Category: Nursing

  • Eczema unresponsive to treatment

    Eczema unresponsive to treatment

    Patient care hinges in part on adequate and timely information exchange between treating providers. Referral and reply letters are common means by which doctors and nurse practitioners exchange information pertinent to patient care.

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    Ensuring that letters meet the needs of letter recipients saves time for clinicians and patients, reduces unnecessary repetition of diagnostic investigations, and helps to avoid patient dissatisfaction and loss of confidence in medical practitioners.As a Nurse Practitioner (NP) you will need to know the difference between a consultation and a referral for treatment, when ordering and when carrying out consultations or referrals.ConsultationsA consultation is a request for opinion or advice, so that the requestor can manage the patient. A consultation is billed under one of the consultation codes listed in Physicians’ Current Procedural Terminology (CPT) (99241-99245 for outpatient of office consultations). If the NP is the consultant, the NP should document the request for a consultation, the reason for the consult, and the NP’s evaluation and recommendations.When an NP requests a consultation from another provider, the N P should request “consultation” on the referral form, rather than “referring.”
    Referrals:
    A referral is made when the referring provider wants to turn the management of the patient over to the referred-to provider, at least for the current complaint.When a NP refers a patient, the NP should state on the referral form that the NP is “referring the patient for evaluation and treatment.” The referred-to provider will bill an evaluation and management code, rather than a consultation code. 
    Writing Assignment: Consult:
    Write up a consult request and include all key elements.Ms. Perez has been referred to Ms. Wilson FNP-C,APRN, MSN  for consultation regarding eczema unresponsive to treatment in the past six months. Document the evaluation and recommendations for how Ms. Wilson FNP-C,APRN,MSN should deal with the consultation request and bill a consultation code eczema unresponsive to treatment. 
    Writing Assignment: Referral:
     Write up a referral request and include all key elements.As an NP and Ms. Perez primary care provider, you decide to refer her to Dr. Owens a dermatologist for evaluation and treatment regarding eczema unresponsive to treatment in the past six months.1. Document your referral to Dr. Owens2. Document the evaluation and recommendations for how Dr. Owens should deal with the referral and bill a referral code.

    Written Paper (Microsoft Word doc): minimum 2000 words using 6th edition APA formatting  Please review the grading rubric under Course Resources in the Grading Rubric section. eczema unresponsive to treatment.

  • Reflective Practice: Pants on Fire

    Reflective Practice: Pants on Fire

    Read the section titled “Reflective Practice: Pants on Fire” from chapter “Health Policy, Politics, and Professional Ethics” and address the questions below:

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    How do you judge Palin’s quote? [“And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.] Effective strategy to oppose Democrats’ plans for health care reform or unethical scaremongering?

    Reflect on what informs your judgment: commitment to advance care planning, analysis of facts, and/or political party loyalties?

    Is it right for nurses to endorse health reform legislation even if the legislation is not perfect? Does this apply to the recently failed American Health Care Act? Reflective Practice: Pants on Fire

    Reflective Practice: Pants on Fire

    Sarah Palin is famous for urging her supporters to oppose Democratic plans for health care using the scare tactic of death panels. She said the Democrats plan to reduce health care costs by simply refusing to pay for care:

    And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s death panel so his bureaucrats can decide, based on a subjective judgment of their level of productivity in society, whether they are worthy of health care. Such a system is downright evil.

    In fact there was no panel in any version of the health care bills in Congress that judges a person’s level of productivity in society to determine whether they are worthy of health care.

    The truth is that the proposed health bill would have allowed Medicare, for the first time, to pay for optional doctors’ appointments for patients to discuss living wills and other end-of-life issues with their physicians. PolitiFact awarded Palin with the 2009 Lie of the Year for the death panel claim, but the political impact of her statement is hard to overstate. In 2011, the Obama administration even deleted all references to end-of-life planning in a new Medicare regulation when opponents interpreted the move as a back-door effort to allow such planning. So even, in the regulations Palin achieved her goal (Holan, 2009). Reflective Practice: Pants on Fire

  • NURS 6670 Reimbursement Rate Template

    NURS 6670

    Reimbursement Rate Template

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    Type of Service

    eg. -New office visit

    -Established office visit

    -Inpatient hospital

    -individual psychotherapy

    -group psychotherapy (see examples below)

    CPT code

    Private insurer reimbursement rate for PMHNP

    Private insurer reimbursement rate for physicians

    Medicare

    reimbursement rate for PMHNP

    Medicare

    reimbursement rate for physician

     

     

     

     

    NURS 6670 Reimbursement Rate Template

     

     

     

     

     

     

     

    As the PMHNP becomes proficient in diagnosing and treating, it is also important to learn how to bill for your time. The CMS sets up codes to identify the type of service you are providing. You will generally complete this task at the end of the visit as you are documenting the visit with the client. Here are examples of the codes to know:

    CPT Codes for Psychiatric and Psychological Procedures

     

    HMSA recognizes the following service codes for the reporting of psychiatric and psychological services. (See
    Code Books
    for information on how to obtain the books.) NURS 6670 Reimbursement Rate Template.

     

    CPT Code

    Footnote(s)

    Description

    90791

    1

    Psychiatric diagnostic evaluation

    90792

    1,3

    Psychiatric diagnostic evaluation with medical services

    90832

    2

    Psychotherapy, 30 minutes with patient and/or family member

    90833

    2,3

    Psychotherapy, 30 minutes with patient and/or family member when performed with an evaluation and management service

    90834

    4

    Psychotherapy, 45 minutes with patient and/or family member

    90836

    3,4

    Psychotherapy, 45 minutes with patient and/or family member when performed with an evaluation and management service

    90837

    6

    Psychotherapy, 60 minutes with patient and/or family member

    90838

    3,6

    Psychotherapy, 60 minutes with patient and/or family member when performed with an evaluation and management service

    90839

    6

    Psychotherapy for crisis; first 60 minutes

    90840

    2

    each additional 30 minutes

    90846

    4

    Family psychotherapy (without the patient present)

    90847

    4

    Family psychotherapy (conjoint psychotherapy) (with patient present)

    90849

    4

    Multiple-family group psychotherapy

    90853

    4

    Group psychotherapy (other than of a multiple-family group)

    90870

    1, 5

    Electroconvulsive therapy (includes necessary monitoring)

    96101

    1

    Psychological testing (includes psychodiagnostic assessment of personality, psychopathology, emotionality, intellectual abilities, e.g., WAIS-R, Rorschach, MMPI) with interpretation and report, per hour. NURS 6670 Reimbursement Rate Template.

     

    Note:
    All hours of psychological testing done on a single day will be counted as one visit (either inpatient or outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum. However, payment will be made to the participating provider on a per-hour basis.

    96118

    1

    Neuropsychological testing battery (e.g., Halstead-Reitan, Luria, WAIS-R) with interpretation and report, per hour

     

    Note:
    All hours of psychological testing done on a single day will be counted as one visit (either inpatient or outpatient as appropriate) toward the patient’s inpatient or outpatient visit maximum. However, payment will be made to the participating provider on a per-hour basis.

     

    Links to websites that discuss this:

    https://www.psychiatry.org/psychiatrists/practice/practice-management/coding-reimbursement-medicare-and-medicaid/coding-and-reimbursement

    http://www.mb-guide.org/medical-coding-guidelines.html

    NURS 6670 Reimbursement Rate Template

  • Calculating t-tests for Independent Samples

    Calculating t-tests for Independent Samples Question description

    Calculating 
    t
    -tests for Independent Samples: Hello, help needed on these questions.

    Data Set: 
    Click to use this data set for this assignment

    EXERCISE 31

    Calculating 
    t
    -tests for Independent Samples

    1. Do the example data meet the assumptions for the independent samples 
    t
    -test? Provide a rationale for your answer.

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    2. If calculating by hand, draw the frequency distributions of the dependent variable, wages earned. What is the shape of the distribution? If using SPSS, what is the result of the Shapiro-Wilk test of normality for the dependent variable?

    3. What are the means for two group’s wages earned?

    4. What is the independent samples 
    t
    -test value?

    5. Is the 
    t
    -test significant at 
    a 
    = 0.05? Specify how you arrived at your answer.

    6. If using SPSS, what is the exact likelihood of obtaining a 
    t-
    test value at least as extreme or as close to the one that was actually observed, assuming that the null hypothesis is true?

    7. Which group earned the most money post-treatment? Calculating t-tests for Independent Samples.

    8. Write your interpretation of the results, as you would in an APA-formatted journal.

    9. What do the results indicate regarding the impact of the supported employment voca­tional rehabilitation on wages earned?

    10. Was the sample size adequate to detect significant differences between the two groups in this example? Provide a rationale for your answer.

    EXERCISE 32 

    Calculating 
    t
    -tests for Paired (Dependent) Samples

    Data Set: 
    Click to use this data set for this assignment

    1. Do the data meet the assumptions for the paired samples 
    t
    -test? Provide a rationale for your answer.

    2. If calculating by hand, draw the frequency distributions of the two variables. What are the shapes of the distributions? If using SPSS, what are the results of the Shapiro-Wilk tests of normality for the two variables?

    3. What are the means for the baseline and post-treatment affective distress scores, respectively?

    4. What is the paired samples 
    t
    -test value?

    5. Is the 
    t
    -test significant at α = 0.05? Specify how you arrived at your answer.

    6. If using SPSS, what is the exact likelihood of obtaining a 
    t-
    test value at least as extreme as or as close to the one that was actually observed, assuming that the null hypothesis is true?

    7. On average, did the affective distress scores improve or deteriorate over time? Provide a rationale for your answer. Calculating t-tests for Independent Samples.

    8. Write your interpretation of the results as you would in an APA-formatted journal.

    9. What do the results indicate regarding the impact of the rehabilitation on emotional dis­tress levels?

    10. What are the weaknesses of the design in this example? Calculating t-tests for Independent Samples.

  • Mrs. Klausman assisted living facility Case Study

    Mrs. Klausman assisted living facility Case Study

    Can Mrs. Klausman Stay in Assisted Living?

    Mrs. Klausman is a 92-year-old resident in an assisted living facility. She has a mild cognitive impairment and needs help with bathing and medication administration. Because of progressive arthritis, she is having difficulty eating. The silverware slips out of her hands and falls to the floor so that staff members must keep replacing it. Mrs. Klausman becomes visibly frustrated and embarrassed. The food service manager and the administrator decide to meet with Mrs. Klausman’s daughter and recommend that the family should hire a home care provider to assist Mrs. Klausman at mealtimes. The facility does not have staff resources to feed residents. The resident’s daughter is thinking whether a skilled nursing facility would be more appropriate for her mother.

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    Questions

    1.  Identify and evaluate Mrs. Klausman’s deficit in self-feeding from different perspectives on what long-term care consists of.

    2.  Should Mrs. Klausman be transferred to a skilled nursing facility? Explain.

    3.  Is hiring a homemaker appropriate? Why or why not? What do you suggest? Mrs. Klausman assisted living facility Case Study

    Chapter 1 Case study

    Identify and evaluate Mrs. Klausman’s deficit in self-feeding from different perspectives on what long-term care consists of. Long-term care is associated with physical and/or mental deficits that limit a person’s ability to do regular daily tasks that most humans take for granted. Long -term care services are needed under three circumstances such as the need for assistance in doing tasks of daily living, need for continuity of care after hospitalization, and need for care in specialized environments. There are two standard measures that are available to assess a person’s level of dependency which are the activities of daily living(ADL) and instrumental activities of daily living(IADL). In Mrs. Klausman’s case, she falls under the ADL measure by her level of dependency. Due to her progressive arthritis, she is unable to feed herself and that is one of the daily living activities she needs assistance with. Mrs. Klausman assisted living facility Case Study.

    Should Mrs. Klausman be transferred to a skilled nursing facility? Explain. I think Mrs. Klausman should be transferred to a skilled nursing facility because she has a mild cognitive impairment, she needs help with bathing and medication application, and she also has progressive arthritis which makes it difficult for her to feed herself. Mrs. Klausman assisted living facility Case Study. So, a skilled nursing facility will be good for her and it is adequately equipped to care for someone with complications such as herself.

    Is hiring a homemaker appropriate? Why or Why not? What do you suggest? A homemaker would not be appropriate because Mrs. Klausman needs more than just assistance during meal-time. She has a mild cognitive impairment which is a mental disorder that is indicated by a person having difficulty remembering, learning new things, concentrating, or making decisions that affect the individual’s everyday life. She would need around the clock care and assistance during meal-time is not enough. If Mrs. Klausman’s daughter decides to get a home-maker, I would suggest she get a skilled nurse from the skilled nursing facility who can assist Mrs. Klausman’s multiple conditions and needs. Mrs. Klausman assisted living facility Case Study

  • EHR Proposal Summary

    EHR Proposal Summary

    Imagine
     you are working at a doctor’s office. You are approached by the office manager, who asks you to develop an effective way of storing patient information.

    Write
     a 350- to 700-word summary to your office manager informing her of the advantages of using electronic health records (EHRs) to store patient information. Be clear and concise, use complete sentences, and use examples to support your responses.

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    Include
     the following in your response:

    Discuss the functions and advantages of using EHRs.

    Discuss three to four forms used to keep patient information in EHRs.

    What is the purpose of each form? EHR Proposal Summary.

    EHR Proposal Summary – Sample 1

    Storing patient information has never been easier.  Gone are the days of rooms full of filing cabinets and rows of files.  With the advancement of technology in medicine comes the use of Electronic Healthcare Records (EHRs).  EHRs allow offices to store patient’s records electronically, thus streamlining their patient files.  EHRs will revolutionize the way that our office provides care to the patients.  Through their various functions, advantages, and forms used we will be able to move this practice further into the technological age of record keeping. EHR Proposal Summary.

    Electronic health care records have many functions that will help this office change the way keep patient records.  The first function that EHRs provide a way to keep track of and manage every patient’s record individually, and electronically (Gartee, 2011).  They also keep track of patient demographic information and care management data (US Department of Health and Human Services, n.d.).  Having a person’s information in an electronic format helps to ensure correctness, and provide ease of access.  Next, the electronic healthcare record operates as a legal document.  In court proceedings, a lawyer can use their client’s health record to prove wrongdoing or evidence in a case (Gartee, 2011).  Another function of an EHR is it is used to prescribe medication electronically (US Department of Health and Human Services, n.d.).  A physician can fill out a prescription for a patient and send it to the pharmacy electronically thus saving time and issues with confusing handwriting.  Lastly, records help in patient education (US Department of Health and Human Services, n.d.).  At the end of an appointment, a doctor can use an EHR to print information on a patient’s condition or exam notes for that consultation.  These standard functions of EHRs better shape the ability to keep track of the patients in this office.

    Not only do EHRs serve multiple functions, but they also have many advantages to using them.  The first advantage in electronic records is thorough, up-to-date records on every patient (Health IT, n.d.).  Having up-to-date information reduces the chance of a medical error.  Using EHRs will enable our office to have faster access to every patient’s record when needed, and also the ability to share with specialists in a secure manner (Health IT, n.d). EHR Proposal Summary.  Thus, saving the patient time from filling out redundant paperwork.  Another advantage of EHRs is the ability for physicians to better diagnose patient ailments (Health IT, n.d.).  Lastly, they will lessen the amount of time spent on every patient’s record; therefore, increasing the time with patients. (Health IT, n.d.).  EHRs have many advantages that will further this practice technologically.

    Like their paper counterparts, EHRs still use forms to store patient’s information.  The first example is the registration form.  This type of form includes patient’s demographic data such as home address, and phone numbers (Gartee, 2011).  This form is one of the most important, and if mistakes occur, it could mess up billing later on.  The second type of form used is various consent forms.  Consent forms such as treatment agreements or HIPPA consent are common examples of a consent form (Gartee, 2011).  The primary purpose of these forms is to protect the patient from unauthorized care or viewing of their records.  The third type of form is a patient’s medical history.  Having this form on file for every patient is important so that the physician or nurse has a comprehensive background, and can make decisions based on the forms data.  If data is missing mistakes could happen to jeopardize patient care.  Forms are the backbone of an EHR, by providing accurate and complete data physicians will know to treat the patients.

    As you can see, switching to EHRs from our current paper method is a better solution to storing patient files.  The functions and advantages of records continue to improve the capabilities of medical professionals on a daily basis, leaving more time to spend with patients.  The same forms that took up excess space in files would now be in digital format making it easier to find patient data.  Patients are the customers of medicine, and by using electronic health records instead of paper, we can provide a better medical experience each time.

    References

    Gartee, R. (2011). Health information technology and management. Retrieved from The University of Phoenix eBook Collection database. EHR Proposal Summary.

    Health IT. (n.d.). What are the advantages of electronic health records?. Retrieved from https://www.healthit.gov/providers-professionals/faqs/what-are-advantages-electronic-health-records

    US Department of Health and Human Services. (n.d.). Common EHR functions. Retrieved from http://www.hrsa.gov/healthit/toolbox/healthitimplementation/implementationtopics/selectcertifiedehr/selectacertifiedehr_5.html

    EHR Proposal Summary Sample 2

     
    As a health care provider, you have so many different concerns on a day to day basis when it comes to the EHR system at the office. You should know your advantages and disadvantages of an EHR system and what you can benefit from to your facility and staff. The advantages that I would consider addressing would be improving the aspects of health care for the well-being and safety of the patient’s overall care. The EHR system ameliorates order and decreases the health care costs by encouraging preventive medicine and enhance straight order of health care services, and decreasing waste and unnecessary tests. EHR Proposal Summary. EHR system has different characteristics that authorize a superior clinical conclusion building by cross examining patient information from numerous areas (healthit.gov, 2014).

    There are more advantages for the EHR system in the office of a provider with real time information on all clients at the time needed for service. This gives the faculty time to have all the clients records quickly as possible for a more smoother transition of care. EHRs additionally contribute a reliable electronic data will share with clients in the hospitals. EHR systems authorize providers with achievable results for the patients. Lower medical mistakes and supply protected care with ready to use guide that the provider use for physical exam care. Health maintaining is a great tool that is contained in EHR systems to stop diseases and to catch it at the beginning stage, this is down with precautionary care screenings and immunizations that’s within the plan of care systems. (Gartee, 2011). EHR Proposal Summary. EHR systems has more great advantages that enhances the communication interaction from clients to providers so the provider has looked over the reason for the ins office visit so they have a brief description to the diagnosis. It is vital that EHR systems have accurate legible, and complete patient information for health care providers and billing purposes. (healthit.gov, 2014). EHR Proposal Summary.

    EHRs provide different applications for client information that takes the place of the paper forms. One vital form that is in electronic system with access to patient demographic’s, insurance and urgent contact information. Some of the features that are different from paper is electronic system can send reminders and alerts via text or email if the client requests like for billing, scheduling and patient information.   Intake forms are for past medical history that offers you the option to record the information quicker, with the access to the check off boxes, drop down menu, popup windows for easy access. (Gartee, 2011). Intake forms make it a smooth transition for providers to go right to it by the click of the browsers. Flow charts show information for resent data from different tables that has a side by side comparison of information over a period (Gartee, 2011). Flowchart stores client’s vitals and taking in/take out information that can be related to diagnosing patients. Many hospital settings use these flow charts to capture patient vitals, take in/take out for shift to shift to relate to a patient’s state during a particular time frame. EHR Proposal Summary. Physicians may order diagnostic tests, labs and prescriptions when completing a total exam. Another feature is commercial EHR systems is to keep a copy of clinical frequently used orders that the provider all prescription by a click of the mouse (Gartee, 2011).. The motivation of all the forms is to become better in all direction of patient care, communication, education, timeliness, efficiency and equity.

    References

    Gartee, R. (2011).
    Health Information Technology and Management
    (first edition). Upper Saddle River, NJ: Prentice Hall. EHR Proposal Summary.

    gov. (2014, September 4). What are the advantages if electronic health records? Retrieved from http://www.healthit.gov/providers-professionals/faqs/what-are-advantages-electronic-health-records

  • Asthma And Stepwise Management Essay

    Asthma And Stepwise Management Essay

    Asthma is a respiratory disorder that affects children and adults. Advanced practice nurses often provide treatment to patients with these disorders. Sometimes patients require immediate treatment making it essential that you recognize and distinguish minor asthma symptoms from serious, life-threatening symptoms. Since symptoms and attacks are often induced by a trigger, advanced practice nurses must also help patients identify their triggers and recommend appropriate management options. Asthma And Stepwise Management Essay. Like many other disorders, there are various approaches to treating and managing care for asthmatic patients depending on individual patient factors. One method that supports the clinical decision-making of drug therapy plans for asthmatic patients is the stepwise approach, which you explore in this Assignment. Asthma And Stepwise Management Essay.

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    To prepare
    :

    · Consider drugs used to treat asthmatic patients including long-term control and quick relief treatment options for patients. Think about the impact these drugs might have on patients including adults and children.

    · Review Chapter 25 of the Arcangelo and Peterson text. Reflect on using the stepwise approach to asthma treatment and management.

    · Consider how stepwise management assists health care providers and patients in gaining and maintaining control of the disease. Asthma And Stepwise Management Essay.

    What to do
    :

    · Describe long-term control and quick relief treatment options for asthma patients, as well as the impact these drugs might have on patients.

    · Explain the stepwise approach to asthma treatment and management.

    · Explain how stepwise management assists health care providers and patients in gaining and maintaining control of the disease.

    Please pay attention to drug-drug interactions. Asthma And Stepwise Management Essay.

     

    The NLH guidelines for asthma are a good reference.

    – This work should have Introduction and conclusion

    – This work should have at 4 to 6 current references (Year 2012 and up)

    – Use at least 2 references from class Learning Resources Asthma And Stepwise Management Essay

    The following Resources are not acceptable
    :

    1. Wikipedia

    2. Cdc.gov- nonhealthcare professionals section

    3. Webmd.com

    4. Mayoclinic.com

    Required Readings

    Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). 
    Pharmacotherapeutics for advanced practice: A practical approach
     (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

    Chapter      18, “Otitis Media and Otitis Externa” (pp. 243-252)

    This chapter compares the causes and pathophysiology of two common ear      infections—otitis media and otitis externa. It also identifies types of      drugs used to treat these ear infections.

    Chapter      24, “Upper Respiratory Infections” (pp. 259-374)

    This chapter explores the causes, pathophysiology, and diagnostic criteria      of two upper respiratory infections—the common cold and sinusitis—as well      as drug therapy for both infections. It also covers monitoring patient      response and patient education of drug therapy for these infections. Asthma And Stepwise Management Essay.

    Chapter      25, “Asthma” (pp. 377-392)

    This chapter examines the causes, pathophysiology, pharmacogenomics, and      diagnostic criteria of asthma. It also outlines suggested drug therapy      plans for asthmatic patients.

    Chapter      26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)

    This chapter explains the causes and pathophysiology of chronic      obstructive pulmonary disease (COPD). It also examines the process of      selecting, administering, and managing drug therapy for COPD patients.

    Chapter 27, “Bronchitis and      Pneumonia” (pp. 407-424)

    This chapter begins by examining the causes, pathophysiology, and      diagnostic criteria of acute bronchitis, chronic bronchitis, and      community-acquired pneumonia. It then explores the process of selecting,      administering, and managing drug therapy for patients with bronchitis and      pneumonia.

    Drugs.com. (2012). Retrieved from http://www.drugs.com/

    This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

    National Heart Lung and Blood Institute. (2007). 
    Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma
    . Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

    This website presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.
      Asthma And Stepwise Management Essay

  • Evidence-based practice proposal topic for the capstone project assignment

    Evidence-based practice proposal topic for the capstone project assignment

    In collaboration with your approved course mentor, you will identify a specific evidence-based practice proposal topic for the capstone project. Consider the clinical environment in which you are currently working or have recently worked. The capstone project topic can be a clinical practice problem, an organizational issue, a quality improvement suggestion, a leadership initiative, or an educational need appropriate to your area of interest as well as your practice immersion (practicum) setting. Examples of the integration of community health, leadership, and an EBP can be found on the “Educational and Community-Based Programs” page of the 
    Healthy People 2020
     website.

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    Write a 500-750 word description of your proposed capstone project topic. Make sure to include the following:

    The problem, issue, suggestion, initiative, or educational need that will be the focus of the project

    The setting or context in which the problem, issue, suggestion, initiative, or educational need can be observed.

    A description providing a high level of detail regarding the problem, issue, suggestion, initiative, or educational need. Evidence-based practice proposal topic for the capstone project assignment.

    Impact of the problem, issue, suggestion, initiative, or educational need on the work environment, the quality of care provided by staff, and patient outcomes.

    Significance of the problem, issue, suggestion, initiative, or educational need and its implications to nursing.

    A proposed solution to the identified project topic

    You are required to retrieve and assess a minimum of 8 peer-reviewed articles. Plan your time accordingly to complete this assignment. Evidence-based practice proposal topic for the capstone project assignment.

  • Diabetes And Blood Pressure Teaching Plan Related To Obesity

    Diabetes And Blood Pressure Teaching Plan Related To Obesity

    This is an individual assignment. In 1,500-2,000 words, describe the teaching experience and discuss your observations. The written portion of this assignment should include:

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    Summary of teaching plan

    Epidemiological rationale for topic

    Evaluation of teaching experience

    Community response to teaching

    Areas of strengths and areas of improvement

    Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    You are required to submit this assignment to Turnitin. Diabetes And Blood Pressure Teaching Plan Related To Obesity.

  • NURS 6501 Assignment 1

    6501 Assignment 1

    As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis. NURS 6501 Assignment 1.

    Consider the following scenarios:

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    Scenario 1:

    Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute. NURS 6501 Assignment 1.

    Scenario 2:

    Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids, but says that it never hurt and he always washed his hands when he was finished. NURS 6501 Assignment 1.

    Scenario 3:

    Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred lately in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

    To Prepare

    · Review the three scenarios, as well as Chapter 6 in the Huether and McCance text.

    · Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations. NURS 6501 Assignment 1.

    · Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to construct a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

    · Review the Application Assignment Rubric found under Course Information

    To Complete

    Write a 2- to 3-page NURS 6501 Assignment 1 paper excluding the title page, reference page and Mind Map that addresses the following:

    · For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.

    · Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations. NURS 6501 Assignment 1.