriculum. Throughout your nurse practitioner program, discussions are used to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice. Prophylactic Hysterectomy Essay assignment papers.

Discuss any “take-away” thoughts from the article.

What are the ethical dilemmas to consider with prophylactic surgeries?

Discuss the screenings/interventions/options/education that you would provide to a patient that has a strong family history of ovarian cancer. What if the patient has no health insurance? What resources could you offer to assist the patient?

Prophylactic Hysterectomy

Womens_Prophylactic_Hysterectomy

Prophylactic Hysterectomy Essay assignment papers

Critical​ ​Thinking​ ​Essay

Jrn1-2.Prmpt

Journals 1-2 Prompt

Description:

This is a personal journal where students record, track, and process personal observations

and reflections about critical thinking in their daily life. The students should be focusing

on their own, internal infractions of critical thinking principles and those of others, such

as family and friends in interpersonal interactions. Focus on infractions that are unique to

your own, personal life, your inner reflection about your life and actions, your thoughts,

your interactions with others, things your family or friends do. The point is to take note of

situations in which critical thinking is not present and the effects of this are apparent. The

purpose of this journal is for students to be more self-aware of the regularity of critical

thinking problems in their lived, daily life so that those problems are less pernicious.

Directions:

1. In at least one paragraph, describe the critical thinking infraction as it occurred.

Think of the following points in your description:

a. What, exactly, happened? Tell the story, paying attention to the

who-what-when-where-how details. This context matters for critical

thinking infractions, both in provoking them and understanding them.

b. What, specifically, was the infraction? Thinking of critical thinking as

principles of good reasoning, which principles were absent or violated?

2. In at least one paragraph, interpret the situation and the infraction. Think of the

following points in your interpretation:

a. Why did the infraction occur in this situation? Attempt to form an

explanation of the situation such that it produced this infraction as a result.

b. Of all of the possible ways for the situation to proceed, why did it proceed

this way–where a critical thinking rule was broken or absent–rather than

the other ways? What was the cause, in other words?

c. In your interpretation, how severe or consequential was the infraction?

Aside from leading to irrationality and false beliefs, what else could occur

as a result if anything? Critical​ ​Thinking​ ​Essay

3. In at least one paragraph, consider how to resolve the critical thinking infraction

as best as you can. Consider the following points in this resolution:

a. If the situation were repeated, what measures would have to be taken in

order to prevent the infraction from occuring?

b. Given that the infraction actually occurred, what do you do about it now,

after the fact?

c. What factors do you foresee getting in the way of, or at least making

difficult, the prevention or resolution of this infraction?

Barrier.Worksheet

Barriers​ ​to​ ​Critical​ ​Thinking​ ​Worksheet

1. The likelihood of two star-systems, the moon, and the sun aligning on Sept. 23rd in

accordance with Biblical numerology is so improbable that it must herald some kind of

major cosmic event, perhaps the planet Nibiru colliding with our planet or the Rapture.

2. We are not morally obligated to assist Rohingya Muslims as they flee Myanmar to

Bangladesh because there are many other people on the planet who can do something

about it, like the people in Bangladesh who are closer.

3. I’m not going to the birthday party later because my family’s political views are just too

much to handle. If I have to go, I’m simply not going to talk to the people with views too

far from my own.

4. I have been researching the Mandela Effect constantly for almost five years now, but it’s

very difficult to find any more data on than what already exists. So far, there is evidence

of the phenomenon, but not enough to understand it properly. I have to keep researching

and working to find the truth.

5. As a student, I can tell you that college is too expensive, and it should just be free.

6. It’s not my fault I failed the class. I have done well in all of my classes except the ones

with bad professors. It’s their fault. I am an above average student, so how can I have a

1.9 GPA? Bad professors. Critical​ ​Thinking​ ​Essay

7. I believe it is right not to eat meat because I am a member of PETA.

8. Liberals are college educated people who read too much Marx and are now Communists.

9. Human nature is either completely self-interested or altruistic. It’s obviously true that all

people are always self-interested, then. Just look around you. My philosophy professor

said all people are naturally self-interested too.

10. I’m meeting my friends at the bar tonight instead of studying because, if I don’t, they’ll

think I’m the kind of person who takes books more seriously than having fun with

friends.

11. Even if climate change is human induced, it shouldn’t matter to humans. The fact is that a

warmer climate will open previously inaccessible, unworkable frozen regions for

economic opportunities.

12. My friend is having a really hard time. I just repeated by saying that helps me out, “Live,

laugh, love.” I thought she needed to hear that kind of positivity to help her find some

guidance. Critical​ ​Thinking​ ​Essay

13. I don’t really know anything about politics, so I don’t really get involved in the things

that people get worked up about. I’m just not into politics and it doesn’t have an effect on

me. I’m happier and healthier that way. When people try to talk to me about it, I just say,

“I have no relationship with the political.” Don’t know; don’t care. Critical​ ​Thinking​ ​Essay.

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

SOAP Note Section II: Lifestyle Pattern and Section III: ROS

This section of the SOAP note will include history of lifestyle patterns and the review of systems (ROS).

Document appropriate data in the relevant body system.

Do not state “Negative, NA or Unremarkable” for any systems because the reader will not know which questions were actually asked by the provider.

This is a comprehensive health history and should not contain physical exam findings
. The focused history data is relevant to the chief complaint and identified by pertinent positive data documented during the health history.

Address each component of the SOAP note as noted in the written guide with relevant data.

You may continue with the same volunteer to complete each section of the SOAP note.

Click here
 for the 
written guide
 for this Assignment.

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

MN552 Advanced Health Assessment

Unit 2 SOAP Note Section I Written Guide

History, Interview, and Genogram Guide

Date of History/Interview:

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Source of history and Reliability: (client)

Biographical Data

Name (use initials only): W.W.

Address: George street, House no. 4, California

Phone number 305-555-5555

Primary language: speaks English

Authorized representative: her daughter

Age and Date of Birth: 50 y/o, July 15, 1967

Place of Birth: San Diego, California

Gender: female

Race: black

Marital Status: divorced

Ethnic/Cultural Origin: African

Education: master’s in criminology

Occupation/Professional: lecturer

Health insurance: full medical coverage

 

Chief Complaint (reason for seeking health care):

Brief spontaneous statement in client’s own words

“The cough started as a chest cough but it has not been better since my first time visit to the clinic. During the day it doesn’t bother me as much, but during the night I cough a lot. For the last few weeks I have experienced pain in the chest.”

Includes when the problem started

“I started coughing like three months ago. I have undergone treatment from regular hospitals but nothing seems to change.”

History of Present Illness: A well organized, chronological record of client’s reason for seeking care, from time of onset to present. Please include the 8 critical characteristics using the PQRSTU pneumonic.

P – Provocative or palliative

The client states that in most cases room temperature affects her cough, when she feels cold she coughs more. She is also affected by strong smells like perfumes, and states that she cannot sit directly under a fan or air conditioner because the strong wind promotes her cough. MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS.

Q – Quality or quantity

The client feels pain in her chest when she coughs. Her throat is also sore. The cough produces sputum that seems clear.

R – Region or radiation

She only has coughing problem. No other complains.

S – Severity

The severity according to the patient is at 6 out of 10.

T – Timing

She states that when she starts coughing it can last for more than five minutes without stopping. She coughs mostly during the night or when she is irritated by a disturbing smell during the day or even strong wind.

U – Understand Patient’s Perception of the problem

Her fever seems low grade at 100 degrees without chills. After a long conversation with the client she says that she is worried she might have pneumonia. She has not had shortness of breath, she also denies postnasal drip. She has undergone chest X-rays, TB test, and taken many over the counter drugs and home remedies, with no improvement. MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS.

Past Medical History

Medical Hx: major illnesses during life span, injuries, hospitalizations, transfusions, and disabilities.

No other major medical complications, she was diagnosed with diabetes at age 45, present concern is only her cough. hospitalized once for vaginal delivery, no other surgical hx.

Childhood Illnesses: Measles, chickenpox, Mumps, strep throat

Surgical Hx; dates, outpatient, X-rays.

Vaginal delivery on 02/26/1987, Chest X ray 08/15/2017

Obstetric HX:

Only one pregnancy, and one delivery, she gave birth to her daughter who is the only child.no miscarriages or abortion cases.

Immunizations: only as a child, immunization like MMR, Varicella, Tetanus, has not received busters as adult, but last visit to the doctor they gave her the flu shot. Patient states that she does not like getting vaccines.

Psychiatric Hx: no psychiatric conditions reported.

Allergies: allergic to dust

Current Medications: Metformin 500mg BID for diabetes type 2.

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

No eye problem

No foot problem

There are some cavities

No hearing problem

EKG; normal

Chest X-Ray; diffuse wheezes are present bilaterally with expiration. No crackles or bronchi.

Pap test; no cervical cancer

Mammogram; no signs of breast cancer

Serum cholesterol; cholesterol level is at 200

Stool occult blood; no colon cancer

Prostate; not relevant

PSA; not relevant

UA; not collected

TB skin test; not detected

Sickle- cell; no sickle cell disease

PKU; non-applicable

Hamatocrit; 35% – normal

Genogram Three Generation

Section 2

This section has a family medical history as stated by the patient. Patient states that she is currently divorced from her husband whose whereabouts are unknown, prior to divorce he was in good health.  Patient W.W. had one daughter with her ex-husband, she is alive and has history of asthma. Patient narrates that her mother is alive and heathy for her age, her father is deceased, he had a history of heart failure. Her maternal grandmother is alive and overall healthy, just debilitated due to her age, her maternal grandfather had a heart attack and is deceased. Patients   grandmother is alive with arthritis, and her paternal grandfather is alive with diabetes.  On the Ex-husband family side, she knows in his family in his mother’s side his mother is alive and with diabetes, his father alive and with hypertension, his grandmother had a stroke and is deceased, and his grandfather had committed suicide.  On her Ex-husbands fathers side his grandmother alive with diabetes and HTN and his grandfather is alive with prostate issues and diagnosed with BPH. MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS.

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

MN552 Advanced Health Assessment

Unit 3 SOAP Note Section II and III Written Guide

Document appropriate data in the relevant body system.

Do not state “Negative, NA or Unremarkable” for any systems because the reader will not know which questions were actually asked by the provider.

This is a comprehensive health history and should not contain physical exam findings. The focused history data is relevant to the chief complaint and identified by pertinent positive data documented during the health history.

Address each component of the SOAP note as noted in the written guide with relevant data.

You may continue with the same volunteer to complete each section of the SOAP note.

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

Life style patterns

Immigrant status

Spiritual resources/religion

Health perception

Nutritional patterns: Appetite (any changes); satisfaction with current weight; gains or losses; recall of usual intake; any cultural restrictions/intolerances; amount of fluid per day and type

Elimination patterns: Bowel (usual pattern and characteristics); bladder (usual pattern and characteristics); any incontinence

Living environment: City, state; urban, rural, community; type of dwelling, facilities; known exposures to environmental toxins

Occupational health: Known exposure to environmental toxins at work

Functional assessment: ADLs, IADLs, interpersonal relationships/resources (see page 57 in Jarvis textbook)

Role and family relationships: Immediate family composition; how are family decisions made; impact of family member’s health on family

Cognitive function: Memory; speech; judgment; senses

Rest/sleep patterns: Number of hours; naps; number of pillows; any aids for sleep

Exercise patterns: Type and frequency

Hobbies/recreation: Leisure activities; any travel outside of the US

Social habits: Tobacco; alcohol; street drug use

Intimate partner violence (review screening questions on page 58 in the Jarvis textbook)

Coping/stress management: Any major life change in past 2 years; do you feel tense; source; what helps

Sexual patterns: Are you sexually active; gender preference; has anything changed about your sexual health/function

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III. Review of Symptoms
 

 

Symptoms to Inquire About

(please see page 54–56 in Jarvis textbook)

Document pertinent negatives and/or positives

The first system is addressed to provide a guide

General

Wgt Δ; weakness; fatigue; fevers

 

Pertinent negatives
: No weight gain or losses; no weaknesses, fatigue, or fevers

Pertinent positives:
Positive weight gain over past 2 months with fatigue and weakness; no fevers

Skin

Rash; lumps; sores; itching; dryness; color change; Δ in hair/nails

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

Head

Headache; head injury; dizziness or vertigo

Eyes

 

Vision Δ; eye pain, redness or swelling, corrective lenses; last eye exam; excessive tearing; double vision; blurred vision; scotoma

Ears

Hearing Δ; tinnitus; earaches; infections; discharge, hearing loss, hearing aid use

Nose/

Sinuses

Colds; congestion; nasal obstruction, discharge; itching; hay fever or allergies; nosebleeds; change in sense of smell; sinus pain

Throat/

Mouth

Bleeding gums; mouth pain, tooth ache, lesions in mouth or tongue, dentures; last dental exam; sore tongue; dry mouth; sore throats; hoarse; tonsillectomy; altered taste

Neck

Lumps; enlarged or tender nodes, swollen glands; goiter; pain; neck stiffness; limitation of motion

Breasts

Lumps; pain; discomfort; nipple discharge, rash, surgeries, history of breast disease; performs self-breast exams and how often, last mammogram; any tenderness, lumps, swelling, or rash of axilla area

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

Pulmonary

Cough — productive/non-productive; hemoptysis; dyspnea; wheezing; pleuritic pains; any H/O lung disease; toxin or pollution exposure; last Chest x-ray, TB skin test

Cardiac

Chest pain or discomfort; palpitations; dyspnea; orthopnea; edema, cyanosis, nocturia; H/O murmurs, hypertension, anemia, or CAD

G/I

Appetite Δ; jaundice; nausea/emesis; dysphagia; heartburn; pain; belching/flatulence; Δ in bowel habits; hematochezia; melena; hemorrhoids; constipation; diarrhea; food intolerance

GU

Frequency; nocturia; urgency; dysuria; hematuria; incontinence

Females:
Use of kegal exercises after childbirth; use of birth control methods; HIV exposure; Menarche; frequency/duration of menses; dysmenorrhea; PMS symptoms: bleeding between menses or after intercourse; LMP; vaginal discharge; itching; sores; lumps; menopause; hot flashes; post-menopausal bleeding;

Males:
Caliber of urinary stream; hesitancy; dribbling; hernia, sexual habits, interest, function, satisfaction; discharge from or sores on penis; HIV exposure; testicular pain/masses; testicular exam and how often

Peripheral Vascular

Claudication; coldness, tingling, and numbness; leg cramps; varicose veins; H/O blood clots, discoloration of hands, ulcers

Musculo-skeletal

Muscle or joint pain or cramps; joint stiffness; H/O arthritis or Gout; limitation of movement; H/O disk disease

Neuro

Syncope; seizures; weakness; paralysis; stroke, numbness/tingling; tremors or tics; involuntary movements; coordination problems; memory disorder or mood change; H/O mental disorders or hallucinations

Heme

Hx of anemia; easy bruising or bleeding; blood transfusions or reactions; lymph node swelling; exposure to toxic agents or radiation

Endo

Heat or cold intolerance; excessive sweating; polydipsia; polyphagia; polyuria; glove or shoe size; H/O diabetes, thyroid disease; hormone replacement; abnormal hair distribution

 
Unit_3_SOAP_GR

Psych

Nervousness/anxiety; depression; memory changes; suicide attempts; H/O mental illnesses

MN552 Advanced Health Assessment – SOAP Note Section II & III: History of Lifestyle Patterns and Review of Systems ROS

GI Case Study: H. Pylori infection

Questions: As an NP student, needs to determine the medications for recurrent H. Pylori infection.

According to the ACC/AHA Guidelines, what medication should this patient be prescribed? Write her complete prescriptions using the prescription writing format.

ACC/AHA Guidelines

Chief complaint:
 “ I have recurrent H. Pylori infection”.

HPI: 
M.C. a 46-year-old hispanic female presents to the GI clinic for complaint of recurrent H. Pylori infection. She was treated about 2 ½ months ago with H. Pylori triple therapy and failed treatment. She has pmhx of dyspepsia, GERD.

She also indicates that she has noticed that her symptoms of dyspepsia are worsening for past 2 months. She has associated her symptoms with nausea, upset stomach with all foods.

Denies associated symptoms of hematochezia, melena, hemoptysis, abdominal pain, fever, chills, pain or any other symptoms.

PMH:

H. Pylori infection gastritis

Diabetes Mellitus, type 2

Surgeries: None

Allergies
:
 
NKDA

Vaccination History:

She receives an annual flu shot. Last flu shot was this year

Social history:

High school graduate, married and no children. He frequently eats out in restaurants. He drinks one 4-ounce glass of red wine daily. He is a former smoker that stopped 3 years ago.

Family history:

Both parents are alive. Father has history of DM type 2, Tinea Pedis.

mother alive and has history of atopic dermatitis, tinea corporis and tinea pedis.

ROS:

Constitutional: Negative for fever. Negative for chills.

Respiratory: No Shortness of breath. No Orthopnea

Cardiovascular: No edema. No palpitations.

Gastrointestinal: No vomiting. +Dyspepsia. + Nausea. No constipation. No melena. No abdominal pain.

Skin: No lesions. No rash. No itching.

Psychiatric: No anxiety. No depression.

Physical examination:

Vital Signs

Height: 5 feet 5 inches Weight: 140 pounds BMI: 31 obesity, BP 110/70 T 98.0 po P 80 R 22, non-labored

HEENT
: Normocephalic/Atraumatic, PERRL, EOMI; No teeth loss seen. Gums no redness.

NECK
: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement.

LUNGS
: Lungs clear bilaterally. Equal breath sounds. Symmetrical respiration. No respiratory distress.

HEART
: Normal S1 with S2 during expiration. Pulses are 2+ in upper extremities. No edema.

ABDOMEN
: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses.

GENITOURINARY
: No CVA tenderness bilaterally. GU exam deferred.

MUSCULOSKELETAL
: Slow gait but steady. No Kyphosis.

SKIN:
 Dry. Intact.

PSYCH
: Normal affect. Cooperative.

Labs day of visit
:: Hgb 15.2, Hct 40%, K+ 4.0, Na+137, Serum Creatinine normal 1.0, AST/ALT normal. TSH 3.7 normal, glucose 98 normal

A:

Primary Diagnosis: Recurrent H. Pylori infection gastritis

Secondary Diagnoses:

Dyspepsia

Differential Diagnosis:

Peptic Ulcer Disease

Previous medication plan:
 
two months ago and failed.

Clarithromycin 500 mg po BID for 2 weeks

Omeprazole 40 mg po BID for 2 weeks and then po daily.

Cipro 500 mg po BID for 2 weeks

Plan: Tests

Pt had EGD done 2 weeks ago that showed H. Pylori positive gastritis in biopsy results.

Urea breath test 8 weeks after treat with H. Pylori medications. Pt needs to stop PPI’s 2 weeks prior to Urea Breath test.

Labs: 
No new labs are needed.

Referrals
: may refer based on effect of medication therapy given for 2 weeks.

Follow up
: return to office in 8 weeks to reevaluate her symptoms.

GI Case Study: H. Pylori infection

Putting it all together

Objectives:

By the end of this week you will be prepared to make a proposal to transform an organization to one that is more strategic, using the outside in approach. In addition you will include metrics to evaluate the success of the HR function and display a time line for the implementation of the transformation plan.

Watch:

ULRICH: Accountability and Change (You Tube)

Read:

Steen, A., & Welch, D. (2011). Are Accounting Metrics Applicable to Human Resources? The Case of Return on Investment in Valuing International Assignments. Australasian Accounting Business & Finance Journal, 5(3), 57-72.

Article PDF

 

Activity #1

a)   Select three metrics that you will use in your final paper to measure the effectiveness of the HR programs at the end of the transformation you will design.

b) Share with the class why you have selected the metrics you did.

Interact with at least two students this week.

You should use at least one reference.

Economics in Healthcare Essay Paper

Part I

Consider the four health plans below with an eye to choosing one to offer to the company’s employees. Assume that the health plans and their annual per employee premiums are as follows:

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Health Plan

Premium, Individual

Premium, Family

Aetna Health $4,555                           $11,428

MetroPlus $4,267                           $10,540

Empire        $4,217                           $10,767

Oxford        $6,029                           $13,417

The employer will pay 80% of the premium for individual coverage, and the employee will pay the remaining 20% as well as the entire additional premium for family coverage. (The premiums listed above, while realistic in magnitude, are hypothetical and computed solely for the purpose of this project.) All of the plans are managed care plans. Assume that the benefit package is the same across all plans, so there is no difference between them in what services are covered.

In addition to the above data, click 
here
(
https://www.health.ny.gov/health_care/managed_care/reports/quality_performance_improvement.htm#link3)
 to access the latest report for ‘Health Plan Comparison in New York State’. Review the online report and incorporate relevant information into your evaluation.

You can view the various categories of measures on which health plans are rated (e.g., Access to Care, Adult Living with Illness, etc.). Click each link for a summary chart that presents the performance (usually as a percentage score) of each plan in the group on the relevant measures and how each plan compares to regional and statewide scores.

Provide an analysis that outlines the plan you selected and why. Generally, you would select the plan with the highest score, but if you chose a plan with a lower score, explain why. Include the following elements in your analysis
:

· 
Explain which factors (e.g., price and/or performance measures) were most important to your choice of plan and how you derived the weights for each factor you used.

· 
Indicate, on a scale of 1 to 10, how comfortable or confident you are that you made the right choice, with 10 being most confident.

Part II

You need to use the multi-attribute utility (MAU) technique to respond to the following questions. Although the technique can be performed with pencil and paper, it is recommended you use a Microsoft Excel to do the various calculations involved.

Click the following links to access the information on using the MAU technique:

· 
MAU Model

· 
MAU Example

· 
Compare your level of confidence at the time you completed Part I to your confidence level for Part II, when you used this decision aid.

· 
Was it helpful? What were its advantages and disadvantages?

Did it make the decision harder to make or easier to justify?

Resource:

SU_HCM3002_W4_A2_MAU_model1

SU_HCM3002_W4_MAUexample

Hahn, W.J., Seaman, S.L., & Bikel, R. (2012). 
Making decisions with multiple attributes.
 Retrieved from http://gbr.pepperdine.edu/2012/08/making-decisions-with-multiple-attributes-a-case-in-sustainability-planning/.

Economics in Healthcare Essay Paper

Case Study: Fetal Abnormality & Moral Theories – Jessica, Marco, Maria, and Dr. Wilson

Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the U.S. for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant. Case Study: Fetal Abnormality & Moral Theories – Jessica, Marco, Maria, and Dr. Wilson.

Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted and it is determined that the fetus has a rare condition in which it has not developed any arms, and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.

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Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud. Case Study: Fetal Abnormality & Moral Theories – Jessica, Marco, Maria, and Dr. Wilson.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis, and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears. Case Study: Fetal Abnormality & Moral Theories – Jessica, Marco, Maria, and Dr. Wilson.

PHI-413V-RS-T2CaseStudy1

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes, but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place, and urges Jessica to think of her responsibility as a mother. Case Study: Fetal Abnormality & Moral Theories – Jessica, Marco, Maria, and Dr. Wilson.

PHI-413V – Case Study: Fetal Abnormality

Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the U.S. for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.

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Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted and it is determined that the fetus has a rare condition in which it has not developed any arms, and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome. PHI-413V – Case Study: Fetal Abnormality.

Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.

Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis, and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears. PHI-413V – Case Study: Fetal Abnormality.

Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes, but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place, and urges Jessica to think of her responsibility as a mother. PHI-413V – Case Study: Fetal Abnormality

Research Proposal Draft – Health Care

People will often judge others not just on the answer that is provided but also the question that is asked. Since we can’t always get the answer right, we should try to at least get the question right!  So in this humbled researcher’s opinion, the most relevant question for a nurse practitioner is very important.  The question is: how can we elevate the level of health care in the United States and potentially the entire world while containing costs and effectively supply the voracious and ever growing need for compassionate, competent, and effective health care workers. This should also be accomplished as we fill the need for elevating the suboptimal work conditions, addressing the lack of respect, increasing the sub optimal remuneration, that advanced nurse practitioners are forced to endure on a daily basis.

The problem: Nurse practitioner are often bright, motivated, and talented individuals who are patient and just wanted to help the infirmed while making a career for themselves, which is barely possible in “todays climate”.

The cause: Bright students are often pigeoned hole out of having the opportunity to attend medical schools by an antiquated and unfair school system in the United States. This system unfortunately often weeds out very talented and passionate individuals. I believe that schools from the very early ages are teaching many outdated concepts and use very tricky, sneaky, and unfair testing practices and questions.  These schools waste a lot of time teaching out dated concepts and facts.  Our world and has change so much yet schooling is locked into teaching many of the same concepts it did a hundred years ago while often ignoring more important concepts such health and cancer related topics as well as finances.  Unfortunately, the teachers and their unions resist change and show no willingness to correct this because they are resistant to change, challenges, and learning themselves.  It reminds me of a parallel to the auto industry and their reluctance accept electric vehicles. As a result, many excellent people lose the opportunity to attend medical school or veterinary schools. Those who manage to navigate into the medical school system then are at risk of suffering form human arrogance and entitlement. As such, others ” less fortunate” are at risk of being treated as substandard in terms of pay, respect, decision making abilities granted, and just about every other right has been diminished (Consumer Report, March 2018, p. 48-57). Research Proposal Draft – Health Care.

But the question still lingers, can bright, compassionate, and intelligent, advanced nurse practitioners provide adequate health care to the masses as well or better than physician and the current system in place? The answer is yes! In fact, I would argue that physician to are under paid and over worked as our politicians and lawyers squander away our national dollars. Doctors no longer have the time to properly attend the needs of all of their patients as their salaries are constantly being lowered and their duties expanded on an almost daily basis. This gap is perfect for the advanced nurse practitioner to fill as our population expands. Additionally, it much less time consuming for our graduate schools to crank out an effective advanced nurse practitioner than a doctor. Physicians unfortunate loose so many years in non clinical classrooms learning antiquated facts and concepts due to a resistance for change on the behalf of the medical school system and it’s arrogant and self serving teachers associations. I guess maybe they still haven’t realized that the age of Google, electric cars, led lighting, robotic surgical equipment and advanced space travel is upon us and change is growth (Consumer Report, March 2018, p. 48-57).

In The Null Hypothesis a researcher tries to nullify, disprove, or reject, a hypothesis. The hypothesis the that an advanced nurse practitioner is inadequate for managing a patent is wrong and ca not be supported intelligently in this researcher’s humble opinion (Consumer Report, March 2018, p. 48-57).

The operational variables involved in determining the effectiveness and appropriateness of having a nurse practitioner, play an important role on the healthcare team, in decision making, and in complete having complete autonomy in managing a patient’s care are multiple.  Fortunately, studies have addressed these which can include: Patient satisfaction, improvement in health status, cost containment, availability of medical care. A recent article from consumers reports and others have revealed that nurse practitioners as well as physician’s assistants fill a crucial and vital role in the healthcare system and can adequately replace a physician especially when working with physician oversight, for many of the daily health care needs of many individuals in the United states (Consumer Report, March 2018, p. 48-57)(Ljungbeck & Sjögren Forss, 2017).

“Success of the MOQI model reinforces decades of research demonstrating that care provided by APRNs is cost-effective, safe, and associated with positive health outcomes and patient satisfaction” (Rantz , Birtley , Flesner , Crecelius , & Murray, Nov 2017). Research Proposal Draft – Health Care.

 

References

Consumer Report. (March 2018). The ___ will see you now.
CR.ORG
, 48-57.

Ljungbeck , B., & Sjögren Forss , K. (2017). Advanced nurse practitioners in municipal healthcare as a way to meet the growing healthcare needs of the frail elderly: a qualitative interview study with managers, doctors and specialist nurses. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/29176932. Research Proposal Draft – Health Care.

Rantz , M. J., Birtley , N. M., Flesner , M., Crecelius , C., & Murray , C. (Nov 2017). Call to action: APRNs in U.S. nursing homes to improve care and reduce costs. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/28993075. Research Proposal Draft – Health Care.

How to write a literature review

Literature review  definition

The literature review format may vary from one discipline to another as well as from one assignment to another.

A literature review may be a self-contained unit – an end in itself – or a preface to and rationale for engaging in primary research. A review is a required part of grant and research proposals and often a chapter in theses and dissertations.

Generally, the purpose of a review is to analyze critically a segment of a published body of knowledge through summary, classification, and comparison of prior research studies, reviews of literature, and theoretical articles.

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How to write a literature review introduction

In the introduction of the literature review, you should:

Define or identify the general topic, issue, or area of concern, thus providing an appropriate context for reviewing the literature.

Point out overall trends in what has been published about the topic; or conflicts in theory, methodology, evidence, and conclusions; or gaps in research and scholarship; or a single problem or new perspective of immediate interest.

Establish the writer’s reason (point of view) for reviewing the literature; explain the criteria to be used in analyzing and comparing literature and the organization of the review (sequence); and, when necessary, state why certain literature is or is not included (scope).

How to write the body of the literature review?

In the literature review body, you should:

Group research studies and other types of literature (reviews, theoretical articles, case studies, etc.) according to common denominators such as qualitative versus quantitative approaches, conclusions of authors, specific purpose or objective, chronology, etc.

Summarize individual studies or articles with as much or as little detail as each merits according to its comparative importance in the literature, remembering that space (length) denotes significance.

Provide the reader with strong “umbrella” sentences at beginnings of paragraphs, “signposts” throughout, and brief “so what” summary sentences at intermediate points in the review to aid in understanding comparisons and analyses.

Writing the literature review conclusion

In the conclusion of the literature review, you should:

Summarize major contributions of significant studies and articles to the body of knowledge under review, maintaining the focus established in the introduction.

Evaluate the current “state of the art” for the body of knowledge reviewed, pointing out major methodological flaws or gaps in research, inconsistencies in theory and findings, and areas or issues pertinent to future study.

Conclude by providing some insight into the relationship between the central topic of the literature review and a larger area of study such as a discipline, a scientific endeavor, or a profession. How to write a literature review.