Instructions: Read the following case study and answer the reflective questions.

                     Please provide rationales for your answers. 

                     Make sure to provide a citation for your answers, No more 5 years.

                     APA format

                    No plagiarism.

Deadline: Due by Thursday 27, 2021 . 

CASE STUDY: Family Member with Alzheimer’s Disease: Mark and Jacqueline

 Mark and Jacqueline have been married for 30 years. They have grown children who live in another state. Jacqueline’s mother has moved in with the couple because she has Alzheimer’s disease. Jacqueline is an only child and always promised her mother that she would care for her in her old age. Her mother is unaware of her surroundings and often calls out for her daughter Jackie when Jacqueline is in the room. Jacqueline reassures her mother that she is there to help, but to no avail. Jacqueline is unable to visit her children on holidays because she must attend to her mother’s daily needs. She is reluctant to visit friends or even go out to a movie because of her mother’s care needs or because she is too tired. Even though she has eliminated most leisure activities with Mark, Jacqueline goes to bed at night with many of her caregiving tasks unfinished. She tries to visit with her mother during the day, but her mother rejects any contact with her daughter. Planning for the upcoming holidays seems impossible to Mark, because of his wife’s inability to focus on anything except her mother’s care. Jacqueline has difficulty sleeping at night and is unable to discuss plans even a few days in advance. She is unable to visit friends and is reluctant to have friends visit because of the unpredictable behavior of her mother and her need to attend to the daily care. 

Reflective Questions

 1. How do you think this situation reflects Jacqueline’s sense of role performance? 

2. How do you think that Jacqueline may be contributing to her own health? 

Directions for Part 1

1. Review the Direct Care Project Overview above. Select topic (Air Quality OR Substance Use) from the table. This will be the topic of your entire course project.
2. View the Direct Care Project Part 1 Tutorial (Links to an external site.).
3. Download the corresponding Assessment and Diagnosis template under Templates below. For example, if you have selected Air Quality as your topic, download the Air Quality Assessment and Diagnosis Template.
4. Collect the data outlined in the template. There are two parts:
   • Online data collection – gather data from the weblinks provided on the template
     • Please note, if you live in Washington D.C. it may be listed as a state or county. You may list the Washington D.C. data as state and county, then compare to the U.S. data.
   • Modified windshield survey data collection – gather local community data by physically looking at your community
     • If possible, plan on asking someone to drive during your survey so that you can take notes.
     • Your community should be the area where you live or the area surrounding your work. The community must include a residential area and be a large enough area to answer the survey questions. If you live in a large area, you may choose a suburb.
     • Note: It is helpful to conduct this portion of the assessment at least two different times: during the day or evening, on a weekday, and/or on the weekend.
5. Identify a nursing problem (nursing diagnosis) based on data and observations
   • You must select a problem caused by your topic
   • Important: the problem you identify will be utilized in Parts 2, 3, and 4 of the project.
6. Identify the vulnerable population that the problem affects. This will also determine who you will present to in Part 3.
7. Write the nursing diagnosis (See template and chapter 6 in Nies & McEwen textbook for more information)
8. Submit template through the submit assignment button on this page.

Templates

Select and download from the links below the one that corresponds with selected topic:

Air Quality Assessment and Diagnosis Template (Links to an external site.)

Substance Use Assessment and Diagnosis Template

Adult Health 1 Study Guide

Hematologic (Blood) Unit 

Chapters 32, 63-64 

Remember that assigned textbook readings should be supplemental to reviewing & studying the Powerpoint presentations. Answers to these study guide questions can be obtained from the textbook chapters, powerpoint presentations, as well as class lectures & in-class activities. 

Chapter 32: Assessment of Hematologic Function & Treatment Modalities – (p. 917-922)

*This chapter is an A&P overview of the hematologic system structures, assessment, & diagnostics. 

Must Know: Blood Transfusions – (p. 917-922)

1. Describe the pre-transfusion assessments & nursing care that is necessary for patients who are to receive a blood transfusion. See Chart 32-2. 

2. Describe the nursing care involved when initiating a blood transfusion for a patient. See Chart 32-2. What additional checks need to be made before hanging & starting the blood transfusion?

3. Describe the nursing care involved following completion of a blood transfusion for a patient. See Chart 32-2.

4. There are many different types of transfusion reactions that can occur in patients. What are some signs and symptoms of transfusion reactions? 

5. What should the nurse do if he/she suspects the patient is having a transfusion reaction? 

Chapter 33: Management of Patients with Nonmalignant Hematologic Disorders – (p. 925-931, p. 933-941)

Conditions to Know: Anemias, Iron deficiency anemia, Megaloblastic anemia, Pernicious anemia, Sickle cell anemia 

1. What is anemia and what are some of the common causes of this condition? 

2. What are some risk factors for anemia?

3. What are some signs and symptoms of anemia? 

4. What lab values or cultures do we look at to diagnose anemia? 

5. What is iron-deficiency anemia and what is the most common cause? 

6. What is the primary treatment method for iron-deficiency anemia? What are patient teaching points we would want to include in our patient education regarding this treatment modality? See Chart 33-3. 

7. Patients with iron-deficiency anemia should also be encouraged to consume foods high in iron. What are some foods that are high in iron that we should recommend? 

8. Megaloblastic anemias develop slowly (over months) and the body can compensate well for a long time before symptoms of anemia will develop. The erythrocytes produced in this type of anemia are abnormally large. Megaloblastic anemia results from a deficiency of which two sources? 

9. What are risk factors for the development of folic acid deficiency anemia?

10. What is pernicious anemia? 

11. What are some signs and symptoms of pernicious anemia? 

12. How is folic acid deficiency and pernicious anemias treated? What teaching points would we want to include in our patient education regarding this treatment modality? 

13. What are foods that are high in folic acid or vitamin B12? 

14. What is sickle cell anemia & how do patients inherit this disorder? 

15. Describe the nursing care that is necessary when caring for a patient in sickle cell crisis. 

Let’s return to the ethical scenario presented within Page 2 of the Explore section of Week 4 to consider it further. Upon learning that a medication error occurred resulting in a child’s death, the Chief Nursing Officer (CNO) of a regional acute care facility held a press conference to announce the mistake. The conference centered on reporter questions about why the nurse was not fired. The CNO explained that the nurse was highly regarded and that the problem was a “system” problem, not simply a problem of an incompetent nurse. The CNO also explained that an examination of the medication administration procedures was ordered and that an electronic medication error avoidance system would be implemented to ensure that such an error would not happen again. Consider this scenario to address the following.

1-As the CNO in the scenario, defend your decision to disclose the incident to the media. How does this decision influence value-based healthcare? What risks might you encounter? What impact might this decision have on you personally and professionally?

2-At a regional health consortium, fellow CNOs remark that they would not disclose such an incident to the media. Provide two justifications for withholding disclosure of the error to the public. How does this decision influence value-based healthcare?

3-Imagine you are the patient’s family. How would you want the issue to be handled by the CNO? Explain your rationale.

Please answer each question separated and use at least 3 sources no later than 5 years. 

Instructions for Answer to 4 Question

1- After Each DQ (question), write down references

2- 300 minimum words for every DQ, you can go up to 800 words but answer should be complete.

3- 2-3 Peer Reviewed/ scholarly references for each question

4- References should be within 4 years

5- I am in acute care nurse practitioner program.

6- The response to the DQ is expected to be a minimum of 300 words. A minimum of two peer reviewed/ scholarly  resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”