Tag: Clinical-Nursing

  • NR447 RN Collaborative Healthcare

    NR447 RN Collaborative Healthcare

    Week 4 Discussion

    Transformational Nursing Leaders

    CO7 Apply leadership concepts in the development and initiation of effective plans for the microsystems and system-wide practice improvements that will improve the quality of healthcare delivery. (POs 2 and 3)

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    Review Appendix A, Sections I–V in Finkelman (2016).

    Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies. Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.

    In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?

    Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences.

    Week 4 Discussion

    Transformational Nursing Leaders NR447 RN Collaborative Healthcare

    CO7 Apply leadership concepts in the development and initiation of effective plans for the microsystems and system-wide practice improvements that will improve the quality of healthcare delivery. (POs 2 and 3)

    Review Appendix A, Sections I–V in Finkelman (2016).

    Select one of the sections and share how your chief nurse executive demonstrates expertise in these competencies. Your comments should be about the “highest nursing leader” in your organization. Typically this is the leader who represents nurses and nursing to the governing board.

    In your own words, explain the differences between a transactional nursing leader and a transformational nursing leader. What one is more like your Nurse Executive?

    Describe how the Nurse Executive “leads the charge” for transformational leadership in an organization where you work or have done prelicensure clinical experiences. NR447 RN Collaborative Healthcare.

  • NR394 Transcultural Nursing

    NR394 Transcultural Nursing

    Week 2 Discussion

    Transcultural Nursing Skills Self-Assessment

    CO2: Describe cultural differences related to drugs.

    CO4: Perform a culturally competent nursing assessment. (PO7)

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    Nurses complete assessments on individuals on a daily basis. Self-assessments are in order before considering our abilities to provide culturally competent nursing care. NR394 Transcultural Nursing.

    Complete Transcultural Nursing Skills Self-Assessment Form (Links to an external site.)Links to an external site.

    Note the number of No answers in your self-assessment. Share one or two of your No answers with your classmates, and describe how you will convert the No to a Yes over the next few weeks.

    What interventions are needed to turn each No into a Yes response NR394 Transcultural Nursing?

  • DNP820 Health Policy and Advocacy Essay

    DNP820 Health Policy and Advocacy Essay

    Module 1 Assignment

    Write a 1500 word APA essay reflecting on:

    1. The current nursing culture and whether the bar for nursing leadership is set at the individual patient-nurse relationship or the community-nurse relationship. Give examples of each.Use at least three references to support your findings.

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    2. Review the DNP Essentials and the 2011 Institute of Medicine Future of Nursing Report for statements on nursing leadership in health policy. Identify how these documents define nursing leadership in relation to health policy and the community. Use at least three references to support your findings DNP820 Health Policy and Advocacy Essay.

    Module 4 Discussion

    DQ1 Choose four nursing organizations. Compare and contrast their legislative agendas. Synthesize the connections between organizational missions and legislative agendas.

    DQ2 Evaluate the legislative priorities of four nursing groups. How many focus on the profession of nursing? How many focus on the health of the community? Support your discussion with two peer reviewed articles that evaluate advocacy of the nursing profession versus health patient/community DNP820 Health Policy and Advocacy Essay. How does advocating for the nursing profession support healthy outcomes?

    Module 4 Discussion

    DQ1 Choose four nursing organizations. Compare and contrast their legislative agendas. Synthesize the connections between organizational missions and legislative agendas.

    DQ2 Evaluate the legislative priorities of four nursing groups. How many focus on the profession of nursing? How many focus on the health of the community? Support your discussion with two peer reviewed articles that evaluate advocacy of the nursing profession versus health patient/community. How does advocating for the nursing profession support healthy outcomes? DNP820 Health Policy and Advocacy Essay.

  • NR393 nursing history Course Project Milestone 3 Template completed samples

    nr393 nursing history Course Project Milestone 3 Template completed samples

    Course Project Milestone 3 Template

    Prior to completing this template, carefully review Course Project Milestone 3 Guidelines paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly on this template, and save again. This assignment is due by Sunday end of Week 6 by 11:59 p.m. MT.

    Student Name:
    _______Alicia xxxx______________

    Assignment Criteria

    Type the statements into the boxes below. Use exact words spoken by each person.

    Note: See Milestone 3 Rubric for details required in each area.

    Introduction:

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    Student Introduction and Statement of Purpose

    30 points

     

    [Alicia:  Good afternoon Kathy, My name is Alicia Ellett. I would like to thank you for giving me the opportunity to interview with you today, like I mentioned before the purpose of this interview is for a class I am taking through Chamberlain College and I have asked you for permission to go forth with the interview, the date for this interview is Monday August 13
    th
    , 2018, and it is approximately 9 pm and we are located in the conference room of 3South Good Samaritan Hospital. As you are aware I have asked you to this interview as you have been a nurse for over 40 years and I feel you have great knowledge of how nursing has changed through out the years and I would love to hear your experiences.] nr393 nursing history Course Project Milestone 3 Template completed samples

    Nurse Introduction

    30 points

     

    [Alicia: So today I will be interviewing Katherine Lay, who is an RN, and holds her BSN. Kathy has been a nurse for over 40 years and has worked in a variety of med surg settings at Lancaster General Hospital in units that included orthopedics, oncology, urology and cardiac.]

    Nurse States Verbal Permission for Interview and Submission

    30 points

     

    [Alicia Ellett: Kathy before we begin this interview I would like your verbal permission to interview you and document your responses and submit to faculty for scoring purposes?]

    [Kathy: yes this is fine, you have my permission. ]

    Questions and Answers

    Primary Question 1

     

     

    [Alicia: Ok Kathy, let’s start with the first question. What where some of your favorite memories in nursing school]

    [Kathy: My favorite memories were probably clinical days, they were my favorite because they were exciting and scary all at once. For me it was the carrot that kept me wanting do the hard work and I knew it would lead me to bedside care. nr393 nursing history Course Project Milestone 3 Template completed samples. My favorite memory is the first time I had to do bedside care and I froze, I was walking past a patient to begin my med administration (he was a psych patient) and I thought I was prepared, in fact I thought nothing could scare me, yet when I first went to see my patient he threw a cup at me,( at the time I didn’t know what it was) I froze and bolted out the room. Everything I had learned went out the window and I walked right out the room, and my instructor marched me right back in and told me to get a grip. ]

    Follow-up
    a

    [Alicia: What were some of your favorite classes in Nursing school?]

    [Kathy: The college I attended required a year and a half of mandatory and elective classes before you were allowed to start the school of nursing, My favorite classes then and throughout college were the social sciences; sociology, philosophy, religion, but especially psychology. I also liked anatomy and physiology. Once I was accepted into the nursing program my favorite classes were pathophysiology, I loved to study diseases and their treatment.]

    Follow-up
    b

    [Alicia : How did classmates or instructors impact your development as a nurse?]

    [Kathy : The department head of the nursing school, Dr. Rena Lawrence, she was a phenomenal instructor and mentor. She encouraged, motivated and lead by example. Her evaluations were tough, but honest and fair. nr393 nursing history Course Project Milestone 3 Template completed samples. She in my opinion encapsulated everything I wanted to become as a nurse. Except the “Dr.” part. While I consider myself a lifelong learner, I never aspired to go beyond my BSN education.]

    Primary Question 2

    [Alicia: How have you improved the quality of nursing practice during your career?]

    [ Kathy: I believe I have improved the quality of nursing by the care I provide. I strive to better myself as a nurse every day. I take pride in what I do, and I try to improve in all areas I feel is a weakness. Technology has changed throughout my career and as you know Alicia I am not afraid to ask questions, and I may at times have to look to the younger generations for assistance. I am not ashamed in this nor do I feel threatened by the younger generation.  I even have to ask you for help at times, I have learned I have to keep up with the “times” in order to provide better care. I have learned to admit when I don’t understand something and I have learned to find the resources I need to find the answer. I am a patient advocate when I’m needed, I am a voice for other nurses especially when I serve as a mentor to a new nurse, my job is to educate them and make them feel welcome. When I serve as charge nurse I look out for other nurse and make sure their workload is acceptable and must always consider patient safety, all this I believe contribute to improved quality care for nurses. I hope I lead by example. ]

    Follow-up
    a

    [Alicia : What have been some major changes that has happened throughout your career with this profession?]

    [Kathy: I have seen so many changes throughout my forty years. Models of patient care delivery has shifted. Team nursing prevailed; when I first graduated as a registered nurse, LPN’s and nurse aids were responsible for 15-20 patients. Initially, only RN’s could give medication and a large part of your shift was spent doing this. When LPN’s became proficient in med administration, care delivery transitioned to primary nursing with RN’s responsible for the care of their assigned patients and oversight of the LPN”s care. Lately, we have seen a shift to an RN based primary care model in the acute care setting. Technology has probably played the biggest part in the changes I have witnessed nr393 nursing history Course Project Milestone 3 Template completed samples. It has touched every aspect of patient care from diagnostics and treatments, to assessment, documentation, and communication in general. It has greatly increased the amount of information available to the provider and the speed with which new information is available. I have come to find it has enabled us as nurses to track progress more efficiently during a patient’s acute stay and through the healthcare continuum. Also, I have seen changes in reimbursement models which has impacted how we practice healthcare. The focus is now on healthcare improvement and it has mobilized and mainlined the research aspect. It has lead to evidenced based standardization of care and these pathways have impacted our patient’s length of stay. It has shifted attention to outcomes and patient satisfaction. Healthcare improvement initiatives have greatly impacted the way things are done and are directed at patient safety, which reduces as you know medication errors and unnecessary injuries and infections. ]

    Follow-up
    b

    [Alicia: What are some personal achievements you would like to share, or perhaps any professional achievements that you have accomplished?]

    [ Kathy: ] After four years into my career, my husband and I began a family, and I changed my status, first I began part time, then went to per diem. I only did this when it first become an option which I believe was in 1991. Family has been my greatest accomplishment. Nursing is tough and always a challenge but raising a family and trying to balance a career is even tougher. Raising kids is a challenge in itself, its unpredictable and there is no book on how to be a parent. Although I have had many accomplishments in my career, nothing comes close to raising 3 daughters and now being a grandmother. Motherhood is a blessing, and I have learned through my career you have to step back and enjoy the simple things in life. nr393 nursing history Course Project Milestone 3 Template completed samples.

    Primary Question 3

    [Alicia: What areas of nursing have your worked and which area is your favorite and why?]

    [ Kathy: The first six years after I graduated, were spent working in a variety of med surg settings at Lancaster General. During this time LGH (Lancaster General Hospital) engaged in an initiative to group patients geographically based on the admitting group. I worked on three different units, and had exposure to orthopedics, oncology, urology, and cardiac patients. I worked with a team that would fill in periodically for the ostomy nurse and served on a few committees. After six year, I was ready to move on and found most of the other local hospitals had hiring freezes in effect. My goal at the time was to stay in hospital nursing so I expanded my search and found a job at Good Samaritan Hospital ICU/CCU. At this time I had never considered a critical care position before, due in part to fear of the critically ill patients and in part to the admiration and respect I had for ICU nurses I had come in contact with. At the time, the GSH unit had 12 beds and worked with lines and vents but this was before the start of invasive diagnostic and interventional cardiology, interventional radiology, balloon pumps, open hearts and so on. The staff I remember was so welcoming and supportive and the preceptor I was paired with helped me to navigated the complex medical and emotional needs of the acutely ill patients. I was able to take a holistic approach to patient care that I felt that the ratios was much better and quickly realized med surg never allowed such nurse to patient ratios. I was able to dive deep into the patient’s case and attend to the patient and family serving as a liaison between them and medical staff. I found my happy place as the patient advocate, which is one of my favorite roles as a nurse.]

    Follow-up
    a

    [Alicia: Do you intend to switch areas in nursing? Why or why not ]

    [Kathy: That is the beauty of nursing, you don’t ever have to stay in one area of nursing, right now I am content and I hope to stay per diem and perhaps one day soon retire for good, but I like practicing and I haven’t convinced myself that it’s time to throw in the towel quite yet. I don’t have a reason to switch areas as of now, I’m content. nr393 nursing history Course Project Milestone 3 Template completed samples]

    Follow-up
    b

    [Alicia: What made you pursue the area you currently work in and why?]

    [Kathy: The medical staff was courteous, willing to teach and open to input from other nurses, it allowed us to work autonomously within parameters. I am allowed to think critically and give voice to the clinical decision making that my instructors had worked so hard to develop in me.]

    Primary Question 4

    [Alicia: How have you contributed to the profession of nursing and to nursing history?]

    [Kathy:  I hope I have contributed in a positive way, anytime there is change I have evolved as a nurse and I hope I have given back to the profession such as telling you my story, I share my experiences with new nurses and my knowledge within the last 40 years, I put my all in anything I do and I hope to inspire future generations of nurses.]

    Follow-up
    a

    [Alicia: Why has work, in the area you work in now become your passion?]

    [Kathy: I love the population of people I am working with right now. I love the fact that I am still able to work and I hope to continue to make a difference. I love working with the heart and working on this cardiac unit has been a rollercoaster and I love the challenge. The drugs used today is constantly evolving. This area is much different from other floors as it requires you to think on your feet. As you know the heart can be very unforgiving and requires quick thinking. It keeps me young in a sense and keeps my brain sharp and there is something every exciting about problem solving.]

    Follow-up
    b

    [Alicia: What professional objective did you set out to complete and have met thus far?]

    [Kathy: ] My professional objectives when first out of school was to expand my knowledge base and skill set; to gain confidence in my decision making ability, time management and prioritization; to serve in the role of patient advocate.

    Primary Question 5

    [Alicia : Who is your favorite nurse in nursing history?]

    [ Kathy: Of course I’d have to say Florence Nightingale, because she responded to a calling that at the time was not even looked at twice, She is the reason you and I are here today. Florence made the profession and made it a respected one at that. Florence changed the course of this nation for sure. I also really like Edith Cavell, because she also contributed to hospitals all around promoting standards of improvement and pushed for nurses to provide the patients with quality care and this of course is something I am passionate about. Like her I strive to treat others with respect and I would hope to never discriminate when caring for a patient. Like Edith I was taught some great principles in life by my parents and I feel she stood by her principles and what she believed in. ]

    Follow-up
    a

    [Alicia: What or who influenced you to pursue a career in nursing? ]

    [ Kathy: My favorite nurse was my mother even though I never witnessed her functioning in that role. She worked as a pediatric and private duty nurse and served as an army nurse during World War II. She worked in my father’s medical practice until she started her own family. Even though she left nursing when  she started her family she never stopped using her nursing judgment and knowledge. She raised 3 boys, two which were diabetic, and a girl. My mother never seemed to lose interest in new advances in medical or nursing care, and led by her word and led by example the benefits of a healthy lifestyle.]

    Follow-up
    b

    [Alicia : From what you have learned through your career; what  do you hope to teach or pass on?]

    [Kathy: I hope to maintain my flexibility and teach others that change is inevitable and we must change with technological advances and research based guidelines, I hope to be supportive of the next generation of nurses and recognize and honor the contributions of all nurses who have played such a vital role in forming the nurse I have become. I hope I can continue to contribute to my own unit by providing feedback to nursing leadership and serving as a resource for co-workers. I hope we as a floor work toward unit goals and quality management and I have hopes to support and recognize our healthcare system to the community for the quality of care we provide. ]

    Conclusion:

    Gratitude

    20 points

    [Alicia: Kathy, I think I have asked you all the questions I had, and I want to thank you for taking the time and sitting with me and answering all my questions. I want you to know I look up to you and have always admired the nurse you are. You are a wealth of knowledge and I am always appreciative of your teachings, and guidance in my own career. I have learned quite a lot from you and about you. I can’t thank you enough for all your contributions, past and present and I hope to one day be half the nurse that you are. Thank you again for your time. ]

    Learning

    20 points

    [Alicia: I have learned a great deal from Kathy, I have learned that change is inevitable and like her I will need to change with this forever changing field. I have learned that one does not ever stop learning and we can grow in many aspects. Flexibility is key,  and openness to new ideas and change can guide me in a long happy career.  Nursing is a vast field that allows us to transform ourselves time and time again. Kathy is a wealth of knowledge and I have even more respect for what she does and continues to do.]

    Total Points Possible = 300

     

     

    Course Project Milestone 3 Template

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    Prior to completing this template, carefully review Course Project Milestone 3 Guidelines paying particular attention to how to name the document and all rubric requirements. After saving the document to your computer, type your answers directly on this template, and save again. This assignment is due by Sunday end of Week 6 by 11:59 p.m. MT nr393 nursing history Course Project Milestone 3 Template completed samples.

    Student Name:
    xxx

    Assignment Criteria

    Type the statements into the boxes below. Use exact words spoken by each person.

    Note: See Milestone 3 Rubric for details required in each area.

    Introduction:

    Student Introduction and Statement of Purpose

    30 points

     

    The purpose of the interview is to compare historical attributes to living nurses of today.

    Nurse Introduction

    30 points

     

    Lyle Levesque MSN, RN, CNL

    Areas worked emergency medicine, administrative, educator, registered nurse for 20 years.

    Nurse States Verbal Permission for Interview and Submission

    30 points

     

    Lyle: I give permission for the interview and submission of the interview for grading purposes.

    Questions and Answers

    Primary Question 1

    Sarah: 1: What are some of your favorite memories of nursing school?

    Lyle: Whenever I first felt like I was a nurse in my preceptorship. Throughout nursing school, you feel like a baby nurse but on during my preceptorship I finally knew what it felt like to be a nurse it was refreshing.

    Follow-up a

    Sarah: What was one of your biggest fears as a student nurse?

    Lyle: My biggest fear was failing I did not want to fail out of nursing school it was one of the hardest things I ever had to do. If I failed out all that hard work would have been for nothing.

    Follow-up b

    Sarah: How did classmates or instructors impact your development as a nurse?

    Lyle: I was inspired by many of my instructors throughout nursing because some of them had come so far and showed how much they wanted us to pass. My classmates were a huge impact on me. We all worked hard together nr393 nursing history Course Project Milestone 3 Template completed samples

     

    Primary Question 2

    Sarah: How have you improved the quality of nursing practice during your career?

    Lyle: My passion for nursing and becoming a preceptor became something I was very much interesting I loved to teach new nurses how to provide evidence-based care. I also created a trauma rotation for exercise science students to do as their internship, so they could learn how to do many things in the hospital. I feel that my quality of nursing practice evolved into what I love most as I continued with my career in the trauma department.

    Follow-up a

    Sarah: What are conflicts you had during your career?

    Lyle: Throughout nursing there will always come a time when there are conflicts. As a charge nurse you know that there will always be a conflict when dealing with equity. I learned that you let your fellow workers know that it is not personal you just have to separate people the best you can even if others are not happy with the case load they were give. However, it is important to always be there for others and see the sides of each individual nr393 nursing history Course Project Milestone 3 Template completed samples.

    Follow-up b

    Sarah: How did you teach a new nurse the importance of teamwork?                                                                               Lyle: When a new nurse is on the unit each nurse offers a helping hand because as a new nurse you can have a lot of questions. I always make sure new nurses know that we are a team and we work together when times get tough and work together to keep the unit running efferently. Taking time to huddle and share experiences with new nurses always gave them comfort and eventually a sense of belonging.

    Primary Question 3

    Sarah: What was the best part of being a trauma nurse?

    Lyle: Being trauma nurse, you treat patients in a state of emergency and get to handle urgent situations where the cause is unknown. You learn to assess patients at another level being a trauma nurse you feel like you are saving people’s lives each day and treating them at their most vulnerable moments.

    Follow-up a

    Sarah: What was your greatest struggle as a trauma nurse?

    Lyle: Dealing with death happens a lot as a nurse but it comes even more when you are working in trauma. I struggled with this a lot at first but learned that I provided the best care possible. Codes come in often it is important to remember that you work as a team and then you have to pull yourself together because there will be another patient that needs you. nr393 nursing history Course Project Milestone 3 Template completed samples.

    Follow-up b

    Sarah: How did this impact you?

    Lyle: I became a stronger nurse and more effective nurse from working in the emergency department.

    Primary Question 4

    Sarah: How have you contributed to the profession of nursing and to nursing history?

    Lyle: My passion for nursing has grown throughout the years I found a love in the trauma unit and stay there for a long time doing many different roles. If you work hard you can achieve anything.

    Follow-up a

    Sarah: Why has work in that area become your passion?

    Lyle: My passion for the emergency department and trauma grew more and more even to this day now that I do not work in the trauma department. Trauma nurses are a different breed of nurses, I learned so much from being a trauma nurse and I enjoyed showing others and allowing them to establish a love for it as well.

    Follow-up b

    Sarah: Do you ever regret leaving behind trauma and working in a new department?

    Lyle: I think that everyone misses a certain career that they use to do but it is definitely something to look back at and to teach others about.

    Primary Question 5

    Sarah:  Who is your favorite nurse from nursing history?

    Lyle:  If I had to pick a favorite nurse from actually history I would pick Florence Nightingale she accomplished so much in her life and worked hard for so many years. I think that people with worth ethics such as her will go far in their career.

    Follow-up a

    Sarah: What contributions did that nurse bring to nursing? nr393 nursing history Course Project Milestone 3 Template completed samples.

    Lyle:  Florence Nightingale is known as the lady with the lamp. She made many contributions to nursing one of my favorites was how she would walk around at night with her lamp making sure each solder was comfortable and sat with dying solders during Crimean war. Nightingale showed how nurses should treat their patients and expressed her level of care greatly.

    Follow-up b

    Sarah: How has that nurse influenced your own nursing practice?

    Lyle: Florence Nightingale was a warrior of her own kind. As a nursing student I was influenced by her drive for nursing I thought that many nurses should feel the way she does. When I became a nurse, I knew I want to always strive for excellence and continue my education. Also, I wanted to care and practice as she did always putting her patients first.

    Conclusion:
    nr393 nursing history Course Project Milestone 3 Template completed samples

    Gratitude

    20 points

    Through this interview I am able to receive information about a nurse that has set a whole career path for himself. I was able to see that you can start from something and it can turn into a completely different job. Trauma is a completely different type of nursing being able to learn about someone who has done the management side and worked as a nurse is very refreshing.

    Learning

    20 points

    [Name of speaker: Words speaker says]

    Total Points Possible = 300

    nr393 nursing history Course Project Milestone 3 Template completed samples

  • NR443 Community Settings and Community Health Nursing Roles Essay

    NR443 Community Settings and Community Health Nursing Roles Essay

    Watch the tutorial on tips for completing the NR443 Community Settings and Community Health Nursing Roles assignment.

    This APA paper is expected to be no more than four pages in length (not including the title page and reference list). Below are the requirements for successful completion of this paper.Please use the recommended APA Template linked below, which incorporates the following categories as the first level headings on your paper. APA formatting helps you to organize your paper in a professional manner and provides consistent methods for citing your sources and completing your reference page. See the documents in the APA category in Course Resources for assistance with APA formatting NR443 Community Settings and Community Health Nursing Roles Essay. The Student Success Strategies resource has great sections on writing scholarly papers and APA formatting.

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    The role for this paper must be on Forensic Nursing.

    Click to view and download the NR443 Community Settings APA Template (Links to an external site.)Links to an external site. to complete your paper. The template is formatted with the appropriate running head, title page, page numbers, paragraph formatting, and most of the headings. Please edit the headers and title page with your specific information. You are also encouraged to view the Week 4 assignment tutorial found at the end of the Academic Integrity Reminder. NR443 Community Settings and Community Health Nursing Roles Essay.

    Read the chapter of your textbook on the role and take notes based on the outline below.

    Locate and read at least one scholarly peer-reviewed journal article that is not assigned in the course related to a nurse’s role in health promotion in this setting. Go to the Chamberlain library at http:/library.chamberlain.edu (Links to an external site.)Links to an external site.. Search peer reviewed journals to find a scholarly article on this topic. The article must be less than 10 years old (less than 5 years is best).

    Thoroughly address the following categories using the APA Template that is provided.

    Introduction (one paragraph):

    The introduction should be interesting and capture the reader’s attention. NR443 Community Settings and Community Health Nursing Roles Essay.

    Introduce the assigned community health nurse role and a community setting where this nurse may work.

    Introduce your community and where/how this CHN role is utilized in your community

    Identify population(s) served by this role in your community

    Include a purpose statement NR443 Community Settings and Community Health Nursing Roles Essay.

    Community Setting (two to three paragraphs)

    Describe a practice setting for the assigned CHN role.

    Describe the population(s) served in this setting.

    Discuss three health services provided by the assigned CHN role in this setting.

    You may use your textbook or an outside scholarly source to address these sub-points.

    Health Promotion Nursing Intervention (two to three paragraphs)

    Describe in detail health promotion intervention(s) of the assigned CHN role specific to the community setting identified.

    Identify people/organizations/community members this CHN role may collaborate with in health promotion interventions.

    Include one peer-reviewed journal article discussed that clearly relates to nursing health promotion intervention. NR443 Community Settings and Community Health Nursing Roles Essay.

    Professional Nursing Organization (two paragraphs)

    Provide a detailed description of a professional nursing organization that supports nurses in this role in your own words. Search the text, your article, or the Internet for one professional organization that supports nurses in this role. NR443 Community Settings and Community Health Nursing Roles Essay. If you can’t find an organization specific to this group, search the American Nurses Association (ANA) website for information on this role.Cite the organization in the body of the text with (organization name, year), and include a complete reference on the reference page.

    Discuss one professional issue that this organization is addressing related to this CHN role.

    Summary (one paragraph)

    The summary reiterates key points about:

    The CHN role and community setting

    Health promotion intervention

    Professional organization

    Includes a concluding statement.

    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 or organization, 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 Chamberlain Guidelines for Professional Writing in the APA Folder in Course Resources for examples of properly formatted references. NR443 Community Settings and Community Health Nursing Roles Essay.

    Guidelines

    Application: Use Microsoft Word 2010™ or later to create this assignment on the template provided.

    We highly recommend that you used the specific APA paper template for this assignment linked above as the headings are already included.

    Scholarly Writing: APA format is required. Review APA documents Course Resources, and use the free resources of tutor.com for writing tutors.

    Length: This paper is expected to be no more than 4 pages in length (not including the title page and reference list).

    Quotations should be minimal—please paraphrase your sources. A maximum of one quotation should be used for this paper.

    Save your paper with your last name in the document title (e.g., Smith Community Settings).

    Submission: Submit your paper by 11:59 p.m. MT Sunday of Week 4.

    Late Submission: See the course policy on late submissions.

    Best Practices in Preparing the Paper

    The following are best practices in preparing this project NR443 Community Settings and Community Health Nursing Roles Essay.

    Follow the guidelines above carefully.

    Use only the assigned CHN role

    Complete you own work.

    Use the provided APA assignment specific template.

    Ask you instructor if you have any questions.

    Visit the SSPRNBSN Student Success resource for help with writing a scholarly paper, APA formatting, and library navigation. This should be one of your course tiles.

    Use the 1st column of the grading rubric to make sure all elements of the paper are addressed.

    Cite all sources within the paper as well as on the reference page.

    Proofread prior to final submission. NR443 Community Settings and Community Health Nursing Roles Essay.

  • NR392 all weeks discussions

    nr392 all weeks discussions

    Week 1 discussion

    Defining a Quality Care Issue in Nursing

    Think of an area of opportunity within your current or former clinical setting that is quality driven. Define (D) one nursing care issue (not a workforce issue such as staffing) from a current or former nursing workplace (or clinical setting) that could be impacted by improved quality. This nursing care issue should not be one that has already undergone a quality improvement process. Tell us details of this issue and how it this issue impacts nursing care quality at that facility.

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    Week 2 discussion

    DMAIC Process for a Real Life Issue

    Why is it important to have a structured process to approach and improve nursing care quality? How can use of this structured process help to improve quality nursing care in your setting? nr392 all weeks discussions.

    Week 3 discussion

    Quality Improvement Education

    In your prelicensure nursing education program, what did you learn about quality improvement in nursing? How was quality improvement emphasized? As you consider nursing education today, what would you suggest be included in future education or orientation programs about the important topic of quality improvement in nursing?

    Week 4 discussion

    Culture of Safety

    How does your current or former clinical environment maintain a culture of safety? How are errors reported and managed to improve quality? nr392 all weeks discussions What suggestions would you make as a nurse leader to improve the culture of safety?

    Week 5 discussion

    Strategies for Interprofessional Collaboration to Promote Quality

    This week as we focus on interprofessional collaboration to promote quality, please remember that professionals include dietitians, therapists (respiratory, physical, occupational, and speech), social workers/case managers, psychologists, physicians, pharmacists, and others. Professionals do not include patients, families, aides, or unlicensed assistive personnel.

    Working as an interdisciplinary team helps promote positive patient outcomes. What strategies do you use to successfully work with other professions in your workplace to promote quality care? What strategies are not successful? nr392 all weeks discussions. What are the barriers to interprofessional collaboration, and how will you overcome these barriers?

    Week 6 discussion

    Quality Improvement Using Evidence-Based Practice in Nursing

    Consider a single nursing care issue at your facility where quality has already been improved by implementation of evidence. Answer the following:

    How was evidence on that topic located in scholarly professional nursing journal articles and evaluated?

    What was the implementation plan?

    How was the improvement in quality measured after the implementation?

    What do you suggest that would have improved this implementation and maintenance of improved quality? nr392 all weeks discussions.

    Week 7 discussion

    The Role of Patients in Your Course Project Nursing Issue

    Considering the nursing issue for your Course Project, address the following:

    Provide a brief summary of your Course Project for the class.

    What patient data is collected? What data do you want collected?

    How will this actual and desired data help you to continue to improve quality on this nursing issue?

    Week 8 discussion

    Reflection on AACN BSN Essential II

    Quality is an overriding principle in the AACN BSN Essentials document. Essential II specifically describes the role of the baccalaureate nurse in quality improvement. As you complete this course, reflect on how you will implement lessons learned about quality improvement into your future nursing practice. Provide details about what you plan to do to improve quality in your current or ideal future professional nursing position. Think big! nr392 all weeks discussions.

    NR392 Quality Improvement in Nursing

    Week 2 Discussion

    Quality Improvement Processes

    This week’s graded topics relate to the following Course Outcome (CO).

    CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

    For this week’s discussion, answer the following:

    Why is it important to have a structured process to approach and improve nursing care quality?

    How can the use of this structured process help to improve quality nursing care in your current or former setting?

    NR392 Quality Improvement in Nursing

    Week 4 Discussion

    Quality Improvement Data

    This week’s graded topics relate to the following Course Outcome (CO).

    CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

    Consider the following questions:

    How does your current or former clinical environment share data collected on quality measures or initiatives with the staff? nr392 all weeks discussions.

    What further data would you like to have shared and why?

    NR392 Quality Improvement in Nursing

    Week 5 Discussion

    Culture of Safety

    This week’s graded topics relate to the following Course Outcome (CO).

    CO3: Examine culture of safety principles that improve patient outcomes based on current evidence. (POs 7 and 8)

    Consider the following questions:

    How does your current or former clinical environment maintain a culture of safety?

    What suggestions would you make as a nurse leader to improve the culture of safety?

    NR392 Quality Improvement in Nursing

    Week 7 Discussion

    Sustaining Quality After Improvement

    This week’s graded topics relate to the following Course Outcome (CO).

    CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

    Considering the nursing issue for your Course Project, address the following:

    Provide a brief summary of your Course Project nr392 all weeks discussions.

    How could your plans sustain quality in your setting?

    NR392 Quality Improvement in Nursing

    Week 8 Discussion

    Reflection on AACN BSN Essential II

    This week’s graded topics relate to the following Course Outcomes (COs).

    CO1: Identify the role of the BSN nurse in the quality improvement process as a member of the collaborative interprofessional team. (POs 2 and 7)

    CO2: Discuss effective processes and strategies to improve quality in nursing. (POs 2 and 8)

    Quality is an overriding principle in the AACN BSN Essentials document. Essential II specifically describes the role of the baccalaureate nurse in quality improvement.

    As you complete this course, reflect on how you will implement lessons learned about quality improvement into your future nursing practice. Provide details about what you plan to do to improve quality in your current or ideal future professional nursing position nr392 all weeks discussions.

  • NR392 Quality Improvement in Nursing Project Milestone 1 Completed

    NR392 Quality Improvement in Nursing Project Milestone 1 Completed

    Project Milestone 1

     
    Directions: Prior to completing this template,
    carefully review Course Project Milestone 1 Guidelines paying particular attention to how to name the document and all rubric requirements.
    After saving the document to your computer, type your answers directly on this template and save again. This assignment is due by Sunday end of Week 1 by 11:59 p.m. Mountain Time.

    Your Name:
    _____ _____________________

    Assignment Criteria

    Your Answers:

    NOTE: See Milestone 1 Rubric for details required in each area.

    ORDER A CUSTOM-WRITTEN PAPER NOW

    Nursing Issue

     

    30 points

    Medication error is defined by the NIH as “a failure in the treatment process that leads to, or has the potential to lead to, harm to the patient’ (NIH.gov) Medication error has been a serious problem in the healthcare industry. Mistakes involving medications are among the most common health care errors. There different types of medication errors; failing to perform any of the 6 rights of medication administration can lead to medication error, cross sensitivity, wrong diagnosis etc. Medication error could sometimes generate from the prescriber, the dispenser, the manufacturer, monitoring of blood levels, educating patient correctly and administration. The nurses are usually the ones administering these medication directly to the patient, therefore is our responsibility to do last safety check before medication administration. Now there are certain instances where the nurse has no control over the error that is being made because they are not trained to identify the mistakes of the doctor or pharmacist. For example misdiagnosing a patient and giving the medications inappropriately and sometime pharmacy failing to recognize problems like cross sensitivity of certain medications given to the patient. NR392 Quality Improvement in Nursing Project Milestone 1 Completed. Nurses have direct contact with patients daily and in the acute care setting, they are usually the ones administering these medications directly to the patients, and so that makes medication errors a big issue in nursing.

    Details of the Issue

     

    45 points

    According to NIH, It has been estimated by the Institute of Medicine that medication errors cause 1 of 131 outpatients and 1 of 854 inpatient deaths (Nih.gov). When medication error occurs a lot of people are held responsible for the mistake, especially the nurses who are suppose to be performing the last check prior to administration. Medication errors can and has had a wide range of effects on patients. NR392 Quality Improvement in Nursing Project Milestone 1 Completed. The effects of medication error ranges from nothing happening to the something as serious as death of the patient. Even though they have been significant improvement with prevention of medication errors, there are still serious errors being made by members of the care team. Is no denying fact that acute care facilities have taken great steps to prevent medication errors from occurring, such as the electronic medication record which is linked to the pharmacy, scanning patients wrist band before giving medications, having two nurses verify certain medications, pharmacy reviewing PT/INR and ordering Coumadin on a daily basis etc. As nurses we are trained to review lab results, diagnostic results, and patient’s diagnosis and also understand why certain medications are prescribed for patients before administering the medication. Sometimes the nurses fail to do so and encounter the possibility of a medication error. We had a situation where a patient INR was 3.1 and patient was on 5mg of Coumadin, the INR goal for the patient was 2-3. The pharmacist made a mistake and orders 3mg of Coumadin but fails to discontinue the 5mg making it a total of 8mg. The nurse failed to question the order, administer the 8mg and the next INR was 4.8. Although the pharmacy made an error, the nurse administering the mediation was held accountable as well for not reviewing the labs and questioning the order. This example goes to emphasize the fact that, although we have certain measures put in place, it is very essential for nurses to follow the 6 rights of medication administration and review labs results before giving any medications. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

     

    My facility has put forward a series of measures to try and decrease the amount mediation error that occurs. We have access to the patient’s  medication record for their community pharmacy. This enables us view the medication the patient is on, compare it with the home list the patient brought in and ask question if we have any doubts. It eliminates the problem of missed doses and wrong prescription by the provider. The hospital discourages the use of home medications. We ask their loved ones to take their medications back home after comparing the bottles to their home list. NR392 Quality Improvement in Nursing Project Milestone 1 Completed. The only exception to this is, if the patient is taking a medication that is in not in our pharmacy formulary, then the pharmacy has to verify the medication, label it with a barcode and the nurses must lock it up in the medication drawer and administer it to the patient as directed until discharge. Two nurses have to verify insulin prior to administration as well as heparin drip. All medications that are not scanned are reported to the manager at the end of the month an each nurse need s to score 98% scanning rate or above. All medications entered has to be verified by the pharmacy before it could be pulled out of the pyxis or administered to patients.

    Reporting the errors as soon as you realize it can produce a better outcome for the patient. For example mistakenly administering 60units of short acting insulin instead of long acting insulin to a patient needs to be reported right away or it might be detrimental to the patient’s life. I will encourage my colleagues to talk to patient about their  home medication regimen on admission and question any orders if they have doubts. If any errors occur, I will encourage the staff to report it in a timely manner and not hide it. Creating a non punitive environment for staff could encourage staff to report the issue without fear of been punished.

     

    Reason Issue Selected

     

    25 points

    In the acute care setting that I work in, I have seen so many mediation errors stemming from different levels of the care team. I recently witnessed an actual medication error which thankfully did not cause any harm to the patient. Two months ago, I had a patient that was misdiagnosed by the Radiologist for having a blood clot in the pelvis.  The patient was started on Coumadin/Lovenox bridge because her INR was 1.0. She was getting 60mg of Lovenox twice daily and Coumadin 5mg daily which was subjected to change based on the daily PT/INR. The Coumadin went as far up as 10mg. The patient goal was to bring the INR between 2-3 NR392 Quality Improvement in Nursing Project Milestone 1 Completed. The PA was assigned to the patient for the first 5 days after her diagnosis. On the 4
    th
    day when a doctor took that assignment, he questioned the MRI results based on the images he reviewed. The Radilogist was called and he was later concluded that the patient was misdiagnosed. So the patient did receive such high dosage of blood thinners for no apparent reason. The patient and her family were notified by the hospital. The patient daughter made it very clear she was taking legal actions against the hospital. The patient INR only came up to 1.8 thankfully. In this situation, the medication error stems from the provider esp. the Radiologist who misdiagnosed the patient. I thought this particular incident actually highlighted the fact that medication error still occur in acute care settings even with several measures put in place to prevent errors from happening. Although the person who originated this error was the diagnosing doctor, so many people were held accountable. The radiologist, the prescriber, the nurses who administer the medication. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

    REFERENCES:

    https://learn.ana-nursingknowledge.org/products/Preventing-High-Alert-Medication-Errors-in-Hospital-Patients
    , Retrieved, October 2016.

    https://www.ncbi.nlm.nih.gov/pubmed/24981217
    , Retrieved, October 2016.

     

    Course Project Milestone 2 Template

    Directions: Prior to completing this template,
    carefully review Course Project Milestone 2 Guidelines paying particular attention to how to name the document and all rubric requirements.
    After saving the document to your computer, type your answers directly on this template and save again. This assignment is due by Sunday end of Week 3 by 11:59 p.m. Mountain Time.

    Your Name:
    Latoya Harrison

    Assignment Criteria

    Answers:

    (
    NOTE: See Milestone 2 Rubric

    for details required in each area
    .)

    Define
    :

    Approved Nursing Issue from Milestone 1

    25 points

    My Approved Nursing issue that was thoroughly explained in my Milestone 1 assignment is Nurse Mentoring. Nurse mentoring can be defined as a continuous collaborative relationship between two individuals. One of which is a novice and an expert/senior. Nurse mentoring is a reciprocal learning relationship between two persons, who have mutual goals as it relates to the care being provided. At some point in our lives, many of us go through numerous working experiences where everything is new to us, and to be quite honest, this is a rather unpleasant feeling. It is the fear of the unknown, or just that generalized uncomfortable feeling. We’ve all been there and will continue to experience this as we navigate our way through different working experiences. What would have made these experiences more pleasant, is a mentor. The concept of nurse mentoring continues to be an overlooked issue that is need of Quality improvement. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

     

    Measure
    :

    Identify Measures (Indicators) to Support the Issue

    75 points

    The lack of nurse mentoring/mentorship is a worldwide issue that affects both patient outcomes, and nurse retention rates in hospital facilities. Take my experience for example. At my former facility, there were always a shortage of new nurses. Over the span of 1 year, the facility has had difficulties retaining nurses. I will briefly explain why. This facility lacked the teamwork/collaboration approach. It was almost as if I was thrown to the wolves as soon as I got to the floor. A warm accepting environment did not exist. I received constant attitudes whenever I asked for help, and had no one to orient me to the areas that I was unfamiliar with. Most of the nurses were in their own little worlds and preferred to work independently. I believe they looked at it as if I would be slowing them down. Myself, along with other new nurses, faced feelings of uncertainty and we all yearned for consistent guidance. We began to feel resistance from the more experienced nurses. It was almost like they were “eating their young”. Retention rates decreased significantly. At this specific time, my facility hired 14 new RN’s. Within a 6-month time frame, 10 quit their positions including myself. There are a multitude of things that could have been better had there been effective mentoring relationships, and or mandatory programs putting this in place. My self confidence level would have been increased, leadership skills enhanced, stress levels reduced, improved networking abilities, and enhanced communication skills. NR392 Quality Improvement in Nursing Project Milestone 1 Completed.

     

     

     

    Measure
    :

    List Stakeholders (important persons) in Improving this Nursing Issue

    50 points

    There are in fact several stakeholders that can impact this continuous issue in a positive way. These include nurses, physicians, advocacy groups, policy makers, professional society groups, health care coordinators and health care administrators.

    Experienced nurses are able to improve this issue by using their knowledge and wisdom in order to provide a meaningful learning experience, for novice nurses, in addition to striving to offer warm, accepting environments for new nurses, during their transition phase. This is key. Physicians, advocacy groups and professional societies can all serve as spokespersons as it relates to this issue, by advocating and voicing concerns, as well as the negative impacts for both the health care professional and patient outcomes. Policy makers, health care coordinators and administrators can strive to enforce that there be mandatory orientation and mentorship programs available at all times NR392 Quality Improvement in Nursing Project Milestone 1 Completed. If you really look into it, in the end, everyone is affected by this issue, most importantly, the patients. By having these stakeholders push to make a change, hospital retention rates and the quality of care being provided will make a remarkable turn.

    Analyze
    :

    Analyze the Causes of the Nursing Issue

    50 points

    The cause of this nursing issue is simple. There is a lack of orientation and mentorship programs available in health care facilities. Due to this, policies are not in place that pushes health care providers to help others in need of assistance. Often times nurses also get too caught up with their health care tasks, that they believe helping others will throw their process off or slow their process down. We cannot think like this nor allow others to think this way. It should always feel like a team work approach because ultimately, patient care is what’s affected. “Mentoring has proven to be a successful way of facilitating the professional growth and development of recently graduated nurses and other nurses transitioning to a new role” (Minority Nurse, 2016).

    Reference

    Mentoring Nurses Toward Success. (2016, March 23). Retrieved March 21, 2018, from 
    https://minoritynurse.com/mentoring-nurses-toward-success/

    NR392 Quality Improvement in Nursing Project Milestone 1 Completed

  • NR 509 Advanced Physical Assessment

    NR 509 Advanced Physical Assessment

    1.     A patient tells the FNP that he is very nervous, that he is nauseated, and that he “feels hot”. This type of data would be:

    2.     The patient’s record, laboratory studies, objective data, and subjective data combine to form the:

    3.     The FNP is reviewing information about evidence-based practice. Which statement best reflects evidence-based practice?

    4.     A 59-year-old patient tells the FNP that he has ulcerative colitis. He has been having black stools for the last 24 hours. How would the FNP best document his reason for seeking care?

    5.     A 29-year-old woman tells the FNP that she has excruciating pain in her back. Which would be an appropriate response by the FNP to the woman statement?

    6.     In recording the childhood illnesses of a patient who denies having had any, which note by the FNP would be most accurate?

    7.      If a female patient tells the FNP that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the FNP record this information? NR 509 Advanced Physical Assessment.

    8.     If a female patient tells the FNP that she has had six pregnancies, with four live births at term and two spontaneous abortions. Her four children are still living. How would the FNP record this information?

    ORDER A PLAGIARISM-FREE PAPER HERE

    9.     Which of these statements represents subjective data the FNP obtained from the patient regarding the patient’s skin?

    10.  The FNP is obtaining a history for a 30-year-old male patient and is concerned about health promotion activities. Which of these questions would be appropriate to use to assess health promotion activities for this patient?

    11.  Which statement indicates that the FNP understands the pain experienced by an elderly person?

    12.  The FNP is performing a vision examination. Which of these charts is most widely used for visual examination?

    13.  During a complete health assessment, how would the FNP test the patients hearing?

    14.  The FNP has just completed an examination of a patient’s extra-ocular muscles. When documenting the findings, the FNP should document the assessment of which cranial nerves?

    15.  A patient’s uvula rises midline when she says “ahh” and she has a positive gag reflex. The FNP has just tested which cranial nerve?

    16.  During an examination the FNP notices that a patient is unable to stick out his tongue. Which cranial nerve is involved with successful performance of this action?

    17.  A patient is unable to shrug her shoulders against the FNP‘s resistant hands. What cranial nerve is involved with successful shoulder shrugging?

    18.  During an examination, the patient has just successfully completed the finger to nose and rapid alternating movements test and is able to run each heel down the opposite shin. The FNP would conclude that the patient’s___ function is intact. NR 509 Advanced Physical Assessment

    19.  A five-year-old child is in the clinic for checkup. The FNP would expect him to:

    20.  When the FNP performs the confrontation test the FNP has assessed:

    21.  Which of these statements is true regarding the complete physical assessment?

    22.  Which of these statements is true regarding recording of data from the history and physical examination?

    23.  Which of these is included in assessment of general appearance?

    24.  The FNP is performing a review of symptoms. Which of these questions are appropriate as Health promotion questions to ask during this time?

    25.  The FNP is incorporating a person’s spiritual values into the health history. Which of these questions illustrates the community portion of the FICA questions?

    26.  The FNP is preparing to complete a health assessment on a 16-year-old girl whose parents have brought her to the clinic. Which instruction would be appropriate for the parents before the interview begins? NR 509 Advanced Physical Assessment

    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: NR 509 Advanced Physical Assessment.

    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 NR 509 Advanced Physical Assessment

    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? NR 509 Advanced Physical Assessment.

    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 Advanced Physical Assessment.

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

    What does dullness when percussing lung fields: Jarvis pg 427

    Facial sensation controlled by which CN: Jarvis 283,

    Know what two salivary glands are accessible during exam

    What CN is being … when pt shrugs shoulders Jarvis 646

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

    Concern for malignant nodules versus benign lymph nodule

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

    Define visual acuity

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

    Example of good visual acuity : Jarvis 289

    Example of poor visual acuity: Jarvis 289

    What is …. with corneal light reflex-

    Know normal variances of sclera : Jarvis 283

    Know how to check for Ptosis: Jarvis 292

    What does ptosis indicate: Jarvis 292

    NR 509 Advanced Physical Assessment

    Nasal fissure of pt with chronic allergies : Jarvis 271

    Acute allergies : Jarvis p 363 .

    What is an abnormal palpation of sinuses: Jarvis 362

    Normal palpation of sinuses

    Know normal variations in gingival margin

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

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

    A teenage girl has arrived complaining of pain in her left wrist. She was playing basketball when she fell and landed on her left hand. The FNP examined her hand and will expect a fracture if the girl complains: NR 509 Advanced Physical Assessment.

    A patient has been diagnosed with osteoporosis and asked the FNP “what is osteoporosis?” The FNP explains to the patient that osteoporosis is defined as:

    Patient states, “I can hear a crunching or grating sound when I kneel”. She also states “that it is very difficult to get out of bed in the morning because of stiffness and pain in my joints”. The FNP should assess for signs of what problem?

    When taking the history on a patient with a seizure disorder the FNP assesses whether the patient has an aura. Which of these would be the best question for obtaining this information?

    The FNP is teaching a class on osteoporosis prevention to a group of post menopausal women. A participant shows that she needs more instruction when she states I will:

    The FNP is performing a neurological assessment on a 41-year-old woman with a history of diabetes. When testing her ability to feel the vibrations of a tuning fork the FNP notices that the patient is unable to feel vibrations on the great toe or ankle bilaterally, but she is able to feel vibrations on both patella. Given this information what would the FNP suspect?

    And 80-year-old woman is visiting the clinic for a check up. She states “I can’t walk as much as I used to”. The FNP is observing from motor dysfunction in her hip and should have her:

    The FNP is testing the function of cranial nerve XI. Which of these best describes the response the FNP should expect if the nerve is intact? The patient:

    A 50-year-old woman is in a clinic for weakness in her left arm and leg that she noticed for the past week. The FNP should perform which type of neurologic examination?

    During the neurological assessment of a healthy 35-year-old patient the FNP asks him to relax his muscles completely. The FNP then moves each extremity through full range of motion. Which of these results would the FNP expect to find?

    A woman who is 8 months pregnant comments that she has noticed a change in posture and is having lower back pain. The FNP tells her that during pregnancy women have a posture shift to compensate for the enlarging fetus. NR 509 Advanced Physical Assessment This shift and posture is known as:

    A patient is able to flex his right arm forward without difficulty or pain but is unable to abduct his arm because of pain and muscle spasm’s. The FNP should suspect:

    A professional tennis player comes into the clinic complaining of a sore elbow. The FNP will assess for tenderness at the:

    The FNP suspect that a patient has carpal tunnel syndrome and wants to perform the Phalens test. To perform this task the FNP should instruct the patient to:

    During the history a patient tells the FNP that “it feels like the room is spinning around me”. The FNP would document this as:

    The assessment of a 60-year-old patient has taken longer than anticipated. In testing his pain perception the FNP decides to complete the test as quickly as possible. When the FNP applies the sharp point of a pin on his arm several times he is only able to identify these as one very sharp prick. What would be the most accurate explanation for this?

    An 85-year-old patient comments during his annual physical that “he seems to be getting shorter as he ages”. The FNP should explain that decrease height occurs with aging because:

    A patient is complaining of pain in his joints that is worse in the morning, is better after he has moved around for a while, and then gets worse again if he sits for long periods of time. The FNP should assess for other signs of what problem?

    When the FNP asks a 68-year-old patient to stand with feet together and arms at his side with his eyes closed he starts to sway and moves his feet farther apart. The FNP would document this finding as: NR 509 Advanced Physical Assessment

    During an assessment of the cranial nerves the FNP finds the following asymmetry when the patient smiles or frowns, uneven lifting of eyebrows, sagging of lower eyelids, and escape of air when the FNP presses against the right path cheek. This would indicate dysfunction of which of these cranial nerves?

    The FNP is teaching a class on osteoporosis prevention to a group of postmenopausal women which of these actions is the best way to prevent or delay bone loss in this group?

    In obtaining a history on a 74 year old patient the FNP notes that he drinks alcohol daily and that he has noticed a tremor in his hands that affects his ability to hold thing. With this information what should the FNP‘s response be?

    During a history of a 78-year-old man his wife states that “he occasionally has problems with short-term memory loss and confusion. He can’t even remember how to button his shirt”. In doing the assessment of his sensory system which action of the FNP‘s is most appropriate?

    While obtaining a history of a 3 month old infant from the mother the FNP asks about the infants ability to suck and grass the mothers finger. What is the FNP assessing?

    The FNP is doing an assessment on a 29-year-old woman who visits the clinic complaining of always dropping things and falling down. While testing rapid alternating movements the FNP notices that the woman is unable to pat both her knees. Her response is very slow and she misses frequently. What should the FNP suspect? NR 509 Advanced Physical Assessment.

    NR 509 Week 3 Quiz (Version 2)

    What piece of equipment can be used to test for peripheral neuropathy

    How would you test for Romberg sign

    Diagnosis for patient with complaint of room spinning

    Know expected postural changes in pregnancy

    Know what the phalen’s test is and how to conduct it

    Hands back to back for 60 secs looking for development of

    Positive Phalen’s test

    Older pt that can’t remember to tie shoes in order to assess this you first want to?

    What is loss of bone density

    Disease that is accompanied by joint pain in the morning that improves with movement and worsens with sitting

    What is summation effect and what does it mean

    Know what is normal findings in passive ROM

    … evaluate a pt with migraines in regard to if they have an aura

    Know abnormal finding of rotator cuff

    Know the type of neuro exam to complete on a pt presenting with one sided weakness

    Understand tennis elbow

    Know common reflexes at various ages

    What tremors improve with ETOH

    Understand CN 11

    What concerns exist when pt is slow with RAM

    R/O MS NR 509 Advanced Physical Assessment

    Know education for pts on exercises that help to prevent osteoporosis

    What does hip abduction reveal

    A 35-year-old man is seen in the clinic for an infection in his left foot. Which of these findings should the FNP expect to see during an assessment of this patient?

    The direction of blood flow through the heart is best described by which of these

    In assessing the carotid artery’s of an older patient with cardiovascular disease, the FNP would

    When listening to heart sounds the FNP knows that the valve closures that can be heard best at the base of the heart are

    The sack that surrounds and protects the heart is called the

    When assessing a newborn infant who is five minutes old the FNP knows that which of these statements would be true?

    The FNP is performing an assessment on an adult. The adults vital signs are normal and capillary refill is five seconds. What should the FNP do next?

    During an assessment of an older adult the FNP should expect to notice which finding as normal physiologic change associated with aging process NR 509 Advanced Physical Assessment?

    The mother of a three month old infant states that her baby has not been gaining weight. With further questioning the FNP finds that the infant falls asleep after nursing and wakes up after a short amount of time hungry again. What other information with the FNP want to have?

    In assessing a patient’s major risk factors for heart disease which would the FNP want to include when taking a history?

    The FNP is … the pulses of a patient who has been admitted for untreated hyperthyroidism. The FNP should expect to find a____pulse

    A patient complains of leg pain that wakes him at night. He states that he has been having problems with his legs. ….. his legs when they are … and disappears when he dangles them. He recently noticed a sore on the inner aspect of his right ankle. On the basis of this history information the FNP interprets that the patient is most likely experiencing

    During an assessment the FNP uses the profile sign to detect

    Which of these statements describes the closure of the valves in a normal cardiac cycle?

    When performing a peripheral vascular assessment on a patient the FNP is unable to palpate the ulnar pulses. The patient skin is warm and capillary refill is normal. The FNP should next

    A 67-year-old patient states that he “recently began have pain in his left calf when climbing the 10 stairs to his apartment”. This pain is relieved by sitting for about two minutes then he’s able to resume activities. The FNP interprets this patient is most likely experiencing

    In assessing a 70-year-old man the FNP finds the following blood pressure 140/100 mmHg, heart rate 104 and slightly irregular, split S2. Which of these findings can… by expected hemodynamic changes related to age?

    The FNP is examining the lymphatic system of a healthy three year old child. Which finding should the FNP expect?

    The FNP is preparing to perform modified Allen test. Which is an appropriate reason for this test?

    A 25-year-old woman is in her fifth month of pregnancy has a blood pressure of 100/70 mmHg. In reviewing her previous exam the FNP notes that her blood pressure in her second month was 124/80 mmHg. When evaluating this change what does the FNP know to be true?

    Findings from an … of a 70-year-old patient with swelling in his ankles include jugular venous pusations, 5 cm above the sternal angle when the head of his bed is …. 45°. The FNP knows that this finding indicate:

    The component of the conduction system referred to as the pacemaker of the heart is the

    The FNP is reviewing anatomy and physiology of the heart. Which statement best … by atrial kick?

    A 45-year-old man is in the clinic for a routine physical. During history the patient states he has been having difficulty sleeping. I’ll be sleeping great and then I wake up and feel like I can’t catch my breath. The FNP‘s best response to this would be

    When assessing a patient the FNP notes that the left femoral pulse as diminished 1+/4+. What should the FNP do next?

    An older patient has been diagnosed with pernicious anemia. The FNP knows that this condition could be related to NR 509 Advanced Physical Assessment

    ….. examining a patient who tells the FNP “I sure sweat a lot especially on my face and feet but it doesn’t have an odor”. The FNP knows that this could … related to

    During an abdominal assessment the FNP elicits tenderness on light palpation in the right lower quadrant. The FNP interprets that this finding could indicate a disorder which of these structures?

    An Inuit visiting Nevada from anchorage has come to the clinic in July during the hottest part of the day. It so happens that the clinics air conditioning is broken and the temperature is very hot. The FNP knows that which of these statements is true about the Inuit sweating tendencies?

    The FNP notices that a patient has black, tarry stool and recalls that a possible cause would …

    ….. an abdominal …. deep palpation is used to determine

    The FNP is assessing the abdomen of an aging adult. Which of these statements regarding an aging adult and abdominal assessment is true?

    During examination the FNP finds that a patient has excessive dryness of the skin. The best term to describe this condition is

    A FNP notices that a patient has ascites, which indicates the presence of

    The FNP is performing percussion during an abdominal assessment. Percussion notes during the abdominal assessment may include

    The FNP is caring for a black child who has … with marasmus. The FNP would expect to find the

    … patient’s medical record that the patient has a lesion that is confluent in nature. On examination the FNP would expect to find

    The FNP is assessing the abdomen of a pregnant woman who is complaining of having acid indigestion all the time. The FNP knows that esophageal reflux during pregnancy can cause

    The patient has abdominal borborygmi. The FNP knows that this term refers to

    A patient has a terrible itch for several months that he … scratching continuously. On examination the FNP might expect to find

    During aging process, the hair can look gray or white and begin to feel thin and fine. The FNP knows that this occurs because of a decrease in number of functioning

    The FNP notices that a patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. When documenting this finding the FNP would report this as a

    During an abdominal assessment the FNP would consider which of these findings as normal?

    A 52 -year-old Woman has a papule on her nose that has a rounded pearly border and a central red ulcer. She said she first noticed it several months ago and that it is slowly growing larger. The FNP suspects which condition? NR 509 Advanced Physical Assessment

    The FNP is listening to bowel sounds. Which of these statements is true about bowel sounds?

    The FNP is watching a new graduate FNP perform auscultation of a patient abdomen. Which statement by the new graduate shows a correct understanding of the reason auscultation proceeds percussion and palpitation of the abdomen?

    A patient is complaining of a sharp pain along the costovertebral angles. The FNP knows that this symptom is most often indicative of

    The patient is … of having inflammation of the gallbladder or cholecystitis. The FNP should conduct which of these techniques to assess for this condition?

    A newborn infant is in the clinic for a well baby check. The FNP observes the infant for possibility of fluid loss because of which these factors?

    During an assessment of a newborn infant, the FNP recalls that pyloric stenosis would … manifested by

    NR 509 Week 5 Quiz: Skin, Hair, Abdomen

    Question: The FNP is assessing the abdomen of an aging adult. Which of these statements regarding the agind adult and abdominal assessment is true?

    Question: The FNP notices that a patient has had a black tarry stool and recalls that a possible cause would be

    Question: The FNP knows that during an abdominal assessment deep palpitation is used to determine

    Question: A patient has abdominal borboygmi. The FNP knows that this term refers to

    Question: During an abdominal assessment, the FNP would consider which of these findings as normal? NR 509 Advanced Physical Assessment

    Question: The FNP is caring for a black child who has been diagnosed with marasmus. The FNP would expect to find the

    Question: An Inuit visiting Nevada from Anchorage has come to the clinic in July during the hottest part of the day. It so happens that the clinic’s air conditioning is broken and the temperature is very hot. The FNP knows that which of these statements is true about the Inuit sweating tendencies?

    Question: The FNP is performing percussion during an abdominal assessment. Percussion notes heard during the abdominal assessment may include:

    Question: During an abdominal assessment, the FNP elicits tenderness on light palpation in the right lower quadrant. The FNP interprets that this finding could indicate a disorder of which of these structures NR 509 Advanced Physical Assessment?

    Question: A patient has a terrible itch for several months that he has been scratching continuously. On examination, the FNP might expect to find

    Question: The FNP is listening to bowel sounds. Which of these statements is true of bowel sounds?

    Question: A patient is complaining of a sharp pain along the costovertebral angles. The FNP knows that this symptom is most often indicative of

    Question: The FNP notices that a patient has a solid, elevated, circumscribed lesion that is less than 1 cm in diameter. When documenting this finding, the FNP would report this as a

    Question: A patient is suspected of having inflammation of the gallbladder, or cholecystitis. The FNP should conduct which of these techniques to assess for this condition?

    Question: The FNP just noted from a patient’s medical record that the patient has a lesion that is confluent in nature. On examination, the FNP would expect to find

    Question: During an examination, the FNP finds that a patient has excessive dryness of skin. The best term to describe this condition is

    Question: An older patient has been diagnosed with pernicious anemia. The FNP knows that this condition could be related to NR 509 Advanced Physical Assessment

    Question: A 52 year old woman has a papule on her nose that has rounded, pearly borders and a central red ulcer. She said she first noticed it several months ago and that it has slowly grown larger. The FNP suspects which condition?

    Question: The FNP is watching a new graduate FNP perform auscultation of a patient’s abdomen. Which statement by the new graduate shows a correct understanding of the reason auscultation precedes percussion and palpation of the abdomen?

    Question: A newborn infant is in the clinic for a well-baby check. The FNP observes the infant for the possibility of fluid loss because of which of these factors?

    NR 509 Week 5 Quiz Review

    Tenderness in RLQ is concerning for

    Inuit people tend to sweat more on face than trunk and extremities when exposed to heat

    spot on face with round pearly boarder with central red lesion concerning for

    Murphy sign= positive with deep palpation causes pain on inspiration

    NR 509 Advanced Physical Assessment

    Why do you auscultate first in abd assessment

    Tympany in the umbilical area

    Pt with decreased gastric secretions is at increase

    Another name for hyperactive bowels

    Black tarry stool concerning

    Lichenification caused by

    A papule is

    Older adults have

    CVA tenderness

    Confluent lesions

    Dryness of the skin

    Newborns are at greater risk of fluid loss

    High pitched irregular bowel sounds

    Changes in hair texture and color of an AA child with Marasmus

    Know how to assess for enlarged organs in the abd region

    Know three sounds heard in percussion

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    A woman has come to the clinic to seek help with a substance-abuse problem. She admits to using cocaine just before arrival. Which of these assessment findings would the FNP expect to find when examining the woman?

    A 63-year-old Chinese American man enters the office with complaints of chest pain, shortness of breath, and palpitations. Which statement most accurately reflect the FNPs best course of action?

    The FNP is planning to assess new memory with the patient. The best way for the FNP to do this would be NR 509 Advanced Physical Assessment

    During the health history the FNP asks a female patient “how many alcoholic drinks do you have a week?” Which answer by the patient would indicate at risk drinking?

    Symptoms such as pain are often influenced by a person’s cultural heritage. Which of the following is a true statement regarding pain?

    The FNP suspect abuse when a 10-year-old child is taken to the urgent care center for leg injury. The best way to document the history and physical findings is to

    During a mental status assessment, which question by the FNP would best assess a persons judgment?

    The FNP is performing a mental status assessment on a five-year-old girl. Her parents are undergoing a bitter divorce and are worried about the effect it is having on their daughter. Which action or statement might leave FNP to be concerned about the girls mental status?

    During mental status examination, the FNP wants to assess a patient’s affect. The FNP should ask the patient which question?

    During an examination FNP notices a patterned injury on a patients back. Which of these would cause such an injury? NR 509 Advanced Physical Assessment

    The FNP is aware that intimate partner violence screening should occur with which situation?

    Which statement is best for the FNP to use when preparing to administer the abuse assessment screen?

    The FNP is conducting a class on alcohol and the effects of alcohol on the body. How many standard drinks (each containing 12 g alcohol) Per day are associated with increased deaths from cirrhosis, cancers of the mouth, esophagus and injuries in men?

    A woman who has just discovered that she is pregnant is in the clinic for her first obstetric visit. She asked the FNP how many drinks a day safe for my baby? The FNP‘s best response is

    The FNP is performing the Denver II screen test on a 12 month old infant during a routine well child visit. The FNP should tell the infants parents that the Denver II

    Which term refers to a one produced by tearing or splitting of body tissue usually from blunt impact of a bony surface

    When reviewing the use of alcohol by older adults the FNP notes that the older adults have several characteristics that can increase the risk of alcohol use which would increase the bioavailability of alcohol in the blood for longer periods of time in the older adult?

    The FNP is reviewing concepts of cultural aspects of pain. Which statement is

    true regarding pain?

    The FNP is planning to assess a child using behavioral checklist. This tool is most appropriate for a(an)

    The FNP is assessing orientation in a 79-year-old patient. Which of these responses … leave the FNP to … that the patient is … ?

    As a mandatory reporter of elder abuse, which of these must be present before an FNP notifies the authorities?

    A 30-year-old female patient is describing feelings of hopelessness and depression. She has attempted self-mutilation and has a history of prior suicide attempts. She describes difficulty sleeping at night and has lost 10 pounds in the past month. Which of these statements or questions is the FNP‘s best response in this situation?

    For persons age 12 years and older which of these illicit substances was one of the most commonly used? NR 509 Advanced Physical Assessment

    Which of these individuals would the FNP consider at highest risk for suicide attempt?

    The FNP is …. a patient who has … for cirrhosis of the liver secondary to chronic alcohol use. During the physical … the FNP looks for cardiac problems that are … with chronic heavy use of alcohol such as

    During an examination of an aging male the FNP recognizes that normal changes to expect would be:

    During a health history, a 22-year-old woman asks “can I get that vaccine for HPV? I have gentle warts and I’d like them to go away!” What is the FNP‘s best response?

    During a speculum inspection of the vagina the FNP would expect to see what at the end of the vaginal canal?

    A 62-year-old man is experiencing fever, chills, malaise, urinary frequency and urgency. He also reports urethral discharge and a dull aching pain in the perineal and rectal area. The symptoms are most consistent with which of the following?

    When performing a genital examination on a 25-year-old man the FNP notices deeply pigmented, wrinkled scrotal skin with large sebaceous follicles. On the basis of this information the FNP would:

    The mother of a 10-year-old boy asks the FNP to discuss the recognition of puberty. The FNP should reply by saying:

    The uterus is usually … tilting forward and superior to the bladder. This position is known as

    A male patient with possible fertility problems asks the FNP where sperm is produced. The FNP knows that sperm production occurs in NR 509 Advanced Physical Assessment

    A 15-year-old boy is seen in the clinic for complaints of dull pain and pulling in the scrotal area. On examination the FNP palpates a soft, irregular mass posterior to and above the testes on the left. This mass collapses when the patient is supine in refills when he is up right. This description is consistent with:

    In performing an assessment of a woman’s axillary lymph system the FNP should assess which of these nodes?

    A patient contacts the office and tells the FNP that she is worried about her 10-year-old daughter having breast cancer. She describes a unilateral enlargement of the right breast with associated tenderness. She is worried because the left breast is not enlarged. What would be the FNP‘s best response?

    An 11-year-old girl is in the clinic for a sports physical. The FNP notices that she has begun to develop breasts, and during the conversation the girl reveals that she is worried about her development. …. which of these techniques to best assist the young girl in understanding the expected sequence for development? The FNP should:

    A 54-year-old woman who has just completed menopause is in the clinic today for yearly physical examination. Which of these statements should the FNP include in patient education? A post menopausal woman:

    A 62-year-old man states that his doctor told him that he has an inguinal hernia. He asks the FNP to explain what a hernia is……:

    NR 509 Advanced Physical Assessment When performing a genital assessment on a middle-age man, the FNP notices multiple soft, moist, painless papules in the shape of cauliflower like patches scattered across the shaft of the penis. These lesions are characteristics of:

    If a patient reports a recent breast infection, then the FNP should expect to find_____node enlargement

    A 9-year-old girl is in the clinic for a sports physical. After some initial shyness she finally asked “am I normal? I don’t seem to need a bra yet, but I have some friends who do. What if I never get breasts?” The FNP‘s best response would be:

    Which of these statements about the testes this true?

    During an examination FNP observes a female patients vestibule and expect to see the

    A 14-year-old girl is anxious about not having reached menarche. When taking history, the FNP should ascertain which of the following? The age:

    A woman who is 22 weeks pregnant has a vaginal infection. She tells the FNP that she is afraid that the infection will hurt the fetus. The FNP knows that which of these statements is true?

    In performing a breast examination the FNP knows that it is especially important to examine the upper outer quadrant of the breast. The reason for this is that the upper outer quadrant

    An accessory glandular structure for the male genital organs is the

    Which of these statements is true regarding the penis?

    A woman who is 8 weeks pregnant is in the clinic for a check up. The FNP reads on her chart that her cervix is … cyanotic. The FNP knows that the woman is exhibiting____sign and _____sign

    Reflect back over the past eight weeks and describe how the achievement of the course outcomes in this course have prepared you to meet the MSN program outcome #1 and the MSN Essential I. NR 509 Advanced Physical Assessment.

  • Changing role of nursing essay example NRS 440

    Changing role of nursing essay example NRS 440

    Our role as a nurse changing to more home health jobs:

    The country is facing many changes especially with Obama Care being up in the air with the new president. The Affordable Care Act has restructured how we receive our health care in the United States. Nurses have and always will play a very important role in our health care today. Changing role of nursing essay example NRS 440. The one change that is very different from how we receive our health care today is the simple fact that in years to come it is expected that nursing will be in high demand outside of the hospital compared to just having nurses in and around hospitals delivering acute care.

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    The practice of nursing is an ever evolving career. As we grow and evolve as a country so does the career in nursing. The concept of continuity of care used to be considered inside a hospital setting only but because our culture is changing so much it reflects on how nursing is approached. My goal is to provide you with information showing the recent trend of providing in home health care compared to the traditional hospital care we are all used to receiving. Changing role of nursing essay example NRS 440.

    Traditional roles vs. more opportunities

    The traditional role of nursing has been to provide care inside the hospital. As a nurse we tend to think if we would like to work as a RN the place to apply would be a hospital. This is no longer the case. Job opportunities are going to be in the community especially because the Affordable Care Act has placed programs for the elderly to be at home for as long as possible. There are more and more rehabs, assisted living places being opened up by the 100’s.  The need for nurses at these facilities is only going to become greater as the bigger hospitals increase these types of programs. In a recent article by ANA Career Center Staff the topic being looked at was heath care and the affect it had on the nurses. It addressed things like the fact over half of the nurses were looking at retirement. They went as far as to state, “More than half of working nurses are over 50, which means there will be a lot of empty positions to fill in the coming years as they retire, says Susan Yox, EdD, RN, director of editorial content at Medscape.” (ANA, 2015). Changing role of nursing essay example NRS 440.  Peggy Crabtree is from the Camden group and she believes that there will be more opportunities for the nurse to work considering how many patients will be discharged to one of the facilities outside of the hospital. The opportunities are really endless for nurses because there are now programs for this very thing everywhere. One of the options are ACO’s which are Accountable Care Organizations. These are a great alternative for the patient and the nurse to provide care in an environment other than the hospital. The ACO has been defined as a “model of care, an ACO generally consists of an interrelated system of providers that may comprise hospitals, home care and long-term care agencies, physician group practices, and other health care entities, such as medical homes, whose focus is primary care. The ACO assumes responsibility for managing the care of the patient and the delivery of services across the continuum of care, with a strong emphasis on primary care and prevention”. (Hart, 21012) Changing role of nursing essay example NRS 440.

    Home Hemodialysis

    One program that I happened to know a bit more about is Home Hemodialysis. I just switched jobs recently and this is now what I am presently learning.  The home dialysis program is amazing for patient’s. These patients are tied down to the dialyzer for three to four times a week and it usually is for a 4-hour time period. Changing role of nursing essay example NRS 440. So if you can only imagine the life style commitment these people make. So, if you can imagine this machine is the patient’s life line. It really helps that patient feel the least bit of freedom by giving them a bit of control with a home dialysis machine. It can do wonders for their health both mentally and physically. The patient is actually able to travel to different areas in the United States due to the Affordable Health Care Act. Most of them will qualify for the home dialysis unit which is portable if they are at a pretty high functioning level. It has made things like home dialysis an everyday topic rather than a wish that the patient longs for and dreams about. It can make it a reality. Changing role of nursing essay example NRS 440.

    Many years ago these things like home dialysis were not an option. Overtime things like rehab facilities, home health care, hospice, assisted living facilities are all fairly new. With these types of health care being offered over just the acute care units in the hospitals it requires a more diverse set of skills for the nurse to have. While all of this new and upcoming healthcare is great it definitely causes a nursing shortage. It requires the nursing community to rethink about how they are training the new nurses.

    Nurses Response

    I shared this with three colleagues on my floor and asked for their feedback. The following is some of their responses to my presentation. All three basically had the same thing to say in general. They all felt like they knew how fast our health care was changing but were not aware that it was changing towards home health more than the acute care in the hospital. The more all three were talking I saw that they also agreed that in general all of the programs offered were starting to have an affect on the patient census Changing role of nursing essay example NRS 440. There are times of the year we see more patients especially now with the holidays but they also stated that having programs like home Hemodialysis is amazing. It allows our center the ability to see at least 100 more people in need. I think their point was that right now they really have not seen a change in the jobs for nursing dwindling in any way at the hospital but they have seen many of the jobs open up at home because of these new programs. I personally would have to agree with this point they were making too. Basically, in home dialysis there is so many patients waiting to be seen that yes many nursing jobs have been created at the home level but it still is in high demand at the acute care center in the hospital due to how many patients have needed this. Changing role of nursing essay example NRS 440.

    Another point they were making was about the funding for these programs and if it was truly available. They were questioning the fact that like in many clinics or hospitals they never want to pay the nurse what she is truly valued at. They were asking about the load of work a nurse would be expected to do at a home treatment rather than the treatment in the hospital where they have access to PCT’s and CNS’s that help them tremendously. They raised some really good questions and points. They agreed that in general our health care is starting to use things like home health care over coming into the ER room and getting saline due to being dehydrated. They also agreed that these options were so much healthier for a family with a sick loved one Changing role of nursing essay example NRS 440. The amount of time and energy it takes on the family to bring the patient to the hospital and then to be around all the other people that are sick when that person is likely immunocompromised to begin with.

    Our Nursing Future

    Once I shared with them some of the good these home clinics are capable of I think all tree were more likely to be on board with the fact our health care system is changing and it will affect nursing in the areas we actually are providing care to our patients. When you spend time explaining personal stories about how home health care has not only helped a patient but also has allowed the patient to feel a sense of control again over their own life all three of the nurses were listening with a new sense of hearing. We all get complacent with our job and all it took for a renewed outlook on things was for these three nurses was to listen to a presentation. I actually could tell when we went back into the clinic for the acute care hemodialysis that they were extra careful and sensitive with their patients. It made me realize just how much it helps our health care team see things as they are. We all might need to have an open mind about working and providing care in a home, rehab, or assisted care facility rather than the traditional hospital. It will do the whole nursing community a world of good. Changing role of nursing essay example NRS 440.

    References

    Accountable care organizations: the future of care delivery? (n.d.). Retrieved December 18, 2016, from
    https://www.ncbi.nlm.nih.gov/pubmed/22277862

    (n.d.). Affordable Care Act Summary. Retrieved December 17, 2016, from

    Affordable Care Act Summary

    4 Health Care Trends That Will Affect American Nurses. (n.d.). Retrieved December 17, 2016, from

    http://nursingworld.org/MainMenuCategories/Career-Center/Resources/4-Health-Care-Trends-That-Will-Affect-American-Nurses.html

    Nather, D. (n.d.). Understanding Obamacare: A guide about the Affordable Care Act by POLITICO. Retrieved December 17, 2016, from
    http://www.politico.com/obamacare-guide
    / Changing role of nursing essay example NRS 440.

  • NR 509 Week 2 Shadow Health Respiratory Physical Assessment Assignment

    NR 509 Week 2 Shadow Health Respiratory Physical Assessment Assignment

    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 NR 509 Week 2 Shadow Health Respiratory Physical Assessment Assignment. 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.

    ORDER A PLAGIARISM-FREE PAPER HERE

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

    | 
    Overview

    | 
    Transcript

    | 
    Subjective Data Collection

    | 
    Objective Data Collection

    | 
    Education & Empathy

    | 
    Documentation / Electronic Health Record

    | 
    Student Pre-Survey

    | 
    Lifespan Activity

    | 
    Review Questions

    | 
    Self-Reflection Activity

    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. NR 509 Week 2 Shadow Health Respiratory Physical Assessment Assignment. 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.

    | 
    Overview

    | 
    Transcript

    | 
    Subjective Data Collection

    | 
    Objective Data Collection

    | 
    Education & Empathy

    | 
    Documentation / Electronic Health Record

    | 
    Student Pre-Survey

    | 
    Lifespan Activity

    | 
    Review Questions

    | 
    Self-Reflection Activity

    NR 509 Week 2 Shadow Health Respiratory Physical Assessment Assignment