Develop a realistic case and Identify a chronic illness and its relationship to rehabilitation. Could be from a previous experience on your career.

1. Identify chronic illness and its relationship to rehabilitation.
   Choose from one:
   COPD, CHF, Stroke, Hip fracture
2. Create interventions that support an older adult’s adaptation to the chronic illness or disability.
3. Describe the nurse’s role in assisting older adults in managing chronic conditions.
4. From your readings and knowledge which opportunities do you think can be change in the health care system to improve care for older adults with chronic illness and disability.

Submission Instructions:

• The paper is to be clear and concise and students will lose points for improper grammar, punctuation and misspelling.
• The paper is to be 5 pages in length, excluding the title, abstract and references page.
• Incorporate a minimum of 3 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.
• Journal articles and books should be referenced according to APA style.

  

Translation Models

Diabetes is an international crisis and considered to be one of the Global Burden Diseases (The U.S. Burden of Disease Collaborators, 2018). In the primary care setting, translating the evidence of preventing Diabetic Foot Ulcers is done by introducing self-care education to primary care patients with a transitional Model. Almost 1/3 of people with diabetes acquire foot ulcers, and of these ulcers, 3/4 are avoidable (Bus & Van Netten, 2016). Therefore, it is incredibly essential to translate this evidence into action to prevent foot loss by amputation and, ultimately, early mortality. The Knowledge to Action Model (KTA) is used to translate all the evidence-based research knowledge on diabetic foot care into action in the clinic setting. KTA has two main components, “Knowledge Creation” and the “Action Cycle.” Using KTA, we already have numerous research available on diabetic foot care, funneled to identify a knowledge gap or problem. Knowing the problem, we must implement the second phase, which has seven stages called the Action Cycle. It can be continuous and go in either direction if necessary.

Stage One: The problem of poor diabetic foot care education on one-third of diabetics has been identified, and a knowledge gap exists between patients and caregivers.

Stage Two: The local setting of primary care with a high population of Hispanic patients with diabetes.

Stage Three: One of the possible barriers to this self-care program will be staffing and proper nurses’ training as educators. Also, the time it takes to teach patients. Another obstacle will be the patient’s willingness to learn and perform appropriate foot care daily.  This project’s facilitators will be the primary care providers and management at a micro, meso, and macro-level. The facilitators would help ensure proper staffing and more time allotted in the clinic for foot care sessions during diabetic visits.

Stage Four: Implement the project by educating nurses on diabetes and its effect on the body. The second part of implementation would be having the nurses teach foot care to Hispanic Diabetic patients at every visit. Using a transtheoretical Change Model at this stage would be appropriate.

Stage Five: In this stage, we would monitor the nurses’ knowledge using surveys and observation. We would measure the patients learning with a teach-back method and questionnaire.

Stage Six: Evaluating the outcomes might take a little longer to see results. Still, we should assess feedback from the nurses, podiatrist providers, and patients on the knowledge and care provided through surveys and questionnaires.

Stage Seven: This stage is not a final step but rather a step where knowledge is sustained with continuous updates and reassessments. This stage would keep the program fresh, and the key stakeholders would play the role of being receptive to the new norm and not become disengaged.

The resources needed for this project would be a clinical educator to train nurses on the effects and care of diabetic patients, mostly on foot self-care: foot care literature, handouts, and a small foot care kit for patients.  The kit would consist of a lotion, liquid soap, Emory boards, monofilament, and a mirror. This kit would cost about 12-15 dollars per unit. Key stakeholders such as pharmaceutical companies or diabetic organizations and community leaders would be instrumental in funding each diabetic patient with a self-care kit.

References

Bus, S. A., & van Netten, J. J. (2016). A shift in priority in diabetic foot care and research: 75% of foot ulcers are preventable. Diabetes/metabolism research and reviews, 32 Suppl 1, 195–200. https://doi.org/10.1002/dmrr.2738

The U.S. Burden of Disease Collaborators. (2018). The state of U.S. health, 1990–2016 burden of diseases, injuries, and risk factors among U.S. states. JAMA, 319(14), 1444–1472. https://doi.org/10.1001/jama.2018.0158 (Links to an external site.)

I NEED A COMMENT FOR THIS POST WITH AT LEAST TWO-THREE  PARAGRAPH AND TWO SOURCES NO LATER THAN FIVE YEARS

  

Benchmark – Academic Clinical History and Physical Note

Academic clinical history and physical notes provide a unique opportunity to practice and demonstrate advanced practice documentation skills, to develop and demonstrate critical thinking and clinical reasoning skills, and to practice identifying acute and chronic problems and formulating evidence-based plans of care.

Complete an academic clinical history and physical note based on a patient seen during clinical. In your assessment, provide the following. ( Acute Care Hospital)

History and Physical Note

1. Chief complaint/reason for admission/visit/consult.

2. HPI for the H&P or consult notes.

3. Medical, surgical, family, social, and allergy history.

4. Home medications, including dosages, route, frequency, and current medications, if a consultation note

5. Review of systems with all body systems for H&P or consult notes. Review of systems is what the patient or family/friends tell you (by body system).

6. Vital signs and weight.

7. Physical exam with a complete head-to-toe evaluation. Include pertinent positives and negatives based on findings from head-to-toe exam.

8. Lab/Imaging/Diagnostic test results (including date). (CPT codes)

Assessment and Clinical Impressions

1. Identify at least three differential diagnoses based upon the chief complaint, ROS, assessment, or abnormal diagnostic tools with rationale. (ICD-10 codes)

2. Include a complete list of all diagnoses that are both acute and chronic.

3. List the differential diagnoses and chronic conditions in order of priority.

Plan Component Management and Plan Criteria Incorporation

1. Select appropriate diagnostic and therapeutic interventions based on efficacy, safety, cost, and acceptability. Provide rationale.

2. Discuss disposition and expected outcomes.

3. Identify and address health education, health promotion, and disease prevention.

4. Provide case summary with ethical, legal, and geriatric considerations. Consider potential issues, even if they are not evident.

General Requirements

Incorporate at least three peer-reviewed articles in the assessment or plan.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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. Refer to the LopesWrite Technical Support articles for assistance.

Benchmark Information

This benchmark assignment assesses the following programmatic competency:

MSN Acute Care Nurse Practitioner

6.1: Determine differential diagnoses using physiological and pathophysiological evidence.

WEEK 6

This week discussion involves a 68 -year-old Caucasian male who complained of burning when urinating.  He admits to the pain increasing with the more he urinates and it has been going on for the past 5 days.  His past medical history includes prostatic hyperplasia, high cholesterol and hypertension. The medications he is prescribes are Olmesartan 20mg and Crestor 20 mg. He has been diagnosed with nocturia and dysuria. The subjective data I would inquire is his diet. How much water does he consumes daily? Was there an odor present when urinating?  Due to your history of UTI’s, are you taking any probiotics as needed and were you prescribed with antibiotics, if so, how long? With his systolic Blood pressure in the 150’s, when is the last time you took the Olmesartan. Did the fever occur before or after the Burning started, and did you take any acetaminophen or Motrin to break it?

             The Labs that I would order is a urine culture with sensitive, CBC, BMP and lipid panel. A kidney, ureter, and bladder (KUB) X-ray may be performed to assess the abdominal area for causes of abdominal pain, or to assess the organs and structures of the urinary and/or gastrointestinal (GI) system. A KUB X-ray may be the first diagnostic procedure used to assess the urinary system.

           A few diagnoses that can relate to the symptoms will include Bladder infection. They are the most common type of urinary tract infection caused by bacteria and can lead to problems like pain in your lower belly and having to pee way more often than usual (Rhoads, 2021). Symptoms may include Pain in the bladder, groin, lower abdomen, or pelvis that can occur during urination or during sexual intercourse.  The body may experience fatigue, fever, or malaise. Chronic Kidney Disease is a condition in which the kidneys are damaged and cannot filter blood as well as they should. Because of this, excess fluid and waste from blood remain in the body and may cause other health problems, such as heart disease and stroke (CDC,2019) CKD can cause Anemia, increased infections, abnormal electrolytes, loss of appetite or depression.

         A Kidney infection (pyelonephritis) is a type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels to one or both of your kidney. Symptoms observed in a kidney infection are Fever, Chills, Back, side (flank) or groin pain, Abdominal pain, Frequent urination, Strong, persistent urge to urinate and Burning sensation or pain when urinating.

                    Furthermore, patient teaching would include increasing intake of water and/or cranberry juice. Fluids can help remove bacteria from your body when you urinate. Kidney scarring can lead to chronic kidney disease, high blood pressure and kidney failure. When the infection remains in the blood, septicemia can occur.  Your kidneys filter waste from your blood and return your filtered blood to the rest of your body.  Urinate as soon as you need to. Avoid delaying urination when you feel the urge to urinate. It is important to empty the bladder after intercourse. Urinating as soon as possible after intercourse helps clear bacteria from the urethra, reducing your risk of infection (CDC, 2019).

References: 

Centers for Disease Control and Prevention. Chronic Kidney Disease Surveillance System website. https://nccd.cdc.gov/CKD. Accessed January 7, 2019.

Rhoads, J., & Wiggins Petersen, S. (2021). Advanced Health Assessment and Diagnostic Reasoning. Burlington, MA: Jones and Bartlett Learning. ISBN: 9781284105377