Getting a full and complete background of the patient before an assessment is important to know. Reviewing of systems and establishing a baseline of the systems is significant in treatment of their ailment/condition that are addressing. Observation of rate, rhythm, depth, and effort of breathing needs to be done after the heart sounds are heard. This is because with the cued breathing, the heart might increase in rate, and the nurse practitioner should assess for heart sounds at a resting rate. Evidence of respiratory distress at rest or when walking – eg, obvious breathlessness, talking in short phrases rather than full sentences, use of accessory muscles, exhalation with pursed lips (Henderson, 2015). Conpliance is the ability of the lungs to stretch. This mechanism plays the role in gas exchange in breathing. The more the lungs can stretch, the greater the potential volume of the lungs and the greater the volume of the lungs, the lower the air pressure within the lungs (Anatomy and Physiology, 2013).

During observation, if the patient has COPD, the breathing pattern might be different. Accessory muscle use signals difficulty breathing from COPD or respiratory muscle fatigue (Bickley, 2017). Other clinical observation can be that the COPD patient has delayed expiratory breaths. There might even be a possibility to see retractions with the COPD and asthma patients.

References

Anatomy and Physiology. (2013, March 06). Retrieved from https://opentextbc.ca/anatomyandphysiology/chapter/22-3-the-process-of-breathing/

Bickley, L. S. (2017). Bates’ Guide to Physical Examination and History Taking, 12th Edition. [Vitalsource]. Retrieved from https://online.vitalsource.com/#/books/9781496354709

Henderson, R. (2015, December). Respiratory System History and Examination. Information page. Retrieved from https://patient.info/doctor/respiratory-system-history-and-examination

Instructions

In our work and personal lives, we need to be able to identify and analyze effective verbal and nonverbal communication in various situations. In the same way that you would analyze a work or personal life communication situation, you will be asked to create a short presentation (using media choices below) about the nonverbal communication demonstrated in a series of photographs. In addition to identifying aspects of nonverbal communication, you will also need to show how these elements can affect communication both positive and negatively. Include your observations of how nonverbal elements that you see alter the direction of communication.

1. Select four of included photographs.
2. Using either PowerPoint or Prezi, create a presentation that demonstrates your comprehension regarding these communication elements: Please include the following:
   1. A title slide including your name.
   2. Four slides that explain aspects of the nonverbal communication that you see depicted in the photographs. Be sure to include the photograph on the slide. Be as specific and detailed as possible in your description of body language, facial expression, physical distance (if applicable), gesture, and other aspects of nonverbal communication that you see.
3. Using Screencast-o-matic (screencast-o-matic.com) or similar software, create a short video presentation of your PowerPoint or Prezi. Explain in detail the nonverbal elements of communication that you observe in each of the four photographs you have selected. Video should be between four and seven minutes long. This video should either be of the presentation itself or a hybrid video that includes both the presentation and an inset webcam video.
4. Upload your video to screencast-o-matic, YouTube, or similar online video sharing site and provide a link to your video. Include your PowerPoint or Prezi with your submission.

DQ:

Select a topic for your Topic 3 Executive Summary assignment. Post  your idea and basic thoughts about the topic using the Topic 3  Executive Summary assignment details. You should provide thoughts to  your peers about their topics and ideas that may assist them in  completing their projects.

Assignment:(topic 3 executive summary )

In this assignment, you will select a program, quality improvement  initiative, or other project from your place of employment. Assume you  are presenting this program to the board for approval of funding.  Write an executive summary (850-1,000 words) to present to the board,  from which they will make their decision to fund your program or  project. The summary should include:

1. The purpose of the program or project.
2. The target    population or audience.
3. The benefits of the program or  project
4. The cost or budget justification.
5. The basis    upon which the program or project will be evaluated.

Share your written proposal with your manager, supervisor or other  colleague in a formal leadership position within a health care  organization. Request their feedback using the following questions as prompts:

1. Do you believe the proposal would be approved if formally  proposed?
2. What are some strengths and weaknesses of the  proposal?

Submit the written proposal along with the “Executive Summary  Feedback Form.”

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

This assignment uses a rubric. Please review the rubric prior to  beginning the assignment to become familiar with the expectations for  successful completion.

You are required to submit this assignment to LopesWrite. Please refer  to the directions in the Student Success Center.

NRS451V. ExecutiveSummaryFeedbackForm_2-24-24.doc 

APA  FORMAT

2. CITE ALL REFERENCES 

3. PLEASE COMPLETE ALL QUESTIONS. Late assignments will not be accepted!!!

Case Study: Urinary Tract Infection

 You are working in an extended care facility when M.Z.’s daughter brings her mother in for a week’s stay while she goes on a planned vacation. M.Z. is an 89-year-old widow with a 4-day history of non- localized abdominal pain, incontinence, new-onset mental confusion, and loose stools. Her most current vital signs are 118/60, 88, 18, 98.4° F (37.4° C). The medical director ordered a post void catheterization, which yielded 100mL of cloudy urine that had a strong odor, and several lab tests on admission. Urine culture and sensitivity results are pending; the other results are shown in the chart.

Chart View Laboratory Test Results:

Complete metabolic panel: Within normal limits except for the following results:

 BUN 25mg/dL Sodium 131mEq/L

 Potassium 3.2mEq/L

White blood cell count 11,000/mm3

Urinalysis Appearance Cloudy Odor Foul

 pH 6.9

 Protein Negative

 Nitrites Positive

 Crystals Negative

WBCs 6 per low-power field

 RBCs 3

1. What condition do the lab reports point toward?

1. Which assessment findings are typical of an older adult with the condition in Question 1?
2. Considering her history and laboratory results, what other condition is a possibility?

4.The medical director makes rounds and writes orders to start an IV of D5 ½NS at 75mL/hr. and insert a Foley catheter to gravity drainage. Because M.Z. is unable to take oral medications, the medical director orders ciprofloxacin (Cipro) 400mg q12h IV piggyback (IVPB). Are the type of fluid and rate appropriate for M.Z.’s age and condition? Explain.

1. While the IVPB ciprofloxacin is being administered, which adverse effects might occur?

1. You enter the room to start the IV infusion and insert the Foley catheter and find that the nursing assistive personnel (NAP) has taken M.Z. to the bathroom for a bowel movement. M.Z. asks you to help her, and, as you open the door, you observe her wiping herself from back to front. What do you need to do at this time?

1. Because M.Z. has been having diarrhea, what special instructions should you give the NAP assigned to give basic care to M.Z.?

Case Study Progress:

 The next day, you are the nurse assigned to M.Z.’s care. You notice that the NAP emptying the gravity drain is not wearing personal protection devices. You also observe that the drainage port of the drainage bag was contaminated during the process because the NAP allowed it to touch the floor.

1. What issues need to be considered in protecting M.Z.’s safety? Describe your actions in working with the nursing assistant.

1. As you assess M.Z., you notice that her catheter tubing is not secured. Why does the tubing need to be secured, and where is the correct place for the catheter tubing?

1. What changes, if any, will be made to the antibiotic therapy?