Please go over the instructions in the instructions box image. The attachment has all the instructions for this discussion. Carefully follow the instruction. 

Mrs. Law, a 77-year-old female, is at home recovering from a surgery that she had after falling and breaking her hip 5 days ago. She lives with her husband, Dean, who helps to care for her. Mrs. Law is a former smoker and has a past medical history of hypertension and hyperlipidemia.

You are the visiting nurse, assigned to check on her postoperative progress. You ask the client how she is feeling, do an assessment, and inquire as to what she has eaten over the past 24 hours. Mrs. Law states that she has “no pep,” no appetite, has been taking her pain medication as prescribed (every 4 hours—but not real helpful!), cannot sleep well, doesn’t feel much like walking except to the bathroom, and has been unable to move her bowels for several days.

• Breakfast: Two glazed doughnuts, coffee (black)
• Lunch: Tossed salad with oil and vinegar, diet soda
• Dinner: Tomato soup, 1 cup; four soda crackers; and red homemade wine
• Snack: Pretzels, diet soda

What nutrients that contribute to bone health are missing in Mrs. Law’s diet?

What other dietary concerns do you have?

Is Mrs. Law getting the appropriate amount of vitamins and minerals for her age and current condition? Why or why not? 

B
I only need one page paper. Citation and references from the book: Nutritional foundations and clinical application: a nursing approach. 

Thank you 

The Assignment

Address in a comprehensive client assessment of the Hernandez family the following:

• Demographic information
• Presenting problem
• History or present illness
• Past psychiatric history
• Medical history
• Substance use history
• Developmental history
• Family psychiatric history
• Psychosocial history
• History of abuse and/or trauma
• Review of systems
• Physical assessment
• Mental status exam
• Differential diagnosis
• Case formulation
• Treatment plan

What are your thoughts???

Non-experimental research focuses on attempting to study the correlation/relationship between two things. It studies the variables, but unlike experimental, it differs in that these variables are not being manipulated. An example I think of for non-experimental is patients with ICU delirium. Not all patients admitted to the ICU will develop delirium because ICU alone does not cause derlium, but there is a strong chance/relationship if certain measures aren’t taken. This can ultimately lead to worse patient outcomes.

Minimum of 250 words with peer review reference.

Discuss how evidence-based practice is defined as translational research. Describe the framework that supports that definition. Identify a population health issue you are interested in researching and discuss the issue using that framework. As you select an issue, remember you will be building upon your research in this course for your evidence-based practice project in the next course. Think about how you can focus your research now to help you complete your EBP project. 

Note: While you will only be proposing a solution and implementation plan in your EBP project, keep in mind EBP projects lay a foundation for doctoral research, since doctoral candidates have the opportunity to actually implement their projects. If you are interested in pursuing doctoral education, it is a good idea to choose an issue you would be interested in pursuing in greater depth. The research and work you complete on your EBP project now can be used if you choose to move forward into doctoral education.

Multigenerational nursing

Please, respond to the following discussion by using one reference from peer-reviewed Nursing Journal not older than 5 years.

Some of the challenges of having different generations in the workplace include a difference in education, particularly vocational training, and a difference in communication style. As current practices are studied and re-evaluated, traditional practices may be replaced by those that are more recently researched and are evidence-based. Veteran nurses may believe it is a waste of resources to change a practice that has been in place for so long and, in their view, has yielded adequate results.  Similarly, younger generations may readily dismiss suggestions and viewpoints from veteran nurses in favor of the new practices learned in school without considering that years of clinical experience can be just as valuable. This disconnect between nurses of differing generations may be rooted in a difference of communication style. For example, Baby Boomer nurses were trained to only voice their opinions when asked, whereas Millennial nurses’ were taught to speak up any time they have a problem with, or idea for, new practices; this difference in communication may lead the Baby Boomer nurse to regard the Millennial nurse as impertinent and disrespectful of authority instead of realizing that new nurse is actually trying to improve the patient experience (Phillips, 2016, p.198).

In my experience, some veteran workers can be set in their ways to a fault, even if there is clear evidence that practices they are accustomed to are simply not the best practices anymore. This is not to say that middle-aged or younger workers cannot share this attribute, however the veteran workers sometimes use their field experience as a rationale to ignore current research findings and continue using practices they deem appropriate. Also, as an employee that is frequently on the team that rolls out new technology and equipment, I feel that veteran workers take more time to warm up to change and can be somewhat hostile to a younger person, such as myself, training them.

As far as accommodations, we have certain older employees that will not perform job-necessary duties because of back issues, knee issues, or other medical issues in the same vein. As a result, these employees rarely get assigned total care patients, making the younger staff resentful because they feel they, literally, do all the heavy lifting while these older employees are routinely assigned the less acute patients. To a certain extent, allowances should be made for older workers, including nurses. After a lifetime of caring for patients, it is reasonable to deduce that the joints, particularly knees and back, can be irreparably damaged from repeated use. However, in my opinion if an employee is unable to perform the duties required of their job title, they should be doing a different job. It is not fair that one group of nurses consistently gets less acute patients, thereby doing half the work, but still receiving the same benefits as those nurses that pick up the slack. A potential solution would be for the nurses with physical limitations to shift to a position that utilizes their experience but is less physically demanding; such positions include resource nurse, case manager, or patient care coordinator. If this were fiscally feasible, the unit would be able to retain the wealth of knowledge provided by these seasoned nurses and still have room to hire new nurses that can help distribute the patient loads more equitably.

            Life expectancy in the United States has increased over the past few decades and older people are generally healthier than their predecessors, however the incidence of chronic conditions has also increased in this time frame (Tabloski, 2014, p.8). This indicates that there are more people to care for and these patients are more likely to have multiple comorbidities. This trend has the potential to put an enormous strain, economically and physically, on an already overburdened health care system and nurses, particularly bedside nurses, will bear the brunt of this (Tabloski, 2014, p.13). It is important that nurses engage in primary and secondary prevention with this population, including education related to diet, exercise, and proper medication utilization (Tabloski, 2014, p.13). By encouraging older patients to take an active role in preservation of function and overall health, nurses empower these patients to help decrease their risk for chronic conditions, like hypertension, and injury (Tabloski, 2014, p.13). Also, nurses must be educated on specific attributes of the older population, such as increased sensitivity to certain medications, decreased sensory perception, and increased susceptibility to mental health issues, such as depression, that may affect their physical health or motivation to maintain a healthy lifestyle.le