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Nursing – 2025 A mother brings in her 11 year old son Branch because he has had a nosebleed She is concerned

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Nursing – 2025

A mother brings in her 11 year old son, Branch, because he has had a nosebleed. She is concerned about it because they have been applying pressure by pinching it and the nosebleed won’t stop. He has no history of nosebleeds. He has no significant medical history and no known allergies. He is on no medications. Mom and Branch deny trauma to the nose. He says he just woke up with a nosebleed and it won’t stop. He tells you that the left side is the side that is bleeding.

Vital signs: BP 110/70 P 84 R 14 T 97.8 oral Pulse ox 99%

You recognize that simple pressure is not going to stop the nosebleed so you know that you will not have to intervene.

1.Prior to any type of procedure, you have the mother sign an informed consent for a procedure. What are the three major areas you must discuss when doing any type of procedure?
2. Nosebleeds can be divided into three groups. What are they?
3. 90% of nosebleeds fall into which group?
4.Name 4 indications for intervention by a provider for a nosebleed.
5. You place Branch on the exam table at approximately 45 degrees. You drape him appropriately. You have him blow his nose gently to remove clots. You then inspect the right side to familiarize yourself with his anatomy. You then inspect the left side using a nasal speculum. 5.When using the nasal speculum, it is important to use it ______________ (HORIZONTALLY/VERTICALLY).
6. Why is it important to use the nasal speculum a certain way?

7.You note that the bleeding is coming from an area on the septum. You know that the next step is to apply a vasconstrictive solution to the nose. What are two ways you can deliver the vasoconstrictive solution?
8. You note that the area that is the source of the bleeding is about 3 mm in diameter. You make the decision to use a silver nitrate stick. How long should you apply pressure with the stick?

9.Why it is it important not to use the silver nitrate for over that time frame?
10.After hemostasis is obtained, what are three types of treatment methods that can be used to protect the cauterization site?

11.If that had not stopped the bleeding and you had to make the decision to use a nasal sponge or nasal tampon, the sponge/tampon should be coated in _____________ and left in place for __________ hours.
12.After putting in the nasal sponge/tampon, approximately 2 ml of ________ or _______ should be dripped onto the tip to help the sponge expand.
13.After placing the nasal sponge/tampon, the patient should be closely monitored for 3-5 minutes. Why is that?
14.After the close monitoring, the patient should be kept in observation status for ______ minutes.
15. If it is necessary to pack the nose, it may be advisable to give the patient a narcotic or sedative medication (unless a contraindication exists). Why?
16.Name 5 complications of the above procedures.
17.After the procedure, you tell the pt and his mother that he can take acetaminophen for any pain/discomfort. Why is it important not to have him take ibuprofen?
18.What is the leading cause of nosebleeds in adolescents?
19.What CPT code would you use for the above procedure?
20.What is the definition of the above code?

Psychosocial Factors and Patient Education – 2025 Topic 2 DQ 2 The difference in culture origin and worldviews significantly affects how healthcare professionals handle various patients

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Psychosocial Factors and Patient Education – 2025

Topic 2 DQ 2

The difference in culture, origin, and worldviews significantly affects how healthcare professionals handle various patients. Consequently, while working with Sister Mary, a healthcare professional’s possible reservations could have included spirituality, social beliefs, and religious beliefs. Spirituality is the connection between human beings and supernatural beings, essential in patients’ lives. Nonetheless, most health providers do not talk about religious beliefs and spirituality during patient education due to various reasons, such as poor communication, psychosocial factors, and time limits (Henderson et al., 2018). When caring for Sister Mary, healthcare providers must recognize their own biases, try to focus on their care, and not on assumptions or judgments. The most important step in reducing prejudice is acknowledging that it exists and working on being mindful of those attitudes when providing care (Narayan, 2019). A health professional should remain respectful and culturally competent; thus, a health professional should desist from discrimination and judging a patient by appearance, dialect, spiritual inclination, degree of illness, and behavior.

Cultural competence is essential in providing quality and patient-centered care; therefore, while working with Sister Mary, a health provider should make reservations that do not contradict her social beliefs. In a clinical setting, health providers come across patients, such as Sister Mary, who have varied beliefs and cultures; thus, a health professional should reserve their ideas to learn and understand Mary’s religious and cultural beliefs (Lin et al., 2017). Moreover, other reservations a health professional could make include offering compassion and love to Sister Mary, irrespective of the differences in their cultural and social beliefs. Reservations in health care allow healthcare professionals to tailor-make the treatment process to suit every patient; thus, it requires critical thinking, justice, beneficence, and nonmaleficence.

What possible reservations could a health care professional have in working with Sister Mary? (Discuss the psychosocial responses the professional might have.)

Using 200-300 words APA format with at least two references. Sources must be published within the last 5 years

done – 2025 CC is a previously healthy 27 year old man admitted to the critical care unit after

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done – 2025

CC is a previously healthy 27-year-old man admitted to the critical care unit after an accident in which he was hit by a car and dragged along the pavement for nearly 100 feet. He suffered a frontal contusion, fractured clavicle and ribs, and extensive abrasions on his arms, legs, side, back, and buttocks. On admission, he was tachycardic, hypotensive, unresponsive, and ventilating poorly. He was placed on a mechanical ventilator and given IV fluids for the treatment of his shock. CC responded well to fluids, with an increase in blood pressure and an improvement in urine output.

1. Based on his case history and responsiveness to fluid therapy, what type of shock was CC experiencing?

2. What other clinical findings would be helpful in confirming the type of shock? Why?

3. Because of his many open wounds and invasive lines, CC is at risk for sepsis and septic shock. What clinical findings would suggest that this complication has developed?

4. What is the link between sepsis and multiple organ dysfunction syndrome (MODS)?

Gap Analysis Plan and Visio Draft – 2025 Course Project Part 1 Gap Analysis Plan and Visio Draft The process of comparing the current state

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Gap Analysis Plan and Visio Draft – 2025

Course Project Part 1—Gap Analysis Plan and Visio Draft

The process of comparing the current state of a system or workflow and to the desired, future state of the workflow, and then formulating preliminary ideas about how to move from the current to the future is known as a gap analysis. There are several different ways to collect information about an identified problem and potential solution, including observations, interviews, oral surveys, questionnaires, and existing data, tests.

This week you will begin crafting a Gap Analysis Plan to acquire information about a specific workflow issue in your organization or in one with which you are familiar.

Note: Your workflow issue MUST be related to the implementation or optimization of electronic health records (EHRs) in the organization in order to connect to meaningful use and the HITECH Act. If the organization currently uses an EHR system, your workflow issue should be related to an inefficiency or problem with how the EHR system is used. If the organization does not yet have an EHR system, your workflow issue should be related to an inefficiency or problem that could be solved by implementing an EHR system.

To prepare for Part 1 of the Course Project:

Identify the workflow issue you would like to explore throughout your Course Project. This should be a specific task about which you have sufficient content knowledge and access to describe and analyze in detail. Your workflow issue MUST be related to EHRs and be significantly tied to one or more meaningful use objectives. The workflow issue may be related to either the optimization of an existing EHR system or the implementation of an entirely new EHR system.
Establish your goals for conducting your gap analysis. These goals describe why you are conducting the gap analysis, the workflow issue you are pinpointing, and what you hope to accomplish in examining this issue.
Determine how you will collect data about the current workflow you are exploring for the Course Project. For example, you may choose to observe people as they move through the workflow, ask people about their experiences, confer with managers and leaders about their involvement, refer to your organization’s training manual or other informative documents, etc. Be sure to use more than one data-collection method and observe or consult with more than one person to ensure that the information you gather is balanced.

Note: If you are not currently working in a health care organization, you must locate an organization in your area and obtain informal permission to speak with and observe individuals. Consult your Instructor if you have questions on how to proceed.

Participate in the Week 4 Discussion and review the comments made by your colleagues and the Instructor on your preliminary workflow issue. Revise your workflow issue and data-collection methods as appropriate.
After you have revised your workflow issue, begin composing your Gap Analysis Plan paper using the requirements outlined below
As you write your paper, begin drafting the current-state workflow based on your preliminary knowledge (no outside information needed) in Visio. Include a swimlane showing, to the best of your knowledge, who is responsible for each step in the workflow. Use standard modeling symbols for workflow depicted in the Dennis, Wixom, and Roth text and the “Workflow Assessment for Health IT Toolkit” in the Week 4 Learning Resources.

Note:The primary purpose of the draft is to ensure that you are comfortable working with Visio. At this point, no outside sources are needed; your draft should be based only on your preliminary knowledge about the workflow. This exercise is mainly for practice, so your draft should be simple rather than detailed at this stage. In Week 6, you and your colleagues will conduct a peer review of one another’s workflow drafts. You will use the feedback you receive to revise and refine your draft before your first formal Visio deliverable is due in Week 7.

To complete Part 1 of the Course Project:

1. Write a 3- to 4-page Gap Analysis Plan that addresses the following:

Identify the workflow issue you will be exploring in the Course Project (Incomplete Medication Reconciliation, see attached file). Explain how this workflow issue is tied to EHRs. Identify the specific meaningful use objective(s) related to the workflow issue.
List 3 goals you have set for your gap analysis and what you hope to accomplish by examining the workflow you selected.
Describe your methods of data collection and the individuals you will observe, consult, and/or interview. Include any relevant narrative statements, checklists, interview questions, or other tools you will use to collect data.
Explain how you will minimize disruption in the workflow during observations and how you will avoid bias as you conduct your gap analysis.
Describe how you will record, quantify, and analyze the data you collect. Explain how you will establish baseline metrics to normalize data from different sources of information.

2. In a reference list, cite a minimum of four scholarly references (with APA citations) that you used to create your Gap Analysis Plan.

3. Post a draft of your current-state workflow in Visio. Your Visio draft should include your preliminary knowledge about the primary steps and activities within your workflow. In addition, include a swimlane showing who is responsible for each step, and use the appropriate diagramming symbols within your Visio draft.

Required Readings

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 15, “The Electronic Health Record and Clinical Informatics”

This chapter explores the components of electronic health records and explains their significance in patient care. The authors evaluate the political facets of implementing these records and project how their implementation will benefit health care as a whole.

Dennis, A., Wixom, B. H., & Roth, R. M. (2015). Systems analysis and design (6th ed.). Hoboken, NJ: Wiley.

Chapter 3, “Requirements Determination” (pp. 81–115)

Adherence to business requirements is important during a project. It is integral to plan the project with said requirements in mind. In this chapter, the authors demonstrate the processes of familiarizing one’s self with requirements and implementing them in the project plan.

Helmers, S. (2011). Microsoft Visio 2010 step by step. Sebastopol, CA: O’Reilly.

Chaper 1, “A Visual Orientation to a Visual Product” (pp. 1–36)

This introductory chapter walks the user through the basic desktop and tools necessary to get started in using Microsoft Visio. It provides instructions on the Visio ribbon, explores the drawing window, and offers tips on using and manipulating the variety of shapes available.
Chapter 2, “Creating a New Drawing” (pp. 37–68)

This chapter outlines the steps necessary for actually creating a drawing, and covers such topics as selecting the correct shape, connecting shapes, and using the Auto features.

Bayer, S., Petsoulas, C., Cox, B., Honeyman, A., & Barlow, J. (2010). Facilitating stroke care planning through simulation modelling. Health Informatics Journal, 16(2), 129–143.

Retrieved from the Walden Library databases.

This article provides an example of how workflow can be used to improve the level of health care being provided. In this particular case, data analysis and modeling were used to determine the optimal workflow for dealing with stroke patients.

Campbell, E. M, Guappone, K. P., Sittig, D. F., Dykstra, R. H., & Ash, J. S. (2009). Computerized provider order entry adoption: Implications for clinical workflow. Journal of General Internal Medicine, 24(1), 21–26.

Retrieved from the Walden Library databases.

This article assesses the impact of computerized provider order entry (CPOE) on clinical workflow. The mass adoption of advanced data capture and access methods can effect change in both positive and negative ways, so care needs to be taken in the design phase to provide a user friendly system.

Crosson, J. C., Etz, R. S., Wu, S., Straus, S. G., Eisenman, D., & Bell, D. S. (2011). Meaningful use of electronic prescribing in 5 exemplar primary care practices. Annals of Family Medicine, 9(5), 392–397.

Retrieved from the Walden Library databases.

One benefit of the widespread use of electronic health records (EHRs) is the opportunity to have electronic prescription capabilities. This article suggests practices that will help ensure e-prescribing that is high quality, efficient, and safe.

Effken, J. A., & Carrington, J. (2011). Communication and the electronic health record: Challenges to achieving the meaningful use standard. Online Journal of Nursing Informatics, 15(2).

Retrieved from the Walden Library databases.

Transitioning into a heavier use of health IT requires the adoption of more effective means of applying and deriving meaning from the data available. This article addresses the optimal relationship between user/IT communication and proper use of EHRs for achieving high-quality patient care.

Agency for Healthcare Research and Quality. (n.d.). Workflow assessment for health IT toolkit. Retrieved October 22, 2012, from http://healthit.ahrq.gov/health-it-tools-and-resources/workflow-assessment-health-it-toolkit

This web page provides a number of resources that examine how to plan, design, implement, and use workflows and how to analyze current systems to ensure optimum workflow.

Optional Resources

There are a wide variety of online tutorials available to assist you with using Visio. Below are two you might consider, as needed:

Microsoft. (2011). The Visio 2010 MVP sessions. Retrieved from http://office.microsoft.com/en-us/visio/

This free resource, developed by Microsoft, provides video tutorials in the use of all aspects of Visio 2010.

Edson, D. (2011). Visio 2010 essential training. Retrieved from http://www.lynda.com/Visio-2010-tutorials/Essential-Training/75921-2.html

This series of videos provides detailed instruction on all aspects of Visio use. This resource requires a paid subscription.

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Nursing – 2025 A mother brings in her 11 year old son Branch because he has had a nosebleed She is concerned

Psychosocial Factors and Patient Education – 2025 Topic 2 DQ 2 The difference in culture origin and worldviews significantly affects how healthcare professionals handle various patients

done – 2025 CC is a previously healthy 27 year old man admitted to the critical care unit after

Gap Analysis Plan and Visio Draft – 2025 Course Project Part 1 Gap Analysis Plan and Visio Draft The process of comparing the current state

Required Readings

Optional Resources

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