2023 Esther Jackson is a 56 year old black female who is 1 day post op following a left radical mastectomy During morning rounds

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Nursing 2023 nursing

Esther Jackson is a 56 year old black female who is 1 day post op following a left radical mastectomy During morning rounds 2023 Assignment

  

Esther Jackson is a 56-year-old black female who is 1-day post-op following a left radical mastectomy. During morning rounds, the off-going nurse shares with you during bedside report that the patient has been experiencing increased discomfort in her back throughout the night and has required frequent help with repositioning. She states that the patient was medicated for pain approximately 2 hours ago but is voicing little relief and states that you might want to mention that to the doctor when he rounds later this morning. With the patient appearing to be in no visible distress, you proceed on to the next patient’s room for report.

Approximately 1 hour later, you return to Ms. Jackson’s room with her morning pills and find her slumped over the bedside stand in tears. The patient states, “I don’t know what is wrong, I don’t feel right. My back hurts and I’m just so tired. What is wrong with me?” The patient refuses to take her medications at this time stating that she is starting to feel sick to her stomach.

Just then the nursing assistant comes into the patient’s room to record Ms. Jackson’s vital signs, you take this opportunity to quickly research the patient’s medication record to determine if she has a medication ordered for nausea. Upon return, the nursing assistant hands you the following vital signs: T 37, R 18, and BP 132/54, but states she couldn’t get the patient’s pulse because “it is all over the place.”

Please address the following questions related to the scenario.

What do you suspect is the cause of the patient’s symptoms?

Describe the course of action that you will take to confirm this suspicion and prevent further decline.

What further assessments, lab values, and tests will likely be ordered for this patient and how often? If testing is to be completed more than once, please explain the rationale for doing so.

While you are caring for this patient, how will you ensure that the needs of your other patients are being met?

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2023 An applicant s professional history and qualifications are outlined in a resume A cover letter is a way for

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Nursing 2023 nursing leadership and management

An applicant s professional history and qualifications are outlined in a resume A cover letter is a way for 2023 Assignment

An applicant’s professional history and qualifications are outlined in a resume. A cover letter is a way for the applicant to make a professional introduction to the hiring manager and demonstrate an interest in the company.

Develop a current resume and create a formal cover letter for a position for which you would like to apply. Create both the cover letter and resume using a professionally accepted format provided on the Resume-Resources website, located in the Topic Materials.

Include the following:

  1. Resume: Detail your overall education, credentials, and professional experience, such as licenses, earned degrees, certifications, professional experiences, previous positions held, membership in professional organizations, publications, and skills.
  2. Write a one-page double spaced introductory cover letter in which you explain your professional objectives, professional interests, and strengths as an applicant.
  3. Prior to submission, share your resume with a colleague and obtain feedback. Revise your resume as needed

While APA style format is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references should be presented using APA documentation 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.

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2023 Read the case below on Dax Cowart which will be the topic of the Ethical

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Nursing 2023 patient self determination

Read the case below on Dax Cowart which will be the topic of the Ethical 2023 Assignment

Read the case below on Dax Cowart which will be the topic of the Ethical Issue Paper. You will identify both sides of the issue and then analyze the case using ethical theory and principle to support your comments.See the guidelines and grading rubric for details on the assignment. Once completed, the paper will be submitted in the Assignment Submission Area to the link labeled Ethical Issues Paper. Once submitted, the paper will go directly to Turnitin which is a plagiarism tool. Once you have received your similarity report and made any required edits to ensure the similarity percent is below 24%, submit the final paper to the link under the Assignment Submission area labeled Final Paper Submission for grading.

Ethical Issue Paper Grading Rubric

Ethical Issue Paper

Potential 

Points

Actual

Points

Earned

Comments

Assignment-Related Criterion

Introduce the ethical issue

·  Clearly states the purpose for the paper in first or second paragraph (APA 2.05)

·  Fully describes background of the case.

·  Clearly identifies the two opposing views. 

10

Analyze the ethical issue

·  Clearly explains the ethical implications and effects of this issue, without bias, on healthcare today.

·  Identifies, compares and contrasts opposing views with supporting references-based on facts and not personal opinion. 

·  Applies ethical theory and principle to support both sides of the issue. 

·  Identifies interdisciplinary team members and all stakeholders. 

30

Resolution

·  Briefly discuss a possible resolution. What can/should be done to resolve the issue? This can be just a few paragraphs on a possible resolution. 

20

Conclusion

·  Recaps main ideas

·  Reflects on how the discussion within the paper has changed own prior beliefs on the topic. 

20

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2023 Capitation Payers and Provider Behavior Please respond to the following Suggest at least one

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Nursing 2023 Needed ASAP within 13 hours! Discussion question only! No intro or conclusion.

Capitation Payers and Provider Behavior Please respond to the following Suggest at least one 2023 Assignment

“Capitation, Payers, and Provider Behavior”  Please respond to the following:

  • Suggest at least one (1) method by which capitation rates are set for health maintenance organizations in Medicare. Provide one (1) example of an HMO with these types of set rates in order to support your response.
  • Compare the primary available economic resources that health insurance payers may use to monitor, assess, and regulate health care providers’ behavior. Evaluate the degree to which alternative provider payment methods (e.g., capitation, pay for performance, etc.) impact HMO economic and business performance. Provide one (1) example of such a type of method to support your response.

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2023 Sustaining change can be difficult as there are many variables that can affect implementation One critical component of

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Nursing 2023 Professional Capstone and practicum

Sustaining change can be difficult as there are many variables that can affect implementation One critical component of 2023 Assignment

Sustaining change can be difficult, as there are many variables that can affect implementation. One critical component of EBP is to ensure that practice change is part of an organization’s culture so it will continue to impact outcomes over time. Name two potential barriers that may prevent your EBP change proposal from continuing to obtain the same desired results 6 months to a year from now, and your strategies for overcoming these barriers.

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2023 APA format 3 peer review references Response needs to be why you disagree or agree with

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Nursing 2023 need response to below discussion

APA format 3 peer review references Response needs to be why you disagree or agree with 2023 Assignment

APA format 3 peer review references Response needs to be why you disagree or agree with diffential diagnosis and why

 

Patient Information:

TB, 20-year-old, Male, Caucasian

S.

CC Intermittent headaches.

HPI: T.B. is a 20-year-old Caucasian male who presents with intermittent, diffuse headaches.  His headaches have been occurring every week or so since Spring, 2018.  These headaches last for 2 to 3 days and occur over entire head but is worse above the eyes and radiates the nose, cheekbones, and jaw. The pain is described as a pressure that is intense above the eyes. There are no associated signs or symptoms, other than mild relief when enters a dark room.  T.B has not discovered a condition that makes headaches occur or worsen. Currently, the pain is rated as 7/10 pain scale.

Current Medications: Intermittent Acetaminophen Extra Strength 2 several times a day with headaches

Allergies: None is known to date. 

PMHx: Reports has received all recommended immunizations and last tetanus is in 2016.  Appendectomy at age 15.

Soc Hx: Patient is a part-time student at local community college and works part-time as a Barista.  He denies tobacco or recreational drug use, no alcohol use since 2017 in high school. He reports recently beginning to vape.  He lives with a roommate in an apartment and reports has been more active as walks 3 miles daily to work and school.

Fam Hx: Mother is living and in good health.  Father has not been in the patient’s life since infancy.  Sister was diagnosed with epilepsy several years ago.   Patient reports no known family history of cancer or neurological issues

ROS:

GENERAL:  Patient reports no weight loss or fever

HEENT:  Eyes:  Patient reports no visual changes

Ears, Nose, Throat:  Patient reports no hearing loss, congestion, runny nose or sore throat.

SKIN:  Patient reports no rash or itching.

CARDIOVASCULAR:  Patient reports no chest pain, chest pressure or chest discomfort.

RESPIRATORY:  Patient reports no shortness of breath, cough or sputum.

NEUROLOGICAL:  Patient reports no dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities.

LYMPHATICS:  Patient denies knowledge of enlarged nodes. No history of splenectomy.

PSYCHIATRIC:  No history of depression or anxiety reported.

ENDOCRINOLOGIC:  No reports of sweating, cold or heat intolerance. No polyuria or polydipsia reported.

ALLERGIES:  No history of asthma, hives, eczema or rhinitis reported.

O.

Physical exam:

Diagnostic results: MRI should be considered to determine if there is a demyelinating disease or tumor triggering pain. There is no actual diagnostic tool for trigeminal neuralgia temporal, but other causes should be ruled out (Ball, Dains, Flynn, Solomon, & Stewart, 2015).

CT Scan could be ordered if felt to be sinusitis that does not respond to conservative or antibiotic treatment can lead to rare but dangerous sphenoid sinusitis affecting nerves (Velayudhan, Chaudhry, Smoker, Shinder, & Reede, 2017). CT scan is preferred over MRI for sinusitis diagnosis. 

A dental referral would be recommended if another diagnosis is ruled out or pain has oral pain or sign of dental inflammation.

Additional questions for the patient would be

Do you associate the pain with a specific event or timing?

How long have you experienced this pain?

Is the pain increasing, decreasing, or staying the same?

What makes the pain better?

Have you experienced similar pain before?

Do you have pain with chewing?

Do you grind your teeth?

Do you have nasal or postnasal drainage?

Do you have a fever?

A.  Headache with facial pain

Differential Diagnosis:

Trigeminal neuralgia temporal: The trigeminal nerve sends impulses to the upper, middle, and lower portions of the face. In this case, more than one nerve branch may be irritated and sending signals of pain to the upper head and the middle including the nose, cheekbones, and jaw.  It is possible for this pain to be bilateral (National Institute of Neurological Disorders and Stroke, n.d).  Some possible triggers of trigeminal pressure might be pressure from blood vessels or rarely a tumor. Another trigger could be demyelination, such as Multiple Sclerosis (MS). Ball, Dains, Flynn, Solomon, & Stewart (2015) report this condition occurs in older patients. An MRI should be considered to determine if another diagnosis such as MS is triggering the pain.

Headache due to reaction from electric cigarette/Vaping.  Cai & Wang (2017) shared the strong evidence of neurological effects from e-cigarette solvents and flavor additives.  The substances produced from vaping are acrolein, glycerol, propylene oxide, ethyl, ethyl matol, and methol which are toxic and related to neurological issues. Li, Zhan, Wang, Leischow, and Zeng (2016) reported severe headaches occurred after e-cigarette use due to high nicotine and propylene glycol. Fruit flavors also contributed

Sinusitis:  The frontal sinuses lie above the eyes which could contribute to the primary site of pain. The maxillary sinus could be inflamed causing the upper jaw, teeth, nose and cheek pain. One concern is sinusitis typically has postnasal discharge (Ball, Dains, Flynn, Solomon, & Stewart, 2015)

Tension-type headache (TTH):  A primary symptom of TTH is a hatband pain distribution (Ball, Dains, Flynn, Solomon, Stewart (2015).  Although rare, Wagner and Moreira Filho (2018) studied a TTH combined with temporomandibular junction sleep bruxism occurs during periods of anxiety.  This combined scenario could reflect the upper eye and jaw, cheek pain.

Dental Caries or Malocclusion: Ball, Dains, Flynn, Solomon, and Stewart (2015) reports dental disease is a primary source of pain in the jaw, but also could cause pain at top of the head.  In our patient’s case, the pain starts below the forehead and radiates lower making this diagnosis less likely.

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Hua Cai, & Chen Wang. (2017). Graphical review: The redox dark side of e-cigarettes; exposure to oxidants and public health concerns. Redox Biology 3(C) 402-406 https://doi-org.ezp.waldenulibrary.org/10.1016/j.redox.2017.05.013

Li, Q., Zhan, Y., Wang, L., Leischow, S. J., & Zeng, D. D. (2016). Analysis of symptoms and their potential associations with e-liquids’ components: a social media study. BMC public health, 16, 674. doi:10.1186/s12889-016-3326-0

National Institute of Neurological Disorders and Stroke. (n.d). Trigeminal neuralgia fact sheet. Retrieved from https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Trigeminal-Neuralgia-Fact-Sheet

Velayudhan, V., Chaudhry, Z. A., Smoker, W. R. K., Shinder, R., & Reede, D. L. (2017). Imaging of intracranial and orbital complications of sinusitis and atypical sinus infection: What the radiologist needs to know. Current Problems in Diagnostic Radiology, 46(6), 441–451. https://doi-org.ezp.waldenulibrary.org/10.1067/j.cpradiol.2017.01.006

Wagner, B. de A., & Moreira Filho, P. F. (2018). Painful temporomandibular disorder, sleep bruxism, anxiety symptoms and subjective sleep quality among military firefighters with frequent episodic tension-type headache. Arquivos De Neuro-Psiquiatria, 76(6), 387–392. https://doi-org.ezp.waldenulibrary.org/10.1590/0004-282X20180043

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2023 Personal Philosophy of Nursing Paper Write your personal philosophy of nursing The paper should be three typewritten double spaced pages

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Nursing 2023 Philosophy of Nursing

Personal Philosophy of Nursing Paper Write your personal philosophy of nursing The paper should be three typewritten double spaced pages 2023 Assignment

Personal Philosophy of Nursing Paper

Write your personal philosophy of nursing. The paper should be three typewritten double spaced pages following APA style guidelines. The paper should address the following:

1. Introduction that includes who you are and where you practice nursing

2. Definition of Nursing

3. Assumptions or underlying beliefs

4. Definitions and examples of the major domains (person, health, and environment) of nursing

5. Summary that includes:

a. How are the domains connected?

b. What is your vision of nursing for the future?

c. What are the challenges that you will face as a nurse?

d. What are your goals for professional development?

Your paper must be written in APA style. 

The paper will be checked for plagiarism.

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2023 It should also be noted that before collecting any data one ought to choose

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Nursing 2023 Answer this question

It should also be noted that before collecting any data one ought to choose 2023 Assignment

It should also be noted that before collecting any data, one ought to choose the significance level. This is done for several reasons. First and foremost, it is done to prevent the data quantity from influencing one’s decision. Second, the same applies for the quality. In short, in order to ascertain that bias didn’t enter such a study, strict order should be followed.

What will happen when you allow the data to dictate your decision? Well, for one, it will be very similar to a roulette table, where you are about to lay your bets after the ball has just landed on a particular number. That as you surely understand would constitute bias.

What else would be wrong to not follow this order?

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2023 Comment1 The Centers for Medicare and Medicaid Services CMS implemented a non reimbursement policy

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Nursing 2023 Comment

Comment1 The Centers for Medicare and Medicaid Services CMS implemented a non reimbursement policy 2023 Assignment

Comment1

The Centers for Medicare and Medicaid Services (CMS) implemented a non-reimbursement policy for certain never events(serious hospital acquired conditions) to encourage hospitals to fast track improvements of patient’s safety by applying standardized protocols.  The newly defined never events limits the hospitals to bill Medicare for adverse events and complications that are deemed reasonably preventable using evidence-based guidelines (Lembitz & Clarke, 2009).

CMS adopted the non-reimbursement policy for certain “never events” – defined as “non-reimbursable serious hospital-acquired conditions” – in order to motivate hospitals to accelerate improvement of patient safety by implementation of standardized protocols. These newly defined “never events” limit the ability of the hospitals to bill Medicare for adverse events and complications. The non-reimbursable conditions apply only to those events deemed “reasonably preventable” through the use of evidence-based guidelines (Lembitz & Clarke, 2009).

The Centers for Medicare and Medicaid Services (CMS) implemented never events in 2008 as non-reimbursable hospital acquired conditions to create motivation for hospitals to improve patient safety.  Never events are medical errors that should never happen to a patient.  The list includes events which are chiefly avoidable and are obvious negligence.  The Centers for Medicare and Medicaid Services (CMS) adopted never events in 2008 as non-reimbursable hospital-acquired conditions in to create motivation for hospitals to improve patient safety (Votroubek, 2018).

Comment2

Patients have turned to hospitals, especially via emergency departments, as a result of lack of access to health care at a much higher cost than primary care. This has forced hospitals to provide care at a portion of the expense used to being the safety net of health care. In the beginning of this surge, organizations could not foreseen the financial brunt this would cost. Patients went from wanting to be cared for at home by loved ones, to expecting end all care at the hospitals taking a toll on such organizations. Many providers loathe and accept the endless cycle of patients returning to the hospital for care. The U.S Centers for Medicare & Medicare recognized that many of these return visits in short time frames, less than a month, are a reflection of lack of adequate care, education, and resources, so they created policies that hinder repayment for the diagnosis that were recently treated. “These patient safety policies are part of CMS’ efforts to promote higher quality, more efficient health care through value-based purchasing, which are initiatives use performance-based financial incentives and public reporting of quality information to encourage improvement in all aspects of quality, including patient safety” (CMS, 2008). These new reimbursement rules guide providers towards holistic patient care, driving them to decrease readmission rates, diagnostic imaging rates, and focusing on closing the loop in health care.

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2023 Comment 1 There are numerous ways to communicate with the stakeholders as well

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Nursing 2023 Please Do A Comment Base In This Answers. Write At Least 140 Words In Each Answer, Take Reference From (2013-2018) If Is Possible, Academic References Please Because The Teacher Check It Out One By One. SUSTANTIVE POST NEEDED

Comment 1 There are numerous ways to communicate with the stakeholders as well 2023 Assignment

Comment 1

There are numerous ways to communicate with the stakeholders as well as the executives of the hospital. Communication is an important means of transmitting information as well as making other understand oneself. As a leader, I would start sharing my outreach program vision by using written communication. This will help me share effectively and thoroughly through explaining how this program will benefit the entire community. I would also organize a meeting to provide a professional presentation concerning the program’s benefits. I would use non-verbal communication methodologies to make the community members see my vision like making eye contact, having an open stance and smiling among others. I would use effective verbal communication through speaking clearly as well as allow time for others to communicate (Huber, 2018). This will help communicate effectively my vision for the outreach program.

Strategic management may be described as organization management based on its vision. To accomplish this, one needs to develop a vision, set objectives, develop strategies, execute the strategies as well as evaluate the outcomes. I would use the strategic management process to make the outreach program vision a reality. In the written communication as well as the presentation I will ensure that my mission and vision of the outreach program are stated clearly to make sure that stakeholders and the executives understand the purpose of this program. Setting objectives mean explaining the program goal and creating an implementation strategy mean explaining my plan on how to reach the goals. After the executives and the stakeholders decide to execute the strategies for developing an outreach program, then I would evaluate the program effectiveness constantly (Huber, 2018). As a leader, using the strategic management will allow me understand the community needs, determine the community future and set achievable goals and plans.

Comment 2

There are a wide range of tools that can be used for outreach program and implementation of strategic management. Strategic management is defined as the process by which managers of the firm analyze the internal and external environments for the purpose of formulating strategies and allocating resources to develop a competitive advantage in an industry that allows for the successful achievement 00resources, processes and skills and also monitoring of action steps in order to cope with unpredictable internal and external factors. Management in this context therefore indicates the ability to manage the constant changing circumstances, which organizations have to face regularly. Strategic management is therefore said to “understand the strategic position of an organization, its strategic choices for the future and turning strategies into action.” Huber, D. (2014).  Strategic management is, in terms of decision making, not only in the organization of operation-based procedures but also includes more organizational, non- routine and more complex procedures.

 I will use stakeholder approach for the outreach program become reality. The idea of stakeholder approach to strategic management, suggests that managers must formulate and implement processes 00is to manage and integrate the relationships and interests of shareholders, employees, customers, suppliers, communities and other groups in a way that ensures the long-term success of the firm. A stakeholder approach accentuates active management of the business environment, relationships and the promotion of shared interests. Stakeholder approach encourages management to develop strategies by looking out from the firm and identifying, and investing in, all the relationships that will ensure long-term success.

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