Case Study, Chapter 10, Principles and Practices of Rehabilitation

1. Mrs. Adams, 72 years of age, is admitted to the rehab unit with the diagnosis of stroke. The stroke affected the limbic area in the brain, which has caused the patient to have emotional labiality (her mood changes rapidly because she misinterprets situations). As a result of the emotional labiality, she sometimes refuses to be repositioned or to participate in physical or occupational therapy. She sometimes also refuses to eat and drink. The patient’s right side is paralyzed and flaccid. She has no feeling on her right side. She has reddened areas on her coccyx and both heels at least 1 cm in diameter that do not go away with repositioning. She is incontinent of urine and stool. She has problems with communication called global aphasia (difficulties understanding speech and the written word and difficulties with speaking and writing). She is 5 feet tall and weighs 178 pounds. She has a tendency to develop skin tears because her skin is thin, and she has several bandages on her arms. The family states they are concerned because the staff on the previous medical-surgical unit would drag their mother up in bed when she slid down. The staff would chart when their mother refused to be repositioned and then would not reposition her for hours. 

1. Explain the pathophysiology of the risk factors that predispose Mrs. Adams to developing pressure ulcers?
2. What nursing measures need to be instituted for Mrs. Adams based on the information presented in the case study?

2. You are assigned to care for David Ramsey, a 22-year-old male patient who sustained a back injury secondary to being thrown from a motorcycle. He did not damage the spinal cord, but the computed tomography revealed a compression fracture at L-2 (lumbar area). David complains of severe lower back pain with numbness and tingling in the lower extremities. You identify the following nursing diagnosis: Impaired Physical Mobility.

1. What assessments are indicated based on this nursing diagnosis?
2. List other major nursing diagnoses based on David’s clinical presentation.

To Prepare:

• Reflect on your decision to pursue a specialty within the MSN program, including your professional and academic goals as they relate to your program/specialization. 

Post an explanation of your choice of a nursing specialty within the program. Describe any difficulties you had (or are having) in making your choice, and the factors that drove/are driving your decision. Identify at least one professional organization affiliated with your chosen specialty and provide details on becoming a member.

 Discussion: Safe Prescribing

In 1915, the Drug Enforcement Administration was formed, known then as the Bureau of Internal Revenue. Recognizing the variance in state laws and the process for completing applications for prescriptive authority and DEA registration is essential to the role of the NP as a prescriber. Within the last decade, safe prescribing of opioids has also become a national concern. For this Discussion, you will focus on the process for obtaining prescriptive authority after successfully completing your program of study and passing a National Certification Exam. You also will explore safe prescribing.

To prepare:

• Review your state’s process for obtaining prescriptive authority and associated fees
• Review the DEA website and review the process for obtaining a DEA number and associated fees.
• Review and select one of the following case studies and analyze the provider information:
  • Case Study One: Lori, FNP-BC, is a new graduate and has recently passed her certification exam. She has just been hired to work for a Primary Care Clinic in a small town. She will be working with one physician at one site.
  • Case study Two: James, FNP-BC, works with a physician who specializes in pain control. He works in several clinics in the large urban city where he practices.

By Day 3

Post a brief summary of your case study and an explanation of the appropriate prescriptive authority and DEA registration process needed for the case study you selected. Then, explain the safe prescribing practices that these providers should use for these settings.

Topic 1: Child and Adolescent Health Risks

As you discovered in this week’s lectures and readings, several populations face multiple health risks across their lifespan. Children and adolescents are a population that is at a higher health risk for obesity. A national movement is underway to reduce risk factors for developing obesity in children. Part of this movement is the “Let’s Move!” campaign, which is a comprehensive and coordinated initiative to prevent childhood obesity. The initiative emphasizes four primary components: healthy schools, access to affordable and healthy food, raising children’s physical activity levels, and empowering families to make healthy choices.

• Review Healthy People 2020. Identify objectives that will combat childhood and adolescent obesity.
• Provide suggestions on how community health nurses can contribute to these national health objectives and accomplish the goal of decreasing obesity among this population.

Case: Criminal Law

Please view the Healthcare fraud: Billing for services not rendered video below (https://www.youtube.com/watch?v=1ZB2fueXn9g). Then read the case study below the video.

Benevis and Kool Smiles Dental Clinics have joined the ranks of medical professionals and businesses found guilty of defrauding the government. Using the background reading as well as other sources, research the case against this company. After completing your research, please respond to the following questions.

1. Discuss the case against Benevis and Kool Smiles Dental Clinics. Be sure to explain the relationship between the two.
2. What were the actual charges filed against them?
3. What was the punishment?
4. Discuss the final outcome of the case. Was it justified? Be sure to cite reliable sources to support your analysis.

Length: Submit a 3-page paper.

SLP Assignment Expectations

1. Conduct additional research to gather sufficient information to support your analysis.
2. Limit your response to a maximum of 3 pages.
3. This should not be personal opinion (avoid the use of “I” in your paper).
4. Support your paper with peer-reviewed articles and reliable sources, and use at least 3 references. For additional information on how to recognize peer-reviewed journals, see http://www.angelo.edu/services/library/handouts/peerrev.php and for evaluating internet sources:
   https://www.library.georgetown.edu/tutorials/research-guides/evaluating-internet-content
5. You may use the following source to assist in your formatting your assignment: https://owl.english.purdue.edu/owl/resource/560/01/