Cardiovascular Case Study

John is a 76-year-old man with a long history of stable angina and hypertension. He is prescribed nitroglycerin tablets as needed for chest pain and lisinopril for his hypertension. John has noticed that his chest pain is occurring with increasing frequency and less activity is required to initiate the symptoms; however, the pain subsides quickly with rest and one or two nitroglycerin tablets.

John is awakened from sleep with chest pain and shortness of breath. The pain is much more severe than his usual anginal pain and radiates to the jaw and the left arm. He experienced some nausea and became diaphoretic and pale. Upon admission to the local emergency department, he was noted to have significant ST-segment elevation on a 12-lead electrocardiogram (ECG).

Discussion Questions:

1. What diagnosis is consistent with John’s history and physical exam?

2. Please differentiate between a STEMI and Non-STEMI.

3. What are the pathophysiological findings specifying an MI?

4.What are the differences between angina, silent ischemia, and myocardial ischemia?

5.Provide a description of the three factors associated with Sudden Cardiac Death.

6.What are the possible complications post-MI might the NP be aware of when caring for John?

Do two pages.

Provide references.

  

Financial Analysis

How can you assess the financial viability and merit of your program? What indications will inform you and others whether your financial strategies are likely to result in positive health outcomes for the population?

This week you continue to develop Assignment 3, applying the principles of cost-effectiveness, cost-utility, and cost-benefit to your program design process.

To prepare for this week’s section of Assignment 3:

• Review      the information presented in the Learning Resources (see required reading      list further down below).
• Apply      the use of cost-effectiveness, cost-utility, or cost-benefit to your      program design to determine whether the monies put into your program will      result in positive health outcomes for the population.

To complete:

Write a 3- to 5-page paper* due by 22:00 tomorrow 1/17/18 in APA format with a minimum of 6 scholarly references (See Required Readings list below) that address the following:

1) Budget (developed in Week 7 [see attached file for that assignment])

a) Develop a simple revenue and expense budget for 6 months from start-up and develop a break-even analysis.

b) Articulate a justification for the revenue and expenses indicating where the funds are coming from to support the project and what resources the expenses are related to.

c) Explain any variance from the budget that is not budget neutral.

2) Financial Analysis (developed this week [see attached file for this assignment])

a) Articulate whether the monies put into the program will result in positive health outcomes for the population (resulting from your application of the use of cost-effectiveness, cost-utility, or cost-benefit to the program design process).

* Include tables or graphs in your paper to illustrate budget information.

P.S. Start this assignment with an introduction ending with a purpose statement and a conclusion as per the APA guidelines. Make sure to run this paper through TURNITIN to check for plagiarism.

Required Readings

Hodges, B. C., & Videto, D. M. (2011). Assessment and planning in health programs (2nd ed.). Sudbury, MA: Jones & Bartlett Learning.

· Review Chapter 4, “Program Planning: The Big Picture”

· Review Chapter 5, “Social Marketing, Program Planning, and Implementation”

As you review Chapter 4, focus on the budgeting information presented on pp. 113–115.

Kettner, P. M., Moroney, R. M., & Martin, L. L. (2017). Designing and managing programs: An effectiveness-based approach (5th ed.). Thousand Oaks, CA: Sage. 

· Chapter 12, “Budgeting for Financial Control, Management, and Planning”

· Chapter 13, “Developing Line-Item, Functional, and Program Budgeting Systems”

·  Chapter 10, “Performance Measurement, Monitoring, and Program Evaluation”

As you read this chapter, pay attention to the financial functions associated with these forms of evaluation and the data to be collected.

Chapter 12 introduces budgeting as an important part of the planning process, noting that it also serves essential management and control functions for programs. Chapter 13 addresses three systems of budgeting—line item, functional, and program—each of which has a distinct focus.

Gaskin, J., Rennie, C., & Coyle, D. (2015). Reducing periconceptional methylmercury exposure: Cost-utility analysis for a proposed screening program for women planning a pregnancy in Ontario, Canada. Environmental Health Perspectives, 123(12), 1337–1344 doi.org/10.1289/ehp.1409034.

Palumbo, M.V., Sikorski, E.A. & Liberty, B.C. (2013). Exploring the cost-effectiveness of unit-based health promotion activities for nurses. Workplace Health & Safety, 61(12), 514–520.

U.S. Small Business Administration. (n.d.). Writing a business plan. Retrieved December 12, 2011, from http://www.sba.gov/category/navigation-structure/starting-managing-business/starting-business/writing-business-plan

The “Writing a Business Plan” section of this website introduces elements of a good business plan, which is an essential document for any program. Investigate the information presented. In addition, see the “Preparing Your Finances” section for information on break-even analysis and other budgeting-related matters.

Robbins, L.B., Pfeiffer, K.A., Weolek, S.M., & Lo, Y. (2014). Process evaluation for a school-based physical intervention for 6th and 7th grade boys: Reach, dose, and fidelity. Evaluation and Program Planning, 42, 21–31 doi.org/10.1016/j.evalprogplan.2013.09.002

Schalock, R.L., Lee, t., Verdugo, M., Swart, K., Claes, C., van Loon, J., & Lee, C. (2014). An evidence-based approach to organization evaluation and change in human service organizations evaluation and program planning. Evaluation and Program Planning, 45, 110–118. 

Optional Resources

Dirubbo, N. E. (2006). Break-even analysis: Can I afford to do this? Nurse Practitioner, 31(7), 11.

This article briefly explains break-even analysis and its use in initiating new programs.

McBryde-Foster, M. J. (2005). Break-even analysis in a nurse-managed center. Nursing Economic$, 23(1), 31–34

This article explains how break-even analysis can be used in a nursing environment and how to apply it for program proposals.

U.S. National Library of Medicine. (2008). HTA 101: IV. Cost analysis methods. Retrieved from http://www.nlm.nih.gov/nichsr/hta101/ta10106.html

· Published by the National Institutes of Health, this site offers an explanation of the types of cost analysis including comparison of cost-utility, cost-effectiveness, and cost-benefits.