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

to oppose Democrats’ plans for health care reform or unethical scaremongering?

       I think her strategy was both unethical and excessive, but it was effective.

 She used false, unsubstantiated statements to affect a key health issue that

would have benefited a lot of patients.  The bill would have allowed Medicare to pay for optional doctor’s visits to discuss living wills and end of life issues with their physicians (Mason, 2016).  As a member of Congress, she and her family are afforded a higher level of health insurance that is effective for life after serving 6 years.  Due to her statements all references to end of life planning were deleted from the bill.

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

     I tend to be loyal to my political party but only if the facts support what I think is right.  I believe we should all be afforded the right to discuss end of life issues and living wills and have it covered by our insurance and not have our families burdened with these decisions on their own.

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

     There is no perfect legislation so there must be some compromise.  I think nurses should endorse legislation if it is for the improvement of health care and in the best interest of the patients and nursing practice.

COMMENT1

. The American Cancer Society offers 24 hours a day, and seven days a week support to patients newly diagnosed with cancer, currently going through treatment or to caregivers, by offering information, day-to-day help, and emotional support. Their support ranges from temporary housing, free transportation, understanding the diagnosis, treatment options, treatment side effects and near the end of life support (ACS, 2018).

Educational support starts with understanding the diagnosis. The patient can learn what cancer is, how it spreads to other parts of the body, and how cancers are different. Some cancers spread very quickly, and others grow more slowly. The patient can learn that some type of cancers is best treated with surgery, while others do betters with medication and radiation treatments (ACS, 2018).

Patients can access information online at www.canger.org or via telephone Cancer Helpline 800.227.2345. A team of doctors writes the information provided at the American Cancer Society, master prepared nurses, journalist, editors and translators specialized in medical writing.

The patient can learn how is treatment planned and anticipate their growth rate of cancer. An example would be certain types of leukemias and lymphomas grow faster than solid tumors. Thus, the treatment for those cancers should be started in a couple of days (ACS, 2018). 

The ACS service that I would recommend for someone I knew, who is diagnosed with cancer would be the American Society of Clinical Oncology(ASCO). The reason is finding a clinical oncologist for a second opinion. The diagnosis of cancer is overwhelming and having the reassurance that the right treatment is initiated, or finding out a different treatment option can help the patient explore all options. I would advise the patient to communicate that decision with their physician and to verify with the insurance before making arrangements (ACS, 2018).

COMMENT2

Over the next decade, it is expected that there will be nearly 1.5 million new cancer diagnosis. Factors that contribute to this include people being more in tune with their bodies. More woman are doing routine self-breast exams, and now with the Affordable Care Act, pap smear, mammograms, HPV, lung cancer  and nutrition screening are covered at 100% as preventative health (HealthCare.gov, nd.) . By having more people tested, there will be more diagnosis but hopefully in early stages. Medical advancements also make detecting cancer faster and easier. MRI’s, CT Scans, Pet Scans and now digital mammography make it easier to find abnormalities quicker, leading to faster treatments. It would be nice to see these numbers trend down but having people starting to eat more organic foods and quit smoking, but unfortunately, cancer is a disease that is becoming more common in this day and age.

Research projects being funded and encouraged by the ACS mostly include ways to diagnosis and treat the cancers themselves. Dr. Jennifer Mack (2018), of the Dana-Farber Cancer Institute in Boston, recently received a grant to allow her to study support systems, a different but equally important role in the fight against cancer. The purpose of her research is to improve relationships between parents and their child’s cancer doctor. The focus was on how to encourage positive relationships to help reduce miscommunication and anxiety. The team is studying relationships that are working well along with difficult ones to learn strategies to quickly identify and repair relationships in need. The plan is to design interventions to diffuse stress and distress and eventually put those interventions into action. The ACS has provided comfort and peace of mind to millions of individuals and their families when they receive a cancer diagnosis. With support through donations and fundraising events, this organization will continue to make strides in treatments, hopefully eliminating cancer for good.

Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5 kg
2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
5. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

Pay for performance has been utilized for many years, however it is growing in popularity as a cost controlling measure. Critics argue that pay for performance results in a physician’s unwillingness to treat complicated or difficult cases. Proponents argue that paying for performance will increase quality and result in a higher patient satisfaction.

In this discussion, highlight the pros and cons to pay for performance as a cost saving technique. Additionally, summarize recent studies to determine if physician-based pay for performance is truly delivering the promised cost savings.

Be sure to support your statements with logic and argument, citing all sources referenced. 

Requirments:

– 2 pages 

– APA style

– Citation through the Text

– 3 References minimum