Please, post a response to the following discussion in APA format without cover page, one paragraph, using one reference from peer-reviewed Nursing Journal not older than 5 years.

     Abdominal Assessment

Performing a thorough assessment is an essential skill. The treatment for any client is based on the diagnosis, and that diagnosis relies entirely on the assessment. To assess a 78-year-old male with a chief complaint of abdominal pain, bloody diarrhea, fever, and weight loss; there are many important factors to take into consideration. First, it is crucial to assess more in-depth the chief complaint, known as a history of current illness. These will include an assessment of the abdominal pain following the pqrst. Also, an assessment of his bowel movement (diarrhea), when did it started, what causes it, what makes it subsides; did he took anything to stop it, did he had any changes in his eating habits, ask him to describe his bowel movements, and did any nausea or vomiting accompany it. Next, an assessment of the fever to find out when did start it, what was his highest temperature reading, what causes the fever to subside, was he exposed to any diseases like Clostridium difficile or food poisoning and is it accompanied by chills. Additionally, an assessment of his weight loss to see how much weight did he lost and in how long, was the weight loss intentionally, what type of diet does he follows, is there any cultural or belief factors that affect his diet.  

After the history of the current illness is obtained, the assessment continues into the risk factors. These will include a list of medications, and if the client is taking any NSAIDs or blood thinners; food, drugs, and environmental allergies; use of tobacco, alcohol and recreational drugs; history of vaccinations and traveling out of the country; past medical history (PMH), past surgical history (PSH), family history, previous hospitalizations, history of previous gastrointestinal (GI) problems like GERD, peptic ulcers, inflammatory bowel disease (IBD), anemia, and celiac disease, history of previous diagnostics GI tests and results like endoscopies and lab work. Also, assessment of living conditions, whom does he lives with, who prepares his meals, does he has access to drinking water and electricity. Even though certain diseases are not common in the US, the healthcare provider should never exclude them from the assessment. Assessing for parasitic diseases is a critical component for patients with GI symptoms and fever. Even though is more common in developing countries, it should not be ignored in the US. Commonly caused by ingestion of contaminated food or water, parasitic diseases are often misdiagnosed for tumors. The common symptoms are abdominal pain, diarrhea, bloody stool, fever, and weight loss (Çiftci, Bulut, Özdaş & Yıldırım. 2018). Amebomas are variable in sizes and on assessment are found as a palpable mass that causes obstructive symptoms and mimics many other diseases.

The next step is the physical examination. These start with the inspection, looking for the color, contour, size, shape,  pulsations, and lessions (Jensen, 2015). Then, the assessment continues with the auscultation of the bowel sounds over the four quadrants and the vascular sounds. The next step is percussion of the four abdominal quadrants assessing for the size of the organs and looking for tympanic sounds over the hollow areas and dullness over the organs, masses, fluids or obstructions (Jensen, 2015). The palpation is performed at the end, beginning with light palpation and assessing for pain, then follow by deep palpation to check for organs, masses, or tenderness (Jensen, 2015).

The documentation of the assessment findings is done using the SOAP format. All subjective data is documented under S, and all objective data is documented under O.  The assessment or diagnosis is written under A., And the plan of treatment is documented under P.

 The theoretical foundations of qualitative and quantitative methods are  very different, but many researchers believe both methods should be used  in the research study to increase validity and reliability. What  advantages or disadvantages do you see in using both types of methods in  a nursing study? Support your answer with current evidence-based  literature. 

Assignment 3: The Convergence of Healthcare Financing and Economic Trends and Forces

Due Week 8 and worth 100 points

Note: Use the textbook, course readings, Strayer online library, and other reputable online sources to complete this assignment.

Prepare a fifteen to twenty (15 to 20) slide Microsoft® PowerPoint® presentation with detailed scholarly speaker notes in which you: 

1. Compare the three (3) current health care financing and funding models (i.e., employee based, government based, and individual based) used with the healthcare delivery system of the United States.
2. Compare and contrast key economic goals of public and private health insurance plans.  Evaluate the success potential of key economic goals in terms of populations covered, services included, financing arrangements, reimbursement strategies, and economic competition policies.
3. Analyze the key effects of labor market, insurance market, and competitive market factors on health care delivery requirements at your current or previous organization of employment.
4. Determine what changes are occurring in the economy or concerning labor and regulatory factors that must be considered in the future.
5. Suggest the key national trends that you believe currently affect competition and pricing initiatives. Justify your response.
6. Suggest the main quality indicators that typically affect health insurance pricing at the local level. Justify your response.
7. Use a minimum of six (6) reputable references sources including three (3) sources from peer reviewed journals.

Your assignment must follow these formatting requirements:

• Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. 

Rubric attached!!!

The specific course learning outcomes associated with this assignment are:

• Assess current economic trends that influence the cost, quality, and access to care.
• Analyze the impact of managed care on cost, quality, and access within managed care organizations and the health insurance market.
• Use technology and information resources to research issues in health economics.
• Write clearly and concisely about health economics using proper writing mechanics.

Research Paper

Length:  1500 words (but quality over quantity)

Format:   MLA 

Assignment:

This assignment has developed from a series of other assignments:  interest inventory, narrowing your topic, etc.  For the final paper, you need to write the best draft you can, which means that you should have a clear purpose (an argumentative thesis) and plenty of evidence from quality sources that supports and develops your thesis. 

The module for this week provides excellent guidelines for writing the final draft of your research paper, including organization strategies, exercises for refining your thesis, tips for achieving the proper tone, advice on writing introductions, advice on writing conclusions, and handling quotes properly.  Furthermore there is revision advice:  revising for purpose, thesis, and structure; revising for language (VERY important); and preparing the final draft (avoiding common mistakes).

Other required elements of your essay: 

1.  An interesting and relevant introduction

2.  An effective thesis statement incorporated into your introduction (last sentence)

3.  Strong topic sentences and body paragraphs

4.  An excellent conclusion

5.  Impeccable grammar, mechanics, and style

6.  Correct MLA format

7.  An engaging title

Key concepts for writing effective essays (a review of Composition I):

1.  Clarity—stay focused on the main topic throughout your essay

2.  Coherence—present your ideas in a logical, organized way; use effective transitions

3.  Unity—each paragraph stays on topic and relates to the overall thesis

4.  Development—provide specific details so that the reader can understand the argument

MLA FORMAT:   

You need a works cited page, and you must use proper in-text citation (also called parenthetical citation/documentation) for all paraphrasing, summarizing, and quoting. 

Common problems to avoid:  works cited page errors, in-text citation errors, incorrect block quotation, dumped quotes, incorrect use of historical present tense, punctuating titles.

Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.

Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.

Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.

To Prepare:

• Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
• Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor.
• Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):

Developing Organizational Policies and Practices

Add a section to the paper you submitted in Module 1. The new section should address the following:

• Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
• Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
• Critique the policy for ethical considerations, and explain the policy’s strengths and challenges in promoting ethics.
• Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples.
• Cite evidence that informs the healthcare issue/stressor and/or the policies, and provide two scholarly resources in support of your policy or practice recommendations