Category: Nursing

Application: Taking a Stand

Effective leaders have a high degree of self-awareness and know how to leverage their strengths in the workplace. Assessments are a valuable tool that professionals can use to learn more about themselves and consider how their temperament and preferences influence their interactions with others.

As you engage in this learning process, it is important to remember that everyone—regardless of temperament type or related preferences—experiences some challenges with regard to leadership. The key to success is being able to recognize and leverage your own strengths while honoring differences among your colleagues.

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At some point in your leadership career, you will encounter an ethical or moral dilemma that requires you to take a stand and defend your position. Application: Taking a Stand.

For this Assignment, you evaluate an issue and consider how you could act as a moral agent or advocate, facilitating the resolution of the issue for a positive outcome.

To prepare:

·        Consider the examples of leadership demonstrated in this week’s media presentation and the other Learning Resources. Application: Taking a Stand.

·        To further your self-knowledge, you are required to complete the Kiersey Temperament as indicated in this week’s Learning Resources. Consider your leadership style, including your strengths for leading others and include your results from Kiersey Temperament Sorter to describe potential challenges related to your leadership style.

·        Mentally survey your work environment, or one with which you are familiar, and identify a timely issue/dilemma that requires you to perform the leadership role of moral agent or advocate to improve a situation (e.g., speaking or acting on behalf of a vulnerable patient, the need for appropriate staffing, a colleague being treated unfairly). Application: Taking a Stand.

·        What ethical, moral, or legal skills, dispositions, and/or strategies would help you resolve this dilemma? Define the differences between 
ethical, moral, and legal leadership.

·        Finally, consider the values and principles that guide the nursing profession; the organization’s mission, vision, and values; the leadership and management competencies addressed in this course; and your own values and reasons for entering the profession. What motivation do you see for taking a stand on an important issue even when it is difficult to do so? Application: Taking a Stand.

To complete:

Write a 4 to 5 page paper (page count does not include title and reference page) that addresses the following:

·        Introduce the conceptual frameworks of the ethical constructs of ethics, moral, or legal standards and the purpose of the Application: Taking a Stand paper.

·        Consider  an ethical, moral, or legal dilemma that you have encountered in your work environment and describe it.

·        Analyze the moral, ethical, and legal implications utilized in this situation. Describe your role as a moral agent or advocate for this specific issue.

·        Consider your leadership styles identified by your self-assessment and determine if they act as a barrier or facilitation during this dilemma.

Self Assessment results

Guardians (SJ’s)
are the cornerstone of society, for they are the temperament given to serving and preserving our most important social institutions. Guardians have natural talent in managing goods and services–from supervision to maintenance and supply — and they use all their skills to keep things running smoothly in their families, communities, schools, churches, hospitals, and businesses Application: Taking a Stand.

Guardians can have a lot of fun with their friends, but they are quite serious about their duties and responsibilities. Guardians take pride in being dependable and trustworthy; if there’s a job to be done, they can be counted on to put their shoulder to the wheel. Guardians also believe in law and order, and sometimes worry that respect for authority, even a fundamental sense of right and wrong, is being lost. Perhaps this is why Guardians honor customs and traditions so strongly — they are familiar patterns that help bring stability to our modern, fast-paced world.

Practical and down-to-earth, Guardians believe in following the rules and cooperating with others. They are not very comfortable winging it or blazing new trails; working steadily within the system is the Guardian way, for in the long run loyalty, discipline, and teamwork get the job done right. Guardians are meticulous about schedules and have a sharp eye for proper procedures. They are cautious about change, even though they know that change can be healthy for an institution. Better to go slowly, they say, and look before you leap.

Guardians make up as much as 40 to 45 percent of the population, and a good thing, because they usually end up doing all the indispensable but thankless jobs everyone else takes for granted.

You are most comfortable when your life is structured. As a result you usually prefer a workplace that lets you create a routine you can settle into. Because you are dependable and exacting, your colleagues and customers rely on your work. Your ideal job offers you a clear chain of command, and lets you progress through a hierarchy based on your meeting expectations Application: Taking a Stand.

The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.

 Course Readings

·        Marquis, B. L., & Huston, C. J. (2015). 
Leadership roles and management functions in nursing: Theory and application
 (8th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

o   Chapter 4, “Ethical Issues”

This chapter examines ethical frameworks for decision making and principles of ethical reasoning. You are also introduced to the ANA Code of Ethics and Professional Standards, MORAL decision-making model, and ethics committees. Application: Taking a Stand.

o   Chapter 5, “Legal and Legislative Issues”

Chapter 5 provides an overview of the many legal and legislative issues of which leaders and managers need to be aware. As you read this chapter, keep these issues in mind.

o   Chapter 6, “Patient, Subordinate, and Professional Advocacy”

Nurses are the best advocates for patients and the profession. This chapter examines more closely the role of becoming an advocate, patient rights, subordinate advocacy, whistle-blowing, professional advocacy, advocacy in legislation and public policy, and media.

·        Cianci, A. M., Hannah, S. T., Roberts, R. P., & Tsakumis, G. T. (2014). The effects of authentic leadership on followers’ ethical decision-making in the face of temptation: An experimental study. 
The Leadership Quarterly
, 
25
(3), 581-594. doi:10.1016/j.leaqua.2013.12.001

Abstract excerpt: The present research investigates the impact of authentic leadership on followers’ morality, operationalized as ethical decision-making, in the face of temptation. This experiment finds that authentic leadership and temptation interacted to affect individuals’ ethical decision-making. Specifically, authentic leadership significantly inhibited individuals’ from making unethical decisions in the face of temptation, whereas followers of neutral or less authentic leaders were more likely to succumb to temptation. Application: Taking a Stand.

·        Disch, J. (2014). Using Evidence-Based Advocacy to Improve the Nation’s Health. 
Nurse Leader
, 
12
(4), 28-31. doi:10.1016/j.mnl.2014.05.003

Abstract excerpt: Evidence-based practice is 1 of the 5 competencies that the Institute of Medicine has identified for all health professionals. Its intent is to employ evidence-based practice and integrate best research results, clinical expertise, and patient values to make patient care decisions. Application: Taking a Stand. This article will explore the concept of evidence-based advocacy and describe ways in which one prominent nursing organization, the American Academy of Nursing, uses evidence-based advocacy to positively impact the nation’s health and advance the nursing profession

·        Martin, M. B. (2014). Transcultural Advocacy and Policy in the Workplace: Implications for Nurses in Professional Development. 
Journal for nurses in professional development
, 
30
(1), 29-33.  doi: 10.1097/NND.0000000000000027

Abstract: This article introduces the role of nursing professional development specialists in serving as a resource for both patient and staff advocacy regarding cultural and linguistic matters. The impact of changing demographics, support for civil rights, and established policy related to culture and linguistics is emphasized. An overview of policy at local, state, and national levels is suggested to promote nursing professional development in the interest of culturally and linguistically compliant nursing practice. Application: Taking a Stand.

·        Woods, M. (2014). Beyond moral distress preserving the ethical integrity of nurses. 
Nursing Ethics
, 
21
(2), 127-128.

This guest editorial discusses the difficulties involved in dealing with those sometimes-painful moral problems encountered in practice. Application: Taking a Stand.

ccmh 551 week 5 client termination and evaluation reflection sample essay

Client Termination and Evaluation Reflection

Termination should be discussed at the same time the goals are being created so that the client understands the process of the relationship and the realization that this is not a forever relationship sets in. Once the client has adapted to the processes and utilizes the interventions to better themselves and is successful at it, then the job of the counselor is over, and termination of the relationship must be implemented.

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The process of terminating the counselling relationship is the official term employed when a therapist and a client stop working together. I would think it could be a rather difficult time for both myself the counselor and the client, due to the emotional state of mind that comes when all things end, good or bad. It may, stir perhaps the feelings of past loss and preceding endings for both client and counselor. Termination may also represent time of positive replication and a feeling of achievement by reviewing the work accomplished together. Additionally, some healing about previous losses and/or conclusions might well be achieved when these sentiments and prior occurrences are brought out into the light of day ccmh 551 week 5 client termination and evaluation reflection sample essay.

I think that termination can and will end with mixed emotions on both ends of the spectrum. On the positive side, with some patients, as we discuss and review the work we have completed together, I am sure I will see some amazing changes that have taken place inside this relationship that will truly amaze me and leave me and the client feeling gratified. Once you have reached the clients goals termination is a must, to keep the relationship viable after that point is a disservice to the client and is unethical on the part of the counselor.

Thinking about parallel processing, I suspect that is just a part of the difficulty in saying good-bye to clients, it will represent the reflection of the feelings shared between the client and myself. I assume it will be very hard for me to part from some of my future patients, and undoubtedly I will always wonder where there are in their lives and if I truly made the difference for them.  Finally, after all I have read, I have come to believe that termination might also be viewed as a new beginning and not so much an ending.  I will try in future endeavors to view client’s as graduating to a point where they no longer need therapy, or perhaps they are moving on to a relationship with a new therapist of which can provide a service outside the scope of my abilities.

Without regard of what the new foundation might be, I believe that we both will certainly grow and transform from the distinct therapeutic bond that developed between us. No matter how it all plays out in the future I will be forever grateful to those first few clients that allowed me to be a partner on their journey. ccmh 551 week 5 client termination and evaluation reflection sample essay.

References

Hackney, Harold, and L. Sherilyn Cormier. 
The Professional Counselor: A Process Guide to Helping
. Boston, Mass: Allyn & Bacon, 1996 ccmh 551 week 5 client termination and evaluation reflection sample essay.

Critiquing a Change Effort

As a nurse leader, you need to have the skills and knowledge to collaborate and communicate with those who plan for and manage change. This capacity is valuable in any health care setting and for many different types of change. Furthermore, it is essential to be able to evaluate a change effort and determine if it is promoting improved outcomes and making a positive difference within the department or unit, or for the organization as a whole.

To prepare:

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· Review Chapters 7 and 8 in the course text. Focus on the strategies for planning and implementing change in an organization, as well as the roles of nurses, managers, and other health care professionals throughout this process Critiquing a Change Effort.

· Reflect on a specific change that has recently occurred in your organization or one in which you have worked previously. What was the catalyst or purpose of the change?

· How did the change affect your job and responsibilities?

· Consider the results of the change and whether or not the intended outcomes have been achieved.

· Was the change managed skillfully? Why or why not? How might the process have been improved? Critiquing a Change Effort.

By Day 3

Post 
a summary of a specific change within an organization and describe the impact of this change on your role and responsibilities. Explain the rationale for the change, and whether or not the intended outcomes have been met Critiquing a Change Effort. Assess the management of the change, and propose suggestions for how the process could have been improved.

Learning Resources

Required Readings

Marquis, B. L., & Huston, C. J. (2017). 
Leadership roles and management functions in nursing: Theory and application 
(9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Review Chapter 7, “Strategic and Operational Planning”

· Chapter 8, “Planned Change”

 

This chapter explores methods for facilitating change and the theoretical underpinnings of implementing effective change. Critiquing a Change Effort.

McAlearney, A., Terris, D., Hardacre, J., Spurgeon, P. Brown, C.,  Baumgart, A.,  Nyström, M. (2014). Organizational coherence in health care organizations: Conceptual guidance to facilitate quality improvement and organizational change. 
Quality Management in Health Care, 23
(4), 254–267 doi: 10.1097/QMH.0b013e31828bc37d

An international group of investigators explored the issues of organizational culture and Quality Improvement (QI) in different health care contexts and settings. The aim of the research was to examine if a core set of organizational cultural attributes are associated with successful QI systems. Critiquing a Change Effort.

Mitchell, G. (2013). Selecting the best theory to implement planned change. 
Nursing Management – UK
, 
20
(1), 32–37. doi: 10.7748/nm2013.04.20.1.32.e1013

Retrieved from the Walden Library databases.

Shirey, M. R. (2013). Lewin’s Theory of Planned Change as a strategic resource. 
The Journal of Nursing Administration
, 
43
(2), 69–72. doi:10.1097/NNA.0b013e31827f20a9

Retrieved from the Walden Library databases.

Required Media

Laureate Education (Producer). (2012g). 
Organizational dynamics: Planned change and project planning.
Baltimore, MD: Author. Critiquing a Change Effort.

Optional Resources

Marquis, B. L., & Huston, C. J. (2017). 
Leadership roles and management functions in nursing: Theory and application 
(9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

· Chapter 9, “Time Management”

Batras, D., Duff, C., & Smith, B. J. (2014). Organizational change theory: implications for health promotion practice. 
Health Promotion International
,
 Retrieved from MEDLINE with Full Text
, EBSCO
host Critiquing a Change Effort

This article reviews select organizational change models to identify the most pertinent insights for health promotion practitioners Critiquing a Change Effort.

Treatment of Paranoid Personality Disorder sample essay

Treatment of a Personality Disorder

Paranoid Personality Disorder

The following paper is to include a discussion of Paranoid Personality Disorder (PPD) by applying the major theories of personality, and the problems and impacts associated with this disorder on both a normal and abnormal development scale as it pertains this personality theory. This disorder will be analyzed through literary review using evidence-based counseling strategies that are related to the intervention or the prevention efforts accompanied by PPD Treatment of Paranoid Personality Disorder sample essay. A critique of the reviewed research will discuss what can be learned about this specific disorder as well as what should be further researched to continue the advancement of potential interventions which could sustain the symptoms and ultimately give sufferers a level of functionality. Further discussion will involve how this research can advance the profession of mental health counseling, counselors and clinicians. The conclusion of this paper will entail the application of the theory in treatment by providing a justification for specific treatment models, per current research within the domain of PPD. A detailed description of interventions that are associated with PPD will be demarcated, and the current shortcomings that exist in the future study arenas that may pertain to areas such as cultural, gender, race, socioeconomic and immigrant status. Treatment of Paranoid Personality Disorder sample essay.

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Discussion

Paranoid Personality Disorder is a Cluster A personality type and it is diagnosed by seven (7) major criteria. The Diagnostic and Statistical Manuel states the disorder numerically as 301.0 (F60.0). The populations vary across race, gender, culture, socioeconomic class and immigration status. PPD occurs in the general population at the rate of 4.4%, and is more prevalent in the homeless population occurring at the rate of 13%. It is more prevalent in males than females, and can be a precursor to other disorders if untreated Treatment of Paranoid Personality Disorder sample essay.  The disorder is usually identified in young adults and exists in an array of situations, specified using four (4) or more of the listed symptoms below:

Suspicion without adequate proof, that people are manipulating, hurting or misleading them.

Obsession with unwarranted doubts about the loyalties or ability to trust friends, family and acquaintances.

Unwillingness to disclose information to others, due to unwarranted fears that such dialogue will be used against them maliciously.

Finds hidden connotations or intimidating connotations into benevolent comments or happenings.

Is unable to forgive any insults, grievances or rebuffs and holds onto a grudge.

Sees attacks on character or status that no one else can see and is swift to counterattack with anger.

Maintains regular suspiciousness without proper justifications about partner or spouse fidelity (DSM V, 2013. P649). Treatment of Paranoid Personality Disorder sample essay.

The nature of PPD usually appears in early adulthood at a time when most people are entering the workforce, and they can appear normal in certain settings with people whom they are not familiar. On certain levels of function, they tend to have normal psychology by being viewed as self-reliant, independent and focused, with a strong presence of autonomy (Lenzenweger 2015). They can also be perceived as the strong quiet type, with leadership qualities. But after a bout of inability to collaborate with others, and the strong need to control their environment and the people around them, this illusion dissipates rather quickly (DSM V, 2013. P650).

Whereas in the abnormal psychology they are secretive, quick to anger, distrusting and view the world and people around them as all having hidden agendas to cause them harm either physically, mentally or emotionally Treatment of Paranoid Personality Disorder sample essay. They have a deep distrust of others and rarely seek out mental health services, believing it is not them who have the problem it is everyone else. Another generally difficulty is that those who suffer from PPD find it hard to maintain close interpersonal relationships (DSM V, 2013. P652). They do not get along with others, and because of their hypervigilance tend to be argumentative, have reoccurring complaints about others or on the other end of the spectrum can appear quiet with apparent hostile aloofness. Within the abnormal frame of PPD, these individuals can also seem cold and standoffish with a lack of tender feelings for anything (Edens, 2013) Treatment of Paranoid Personality Disorder sample essay. They act guarded and secretive, and display devious mannerisms, which nearly all their worry comes from ill perceived notions that the world is out to get them. People who suffer from this disorder will look for ways to prove themselves right about others and their intentions (Ahktar, 2014).

Literature Review – Analyzing Evidence-based Interventions & Preventions

           
Preventing PPD is nearly impossible due to the nature of the disorder and its eruption time of early adulthood (Bernstein, 2015). With a predisposition, genetically and the innumerous social, environmental and interpersonal outcomes of every possibility giving regard to upbringing, social status, geographic local etc. It would be a very elusive game of cat and mouse to try to pinpoint cause let alone every prevention (Fulton, 2013).

The interventions however, tend to be positive, if one could build the trust of the client troubled with this disorder. Once trust is established there are several therapies that have worked successfully on PPD. Dialectical Behavior Therapy, Cognitive Behavior Therapy and Client Centered Approach therapy are the most common therapies utilized for the treatment of this personality disorder. All therapist, counselors and clinicians who have communication with clients who suffer from PPD need to maintain a clearly conscious state of being straight-forward with these clients (Hoermann, 2013). Treatment of Paranoid Personality Disorder sample essay Indirect witticisms are more times than not lost on them. References to data about the client not obtained directly from their mouth will increase an excessive deal of suspiciousness. Counselors need to naturally evade trying to have the client sign a release of information (ROI) for info not vital to the present treatment. Situations in life that typically would not give the majority individuals a second thought will simply become part of the focus of attention to these patients, much care must be exerted in dialogues with these particular clients (Dombeck, 2013). An authentic, black and white tactic will more than likely advance the maximum results, concentrating on present life worries which brought the patient into treatment to begin with.

Application of Theory in Treatment

Treatment Justification

The justification of the treatment process in the peer-reviewed articles all portrayed a common theme of isolating other possible conditions before moving forward with specific treatment plans. Most of the subjects studied were in mental health institutions and were monitored over increments of time ranging from 6 months to 1 year (Cramer, 2016). All the articles stated that the building of trust between client and clinician was a first and foremost stipulation to being able to move forward with a treatment plan (Hardy, 2014). A duality of common perceptions among immigrants and minorities was noted, attributing these behaviors as normal within their contexts because of the cultural divides between their cultures and that of the majority cultural within the United States. It is normal for minority cultures to harbor suspiciousness toward the dominate white culture, and this validates their insecurities with barriers to language, culture, socioeconomic and social status in an unfamiliar context (Demarce, 2017). Treatment of Paranoid Personality Disorder sample essay.

Interventions

Short Term Goals for Individuals with Paranoid Disorder:

Client will display levels of a trusting dialogue while communicating with clinician by disclosing emotions and principles.

Classify then document the persons or entities that client distrusts then document why.

Client will show agreeability by cooperating with the clinician by exploration of feelings of susceptibility.

Classification and exploration of historical foundations for the why they feel vulnerable.

Recognize then document clients perceived principles that other people are unable to be trusted and are evil.

Give referral so client can obtain a full psychiatric assessment.

Screen any prescription meds client is prescribed and detail any observed side effects.

Complete a full psychological assessment to measure clients level of obsession.

Make a referral to have a neuro-psychological assessment to cancel out client may suffer from an biological etiology. Treatment of Paranoid Personality Disorder sample essay.

Mirror any oral assembly among fear of others and the clients own feeling of insufficiency.

Decrease allegations about other people plotting to cause harm.

Client will demarcate an improved trustworthiness in others and within the communal setting.

Demarcate trustworthiness of spouse and others, then can move toward a relaxing state while in their company.

Raise societal interactions by eradicating distress or distrust being conveyed (Verheul, 2012).

Long Term Goals for Individuals with Paranoid Disorder:

Learn to trust in others by talking positively about others and report an ease when being social.

Become involved within community and interrelate with other people without becoming self-protective or irritated.

Feel trust of significant other and stop allegations of unfaithfulness.

Decrease caution and doubt around other people, increase relaxation, trust, and be more open to interaction with others.

Achieve a sense of aptitude to think on more significant matters without any intrusion from mistrustful fixations Treatment of Paranoid Personality Disorder sample essay.

Standard suitable effectiveness at place of employment, within community relations with only nominal intrusion from suspicious preoccupations (Raza, 2017).

Current intervention gaps

The current gaps that exist within the scope of PPD are varied and numerous. Because suffers do not usually seek out treatment the study numbers are small and outdated. More research into this disorder is needed to determine if possible links between populations exists. Another area of the population that tends to display this disorder is the prison population, and link between this disorder and crime has been noted but requires further probing to result in adequate research. The link between childhood abnormal treatment and adulthood suffering of PPD is too noted but not researched enough to draw a viable conclusion.

Cultural & Immigrant Status

Cultural behavior among immigrants and minority groups does mimic PPD, but most cases are dismissed as having PPD, due to the overwhelming similarity of symptoms without etiology. It is a culture-related norm to be suspicious of the majority culture, and barriers such as language, lack of knowledge of cultural norms and rules, and political acceptance all play a part in the normal development of suspicion within these groups (Raza, 2015).

Socioeconomic

           
The research indicates a higher number of individuals from lower class to lower middle class suffer from PPD. Evidence that this occurs in upper class is relevant but these suffers tend to have family and means to suppress the diagnosis formally and therefore they are able to go undetected throughout society (Raza, 2015).

 

Gender

           
PPD tends to afflict men over women 3:1. It is inconclusive as to why, but research has shown that women are more likely to seek out help for conditions that afflict them than men are (Raza, 2015).

Conclusion

This paper included a discussion of Paranoid Personality Disorder (PPD) by applying the major theories of personality, and the problems and impacts associated with this disorder on both a normal and abnormal development scale as it pertains this personality theory. This disorder was analyzed through literary review using evidence-based counseling strategies that are related to the intervention and/or the prevention efforts accompanied by PPD. A critique of the reviewed research was discussed and what could be learned about this specific disorder as well as what should be further researched to continue the advancement of potential interventions which could sustain the symptoms and ultimately give sufferers a level of functionality. A brief discussion of how this research evolved, and how this research could advance the profession of mental health counseling, counselors and clinicians. While concluding this paper, it entailed the application of the theory in treatment by providing a justification for specific treatment models, per current research within the domain of PPD. A detailed description of interventions that are associated with PPD were demarcated, and the current shortcomings that exist in the future study arenas that may pertain to areas such as cultural, gender, race, socioeconomic and immigrant status were noted and addressed.

 

References

Ahktar, S. (2014). Paranoid personality disorder: A synthesis of developmental, dynamic and descriptive features. American Journal of Psychotherapy, 44, 5–25

Bernstein, D.P., & Useda, J. (2015). Paranoid personality disorder. In: W. O’Donohue, K. Fowler, & S. Lilienfeld (Eds). Personality disorders: Toward the DSM-V. Thousand Oaks, CA: Sage

Cramer, V., Torgersen, S., & Kringlen, E. (2016). Personality disorders and quality of life. A population study. Comprehensive Psychiatry, 47, 178–184 Treatment of Paranoid Personality Disorder sample essay.

Dialectical Behavior Therapy for Personality Disorders (DBT)

SIMONE HOERMANN, PH.D., CORINNE E. ZUPANICK, PSY.D. & MARK DOMBECK, PH.D. DEC 6, 2013

Edens, J.F., Marcus, D.K., & Morey, L.C. (2013). Paranoid personality has a dimensional latent structure: Taxometric analyses of community and clinical samples. Journal of Abnormal Psychology, 118, 545–553

Fulton M, Winokur G.A comparative study of paranoid and schizoid personality disorders. Am J Psychiatry 2013; 150:1363–1367.

Hackney, H., & Cormier, L. S. (1996). 
The professional counselor: A process guide to helping
. Boston, Mass: Allyn & Bacon.

Hardy, Gillian. & Kellet, Stephen. Clinical Psychology and Psychotherapy Clinical Psychology Psychotherapy 21, 452–464 (2014) Published online 3 June 2013 in Wiley Online Library (wileyonlinelibrary.com). Treatment of Paranoid Personality Disorder sample essay.

Lenzenweger, M. F., Lane, M. C., Loranger, A. W., & Kessler, R. C. (2015). DSM-IV personality disorders in the national comorbidity replication. Biological Psychiatry, 62, 553–564. doi:10. 1016=j.biopsych.2017.04.19

RAZA GINA, DEMARCE JOSEPHINE M., LASH STEVEN J., & PARKER JEFFERSON D. Journal of Ethnicity in Substance Abuse, 13:247–257, 2014 ISSN: 1533-2640 print=1533-2659 online retrieved from http://web.b.ebscohost.com.contentproxy.phoenix.edu/ehost/pdfviewer/pdfviewer?sid=b4edf5ab-02ab-46b4-a5cc-7fe07ebdb0cb%40sessionmgr101&vid=1&hid=130

Verheul, R. (2012). Treatment of Paranoid Personality Disorder sample essay Clinical utility of dimensional models for personality pathology. Journal of Personality Disorders, 19, 283–302. doi:10.1521=pedi.2017.19.4.283

Shadow health respiratory assessment transcript Pre Brief

Tina had an asthma episode 2 days ago. At that time she used her albuterol inhaler and her symptoms decreased although they did not completely resolve. Since that incident she notes that she has had ten episodes of wheezing and has shortness of breath approximately every four hours. Tina presents with continued shortness of breath and wheezing. Be sure to ask pertinent questions during the interview about related body systems. This case study will provide the opportunity to carefully assess lung sounds during the physical examination. Be sure to appropriately document your findings using correct medical terminology.

Reason for visit: Patient presents complaining of a recent asthma episode that is not fully resolved.

NB:
We have all the questions and documented answers as listed and attached below. All you need to do is ORDER NOW for an equivalent of 4 pages for this assignment and all other iHuman/Shadow Health Assignments.

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DON’T STRESS YOURSELF,  JUST CHAT US AT THE RIGHT CORNER BELOW.

Hello my name sara an FNP student and I will be interviewing you today.

Hey.

Can you please state your name for me?

Tina Jones.

Your date of birth?

February 17th.

Year of birth please? (Clarified to What year were you born.)

I was born in . . . [Ms. Jones reports correct birth year.] [AUDIO

COMING SOON]

How old are you ms. Jones? (Clarified to how old are you.)

I’m 28.

What brings you in today?

I came in because I’ve been having breathing problems, and my

inhaler just isn’t working the way it normally does.

Why did you XXX

I XXX normally does.

BRIAN FOSTER CHEST PAIN SHADOW HEALTH ASSESSMENT

I’m XXX.

XXX  that. Shadow health respiratory assessment transcript.

What XXX?

Well. . . I’ve hadxxxx since I was really little, though for a while

there it wasn’t really much of a problem. And I have xxxx,

too.

What XXX?

It’s XXX.

ESTHER PARK ABDOMINAL PAIN SHADOW HEALTH 

How XXX?

I’ve XXX.

XXX start?

I don’t know if I’d call it an asthma attack, but XXX house. She has cats, and I’m

allergic, so I’m used to it being a problem there, but usually the

inhaler fixes it. . . it doesn’t feel totally under control, though.

I’m sorry you’re having difficulty with your breathing problems.

Thanks.

How XXX  problems?

My breathing’s been acting up off and on for the past two days.

How XXX?

DANNY RIVERA SHADOW HEALTH PEDIATRIC PHYSICAL ASSESSMENT 

Maybe XXX? It’s a lot.

And how XXX? (Clarified to

how long does an episode last.)

I haven’t had a XXX normal. .

. that’s not what’s been happening recently, though.

How xxxx?

I haven’t had a xxx, but usually once I use xxx

it only takes a minute or two for my xxxck to normal. .

. that’s not what’s been happening recently, though.

How manyxxxx

Well. . . it’s kind of hard to count because my breathing’s been at

least a little bad most of the past two days, but it’s really acted up,

like with wheezing and everything, probably every four hours or so–

like five times each day.

Is your     ?

My

How     xxx.)

My asthma used to be really scary. I haven’t had a full attack in

years, and if you had asked me before this I would have said my

asthma wasn’t that bad anymore, but the last couple days I’ve had a

lot of trouble breathing.

How xxx?

My asthma used to be really scary. I haven’t had a full attack in

years, and if you had asked me before this I would have said my

asthma wasn’t that bad anymore, but the last couple days I’ve had a

lot of trouble breathing.

Is there xxx?

There usually xxxx. . . I

guess I try to avoid things that make my breathing worse, but that’s

about it. The past couple days, though, it’s been hard to do anything.

Do you wheeze during an asthma exacerbation?

During a full attack, I would wheeze a lot, like I couldn’t breathe at all,

but until the past couple days, I would usually just wheeze a little

when I had breathing problems.

Are you having any chest tightness? Shadow health respiratory assessment transcript.

It’s not so bad right this second, but it’s been pretty tight lately, like I

can’t take in air.

Have you xxx?

I’ve been xxxxa lot, yeah.

How long have you had the xxxx?

Since my asthma acted up two days ago.

How would you describe the xxx?

Um. . . I guess I’d describe it asxxx.

What makes your xxxbetter?

Drinking some water helps a little, as long as the water isn’t too cold.

Have you tried txxx your xxx?

I haven’txxx.

Is your xxx?

It has been the past cxxx, yeah.

Does lxxx worse?

Just recently lying on my back has definitely made my breathing

worse.

To try to help your breathing you may want to elevate your head with

two pillows.

OK, I understand.

Inspected anterior chest wall

Inspected anterior chest wall

Inspected left side chest wall

Inspected anterior chest wall

Inspected right side chest wall

Inspected anterior chest wall

Palpated chest expansion: Both sides rise symmetrically

Palpated fremitus in anterior upper chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in anterior lower chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in posterior upper chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in posterior middle chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Palpated fremitus in posterior lower chest wall: Equal bilaterally,

expected vibration

Ninety-nine.

Percussed anterior left upper lobe

Percussed anterior right upper lobe

Percussed anterior left mid-chest (upper lobe)

Percussed anterior right middle lobe

Percussed anterior left lower lobe

Percussed anterior right lower lobe

Percussed posterior right upper lobe

Percussed posterior left upper lobe

Percussed posterior right mid-back (lower lobe)

Percussed posterior left mid-back (lower lobe)

Percussed posterior right lower lobe

Percussed posterior left lower lobe. Shadow health respiratory assessment transcript.

Percussed posterior left lower lobe on side

Percussed posterior left lower lobe near spine

Percussed posterior right lower lobe near spine

Percussed posterior right lower lobe on side

Auscultated breath sounds in anterior left upper lobe

Auscultated breath sounds in anterior right upper lobe

Auscultated breath sounds in anterior right middle lobe

Auscultated breath sounds in anterior left mid-chest (upper lobe)

Auscultated breath sounds in anterior left lower lobe

Auscultated breath sounds in anterior right lower lobe

Auscultated breath sounds in posterior right upper lobe

Auscultated breath sounds in posterior left upper lobe

Auscultated breath sounds in posterior left mid-back (lower lobe)

Auscultated breath sounds in posterior right mid-back (lower lobe)

Auscultated breath sounds in posterior right lower lobe

Auscultated breath sounds in posterior left lower lobe

Auscultated breath sounds in posterior left lower lobe on side

Auscultated breath sounds in posterior left lower lobe near spine

Auscultated breath sounds in posterior right lower lobe near spine

Auscultated breath sounds in posterior right lower lobe on side

Auscultated voice sounds in anterior left upper lobe

Ninety-nine.

Ninety-nine.

Auscultated voice sounds in anterior right upper lobe

Ninety-nine.

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 10/23

Exam Action

05/11/18 2:01 PM

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Exam Action

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Exam Action

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Exam Action

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Exam Action

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Exam Action

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Ninety-nine.

Ninety-nine.

Auscultated voice sounds in anterior left upper lobe

Auscultated voice sounds in anterior left mid-chest (upper lobe)

Ninety-nine.

Auscultated xxx

Auscultated xxxx

Ninety-nine.

Auscultated voice sounds in anterior left lower lobe

Ninety-nine.

Ninety-nine.

Ninety-nine.

Auscultated xxxx

Ninety-nine.

Auscultated voice sounds in posterior left upper lobe

Shadow health respiratory assessment transcript

Ninety-nine.

Auscultated voice sounds in posterior right mid-back (lower lobe)

Ninety-nine.

Auscultated voice sounds in posterior left mid-back (lower lobe)

Ninety-nine.

Auscultated voice sounds in posterior right lower lobe

Ninety-nine.

Auscultated voice sounds in posterior left lower lobe

Ninety-nine.

Auscultated voice sounds in posterior left lower lobe on side

Ninety-nine.

Auscultated voice sounds in posterior left lower lobe near spine

Ninety-nine.

Auscultated voice sounds in posterior right lower lobe near spine

Ninety-nine.

Shadow health respiratory assessment transcript

Auscultated voice sounds in posterior right lower lobe on side

Ninety-nine.

Checked pulse xxx

Check pulse xx

Checked xxxx

Checked xxx

Always make sure yourxxxx

Sure, I think I understand what you mean.

Make sure to read all instructions and store as indicated (No

matching questions found.)

Make sure to read all instructions and store as indicated

Alright, thanks for letting me know.

Always shake well before using.

Thanks for telling me.

Also after every complete use you should always rinse out your

mouth with water.

Shadow health respiratory assessment transcript.

That makes sense.

What medications do you take?

My xxx is the only prescription I always have, but I usually don’t

need it everyday, except for recently. . .

When did you last use your xxx?

I had to use it early this morning.

How is your xxx prescribed?

Yes.

How often is your xxx?

Yes.

How many times have you use xxx?

I’ve been needing my xxx about every four hours, I’d say.

How many xxxx 4 hours? (Clarified to how xxxx are you prescribed.)

I’m supposed to just do twoxxx [Nurse confirmed with Pharmacy:

xxx]

How many xxx are you doing?

I’m supposed to just do xxx. [Nurse confirmed with Pharmacy:

xxx]

Make sure to follow thexxx instructions as prescribed

Thanks for telling me.

Are you taking any other medications?

No, all I really use is xxx.

You take any over-the-counter medications?

I take xxx, but not

often.

How much xxxdo you take?

I just take a couple. I usually get them at night from reading–

squinting I guess–and so I take one and go to bed. [Nurse confirmed

with Pharmacyxxx ]

How much xxx do you take for cramps?

I take three at a time. And I’d bet I take it up to three times a day.

[Nurse confirmed with Pharmacy: xxx]

Do you have xxxx?

Yeah, I’mxxx.

Do you have axxx?

No, not that I know of.

When didxxx

This all started at my cousin’s house. Shexxxxalways goes crazy when I’m there.

Does being around dust trigger asthma?

Yeah, being around a lot of dust, especially hanging out in a really

dusty house, can make my asthma act up.

Sorry to hear that about your asthma

Thanks for understanding.

Does cxxxa?

Only when I’m in a rush and have to hurry up them.

Do you have xxxx? (Clarified to do you have

seasonal allergies.)

A little while ago, I had some seasonal allergies, but it didn’t really

bother my asthma, and it’s better now.

Does xxxe?

Well. . . sometimes when txxx often.

Do you xxx?

I used to go to Dr. Dewitt, but she moved her practice recently.

Luckily she’s still been able to call in refills of my inhaler, but I haven’t

actually been in to see her in about two years.

Since you have asthma it is important to follow up on a regular basis

with your asthma specialist

Alright, thanks for letting me know.

How xxx?

I’ve had xxxle.

How xxxx?

My xxx.

Have you everxxx?

I xxx?

I used to go to thexxxt not since I

was sixteen.

Have yoxxx?

You mean like, did they ever have to put me on a breathing machine?

No, I haven’t had an asthma attack that serious.

Do you use a xxx?

Not really. . .

Do you cxxx?

I’ve heard of that, but no, I don’t do it.

Do you use xxx

No, but I have before.

We may cxxx

That makes sense.

Also a way to track your asthma symptoms and episodes. (No

matching questions found.)

Also a way to track your     s and episodes.

OK, I understand.

BUY A PLAGIARISM-FREE PAPER HERE

Sending you home with a peak flow meter and document regularly.

I’ve heard of that, but no, I don’t do it.

We will also teach you how to use nebulizer at home.

Sure, I think I understand what you mean.

How often do you change your sheets?

I change my bedding once a week, I’d say.

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 18/23

Question

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Do you have pets at home?

No. . . I’m too busy to take care of a dog, and I can’t have cats

because of my allergies.

Does    ?

No, nobody at home    .

If exposed to secondhand smoke it is definitely a Asthma trigger.

Alright, thanks for letting me know.

Have you ever had eczema?

No, I don’t have that kind of skin problem.

history of sinus problems? (Clarified to do you have a history of sinus

problems?.)

I don’t really have a problem with my sinuses.

Do you have xxx?

I don’t know what that is, so I guess probably not?

Have you ever been   xxx

Have you xxx?

Shadow health respiratory assessment transcript

No, I’ve never done that. I think it’s gross.

I’m glad you think that

Thanks for understanding.

Smoking is a known trigger for asthma

OK, I understand.

Have you xxx

Well, I used to xx. . . but I don’t do that anymore.

When was the xxx?

I haven’t sxxx.

Have you ever experimented with xxxx?

No, no way. That’s a nasty thing to do.

Have you been sick recently?

No, I’m usually healthy.

Have you had any xxx?

No, I haven’t had a xxx.

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 21/23

Question

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Educate

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Have you had any nausea or vomiting?

I haven’t had thrown up, or even had an upset stomach, in a long

time.

Have you had chills?

No, I haven’t.

Are you fatigued?

I feel tired, yeah, probably because I haven’t been able to sleep very

well.

Do you have any xx?

I don’t getxxx, but sometimes I wake up hot and have to kick off

my xxx.

Sometimexxxybe an indication of being sick

That makes sense.

Have you been cxxx anything?

No, nothing’s coming up.

Have you had any problemsxxx?

Nope.

Do you have any nasal drainage?

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 22/23

Question

05/11/18 3:27 PM

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Question

05/11/18 3:28 PM

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Question

05/11/18 3:29 PM

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05/11/18 3:30 PM

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No, my nose has been fine.

Has anyone been sick at home?

No, no one at home has been sick.

Does anyone in your family have asthma?

It’s just me and my baby sister that have asthma, but she really

doesn’t have problems with it.

Does anyone in your family have allergies?

My sister has hay fever, I think, and it sometimes makes her asthma

get pretty bad.

Does anyone in your family have eczema?

No. . .

Do you have a family history of sinus problems?

I don’t think anyone in the family has sinus problems.

Are you in any pain right now?

It doesn’t hurt. . . it’s just hard to breathe, but there’s no pain.

Is there pain when you wheeze? (No matching questions found.)

are you in pain when you wheeze?

5/11/2018 Respiratory | Completed | Shadow Health

https://chamberlain.shadowhealth.com/assignment_attempts/3498304 23/23

Question

05/11/18 3:36 PM

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Question

05/11/18 3:37 PM

CDT

Right now it doesn’t sound too bad, but I’ve definitely been

wheezing the past couple days.

Any changes in your appetite?

I wouldn’t say it’s changed recently, but I do feel hungry a lot.

When was your last chest x-ray?

The last time I went to the hospital for an asthma attack, when I was

still in high school, they did a chest x-ray.

Comments

If your instructor provides individual feedback on this assignment, it will appear here.

shadow health respiratory transcript

APPROACH

Overview

| 
Transcript

| Subjective Data Collection

| Objective Data Collection

| Education & Empathy

| Documentation / Electronic Health Record

| Student Pre-Survey

| Lifespan Activity

| Review Questions

| Self-Reflection Activity

SAMPLE Shadow Health Respiratory Assessment

Model Documentation

Subjective

Social History: She is not aware of any environmental exposures or irritants at her job or home……

Review of Systems:

General: Denies changes in…

Nose/Sinuses:

Gastrointestinal:

Respiratory:

Objective                   

General: Ms. Jones is a pleasant….

Respiratory: Chest expansion is….

Assessment                

Mild-persistent….

Plan

Diagnostics

Obtain office….

Education

Encourage Ms. Jones to continue t….

Referral/Consultation

Refer to…..

 Follow-up Planning

Order ….

Instruct Ms. Jones …..

Revisit….

Tina’s second cousin was diagnosed with asthma at age 5. What would be included in your treatment plan? What factors might concern you related to compliance?

The treatment plan for this child would be to….

Consider that Tina’s uncle is now 68 years old and has smoked heavily every day since he was fifteen. What would you expect to find in his respiratory assessment? How would this affect your oxygenation goals for this patient?

Common significant deviations of the chest for older adults include xxxx (Hogstel & Curry, 2005). xxxx become thinner, more rigid, and change shape, and muscles may become weakened. This results in a lower oxygen level with less carbon dioxide removed from the body, and decreased ability to cough. xxxx causes decreased xxx height. xxx also causes thexxxto lose their shape causing shortness of xxx. Due to diminishedxxxwith decreased sensitivity, large amounts of particles that are more difficult to expectorate can collect in the xxx. In addition, the xxxx is less sensitive to xxxx and xxx and higher residual volume. As a result of these changes, xxx are at increased risk for xxxx and xxxx (Minaker, 2011; Sharma & Goodwin, 2006). Shadow health respiratory assessment transcript.

In the respiratory assessment of this patient, I expect to find xxx, increased xxxx of the xxx, diminished chest expansion, and xxxx. The weakened muscles will result in xxx  levels and lower xxxx leading to decreased xxxx capacity. xxx will also will also lose their shape leading toxxx. Therefore, x goals will hxave to take in cognizance these realities and advise the patient accordingly. Consequently, efforts to increase exercise tolerance, treat complication, and relieve symptoms will be initiated.

If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion?

If the results of Tina’s pulse oximetry had been 97%, which of the following would have been true?

Suppose that, during your lung exam on Tina, you had heard bronchial breath sounds in the left lower lung posteriorly. What would you have suspected based on this finding?

Suppose that while auscultating, you assessed a few scattered expiratory wheezes. Why would this be an expected finding for a patient with Tina’s history

When you observe a patient like Tina throughout an exam, there are many ways to determine whether a patient is experiencing respiratory distress. Identify one indicator of respiratory distress that can be assessed through observation alone.

 

Describe how you would assess Tina for dyspnea

Dyspnea can be assessed both……

Explicitly describe the tasks you undertook to complete this exam.

The examination…..

Explain the clinical reasoning behind your decisions and tasks.

Identify how your performance could be improved and how you can apply “lessons learned” within the assignment to your professional practice Shadow health respiratory assessment transcript.

My performance could be improved by seeking more history from the patient…..

NR 509 Week 1 Shadow Health History Assignment

Pre-brief

Obtaining an accurate history is the critical first step in determining the etiology of a patient’s problem. A large percentage of the time, you will actually be able to make a diagnosis based on the history alone. The value of the history, of course, will depend on your ability to elicit relevant information. Your sense of what constitutes important data will grow exponentially as you practice your interviewing skills and through increased exposure to patients and illness…………………… Interviewing patients is an art and should remain an essential skill for successful practice.

In this activity, you will interview Tina Jones to collect data to assess Ms. Jones’ condition. You will also have the opportunity to educate and empathize with Tina to engage in effective therapeutic communication; create a problem listusing evidence from the data you collected; prioritize the identified problems to differentiate immediate from non-immediate care; plan how to best address the most important concern with further assessment, interventions, and patient education; and compare your documentation to model documentation.

Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Her speech is clear and coherent and she maintains eye contact throughout the interview.

Reason for visit: Patient presents for an initial primary care visit today complaining of an infected foot wound.

| Overview

| Transcript

| Subjective Data Collection

| Objective Data Collection

| Education & Empathy

| Documentation / Electronic Health Record

| Information Processing

| Lab Pass: Certificate of Completion

NR 509 Week 2 Alternate Writing Assignment: Respiratory Summer 2018

Purpose

As a family nurse practitioner, you must possess excellent physical assessment skills. This alternative writing assignment mirrors the discussion content of the debriefing session and will allow the student to expand their knowledge of physical health assessment principles specific to the advanced practice role. Shadow health respiratory assessment transcript.

Course Outcomes

This assignment is guided by the following Course Outcomes (COs):

Apply advanced practice nursing knowledge to collecting health history information and physical examination findings for various patient populations. (PO 1, 2)

Differentiate normal and abnormal health history and physical examination findings. (PO 1, 2)

Adapt health history and physical examination skills to the developmental, gender-related, age-specific, and special population needs of the individual patient. (PO 1, 2)

The purposes of this assignment are to: (a) identify and articulate advanced assessment health history and physical examination techniques which are relevant to a focused body system (CO 1), (b) differentiate normal and abnormal findings with regard to a disease or condition that impacts the body system (CO 2), and (c) adapt advanced assessment skills if necessary to suit the needs of specific patient populations (CO 4).

NOTE
: 
You are to complete this alternative writing assignment ONLY if you had not participated or do not plan to participate in a debriefing session for the given week.

Due Date: 
This alternative written assignment is due no later than the 
Sunday of the week in which you did not attend the weekly debriefing session
. The standard MSN Participation Late Assignment policy applies to this assignment.

Preparing the Paper:

Select a focused body system from the weekly lesson which corresponds with the week of the written assignment.

Carefully read and review the selected body system in your course textbooks.

Incorporate at least 
one
scholarly peer-reviewed journal article that relates to the body system. It may be useful to identify an article that relates to a disease that impacts the body system.

The paper must clearly articulate the relevance of advanced physical assessment skills, techniques, application of advanced practice knowledge, and assessment modification (when necessary) to accommodate for specific patient populations.

Provide concluding statements that should summarize key points of the overall assignment content.

In-text citations and reference page(s) must be written using proper APA format (6thedition).

NR 509 Week 2 Quiz

A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:

During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:

The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:

When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands

A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____

When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:

The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland Shadow health respiratory assessment transcript.

A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:

The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:

The FNP is aware that the four areas in the body were lymph nodes accessible are the:

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:

The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?

A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:

A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:

A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that

When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should

The FNP is performing the diagnostic positions test. Normal findings would be which of these results?

During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?

A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?

The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?

The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?

During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings

During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of:

The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?

The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)

NR 509 Week 2 Quiz

A mother brings her two month old daughter in for an examination says “my daughter rolled over against the wall and now I have noticed that she has the spot soft on the top of her head, is there something terribly wrong?” The FNP‘s best response would be:

During percussion the FNP knows that a dull percussion note elicited over a lung lobe. This most likely results from:

The patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The FNP suspects Damage to:

When examining the face, the FNP is aware that the two pairs of salivary gland‘s that are accessible to examination are the _____ glands

A patient comes to the clinic complaining of neck and shoulder pain and is unable to turn her head. The FNP suspects damage to cranial nerve ____ and proceeds with the examination by____

When examining a patient’s cranial nerve function, the FNP remembers that the muscles in the neck that are innervated by CN XI are the:

The patient’s laboratory data reveal an elevated thyroxine level. The FNP would proceed with an examination of the _____ gland

A patient says that she has recently noticed a lump in the front of her neck below her “Adams apple” that seems to be getting bigger. During the assessment, the finding that leaves the FNP to suspect that this may not be a cancerous thyroid nodule is that the lump:

The FNP notices that the patient’s submental lymph nodes are enlarged. In an effort to identify the cause of the node enlargement, the FNP would assess the patient’s:

The FNP is aware that the four areas in the body were lymph nodes accessible are the:

A 52-year-old patient describes the presence of occasional floaters or spots moving in front of his eyes. The FNP should know that floaters are usually not significant and are caused by:

The FNP is preparing to assess the visual acuity of a 16-year-old patient. How should the FNP proceed?

A patient’s vision is recorded as 20/30 when the Snellen eye chart is used. The FNP interprets these results to indicate that:

A patient is unable to read even the largest letters on the Snellen chart. The FNP should take which action next:

A patient’s vision is reported as 20/80 in each eye. The FNP interprets this finding to mean that

When performing the corneal light reflex assessment, the FNP notes that the light is reflected at 2 o’clock in each eye. The FNP should

The FNP is performing the diagnostic positions test. Normal findings would be which of these results?

During an assessment of the sclera of an African-American patient, the FNP would consider which of these an expected finding?

A 60-year-old man is at the clinic for an examination. The FNP suspects that he has ptosis of one eye. How should the FNP check for this?

The FNP is doing an assessment on a 21-year-old patient and notices that his nasal mucosa appears pale gray and swollen. What would be the most appropriate question to ask the patient?

The FNP is palpating the sinus areas. If the findings are normal, then the patient should report which sensation?

During an oral assessment of a 30-year-old African-American patient, the FNP notices bluish lips and a dark line along the gingival margin. What would the FNP do in response to these findings

During an assessment of a 20-year-old patient with a three day history of nausea and vomiting the FNP notices dry mucous and deep vertical fissures on the tongue. These findings are reflective of: Shadow health respiratory assessment transcript.

The FNP is reviewing the technique of palpating for tactile fremitus with a new graduate. Which statement by the graduate FNP reflects a correct understanding of tactile fremitus?

The FNP student is reviewing physical assessment findings of the HEENT system associated with pregnancy. Which statement by the graduate FNP reflects a correct understanding of expected HEENT changes associated with pregnancy? During pregnancy:

Identifying and Reliability:

Ms. Jones is an obese 28-year-old female who is

presenting to the office today with an athma

exacerbation. She is the primary and only source of

personal and medical data. Pleasent, cooperative

and readily open to freely dissiminate health

information. Good eyeye contact, well-groomed,

good posture, and comunicates clearly with logical

flow of ideas.

General Survey:

Upon entering the patient’s examination room,

patient was found to be sitting straight and erect,

good posture, well-groomed, well nourished with a

pleasent demeanor and manner of communicating.

Reason for Visit:

“Breathing problems and my inhaler just isn’t

working the way it normally does.”

HPI: Ms. Tina Jones is a 28-year-old African

American woman who walked in to the clinic

complianing of SOB and wheezing after nearly

haveing a “bad” asthma attack two days ago. Pt.

Overview

Transcript

Subjective Data Collection

Objective Data Collection

Education & Empathy

Documentation

Student Pre-Survey

Lifespan

Review Questions

Self-Reflection

reports xxx which triggered her asthma

symptoms while she was visitn her cousins house.

Initially, at the time of the climax of her near asthma

attack, xxx It lasted for 5 minutes,

following the use of her rescuexxx . Pt.

reports only chest tightness at the time, which has

continued to the present with no increase in

tightness. Pt. denies all other allergic symptoms

during the exaccerbation of her asthma. The inhalor

had amild to moderate effect, not fully resolving the

asthma symptoms. Pt. reports that since the initial

exacerbation, she has had ten similar asthma

episodes consisting of SOB, “not able to get

enough air in” to her lungs, chest tightness all occur

every 4 hours, even through the night, awakinging

her from sleep. Her symptomsare worsoned when

laying supine, including coughing fits each time she

lays down, which easily resolves once sitting

backup. Instead of using the xxx, pt. has been using xxxx with minimal to moderate relief. Most

recent episode was this morning prior to her arrival.

xxx are aggrevated by exposure

to cats, perhaps dust, and currently exacerbated by

exertion and laying supine with a subsequent

coughing fit. occur Cough is non-productive.

Pt. concerned her new albuterol inhaler is ineffective

compared to previous device. Her asthma has been

slowly interferring with her life the past year or so,

while still being manageable. Over the past 2 days,

her asthma has interferred with her daily life,

including her response that if she had not had these

past two days off of work, she “would have called in

sick for sure.” Pt. feels minimal asthma symptoms

curretly, following her xxx over an hour

ago.

Diagnosed with asthma at 2.5-years-old, She

frequented hospital visits and including five

hospitalizations before she was 16-years-old. Since

then she hasn’t been hospitalized. Pt. xxxx. Pt. doesn’t keep

asthma record of exacerbations and triggers; denies

asthma medication usage excet for albuterolresuce

inhaler. Pt. not currrently beingmanaged by a

pulmonologist or someone for her allergies. Pt.

denies using a vaporizer or nebulizer at home.

PMH:

Pt. reports Type 2 Diabetes, possible borderline

hypertension (no actual dx).

Allergies:

Cats: Develops itchy, watery eyes; an itchy, “runny

nose”; an itchy, sometimes a sore throat, and often

an asthma exacerbation – SOB, DOE, wheezing,

coughing, and chest tightness.

Dust: Develops a rash, no tiching.

Penicillin: “Rash, like, hives.”

HPI: Ms. Jones is a pleasant 28-year-old African

American woman who presented to the clinic with

complaints of xxxxx attack that she had two

days ago. She reports that she was xxxx and was exposed to cats which triggered her

asthma symptoms. At the time of the incident she

notes that her wheezes were a 6/10 severity and her

shortness of breath was a 7-8/10 severity and

lasted five minutes. She did not experience any

chest pain or allergic symptoms. At that time she

used her albuterol inhaler and her symptoms

decreased although they did not completely resolve.

Since that incident she notes that she has had 10

episodes of wheezing and has shortness of breath

approximately every four hours. Her last episode of

shortness of breath was this morning before coming

to clinic. She notes that her current symptoms seem

to be worsened by lying flat and movement and are

accompanied by a non-productive cough. She

awakens with night-time shortness of breath twice

per night. She complains that her current symptoms

are beginning to interfere with her daily activities

Medications:

Rx: xxx.

OTC: xxxfor occasional

xxxx related to readingfor prolonged periods

of . xxxx

Social History:

Pt. reports fairly severe xxx (xxx);

A moderate allergic reaction to excessive dust

accumulation (axxx); and Penicillin (report from

mom when pt.was a child, mother reports

development of a rash only; unknown if xxx and axx

occured as well. Pt. is meticullus about dust,

allergins, mildew accumulation; using hypoallergenic

practices with bed, sheets, pillows and spead.

Mattress is 12 months old. Pt. denies ever using

tabacco in any form, as well as illicit drugs and

prescription medicaton abuse. Pt. does report that

from 15-16-years old she smoked marijuana, but

hasn’t partaken in it since 21-years-old. Pt. states

she doesn’t exercise, eats “whatever”, with some

restrint in high sugar beverages and treats.

Family History: Pt. states sister has history of

asthma and hayfever.

Surgical History: Pt. denies previous surgeries.

ROS:

General: Pt. states recent changes in appetite as

she is “always hungry” even after she has eaten a

large meal. Reports exercise intolerance, usually

feels fatigued. Pt. denies recent weight changes,

fevers, chills. body aches, sweats. feels she is

generally a healthy person.

Skin: Pt. reports skin color and pigment changes

localized only around her neck – which has been

changeing the past couple of years now. Pt. reports

that moles on her back have not changed in size or

color.Skin is dryer than usual and feels dehydrated

and always thirsty. Denies sores, lesions, scabs.

Pulmonary: Pt. states that she has coughing fits

when exposed to allergens like dust adn especially

cats. Coughing also occurs when asthma “acts up”

and anytime she lays down in the past month she

begins to cough. Lately she will wake up twice a

night because of uncontrolable coughing which

resolves after she has been in a sitting or upright

position for a few minutes. Denies productive cough

or coughing up blood. Denies being exposed to

anyone sick, has not traveled.

Reports SOB when she has to hurry somewhere or

whan she climbs a large flight of stairs. Has

orthopnea twice a night with coughing fits. xxxx and denies OSA.

xxx: Pt. state she may have borderline

and she is concerned that her xxxx

seems to be less effective than previous. Currently

she states that her breathing is normal. Diagnosed

with asthma at age 2.5 years. She has no recent use

of spirometry, does not use a peak flow, does not

record attacks, and does not have a home nebulizer

or vaporizer. She has been hospitalized five times

for asthma, last at age 16. She has never been

intubated for her asthma. She does not have a

current pulmonologist or allergist.

xxx: She is not aware of any

environmental exposures or irritants at her job or

home. She changes her sheets weekly and denies

dust/mildew at her home. She uses a hypoallergenic

pillow cover and her mattress is one year old. She

denies current use of tobacco, alcohol, and illicit

drugs. She did smoke marijuana for 5 or 6 years,

her last use was at age 21 years. She does not

exercise.

Review of Systems: General: Denies changes in

weight, fatigue, weakness, fever, chills, and night

sweats.

• xxx: Denies rhinorrhea with this episode.

Denies stuffiness, sneezing, itching, previous allergy,

epistaxis, or sinus pressure.

• Gastrointestinal: No changes in appetite, no

nausea, no vomiting, no symptoms ofxxx

• xxx: Complains of shortness of breath and

cough as above. Denies sputum, xxx,

pneumonia, bronchitis, emphysema, tuberculosis.

She has a history of asthma, last hospitalization was

age 16, last chestxxxx.

hypertension. Pt. denies xxxx,

palpitations, tachycardia or racing heart, orthostatic

changes, edema, heart arrythmias and denies

sickle-cell disease.

Endocrine: Pt. reports having previous diagnosis of

diabetesxxxx, xxx,

lethargy. Pt. reposrts having xxx, dxxx,

being overweight. Pt. denies changes in hair

pattern, weight changes, node enlargement, breast

changes, galactorhea, never been pregnant,

tremors. Shadow health respiratory assessment transcript.

GI: Pt. denies N/V, anorexia, diarhea, GERD, ulcers,

colonoscopy, constipation, hematamesis,

hematechezia, recent changes in bowel evacuation

habits, dysphagia, flatulance.

GU: Pt. reports xxxx, feels

thirsty all the time now, drinks a lot of fluids which

doesn’t seem to quench thirst. She has now been

experiencing nocturia 2-3 times per night. Denies

xxx, chronic or recent xxxx, history

of or knowlingly being xxxx. Reports

haveing three sexual partners in her life, all of which

are men. Has been absinent for over a year now.

Denies incontinence.

Neurologic: Pt. denies changes in sensation,

weakness, light-headedness, dizziness, chronic

xxxxchanges in mentation,

long or short term memory, concussions,xxxx

HEENT: Pt. denies history of xxx, except for

occassionally occuring when she reads too long xxx

changes, except for “blurry eyes” after reading for

too long. Denies other visions problems, hearing

issues, nasal discharge, epistaxis, gingivitis, mouth

sores. Pt. doesn’t see dentist annually nor teetch

professionally cleaned – hasn’t been to the dentist

for “years.”

Objective

Tina is an obese 28-year-old African American

woman who does not seem to be in any acute

distress. Alert and oriented, sitting upright, ,

maintains appropriate eye contact, is

conversational, and answers questions approprietly.

Respiratory: Respiratory examination found Tina’s

chest expansion to be symetrical with respiration.

Bilaterally symetrical tactile fremitous, negative

broncophony anteriorly and posteriorly in all lung

fields. Chest resonent when percussed, devoid of

any dullness. Bilateral lower lxxxx. All other

lung fields clear to auscultation. No crackles,

rhonchi, coarseness noted in lung auscultation.

Muffled words bilaterally with prominent expiratory

wheezes in the posterior lower lobes only.

Spirometry yielded xxxxon room air, xxxx, BP

General: Ms. Jones is a pleasant, xxx 28-year-old

African American woman in no acute distress. She

is alert and oriented and sitting upright on exam

table. She maintains eye contact throughout

interview and examination.

• Respiratory: Chest expansion is symmetrical with

respirations. Normal fremitus, symmetric bilaterally.

Chest resonant to percussion; no dullness. Bilateral

expiratory wheezes in posterior lower lobes.

Bilateral muffled words with notable expiratory

wheezes in posterior lower lobes. No crackles. In

office xxx%.

x

140/81, Temperature xxxdegrees Farenhiet.

Assessment

Mild-Persistent Asthma with Exacerbation. Mild-persistent asthma with exacerbation

Plan

Diagnostics: Obtain oxygen saturation and baseline

spirometry and peak flow readings.

Medication: NMI at office one time. Continue

albuterol rescue inhalor. Initiate step up inhaled

corticosteroid.

Education: Encourage Tina to log her asthma

symptoms and episodes of exacerbation every day

and bring log in to next visit. Monitor trigger

exposures adn resultant asthma symptoms and

severity of exacerbations. Encourage Tina to

remove and/or clean all possible harborers of

allergens, including bedding, seats, pillows carpet.

Change air filters in home and car to incrased

allergiin removal from the air. Encourage an incrase

in fluid consumption, especially water. Help guide

pt. indeveloping an asthma action plan and assess

effectiveness and apropriateness of plan in next

visit.

Orders: xxxx

after each exacerbation for purposes of comparison

and establishing pt. trends.

Instruct Tina to return to clinic if ongoing symptoms.

Also inform xxx if

worsoning asthma symptoms, xxxx that is

unresolved by a short rest. Also go to xxxis

unresolved xxx, wheezing not allevaited

xxx and xxx.

Follow-Up: Return to clinic in 3 weeks for follow-up

evaluation regarding coarse of illness, medication

use and needs, as well as medication effectivenss.

Diagnostics

• Obtain office oxygen saturation

Medication

• xxxin office x 1

• Initiate step-up medication therapy with xxxx

• Continue xxx

Education

• Encourage Ms. Jones to continue to xxx

symptoms and wheezing with associated factors

and bring log to next visit

• Encourage to wash xxx and consider xxx to decrease axxe

symptoms

• Educate to increase intake of water and other

fluids

• Create Axxx

Referral/Consultation

• Refer to allergy specialist for evaluation and testing

Follow-up Planning

• Order PFTs to be completed after exacerbation to

have baseline available for future comparison

• Instruct Ms. Jones on when to seek emergent care

including episodes of chest pain or shortness of

breath unrelieved by rest, worsening asthma

symptoms or wheezing, or the sense that rescue

inhaler is not helping

• Revisit clinic in 2-4 weeks for follow up and

evaluation

Comments

If your instructor provides individual feedback on this assignment, it will appear here.

NR 509 Week 2 Quiz Review – (Jarvis 8,9,13,14,15,16,18), (Swartz 4,6,7,8,9,10)

1.       What does dullness when percussing lung fields: Jarvis pg 427

2.       Facial sensation controlled by which CN: Jarvis 283,

3.       Know what two salivary glands are accessible during exam

4.       What CN is being … when pt shrugs shoulders Jarvis 646

5.       What muscles are being …. when …. CN 11 (spinal accessory nerve)

6.       Concern for malignant nodules versus benign lymph nodule

7.       Know what you’d do next if you palpated a submental lymph node: Jarvis pg 253

8.       Define visual acuity

9.       Know what to do if your patient can’t read the largest number on the Snellen chart: Jarvis 289

10.   Example of good visual acuity : Jarvis 289

11.   Example of poor visual acuity: Jarvis 289

12.   What is …. with corneal light reflex-

13.   Know normal variances of sclera : Jarvis 283

14.   Know how to check for Ptosis: Jarvis 292

15.   What does ptosis indicate: Jarvis 292

16.   Nasal fissure of pt with chronic allergies : Jarvis 271

·         Acute allergies : Jarvis p 363 .

17.   What is an abnormal palpation of sinuses: Jarvis 362

·         Normal palpation of sinuses

18.   Know normal variations in gingival margin

19.   Know what a dehydrated oral cavity will look like: Jarvis 387

20.   What is tactile fremitus, how do you test for it and what does it indicate. Jarvis 425

N 518 Module 2: THE GENERAL SURVEY AND HEENT

Module 2: Discussion Question

Start by reading and following these instructions:

You are responsible for minimally at least 3 posts for each question in your discussion boards; your initial post and reply to two of your classmates. 
Your initial post(s) should be your response to the questions posed in the discussion question. You should research your answer and cite at least one scholarly source when appropriate, and always use quality writing.The discussion board is never a place to use text language or emoticons. You will also be asked to respond to your classmates. This is designed to enhance the academic discussion around the topic. It is all right to disagree with something posted by another, however your responses should always be thoughtful and respectful and reflect your opinions professionally.

Discussion Question:

In your professional opinion, what is the difference between chronic and acute pain? How is the assessment for each type of pain different? What must you keep in mind when assessing acute pain? What must you keep in mind when assessing chronic pain?  Reflect upon a time when you assessed a patient in pain. What did you do well? What points could you have improved upon? How did the pain impact the patient? What specific treatments could have lessened the impact of the pain on the patient?

Your initial posting should be 200 to 300 words in length and utilize at least one scholarly source other than the textbook. Please reply to at least two classmates. Replies to classmates should be at least 100 words in length. To properly “thread” your discussion posting, please click on REPLY.

When you are ready for the discussion, do the following:

Click on the discussion link above.

Start your answer by clicking “Start a New Thread” button with the title of your answer and the body of text following the guidance above.

To properly post your answer, please click on the “Post” button.

After posting your contribution, you must read what others have posted, reply to at least two of those posts, and respond (when appropriate) to those you have responded to you.

To reply to a classmate’s post:

Click on the title of another student’s post.

Click “Reply to Thread” and type your response to the student.

Click the “Post” button to post your reply.

N 581 Module 2: Assignment

Remember to submit your work following the file naming convention FirstInitial.LastName_M01.docx. For example, J.Smith_M01.docx. Remember that it is not necessary to manually type in the file extension; it will automatically append.

Start by reading and following these instructions:

1. Quickly skim the questions or assignment below and the assignment rubric to help you focus.

2. Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.

3. Consider the discussion and the any insights you gained from it.

4. Create your Assignment submission and be sure to cite your sources, use APA style as required, check your spelling.

Assignment:

Exercises
: 

Complete the Shadow Health HEENT assessment.

Professional Development

Write a reflection essay of your experience with the Shadow Health virtual assessment. At least two scholarly sources in addition to your textbook should be utilized. Please be sure to address each of the following prompts:

What went well in your assessment?

What did not go so well? What will you change for your next assessment?

What findings did you uncover?

What questions yielded the most information? Why do you think these were effective?

What diagnostic tests would you order based on your findings?

What differential diagnoses are you currently considering?

What patient teaching were you able to complete? What additional patient teaching is needed?

Would you prescribe any medications at this point? Why or why not? If so, what?

How did your assessment demonstrate sound critical thinking and clinical decision making? What could you change to make it better?

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Shadow Health Physical Assessment Rubric

Shadow Health Physical Assessment Rubric

Criteria

Ratings

Pts

This criterion is linked to a Learning Outcome
Subjective Data, Organization, Communication, and Summary (DCE Score or transcript)

25.0
 pts

Above Average- DCE Score greater than or equal to 93; Comprehensive introduction with expectations of exam verbalized; questions worded in a non-judgmental way; professional language exercised; questions well-organized; appropriate closing with summary of findings verbalized to patient.

21.0
 pts

Average- DCE Score greater than or equal to 86-92; Adequate introduction; some questions worded in a non-judgmental way; professional language mostly exercised; questions generally organized; somewhat complete closing.

10.0
 pts

Below Average- DCE Score greater than or equal to 80-85; Incomplete introduction; many questions worded in a judgmental way; some professional language exercised; questions somewhat organized; incomplete closing.

0.0
 pts

Unsatisfactory- DCE Score less than or equal to 79; Introduction missing; questions worded in a judgmental way; little professional language; questions unorganized; closing missing.

25.0
 pts

This criterion is linked to a Learning Outcome
Objective Data, Physical Examination, Interpretation of Findings, Assessment, and Documentation

20.0
 pts

Above Average- Physical assessment documentation includes all relevant body systems; all pertinent normal and abnormal findings identified; documentation reflects professional language; treatment plan includes each of the following components: diagnostics, medication, education, consultation/referral, and follow-up planning.

16.0
 pts

Average- Physical assessment documentation lacks sufficient details pertaining to one or two relevant body systems; or identifies ≥ 50% of the pertinent normal and abnormal findings; or documentation lacks professional language; or treatment plan lacks one or two components (diagnostics, medication, education, consultation/referral, or follow-up planning).

8.0
 pts

Below Average- Physical assessment documentation lacks sufficient details pertaining to three or more relevant body systems; or identifies < 49% of the pertinent normal and abnormal findings; or documentation includes unprofessional language; or treatment plan lacks three or more components (diagnostics, medication, education, consultation/referral, or follow-up planning). 0.0  pts Unsatisfactory- No physical assessment documentation or no treatment plan. 20.0  pts This criterion is linked to a Learning Outcome Self-Reflection 5.0  pts Above Average- Responds to three of the three reflection post questions; and provides analysis of performance; and reflection posts written using professional language; and reflection posts demonstrate insight. 3.0  pts Average- Responds to two of the three reflection post questions; or provides limited self-analysis of performance; or reflection posts are somewhat unclear related to the assignment and the student’s experience; or reflection posts lack insight. 2.0  pts Below Average- Responds to one of the three reflection post questions; or does not provide self-analysis of performance; or reflections are not related to the assignment and the student’s experience; or does not provide insight 0.0  pts Unsatisfactory- No reflection posts for the assignment. 5.0  pts Total Points:  50.0

Addressing Barriers to Effective Communication Sample Essay

Think of a particular day you spent working in a health care environment, and consider three or four distinct points in time. For each point of time, consider the following: With whom did you interact? Which forms of communication did you use? What issues were communicated about—did they seem to be light-hearted or sensitive? Straightforward or complicated? How would you describe the pace of the interactions and your work?

As you consider these questions, it becomes clear that communication can be quite complex, with many layers of meaning that shape the experience for everyone involved. How could this awareness help you to understand instances of ineffective communication when they arise?

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To prepare:

Review the information in Chapter 19 of the course text, as well as the assigned articles.

Reflect on an incident involving ineffective communication within your organization or another health care setting. Consider this incident through the lens of the communication process outlined in Figure 19.1 of the course text. Addressing Barriers to Effective Communication Sample Essay.

What barriers contributed to this incident? What other challenges may have influenced this situation?

Using the information presented in the other Learning Resources, consider what could have been done to prevent or address the ineffective communication. Why do you think the use of these strategies would have resulted in better outcome(s)?

Post a summary of an incident involving ineffective communication. Describe communication barriers and other challenges that contributed to the incident. Propose one or more strategies that could have been employed to promote a better outcome. Be sure to refer to elements of the communication process.

please paper should have introduction and summary. references should be within 5 years.

 

Addressing Barriers to Effective Communication

Introduction

It is my experience that communication can either be effective or ineffective such that ineffective communication turns out to be frustrating. That is all dependent on how the message has been coded and decoded. In this case, correct coding and decoding to preserve the original message and framework presents effective communication as a consequence (Catalano, 2015). In fact, ineffective communication is resultant from variances in the understanding, context, expectations and framework that impede the coding and decoding to alter the message and make certain that both the receiver and sender have conflicting understandings of what the communication envisioned (Allen & Spitzer, 2015; Harris, 2015). Addressing Barriers to Effective Communication Sample Essay. In this respect, all ineffective communication experiences can turn out to be frustrating since the message is misconstrued and understanding is limited.

Post a summary of an incident involving ineffective communication. Describe communication barriers and other challenges that contributed to the incident.

My most memorable experience with ineffective communication occurred during my teenage years. Prior to taking my driving test and applying for the license, I had received a promise from my father that he would take me out in order to hone my driving skills. We agreed that every evening he would allow me to drive his car in the rarely used public back roads under his supervision. He did not keep his promise and I ended up failing the test and was not issued with a driving license. On informing him about the test outcome, he appeared sympathetic and calm, informing me that there would be other tests in the future. I reacted badly to the whole situation and accused him of not caring about my happiness and never having time to help me out. He in turn told me that his decision not to take me out driving was borne of love and a need to keep me safe, thus making him sabotage my intention to acquire a driving license. He argued that I was still too young to hold a license and become a responsible driving. Addressing Barriers to Effective Communication Sample Essay. As such, I made an erroneous assumption that my father would take me driving while he avoided communicating his concerns with me thereby ensure that any communication between my father and myself was ineffective.

Propose one or more strategies that could have been employed to promote a better outcome. Be sure to refer to elements of the communication process.

One strategy that could have been applied to promote a better outcome would entail having a better grasp of non-verbal cues. These cues consist of conveying messages to express non-vocalized opinions and ideas. In fact, these cues comprise objects, pictures, symbols, signs, contact and touch, tone of voice, gestures, facial expression, and body language. As such, the possibility of effective communication can be improved by understanding non-verbal cues (Guffey & Loewy, 2015).

Conclusion

One must understand that ineffective communication as well as the associated frustration is all about the disconnect between reality and expectation. As long as the reality meets or even exceeds the expectations, then the experience can be considered as satisfactory and non-frustrating. On the other hand, should be reality fall short of expectations, then the experience would be considered frustrating. In addition, one must acknowledge that frustration is all about personal subjectivity such that each individual would have a different interpretation of a communication as either being frustrating or not. In the present case, it is evident that my interpretation of frustration linked to communication is all about understanding what is being communicated.

References

Allen, K. & Spitzer, W. (2015).
Social Work Practice in Healthcare: Advanced approaches and emerging trends
. Thousand Oaks, CA: SAGE Publications. Addressing Barriers to Effective Communication Sample Essay.

Catalano, J. (2015).
Nursing Now! Today’s issues, tomorrow’s trends
. (7
th
ed.). Philadelphia, PA: FA Davis Company.

Guffey, M. & Loewy, D. (2015).
Business communication: process & product
(8
th
ed.). Stamford, CT: Cengage Learning.

Harris, M. (2015).
Handbook of Home Health Care Administration
(6
th
ed.). Burlington, MA: Jones & Bartlett Learning. Addressing Barriers to Effective Communication Sample Essay.

Gastrointestinal Tract: Disorders of Motility Essay
.

Gastrointestinal Tract

Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.

Parietal and proximal cells located in the stomach are responsible for secreting gastric acid. The acid serves a significant digestive function by lowering the pH in the stomach to create prime conditions for enzymes (such as pepsin and gastric lipase) to act on the food. Additionally, gastric acid secretion is initiated in the mouth, with thought, smell and taste acting as vagal stimulants for the stomach’s G cells to begin the secretion. Another stimulant is the ingestion of proteins that increases gastric acid production. Even as gastric acid production increases, the acid circulates within the digestive tract to cause histamine release by enterochromaffin-like cells. Histamine release acts on the H
2
receptors found on parietal cells, causing further pH reduction even as more gastric acid is released. Gastrointestinal Tract: Disorders of Motility Essay A negative feedback mechanism is responsible for regulating the acid production such that when a lot of acid is produced and the pH drops below a set threshold then the antral D cells are stimulated to initial somatostatin release that increases pH and inhibits gastric acid action (Shephard, 2016).

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Gastric acid production is an inherent ability of all people from birth although the secreted amounts only peak at two-years of age. The peak acid production continues all through childhood and into adulthood and even old age. Still, there are occasions when acid production drops as a result of gastritis as a medical condition. In healthy individuals, the mucosa walls of the gastrointestinal tract produce mucus that act as a protection layer against the acid’s corrosion (Garcia, Cid & Sanchez, 2013). The protection against acid corrosion occurs through three main strategies. The first strategy is mucus and hydrogen carbonate (alkali) production that creates a pH gradient that keeps the acid within the tract. The second strategy is epithelial cells lining the tract walls that use their membrane transport system to remove the hydrogen ions from the acid so that it is neutralized. The final strategy is the presence if capillary blood vessels in the tract walls that collects the acid that diffused through the epithelial membrane and eliminates them from the tract. It is notable that a compromise of any one of these strategies will disturb the mucosal membrane and result in the development of peptic ulcer disease (PUD), gastroesophageal reflux disease (GERD), and other gastric disorders (Wyllie, Hyams & Kay, 2016). Gastrointestinal Tract: Disorders of Motility Essay.

As earlier indicated, interfering with the mucosal layer of the gastrointestinal tract causes gastric disorders that include PUD and GERD. Typically,
Helicobacter pylori
infection and non-steroidal anti-inflammatory drugs will interfere with the mucosal membrane.
H. pylori
infection causes tears on the mucosal membrane that are presented as ulcers and inflammation. Non-steroidal anti-inflammatory drugs interfere with the mucosal membrane through topical and systematic action that causes ulcers and inflammation (Vaezi, 2016). In fact, the drugs block cyclooxygenase enzyme action to inhibit prostaglandin production and suppress blood flow, mucus secretion, production of hydrogen carbonate, and cell repair and replication, all in the gastrointestinal tract. Besides that, the drugs have low pH (acidic) and are non-ionized in the presence of gastric acid, thus allowing them to easily diffuse across the walls of the tract and into the epithelial cells, reacting chemically with the hydrogen ions in the cells to increase acidity and cause cell corrosion (Marseglia et al., 2015; Maqbool, 2017).

Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

The selected factor is age. It is notable that children have anti-reflux barrier whose function is compromised so that relaxations ensue more frequently and retrograde flow of gastric contents into the esophagus is experienced. In this case, gastritis occurs when the immature lower esophageal sphincter barrier that exists between the esophagus and stomach is impaired as a factor of age and immaturity among children. This implies that the condition is caused by the lower esophageal sphincter’s incompetence or relaxation. Gastrointestinal Tract: Disorders of Motility Essay The result is that the gastroduedenal contents (that include gastric acid, pepsin, bile acids, and trypsin) find it must easier to corrode the gastrointestinal tract walls. The situation worsens even as the corrosion increases and the naturally occurring defenses (acid clearance and mucosal resistance) are rendered ineffective. This is accompanied by the acid defense mechanism breaks down further (Wyllie, Hyams & Kay, 2016). Gastritis treatment will take either of three forms. Firstly, a change in lifestyle is necessary to include avoiding acidic foods and sleeping in the right posture. For instance, fatty acids should be removed from the diet since they are precipitating foods. Also, the head should be elevated when sleeping. Secondly, the patient should take prescribed medication that reduce acid secretion and exposure to include proton pump inhibitors and histamine-2 receptor antagonists (H
2
RA). Finally, surgery should be conducted to repair the anti-reflux barrier (Vaezi, 2016).

Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

References

Garcia, M., Cid, J. & Sanchez, C. (2013). Gastroesophageal reflux in critically ill children: a review.
ISRN Gastroenterology
, Volume 2013(2013), Article ID 824320. doi: 10.1155/2013/824320. Retrieved from https://www.hindawi.com/journals/isrn/2013/824320/

Maqbool, A. (2017). Cystic fibrosis and gastroesophageal reflux disease.
Journal of Cystic Fibrosis
, 16, S2-S13.

Marseglia, L., Manti, S., D’Angelo, G., Gitto, E., Salpietro, C. … & Romeo, C. (2015). Gastroesophageal reflux and congenital gastrointestinal malformations.
World Journal of Gastroenterology
, 21(28), 8508-8515. doi: 10.3748/wjg.v21.i28.8508 Gastrointestinal Tract: Disorders of Motility Essay.

Shephard, R. (2016).
Physical activity and the gastro-intestinal tract: responses in health and disease
. New York, NY: Routledge.

Vaezi, M. (2016).
Diagnosis and treatment of gastroesophageal reflux disease
. New York, NY: Springer.

Wyllie, R., Hyams, J. & Kay, M. (2016).
Pediatric gastrointestinal and liver disease
(5
th
ed.). Philadelphia, PA: Elsevier.

 

Jamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick Gastrointestinal Tract: Disorders of Motility Essay. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.

Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Gastrointestinal Tract: Disorders of Motility Essay.

To Prepare

Review this week’s media presentation on the gastrointestinal system.

Review Chapter 35 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.

Review Chapter 37 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.

Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor Gastrointestinal Tract: Disorders of Motility Essay.

Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.

To Complete

Write a 2- to 3-page paper that addresses the following:

Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.

Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

References to use in the paper.

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

Chapter 13, “Gastrointestinal Disease”

de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787

Pathophysiology of Gastric Acid Stimulation and Production Gastrointestinal Tract: Disorders of Motility Essay.

Gastric parietal cells are responsible for the production of gastric acid in the stomach. The gastric acid production is as a result of response hormones, merocrine and paracrine inputs. The gastric acid production is primarily stimulated by the G cells which are located in the pyloric mucosa. For the parietal cells, they are typically stimulated to secrete hydrogen ions into the lumen. Each receptor has a different level of functional importance. Cholecystokinin hormone receptor is bound to the enterochromaffin-like cells (ECL) cells and the parietal cells when gastrin is produced as a response to meals (Hammer, & McPhee, 2014). When the gastrin is bound to parietal cells, it results in activation and translocation of hydrogen and potassium ions and releases if intracellular calcium. Histamine production is promoted by the binding of gastrin to ECL cells. The histamine binds to H2 on parietal cells and increases cyclic AMP production which in turn is followed by the activation and translocation of proton pump at the canalicular membrane. Gastric acid secretion can be inhibited by natural inhibitors such as the release of somatostatin, CCK, and secretin (Huether, & McCance, 2015).

Changes due to GERD, on gastric acid production

During GERD, PUD and gastritis conditions, it is evident that gastric acid stimulation and production undergoes several changes. GERD results from reflux of the gastric materials into the esophagus and in turn causing damages to their walls of the esophagus (Denbow, 2015).  The changes in the stimulation and the production of the gastric acid affect the pathophysiology and severity of the conditions (Huether, & McCance, 2015). Gastrointestinal Tract: Disorders of Motility Essay This rise in gastric acid production during the conditions, makes the balance of the acid towards reflux and in turn affect the standard capacity if the mucosa to withstand the amount of acid. Gastritis causes a bacterial infection known as Helicobacter pylori which damages the stomach walls by wearing it out (De Bortoli et al., 2013). The acid stimulation production elevates the number of H. pylori in the stomach.

How H. pyloric affects pathophysiology of GERD, PUD, and gastritis.

pylori are known for its effects on gastric physiology. The bacteria can either increase the production or lower the production of gastric acid depending on the kind of gastritis produced (Hammer, & McPhee, 2014). According to studies, it is suggested that decreased production of gastric acid in severe gastritis corpus can sometimes be beneficial in GERD. The low production of the acid is brought about by H. pylori infection which is characterized by the corpus inflammation. Epidemiological studies have established the negative association between the severity of GERD and H. pylori prevalence (Waldum et al., 2014). Apparently, the results from studies show that H. pylori infection affects the incidence of GERD mostly in Asian countries.

Overproduction of gastric acid characterizes the conditions in most cases. It is clear that excessive acid in the stomach causes duodenal walls damages. As aforementioned, H, pylori are known to bring forth production of acid in the stomach. Therefore removal of the bacteria from the stomach can accelerate the healing of the conditions (De Bortoli et al., 2013). Gastrointestinal Tract: Disorders of Motility Essay.

Diagnosis of GERD, PUD, and gastritis

Physical examination is known to be the most ideal in the exploration of peptic acid conditions in the differential diagnosis. In the physical examination method of diagnosis, stool examination can be used for occult bleeding (Hammer, & McPhee, 2014). This is significant in guiding for prognosis and extensive diagnostic investigation.

Esophagogastroduodenoscopy can also be employed in the diagnosis of the conditions. In this procedure, a diagnostic endoscopy is used to visualize the upper gastrointestinal tract all the way to the small intestines. The procedure does not require any incision, and thus it is correct to term the method as less invasive. The method is modern, and therefore no injuries are adverse. The only adverse effect of the procedure is a sore throat.

Another test that can be used to determine the presence of the conditions is by testing for H, pylori. A serologic test is used for this kind of test to determine whether H, pylori are present Gastrointestinal Tract: Disorders of Motility Essay.

Histological test- this is regarded to as the most functional diagnostic test. In this diagnosis method, the H. pylori organisms are identified to confirm their presence hence establish whether a patient is suffering from the conditions.

Treatment for H. pylori

Antibiotics are administered for 10-14 days in people above 12years in combination with painkillers. Examples include antibiotics such as metronidazole, tetracycline or clarithromycin in combination with analgesics such as bismuth subsalicylate, ranitidine or a proton pump inhibitor. Suppressing acid by the H­­
2
blocker or the proton pump inhibitor in combination with antibiotics significantly help to alleviate ulcer-related symptoms like nausea and abdominal pains which in turn enhances the efficacy of antibiotics (Hammer, & McPhee, 2014).

Summary

Gastric acid is known to be stimulated by the presence of meals in the stomach and sometimes by psychological effects. Gastric acid is responsible for activating pepsinogen into pepsin, as well as maintaining an optimum environment for digestion Gastrointestinal Tract: Disorders of Motility Essay. When gastric acid is produced in excess, it leads to conditions such as PUD, GERD, and gastritis. Such conditions can be lethal because of their adverse effect on the duodenal walls. The conditions, however, can be treated by use of antibiotics in conjunction with analgesics.

References

de Bortoli, N., Martinucci, I., Bellini, M., Savarino, E., Savarino, V., Blandizzi, C., & Marchi, S. (2013). Overlap of functional heartburn and gastroesophageal reflux disease with irritable bowel syndrome. World Journal of Gastroenterology, 19(35), 5787-5797. doi:10.3748/wjg.v19.i35.5787

Denbow, D. M. (2015). Gastrointestinal anatomy and physiology. In Sturkie’s Avian Physiology (Sixth Edition) (pp. 337-366).

Hammer, G. D., & McPhee, S. J. (2014). Pathophysiology of Disease: An Introduction to Clinical Medicine 7/E.

Huether, S. E., & McCance, K. L. (2015). Understanding Pathophysiology-E-Book. Elsevier Health Sciences.

Waldum, H. L., Hauso, Ø., & Fossmark, R. (2014). The regulation of gastric acid secretion–clinical perspectives. Acta physiologica, 210(2), 239-256. Gastrointestinal Tract: Disorders of Motility Essay.

Horizontal and vertical organizations nursing leadership essay example

Significance of Horizontal and vertical organizations (based on literature that speaks to the relevancy of the concept selected in terms of interprofessional leadership).

Note. No introduction and no conclusion. just the answer to the question. please the answer must be detailed

USE the flowing references

Marquis, B. L., & Huston, C. J. (2017). Leadership roles and management functions in nursing: Theory and application (9th ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Chapter 2, “Classical Views of Leadership and Management” horizontal and vertical organizations nursing leadership essay example.

The information introduced through this chapter relates to this week’s Discussion, and will also be referred to in future weeks of the course.

Chapter 3, “Twenty-First Century Thinking About Leadership and Management”

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This chapter examines new thinking about leadership and management and how this may influence the future of nursing.

Review Chapter 12, “Organizational Structure”

Downey, M., Parslow, S., & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders. Journal of Nursing Management, 19(4), 517–521

Allmark, P., Baxter, S., Goyder, E., Guillaume, L. & Crofton-Martin, G. (2013), Assessing the health benefits of advice services: Using research evidence and logic model methods to explore complex pathways. Health & Social Care in the Community, 21, 59–68. doi:10.1111/j.1365-2524.2012.01087.x

Manley, K., O’Keefe, H., Jackson, C., Pearce, J., & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: Organisational transformation using practice development methodology. FoNS 2014 International Practice Development Journal 4-(1).

system based practice

https://www.ahrq.gov/downloads/pub/advances2/vol2/Advances-Johnson_90.pdf

Management for Health Care Professionals Series horizontal and vertical organizations nursing leadership essay example.

Systems & Systems Theory

Dr. Yaseen Hayajneh

http://www.hayajneh.org/a/readings/Systems-Theory.pdf

Horizontal and Vertical Organizations

Organization structure refers to the approach applied in facilitating workflow. It can be considered as a tool that allows personnel to manage tasks and work together within their individual functions. The hallmark of a well aligned health care organization (particularly in terms of leadership) is that capacity to realign and adapt as required. In fact, for a healthcare organization to ensure viability for the long-term, there is a need for its leadership structure to be adjusted to fit financial and fiscal realities without diminishing differentiation and capabilities (Gulati, Mayo & Nohria, 2016). In essence, health care organization structure entails identifying and closing the structural leadership gaps that impede its performance horizontal and vertical organizations nursing leadership essay example.

Traditionally, health care organizations have applied horizontal structure that tends to formalize leadership with the personnel banded together by function. This structure ignores hierarchy and encourages collaboration and exchanges across all levels without regard for any form of seniority or superiority (Allmark et al., 2013). Unlike vertical organization, it reduces the distance between the top and bottom levels nursing staff thus allowing for personal perspectives to be suffused in decisions even as synergy and collaboration are encouraged. This means that nursing personnel are not pitted against each other, rather they are allowed to complement each other when making decisions (Marquis & Huston, 2017). Unlike vertical organization that does not place any particular demands on the nurse leaders, horizontal organization demands that the nurse leaders be empathetic, trustworthy, show genuine concern, and inspire trust from their colleagues. As such, vertical organization objectively perceives communication and facilitates its top-down flow of information among nursing personnel whereas horizontal organization subjectively perceives communication without any ordered way to justify information flow in any direction (Rigolosi, 2013). horizontal and vertical organizations nursing leadership essay example.

The horizontal structure has been contrasted by the less traditional vertical structure that is more flexible and loosely woven to introduce the capacity to respond speedily to changing environments. Vertical organization applies the typical top-down approach that entails a designated leader passing down guidelines and directions to subordinates thus following a hierarchical structure horizontal and vertical organizations nursing leadership essay example. It begins with top-level managers (facility directors), moves down to mid-level managers (department heads), then front-line managers (in-charge nurses) before ending with the low level staff (practicing nurses) thus presenting a management structure that has clear roles with direction and leadership concentrated at the top (Ellis & Bach, 2015).

Although organization structure applied in health care can be contrasted as either horizontal or vertical structure, this designation is fast becoming obsolete horizontal and vertical organizations nursing leadership essay example. That is because the structures have become more flexible to incorporate environment changes such as virtual environments. As it stands, the changes have seen matrix and functional structures being applied to be in line with the increasing presence and evolution of these health organization (Downey, Parslow & Smart, 2011). Rigolosi (2013) mentions that structure is significant in aligning people (competencies, skills and experiences), jobs (necessary responsibilities and roles), organization (operations and processes), and leadership (responsibility for developing and applying strategy as well as observing outcomes). Additionally, it can be accepted that whichever leadership structure health care organizations get to apply, their significance remain the same in addressing declining workforce engagement, reversing improper staffing and disorganization, improving agility, capability and capacity, and filling structural gaps (Manley et al. 2014). In this respect, horizontal and vertical structures are significant to health care organizations since they facilitate leadership and functioning horizontal and vertical organizations nursing leadership essay example.

References

Allmark, P., Baxter, S., Goyder, E., Guillaume, L. & Crofton-Martin, G. (2013). Assessing the health benefits of advice services: Using research evidence and logic model methods to explore complex pathways.
Health & Social Care in the Community
, 21(1), 59-68. doi: 10.1111/j.1365-2524.2012.01087.x

Downey, M., Parslow, S. & Smart, M. (2011). The hidden treasure in nursing leadership: Informal leaders.
Journal of Nursing Management
, 19(4), 517–521. doi: 10.1111/j.1365-2834.2011.01253.x

Ellis, P. & Bach, S. (2015).
Leadership, Management and Team Working in Nursing
(2
nd
ed.). Thousand Oaks, CA: SAGE Publications. horizontal and vertical organizations nursing leadership essay example.

Gulati, R., Mayo, A. & Nohria, N. (2016).
Management: An integrated approach
(2
nd
ed.). Boston, MA: Cengage Learning.

Manley, K., O’Keefe, H., Jackson, C., Pearce, J. & Smith, S. (2014). A shared purpose framework to deliver person-centred, safe and effective care: organisational transformation using practice development methodology.
FoNS 2014 International Practice Development Journal
, 4(1) Article 2.

Marquis, B. & Huston, C. (2017).
Leadership roles and management functions in nursing: theory and application
(9
th
ed.). Philadelphia, PA: Lippincott, Williams & Wilkins.

Rigolosi, E. (2013).
Management and leadership in nursing and health care: an experiential approach
(3
rd
ed.). New York, NY: Springer Publishing Company, LLC. horizontal and vertical organizations nursing leadership essay example.

NR439: Evidence-Based Practice – Research Article Critique essay examples

Research Article Critique

Introduction

“The Effect of Mindfulness-Based Music Therapy on Attention and Mood in Women Receiving Adjuvant Chemotherapy for Breast Cancer: A Pilot Study” is an eight-page journal article that explores strategies for improving attention and decreasing mood distress for breast cancer patients receiving chemotherapy. The author acknowledges that chemotherapy use in cancer treatment is accompanied by a negative effect in the form of damaging the patients’ cognitive functioning. To address this negative effect as a concern, the study proposes the use of mindfulness since it applies contemplative practice to improve cognitive functioning NR439: Evidence-Based Practice – Research Article Critique essay examples. At the conclusion of the study, the author anticipated that the research results would recommend the use of mindfulness-based musing therapy as a supportive treatment strategy when using chemotherapy in treating breast cancer patients to reduce the incidences of cognitive functioning declines (Lesiuk, 2015).

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Research Question

Although the research question was not explicitly mentioned in the article, it was implied: Is mindfulness-based music therapy (MBMT) effective in improving attention and decreasing mood distress experienced by breast cancer receiving adjuvant chemotherapy treatment? This is an appropriate research question since it is realistic in noting that chemotherapy treatment causes increased mood distress and decreased attention. Given that mindfulness strategies have been shown to improve cognitive functioning, it is not hard to imagine that positive results would be noted when used alongside chemotherapy. Although mindfulness could improve cognitive functioning, the question is specific in exploring MBMT as a unique segment of mindfulness. In answering the question, the research shows that MBMT in particular, and not mindfulness in general, is an effective therapy when used alongside chemotherapy for treatment of breast cancer (Lesiuk, 2015). NR439: Evidence-Based Practice – Research Article Critique essay examples.

Design of the Study

The study applied a quantitative, descriptive, longitudinal design to collect primary data. In this case, the design was intended to evaluate the effect of MBMT on participants’ attention and mood as measured by Conners’ Continuous Performance Test II (CPT-II) version 5 and POMS-BF respectively NR439: Evidence-Based Practice – Research Article Critique essay examples. This entailed first recruiting 15 breast cancer patients undergoing chemotherapy after having received institutional approval for the study to proceed. Next, a unique MBMT program was applied over four weeks with one session every week. Finally, data was collected on mood and attention as the variables of interest before conducting statistical analysis to determine if the program had an effect on the variables and if this effect was statistically significant (Lesiuk, 2015). The applied design can be considered appropriate since it gained access to the population of interest and presented a true measure of the variables of interest, showing a true measure of how MBMP performed in influencing the attention and mood of breast cancer patients undergoing chemotherapy (Bryman & Bell, 2015). NR439: Evidence-Based Practice – Research Article Critique essay examples.

Sample/Population of the Study

The sample of the study comprised of 15 breast cancer patients undergoing chemotherapy and who had expressed voluntary willingness to participate in the research. The sample was recruited from the Sylvester Comprehensive Cancer Center where breast cancer patients undergo treatment. The sample can be considered appropriate since it comprised of the population of interest, breast cancer patients undergoing chemotherapy. NR439: Evidence-Based Practice – Research Article Critique essay examples. Additionally, the sample was collected from the right location since the facility specializes as a cancer treatment center thereby ensuring that the population of interest would congregate at the center (Lesiuk, 2015). Still the sample size appears to have been low with implications on the research generalizability. It is understandable that the present sample size of 15 was collected through convenience that entailed identifying all patients who were willing to participate in the study. However, the low number make the results non-generalizable to the larger population of breast cancer patients. A larger population sample should be recruited to improve the results generalizability (Whitley, Kite & Adams, 2012).

Data Collection Methods

Data was collected by subjected the participants to Conners’ Continuous Performance Test II (CPT-II) version 5 that measured attention and POMS-BF that measured mood. These two tools were applied by the research after subjecting the participants to the MBMT program. While there is no mention whether participation was voluntary, the fact that institutional approval was received before the study proceeded is an indication that the participants’ rights were protected to include voluntary participation and withdrawal without repercussions. This would imply that the information the participants provided was honest and truthful since it was not coerced (Lesiuk, 2015). Although the researcher had a good understanding of the study that facilitated data collection efforts, this introduced the possibility of researcher bias. In fact, it is possible that the researcher could have modified the collected data to ensure that it conforms to some preconceived notions. As such, there was a need for the research to address the possibility of researcher bias in data collection (Bryman & Bell, 2015). NR439: Evidence-Based Practice – Research Article Critique essay examples.

Limitations

Although the article does not mention the research limitations, some are evident. Firstly, a small sample size of participants was recruited from a single facility thereby limiting the results to that facility. This implies that the results may not hold true for other cancer treatment facilities. The research should have been conducted with more participants from many facilities to address this limitation NR439: Evidence-Based Practice – Research Article Critique essay examples. Secondly, the study was dependent on an evaluation conducted at a single time rather than many evaluations conducted over a long period, which may have failed to capture some of the complexities of the MBMT program under scrutiny. Having more evaluations would improve results by collecting results from a wider demographic range thereby making for a complete discussion (Bryman & Bell, 2015; Lesiuk, 2015).

Findings

15 participants were recruited in the study with a mean age of 52.6 years. Their ages ranged from 27 to 70 years. An evaluation of attention scores that they improved with the implementation of the MBMT program with time being statistically significant (
F
[1,14] = 6.69,
p
=0.022). Additionally, mood scores showed improvement with implementation of the program with time being statistically significant (
F
[5,65] = 20.83,
p
<0.001). The results show that the MBMT program is effective in improving mood and attention for breast cancer patients undergoing chemotherapy (Lesiuk, 2015). The results can be considered credible since the data analysis procedure has been presented to facilitate replication. Based on the research results, it can be recommended that MBMT should be applied as a supportive treatment strategy when using chemotherapy in treating breast cancer patients to reduce the incidences of cognitive functioning declines particularly mood and attention. NR439: Evidence-Based Practice – Research Article Critique essay examples. Summary of the Article The article under review is an eight-page journal article that discusses MBMT as a strategy for improving attention and decreasing mood distress for breast cancer patients receiving chemotherapy. In fact, the study seeks to answer the question: Is MBMT effective in improving attention and decreasing mood distress experienced by breast cancer receiving adjuvant chemotherapy treatment? To answer the research question, the study applied a quantitative, descriptive, longitudinal design that collected primary data using Conners’ Continuous Performance Test II (CPT-II) version 5 and POMS-BF to collect information on attention and mood respectively. To facilitate data collection, 15 breast cancer patients undergoing chemotherapy and subjected to the MBMT program before the two tools were used to collect information on attention and mood NR439: Evidence-Based Practice – Research Article Critique essay examples. Still, it was noted that the study was limited by the small sample size and dependence on an evaluation conducted at a single time rather than many evaluations conducted over a long period. The research results show that the MBMT program is effective in improving attention and mood for the study participants. Based on the study results, it is recommended that MBMT should be applied as a supportive treatment strategy when using chemotherapy in treating breast cancer patients to reduce the incidences of cognitive functioning declines particularly mood and attention. NR439: Evidence-Based Practice – Research Article Critique essay examples. References Bryman, A. & Bell, E. (2015). Business Research Methods (4 th ed.). Oxford: Oxford University Press. Lesiuk, T. (2015). The effect of mindfulness-based music therapy on attention and mood in women receiving adjuvant chemotherapy for breast cancer: A pilot study. Oncology Nursing Forum , 42(3), 276-282. Whitley, B., Kite, M. & Adams, H. (2012). Principles of Research in Behavioral Science (3 rd ed.). New York, NY: Routledge. NR439: Evidence-Based Practice – Research Article Critique essay examples. Purpose The purpose of this assignment completed as an APA Paper is for the student to learn to examine, analyze, critique, and summarize an original research article. Course Outcomes Through this assignment, the student will demonstrate the ability to meet the following course outcomes: CO1: Examine the sources of evidence that contribute to professional nursing practice. CO2: Apply research principles to the interpretation of the content of published research studies. CO4: Evaluate published nursing research for credibility and lab significance related to evidence-based practice. NR439: Evidence-Based Practice – Research Article Critique essay examples. CO5: Recognize the role of research findings in evidence-based practice. Requirements Through this assignment, the student will: Critique the required article found below and in your own words, describe the research question, sample, design of study, data collection method, findings, and limitations of each. (CO 1, CO2,) Summarize the research article and evaluate the significance to nursing. Do not just quote the author’s words. Paraphrase the information. (CO 4, CO5). You are required to use the article below or you will earn a ”0” for the assignment. In addition, assignments that do not follow the current guidelines and use the required article will be evaluated for evidence of an academic integrity violation. After the due date, there will be no opportunity for revision or resubmission of assignments that have been uploaded to the submission area. It is your responsibility to submit the correct assignment to the correct submission area NR439: Evidence-Based Practice – Research Article Critique essay examples. Guidelines to Writing the Paper This assignment is completed as an APA paper. APA resources can be found on the Course Resources Module. Download the required article for analysis: Lesiuk, T. (2015). The effect of mindfulness-based music therapy on attention and mood in women receiving adjuvant chemotherapy for breast cancer: A pilot study. Oncology Nursing Forum, 42(3), 276-282. NR439: Evidence-Based Practice – Research Article Critique essay examples. https://chamberlainuniversity.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=edswsc&AN=000354233000010&site=eds-live&scope=site (Links to an external site.)Links to an external site. Introduction (one paragraph): The introduction should be interesting and capture the reader’s attention. Provide a brief description of the research article to be discussed. Discuss the purpose of your paper. The purpose statement of the paper should relate to the research article reviewed and the implications that it has to evidence based nursing practice. You will need to summarize and analyze the information from the article in your own words Describe the research question for this study in a paragraph. Describe the research in greater detail. NR439: Evidence-Based Practice – Research Article Critique essay examples. Include your observations about this question. Discuss events or trends that could have affected this question. You will need to summarize and analyze the information from the article in your own words Describe the research design of this study, and in your own words discuss the design. Discuss the research design of the study. Discuss the strengths and weaknesses of the type of design and hypothesize why the author utilized the design as opposed to others. You will need to summarize the information from the article in your own words Describe the sample. Briefly describe the sample size used for this study Make a judgment as to whether the sample size was adequate and defend your answer. Describe the number or participants and determine if the number of participants was adequate compared to the research question and the intent of the study. Are these numbers adequate? Discuss gaps in that you identified. You will need to summarize and analyze the information from the article in your own words Describe the data collection method(s)’ Who collected the data? NR439: Evidence-Based Practice – Research Article Critique essay examples. What tools were used? What were the ethical considerations addressed and discuss gaps you identified. You will need to summarize and analyze the information from the article in your own words Describe the limitations of the study. Identify the limitations within the study Describe how the limitations could be overcome in subsequent studies Comment on why limitations are important to list and discuss within a study You will need to summarize and analyze the information from the article in your own words Describe the findings reported in the study. Describe the findings reported in the study Discuss whether the findings of the study answered the research question posed within the study Discuss the credibility of the findings NR439: Evidence-Based Practice – Research Article Critique essay examples. If the findings do not support the research question posed within the study, what do you believe is the reason? You will need to summarize and analyze the information from the article in your own words Summary Summarize important points from the body of your paper including the key components of the paper. Include a statement about the research question and the findings. Discuss the probability of implementation into practice. Based on these findings, is the evidence that you found on your topic strong enough to suggest a change in practice, or an idea for practice? End with a concluding statement. Citations and References must be included to support the information within each topic area. Refer to the APA manual, Chapter 7, for examples of proper reference format. In-text citations are to be noted for all information contained in your paper that is not your original idea or thought. Ask yourself, ”How do I know this?” and then cite the source. Reference Page: The Reference Page should start on a new page (insert a page break). All references should be cited within the body of the paper as (Author, year) and the full reference should be included in APA format on the reference page. A url link alone is not an adequate reference. See the APA Guidelines in Course Resources for examples of properly formatted references. NR439: Evidence-Based Practice – Research Article Critique essay examples. NR439 Research Article Critique Paper Rubric   Criteria Ratings Pts Research Question (Describe, analyze, and summarize the research question for this study your own words.) Fully describes, analyzes, and summarizes the research question in detail 20.0 pts Generally, describes, and analyzes the research question. 18.0 pts Briefly summarizes the research question, but omits some aspects of the question. 16.0 pts Incorrectly describes the research question. 8.0 pts Does not describe the research question. 0.0 pts 20.0 pts Design of Study (Describe, analyze, and summarize the research design of this study in your own words.) Fully describes, analyzes, and summarizes the design of the study in detail. 20.0 pts Generally, describes, and analyzes the design of the study. 18.0 pts Briefly summarizes the design of the study, but omits some aspects of the design. 16.0 pts Incorrectly describes the design of the study. 8.0 pts Does not describe the design of the study. 0.0 pts 20.0 pts Sample/Population of the Study (Describe, analyze, and summarize the sample in your own words.) Fully describes, analyzes, and summarizes the sample used in the study in detail. NR439: Evidence-Based Practice – Research Article Critique essay examples 25.0 pts Generally, describes, and analyzes the sample used in the study. 22.0 pts Briefly summarizes the sample used in the study, but omits some details. 20.0 pts Incorrectly describes the sample in the study, or omits major details 10.0 pts Does not describe the sample used in the study. 0.0 pts 25.0 pts Data Collection Methods (Describe, analyze, and summarize the data collection method(s)’ in your own words.) Fully describes, analyzes, and summarizes all of the data collection methods used in the study. 25.0 pts Generally, describes, and analyzes the majority of data collection methods used in the study. 22.0 pts Briefly summarizes and describes parts of the data collection method used in the study. 20.0 pts Incorrectly describes the data collection method used in the study. 10.0 pts Does not describe the data collection method used in the study. 0.0 pts 25.0 pts Limitations (Describe, analyze, and summarize the limitations of the study in your own words.) Fully describes, analyzes, and summarizes the limitations found in the study in detail. 20.0 pts Generally, describes, and analyzes the limitations found in the study. 18.0 pts Briefly summarizes the limitations found in the study. 16.0 pts Incorrectly describes the limitations found in the study. 8.0 pts Does not describe the limitations found in the study. 0.0 pts NR439: Evidence-Based Practice – Research Article Critique essay examples 20.0 pts Findings (Describe, analyze, and summarize the findings reported in the study in your own words) Fully describes, analyzes, and summarizes the findings of the study in detail. 20.0 pts Generally, describes, and analyzes the findings of the study. 18.0 pts Briefly summarizes the findings of the study. 16.0 pts Incorrectly identifies the findings from the study 8.0 pts Does not describe the findings of the study. 0.0 pts 20.0 pts Summary of Article (Summarize important points from the body of your paper including the key components of the paper and discuss the probability of implementation into practice.) Summarizes study in detail and states specific rationale for whether a change in practice is warranted. 25.0 pts Generally, summarizes study. Gives broad rationale for whether a change in practice is warranted. 22.0 pts Briefly summarizes study and states rationale for whether a change in practice is warranted. 20.0 pts Minimally summarizes study. Gives poor rationale for whether a change in practice is warranted. 10.0 pts Does not summarize study and does not give rationale for whether a change in practice is warranted. 0.0 pts 25.0 pts Grammar, Punctuation, and Spelling/ APA Formatting (No errors in grammar, punctuation, spelling, and APA formatting.) No errors in grammar, punctuation, APA, and spelling. 20.0 pts One to four errors in grammar, spelling. 18.0 pts Five to eight errors in grammar, spelling, and syntax. 16.0 pts Nine to twelve errors in grammar, spelling, and syntax. 8.0 pts Thirteen or more errors to the point where it is difficult to understand the meaning of the student’s writing. 0.0 pts 20.0 pts Total Points: 175.0 NR439: Evidence-Based Practice – Research Article Critique essay examples   Research Article Critique Introduction Lesiuk (2015) presents the results of a research study to evaluate the position the mindfulness-based music therapy (MBMT) can play in improving the attention and mood of breast cancer patients undergoing chemotherapy. Titled “The Effect of Mindfulness-Based Music Therapy on Attention and Mood in Women Receiving Adjuvant Chemotherapy for Breast Cancer: A Pilot Study”, the eight-page article that although chemotherapy is an effective treatment for breast cancer, it has a negative effect on the mood and attention of the patients. The author notes this negative effects but proposes that since MBMT has been effective in improving cognitive functioning by applying contemplative practice, then it stands to reason that MBMT could improve the attention and mood of breast cancer patients. As such, the study presented in the article seeks to provide evidence to support the use of MBMT alongside chemotherapy to prevent mood distress and attention declines amongst breast cancer patients (Lesiuk, 2015) NR439: Evidence-Based Practice – Research Article Critique essay examples. Research Question The research question was not explicitly presented in the article. Still, the research question was implied that: Is there justification for using MBMT alongside adjuvant chemotherapy treatment for breast cancer patients to prevent attention decline and mood distress? In identifying this question, the research presents a clear purpose as well as goals whose achievement will indicate the end of the research. In this case, the research purpose is to evaluate the possibility of using MBMT to preempt the negative cognitive functioning effects noted when chemotherapy is used in the treatment of breast cancer. NR439: Evidence-Based Practice – Research Article Critique essay examples. To validate the research, the author notes that MBMT has been successfully used to improve cognitive functioning. As a result, the research intelligently postulates that MBMT will prevent attention decline and mood distress as aspects of cognitive functioning (Lesiuk, 2015). Design of the Study The study applied a quantitative, descriptive, longitudinal design to collect the required data. This entailed recruiting 15 breast cancer patients after receiving approval for the study to proceed from the concerned ethics boards. The inclusion criteria required that the patients be undergoing chemotherapy as part of their treatment plan. Once the selected participants gave their consent for inclusion in the study, they were subjected to MBMT before their attention and mood was evaluated. Attention was evaluated using Conners’ Continuous Performance Test II (CPT-II) version 5 whereas mood was evaluated using POMS-BF. At the conclusion of the study, the collected data was evaluated with regards to changes in attention and mood before and after MBMT had been applied. All differences noted before and after MBMT was applied were attributed to the program (Lesiuk, 2015). The design applied in the study can be considered appropriate. That is because it allowed the research to collect the true measure of the variables of interest, using verified tool to collect data so that the noted differences would be attributed to MBMT. That is to say that, any differences noted in mood and attention would show that MBMT is effective in influencing mood and attention for breast cancer patients undergoing chemotherapy treatment (Babbie, 2015) NR439: Evidence-Based Practice – Research Article Critique essay examples. Sample/Population of the Study The study recruited a sample of 15 breast cancer patients who were undergoing chemotherapy treatment. The sample population was recruited from Sylvester Comprehensive Cancer Center, identified as a facility that offers treatment for cancer patients. The recruited sample of participants was appropriate since it was collected from the population of interest to the study. Besides that, the participants were recruited in a treatment facility where the research setting can be controlled thus ensuring that the effects of MBMT could be extensively evaluated (Lesiuk, 2015). Although the study sample was appropriate since it was collected from the population of interest, the sample size of 15 participants recruited from a single location was not appropriate. A larger sample size collected from many locations would have been more appropriate since this would have evaluated different settings and allowed the results to be applied in a wider range of settings (Yanow & Schwartz-Shea, 2015). NR439: Evidence-Based Practice – Research Article Critique essay examples. Data Collection Methods Data of interest to the research was the attention and mood. This was collected using Conners’ Continuous Performance Test II (CPT-II) version 5 for attention and POMS-BF for mood. These two data collection methods are appropriate since they are tools that have been evaluated as accurate and valid in measuring the variables of interest. Besides that, the fact that participation was not coerced, as evidenced by the approval from the institutions ethics board, shows that the information was collected voluntary thus not providing any basis for falsehoods or dishonesty (Lesiuk, 2015). Although the data collection methods make an effort in ensuring that the required data was collected, it does not address researcher bias. This is a source of concern since the researcher is a tutor on music therapy programs and may be biased in supporting MBMT. As such, there was a need to have independent checks in place (other researchers) to ensure that the researcher was not biased in collecting the data to conform to a preconceived idea of what the study results should indicate (Creswell, 2013). Limitations The article does not indicate if the study faced any limitations. Still, there is one limitation that was faced in the research NR439: Evidence-Based Practice – Research Article Critique essay examples. The limitation is that the study recruited 15 participants and yet the population of interest is very large. It is difficult to infer the results from 15 breast cancer patients onto the whole population of breast cancer patients. This means that there is likely to be a population of breast cancer patients who will not conform to the research results. There is a need to recruit more participants in the research to address this limitation (Lesiuk, 2015). Findings The mean age for the 15 participants was reported as 52.6 years with the oldest being 70 years and the youngest being 27 years. The attention scores improved after the MBMT program was implemented ( F [1,14] = 6.69, p =0.022). Similarly, the mood scores showed improvement after the MBMT program was implemented ( F [5,65] = 20.83, p <0.001). Based on the research results, it can be accepted that the MBMT program improves attention and mood for breast cancer patients subjected to treatment using chemotherapy (Lesiuk, 2015). The whole research process has been presented in the article (to include the statistical analysis procedure) thereby showing that arriving at the research results following a logical process that can be replicated. The research findings answer the research question by showing that there is justification for using MBMT alongside adjuvant chemotherapy treatment for breast cancer patients to prevent attention decline and mood distress. Based on these findings, MBMT should be used alongside chemotherapy for treating breast cancer patients to ensure that the negative effects of chemotherapy noted in cognitive functions are preempted. NR439: Evidence-Based Practice – Research Article Critique essay examples. Summary of the Article Lesiuk (2015) explores the potential for using MBMT to preempt the attention decline and mod distress noted breast cancer patients treated using chemotherapy. This is achieved by applying a quantitative, descriptive, longitudinal design that uses Conners’ Continuous Performance Test II (CPT-II) version 5 to collect data on attention and POMS-BF to collect data on mood. 15 breast cancer patients undergoing treatment using chemotherapy were subjected to MBMT along with the data collection tools after which the participants mood and attention was evaluated for MBMT’s effect. Although the study proceeded to conclusion, the small sample size limited its application since this was a small sample when compared to the whole population of breast cancer patients. Based on the research results, it was noted that MBMT should be used alongside chemotherapy for treating breast cancer patients to ensure that the negative effects of chemotherapy noted in cognitive functions are preempted NR439: Evidence-Based Practice – Research Article Critique essay examples. References Babbie, E. (2016). The Basics of Social Research (7 th ed.). Boston, MA: Cengage Learning. Creswell, J. (2013). Research design: qualitative, quantitative, and mixed methods approaches (4 th ed.). Thousand Oaks, CA: SAGE Publications. Lesiuk, T. (2015). The effect of mindfulness-based music therapy on attention and mood in women receiving adjuvant chemotherapy for breast cancer: A pilot study. Oncology Nursing Forum , 42(3), 276-282. Yanow, D. & Schwartz-Shea, P. (2015). Interpretation and Method: Empirical research methods and the interpretive turn (2 nd ed.). New York, NY: Routledge. NR439: Evidence-Based Practice – Research Article Critique essay examples.

Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example

Benchmark – Professional Capstone and Practicum Reflective Journal

FYI : My Capston project is on Obesity

Details:

Students are required to maintain weekly reflective narratives throughout the course to combine into one course-long reflective journal that integrates leadership and inquiry into current practice as it applies to the Professional Capstone and Practicum course. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

In your journal, you will reflect on the personal knowledge and skills gained throughout this course. The journal should address a variable combination of the following, depending on your specific practice immersion clinical experiences:

1.New practice approaches

2.Intraprofessional collaboration

3.Health care delivery and clinical systems

4.Ethical considerations in health care

5.Population health concerns

6.The role of technology in improving health care outcomes

7.Health policy

8.Leadership and economic models

9.Health disparities

BUY A PLAGIARISM-FREE PAPER HERE

Students will outline what they have discovered about their professional practice, personal strengths and weaknesses that surfaced, additional resources and abilities that could be introduced to a given situation to influence optimal outcomes, and finally, how the student met the competencies aligned to this course. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

Reflective Journal

Week 1: New practice approaches

This was the first week, marking an introductory phase to the material we would be covering for the rest of the semester Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example. In fact, it focused on the concept of evidence based practice. In this case, the material presented for the week allowed me to develop an appreciation for the assessment skills and knowledge nurses apply in clinical practice. At the core of the information presented for the course is an emphasis on the nurses’ role in reasoning about diagnostics, aligning thoughts with evidence, reducing risk factors and promoting health. For that matter, the week’s material allowed me to learn strategies for adapting nursing techniques and questions when faced with challenging communication situations, particularly when the patient experiences time-based changes or the patient’s response is unanticipated. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example. Overall, I understand that the unique and unexpected features of the health care environment can help me analyses and apply nursing notions even as I am prepared to effectively practice within any medical care environment. Besides that, the week’s content allowed me to develop an appreciation for how evidence can reinforce the right features of objective and subjective information collection as well as the variations needed for different cultures, age groups and problems (Jensen, 2014).

Week 2: Intraprofessional collaboration

The content for week 2 gave me a new appreciation for intraprofessional collaboration. In fact, I learnt that it is important to maintain collaborative relationships with my nursing colleagues since exchanging information would allow me to gain a better awareness of disease transmission and the appropriate safety precaution Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example. First, was an understanding of collaboration as a multifaceted progression that uses shared responsibility, individual responsiveness and effective communication to ensure that patients receive the best possible nursing care. In essence, effectively collaborating between nurses requires that each nurse concede that individual work achieves less than teamwork such that effective collaboration is guaranteed to offer quality when presenting patient care. Through intreprofessional collaboration, nurses can improve professional performance components that include innovation, shared responsibility and coordination. Also, it reduces tardiness and absenteeism rates. Additionally, it improves decision-making, individual performance, and the nurses’ satisfaction. Besides that, it improves the quality of healthcare. An important aspect of the week’s material was the connotation that intraprofessional collaboration is best achieved through dissention being suppressed, threats being used coercively, emotional support, and sharing knowledge and tasks as tactics (Shohani et al., 2017). Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Week 3. Health care delivery and clinical systems

Attending the classes for week 3 allowed me to gain a better appreciation of clinical systems. It first presented material on the dynamics affecting nursing practice. Next the content identified the main challenges affecting nursing care delivery. This was followed by a tally of the different settings in which patients can receive nursing care. The different types of patient populations were then distinguished. It distinguished the concepts of nursing certification, accreditation and licensure, as well as the functions of nursing agencies. Finally, it identified and described nursing associations and organizations (Wessel & Manthey, 2015). At the conclusion of this week’s material, I understood that nursing care delivery systems are complex with facets that are dependent on the input from different stakeholders.

Week 4. Ethical considerations in health care

This week’s content acknowledged that nurses struggle with ethical challenges in their professional duties. At the core of this struggle is centrality, communication and confidentiality when providing care. In fact, nurses are expected to uphold foundational ethical principles, duties and virtues. Despite this awareness, the unimpressive reality is that nursing personnel are increasingly finding it difficult to practice with integration since they are faced with complex ethical pressures and choices. In essence, nursing personnel can face profound ethical questions of wrong and right to underlie beneficent care provision and decision-making (Scott, 2017) Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example. For instance, as a nursing practitioner, I question the balance between the value of preserving the life of a patient requiring palliative care versus using aggressive physiological approaches to prolong the patient’s anguish while not yielding any meaningful results in terms of providing a cure. The week’s made it clear that each ethical choice scenario is unique and the same choice will have different implications for two different situations. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Week 5. Population health concerns

The lecture material presented population health as focusing on entire population with similar characteristics and medical care concerns. In fact, it presents the results of evaluating the needs of the whole community, addressing these needs as broad health determinants while considering multiple levels of nursing practice. In this case, the practice levels refer to the individual, community and system. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example. The individual includes the family as the smallest population unit with the focus being on altering behavior, practice, beliefs, attitudes, and knowledge for the best outcomes. The community focus looks at behaviors, practices, awareness, attitudes and norms inherent within the community and affect health. The system focus looks at power structures, laws, policies, regulations, and organizations that have an impact on health (Holzemer & Klainberg, 2014). As a nursing practitioner, I am expected to determine an appropriate practice level to address an existing health problem, then develop effective nursing strategies for that level before assigning resources towards the selected strategies. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Week 6. The role of technology in improving health care outcomes

The course material identified technology as being very beneficial to health care outcomes. In fact, it is not possible to appreciate the role of technology without reflecting on how much care provision has changed over the years. For medical facilities and organizations, technological advances has improved public engagement and communication. For nursing personnel and other medical professionals, it has improvement information assessment and records sharing although it raises issues about how information access is governed. For patients and other members of the public, technology advances has offered them tools that facilitate health management through peer support, advice, information acquisition, and support arrangements. Despite the position that technology plays in improving health care outcomes for different stakeholders, it has also introduced some challenges to include cultural change, technical integration, scalability, and financial pressure (Davis & LaCour, 2014). Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Week 7. Health policy

Health policy is presented as a tool for shaping the provision of nursing care. In this case, nurses are presented as persons who have close contact with the patients they serve thus allowing them to better understand their patients’ health care needs. For that matter, nurses are able to speak on behalf of their patients, acting as a logical option for leading the way when setting priorities for health policies. This justifies nurses’ involvement in policy development since they are positioned to offer important information due to their close proximity and interaction with patients, their families, and other community members (Porche, 2017). Through attending this week’s material on health policy, I now understand the opportunities available to me to influence health policies and even translate research into policy implementation.

Week 8. Leadership and economic models

This week’s material conceded that there is limited awareness of nurses’ contribution (whether in terms of potential or significance) to health care through profession, science, policy and practice. Through reviewing the material, I comprehended that investment in nursing can present economic, social and clinical returns. Still, the returns can only be achieved if nurses are involved at the leadership level, other only some of these returns would be achieved (Shamian & Ellen, 2016). As such, as a nursing practitioner, I should encourage investment in nursing to include assigning leadership roles as a tool for improving care outcomes Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Week 9. Health disparities

The material presented this week mentioned that prejudice exists in health care delivery. In fact, data on health disparities should that mortality rates for preventable issues such as drugs, car accidents, suicide, premature births, and chronic ailments were higher for certain population demographics such as marginalized communities. To reverse the reality of health disparities, nurses must be part of developing a solution since they are privileged to interact with their patients and community in an intimate way. In essence, nurses must be ready to address the quality of human life by treating everyone with attention and equally. Ultimately, my understanding of the content is that every person deserves to receive the same nursing care and anything less than equality would be simply unethical (Wesley, 2011). Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Conclusion

The nine units I attended have advanced my knowledge of nursing practice. In fact, I believe that they have turned me into a more proficient nurse capable of offering the best possible nursing care. Still, I believe that some of the material was only covered shallowly and should be expounded on in more detail. That is to say that one week was not enough to comprehensively cover each unit. As such, I would recommend that more time should be assigned to each unit’s coverage. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

References

Davis, N. & LaCour, M. (2014).
Health information technology
(3
rd
ed.). Amsterdam: Elsevier.

Holzemer, S. & Klainberg, M. (2014).
Community health nursing: an alliance for health
(2
nd
ed.). Burlington, MA: Jones & Bartlett Learning.

Jensen, S. (2014).
Nursing health assessment: a best practice approach
(2
nd
ed.). Philadelphia, PA: Lippincott Williams & Wilkins.

Porche, D. (2017).
Health policy: application for nurses and other health professionals
(2
nd
ed.). Burlington, MA: Jones & Bartlett Learning. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Scott, A. (2017).
Key concepts and issues in nursing ethics
. Cham: Springer International Publishing AG.

Shamian, J. & Ellen, M. (2016). The role of nurses and nurse leaders on realizing the clinical, social, and economic return on investment of nursing care.
Health Management Forum
, 29(3), 99-103.

Shohani, M., Valizadeh, L., Zamanzadeh, V. & Dougherty, M. (2017). Effective individual contributions on iranian nurses intraprofessional collaboration process: a qualitative study.
Journal of Caring Sciences
, 6(3), 213-220. doi: 10.15171/jcs.2017.021 Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.

Wesley, Y. (2011). Leadership and healthcare disparities.
Nursing Management,
42(8), 40-45.

Wessel, S. & Manthey, M. (2015).
Primary nursing: person-centered care delivery system design
. Minneapolis, MN: Creative Health Care Management. Benchmark – Professional Capstone and Practicum Reflective Journal – Obesity Essay Example.