The CEO and the Board of Directors has tasked you with developing an intake packet for new patients that will reestablish patient trust in the facility, employees, and staff. The patient packet will address new patient concerns by including information about HIPAA, informed consent, a confidential health history report, and a living will. The new packet will also include the values of the organization and a code of ethics.

Your intake packet will start with the Hospital’s Code of Ethics that includes at least 10 ethical points. The code of ethics should include (at a minimum) include an additional 3

• Patient relations
• Physician activities
• Billing for services
• Political activities
• Conflict of interest
• Communication, including social media
• Privacy

The Code of Ethics should be submitted in bullet format in a Word document with an introduction. APA formatting for the ethical points and proper grammar is required.

Upon completion of your code of ethics, please prepare a PowerPoint presentation  in which you explain each ethical point and its relevance in the healthcare industry with examples to the CEO, so that she can answer questions from the Board.

1. The PowerPoint should have a minimum of 5 slides and a maximum of 12.
2. Describe each ethical point in the Code of Ethics.
3. Use the notes area on each slide as needed to expand on the key points.

1.10 or more ethical points included, but one or two are underdeveloped.

2.Identifies the ethical points and demonstrates the relevance to the healthcare industry but includes examples that are irrelevant or lack details.

 

1) **********minimum 3 full pages ( not words)**************************** (cover or reference page not included) 

2)¨**********APA norms  ( All paragraphs need to be cited properly. All responses must be in a narrative format and each paragraph must have at least 4 sentences)

3)********** It will be verified by Turnitin and SafeAssign 

4) **********References from the last 5 years  

5) The points don’t be must copied in the work. It must be identified by numbers. 

For example:

1.  Communicable and Infectious disease is ………………………….

2.  The principles related are……………………..

3. The three focus areas are…………….

———————————————————————————-

1. Definition of Communicable and Infectious disease and the condition choose.
2. The principles related to the occurrence and transmission of the identified communicable infection and/or infectious disease.
3. Describe and discuss the three focus areas in Healthy People 2020 objectives that apply to the communicable and/or infectious disease chosen.
4. Describe and discuss the epidemiological aspects of the chosen communicable and/or infectious disease.

 WEEK 3 discussion

Tam……

Breathing, Heart, and Lungs

An anxious patient is having rapid and shallow breathing. After a few moments, he complains of a tingling sensation.

1)What could be the causes of this tingling sensation?

Anxiety can increase in those patients that are already having rapid and shallow breathing. Hyperventilation added to this can cause the tingling sensation due to a decrease in C02.

2)What are the various patterns of respiration and their significance?

Normal respirations are 10-20 is also called sigh rate, depth is 500-800ml “air moving in and out with each respiration, pattern is even”. (Jarvis 2016 pg. 442). “These values increase as a normal response to exercise, fear, or fever”. (Jarvis 2016 pg. 442).

Tachypnea Hyperventilation Rapid is shallow breathing. Has an increased rate greater than 24 per minute. This rate can increase with respiratory insufficiency, alkalosis, pleurisy, pneumonia, pleurisy, diabetic ketoacidosis, salicylate overdose, hepatic coma and lesions of the midbrain and alteration in blood gas concentration, but it a normal response to fever, fear, or exercise.

Bradypnea Hypoventilation: Slow breathing. Is a decreased but regular rate less than 10 per minute. Can be caused by drugs, increased intracranial pressure and diabetic coma.

 “An irregular shallow pattern caused by an overdose of narcotics or anesthetics” (Jarvis 2016 pg. 442). It may also occur with conscious splinting of the chest to avoid respiratory pain and with prolonged bed rest.

Cheyne-Stokes Respiration: “respirations gradually wax and wane in a regular pattern, increasing in rate and depth and then decreasing”. (Jarvis 2016 pg. 442). Breathing periods are 30-45 seconds with about 20 second period of apnea. Common causes are severe heart failure, renal failure, meningitis, drug overdose, and increased intracranial pressure.

Biot Respiration is similar to Cheyne-Stokes respiration, except that the pattern is irregular and seen with head trauma, brain abscess, heat stroke, spinal meningitis, and encephalitis.

3)Ethnicity and culture influence risk factors for heart disease. Do you agree? Why or why not?

Heart disease knows no ethnic/culture. Some risk factors that cause heart disease is obesity, tobacco use and high cholesterol. These are modifiable. In other words, most of these can be prevented. High blood pressure is mainly in the Africa American culture and for some of them, blood pressure can be prevented or at least controlled. If not controlled, it can lead to heart disease.

4)What is the technique of percussion and palpation of the chest wall for tenderness, symmetry, bulges, fremitus, and thoracic expansion? Explain.

To palpate the chest wall, place your hands on the anterolateral wall with your thumbs along the coast margins with hands pointing toward the xiphoid process. You ask the patient to take a deep breath while watching your thumbs move apart symmetrically and take note of the smooth chest expansion with your fingers. “Any limitation in thoracic expansion is easier to detect on the anterior chest because greater range of motion exists with breathing here” (Jarvis 2016 pg. 432).

To assess tactile fremitus, began palpating over the lung apices in the supraclavicular areas comparing vibrations from one side to the other as the person repeats the words ninety-nine.

You then palpate the anterior chest wall looking for tenderness or detect any superficial lumps or masses. Note the skin mobility, turgor, temperature and moisture.

With percussion of the chest, you start at the apices in the supraclavicular area, going to the interspaces, comparing one side with the other, going in a downward motion, down the anterior chest.

5)Would you anticipate hearing hyper-resonance on a patient with a history of tobacco use?  Why or why not?

Yes. Hyperresonance is found when too much air is present like in emphysema which is caused from tobacco use.

6)What are the mechanics of breathing with reference to lung borders and the anatomical structure of the lungs and diaphragm?

Inspiration is the breathing in air into the lungs, the chest wall increases in size. When it is expelled it is caused expiration. This is the mechanical action of breathing. Expansion and contraction. There are four major functions of the respiratory system. Supplying oxygen to the body for energy production, removing carbon dioxide as a waste product of energy reactions, maintaining homeostasis of arterial blood and maintain heat exchange.

  

                                                                     Asthma

Complications of asthma can be sudden. Consider the case of Bradley Wilson, a young boy who had several medical conditions. He appeared in good health when he went to school, returned home, and ate dinner. However, when he later went outside to play, he came back inside wheezing. An ambulance took him to the hospital where he was pronounced dead (Briscoe, 2012). In another case, 10-year-old Dynasty Reese, who had mild asthma, woke up in the middle of the night and ran to her grandfather’s bedroom to tell him she couldn’t breathe. By the time paramedics arrived, she had passed out and was pronounced dead at the hospital (Glissman, 2012). These situations continue to outline the importance of recognizing symptoms of asthma and providing immediate treatment, as well as distinguishing minor symptoms from serious, life-threatening symptoms. Since these symptoms and attacks are often induced by a trigger, as an advanced practice nurse, you must be able to help patients identify their triggers and recommend appropriate treatment options. For this reason, you need to understand the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation.

To Prepare

· Review “Asthma” in Chapter 27 of the Huether and McCance text. Identify the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Consider how these disorders are similar and different.

· Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Think about how the factor you selected might impact the pathophysiology of both disorders. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.

· Review the “Mind maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Consider the epidemiology and clinical presentation of both chronic asthma and acute asthma exacerbation.

To Complete

Write a 2- to 3-page paper that addresses the following:

· Describe the pathophysiological mechanisms of chronic asthma and acute asthma exacerbation. Be sure to explain the changes in the arterial blood gas patterns during an exacerbation.

· Explain how the factor you selected might impact the pathophysiology of both disorders. Describe how you would diagnose and prescribe treatment for a patient based on the factor you selected.

· Construct two mind maps—one for chronic asthma and one for acute asthma exacerbation. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

                                                               Learning Resources

Required Readings

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.

• Chapter 26, “Structure and      Function of the Pulmonary System”

This chapter provides information relating to the structure and function of the pulmonary system to illustrate normal pulmonary function. It focuses on gas transport to build the foundation for examining alterations of pulmonary function.

• Chapter 27, “Alterations of      Pulmonary Function”

This chapter examines clinical manifestations of pulmonary alterations and disorders of the chest wall and pleura. It covers the pathophysiology, clinical manifestations, evaluation, and treatment of obstructive lung diseases such as asthma, chronic obstructive pulmonary disease (COPD), chronic bronchitis, and emphysema.

• Chapter 28, “Alterations of      Pulmonary Function in Children”

This chapter focuses on alterations of pulmonary function that affect children. These alterations include disorders of the upper and lower airways.

Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.

• Chapter 9, “Pulmonary      Disease”

This chapter begins with an overview of normal structure and function of the lungs to provide a foundation for examining various lung diseases such as asthma and chronic obstructive pulmonary disease (COPD).

Required Media

Laureate Education, Inc. (Executive Producer). (2012e). Mid-course review. Baltimore, MD: Author.

This media is an interactive mid-course review covering course content.

Optional Resources

American Lung Association. (2012). Retrieved from http://www.lung.org/ 

Asthma and Allergy Foundation of America. (2012). Retrieved from http://www.aafa.org 

Cystic Fibrosis Foundation. (2012). Retrieved from http://www.cff.org/ 

I need a response for this 2 peers 

PEER 1

Common Risk Factors for Polypharmacy 

Multimorbidity 

Multimorbodity refers to the co – occurrence of two or more chronic conditions. Individuals aged 70 years and above are most likely to suffer from chronic illnesses that come with old age. In regards to polypharmacy, research has shown that patients who have eight or more diagnosed diseases are at the highest risk for polypharmacy (Ersoy & Engin, 2018). 

Frailty  

Frailty refers to a clinical syndrome especially in older adults that carries increased risk for decline in health and proper functioning of the body. Frailty predisposes older people to polypharmacy due to the multiple chronic illnesses they may be suffering from, thus the need for medication for each illness (Hovstadius & Petersson, 2016). 

Nurses are better placed to identify the patients at risk for polypharmacy as well as to educate the patients and their families on risk reduction (Willie, 2019).In my clinical practice, I would employ strategies that would help the patients to manage their medications and prevent polypharmacy. For instance, I would discuss with the patients, the need for keeping an accurate list for all the medications they are taking including both over the counter and prescription. I would also advise them to record the medication names, the dosing frequency of the prescribed dosage and the reason for prescription.  

In addition, I would advise the patients to identify and use one pharmacy which to obtain their medications which is important in ensuring that they get the correct dosage as well as reduce the possibility of adverse effects of drugs and interactions (Willie, 2019). Additionally, I would caution them on adhering to their medication in addition to ensuring that they take only the medicine that have been prescribed for them without sharing with others or saving them to use at a later date. I would also help the patients in the establishment of memory aids that would help them to remember to take their doses without fail. 

PEER 2

Polypharmacy will be the usage of a number of different medications by an individual. It’s a typical act which is now practiced by the aged individuals but gets to generate much more damage than good. Polypharmacy is related with numerous unwanted effects on the patient. The risks include greater healthcare cost and increased danger of negative drug events, generally known to us ADEs (Duerden et al., 2013). 

Increased healthcare costs: It’s been mentioned that polypharmacy is related elevated outpatient trips. This has hospitalization which results to increased healthcare price for the individuals. The medications which the individuals snap aren’t provided cost-free (Holmes, 2012). Consequently, they’ve to invest additional cash which they didn’t for to obtain the medications they would like. Thus, that raises the original quantity of expense that they had been using on drugs. The greater number of medications you decide to use, the greater number of cash you invest on medications. 

Adverse drug events (ADE): Research done in 2005 proved that more than 4.3 million folks check out the healthcare because of problems of ADE. The majority of this particular cases are deemed to be from individuals that use much more five distinct kinds of medicines. Thus, the individual take more medicines believing that they will be helped by it, though they wind up heading to the hospital due to the medications they shoot that have been designed to assist them obtain perfectly (Holmes, 2012). 

As a nurse practitioner pupil, I’d choose that aged individuals have being examined often. Doctors and nurses must recommend one medication to an individual rather than offering them a lot of medicines for only one problem (Duerden et al., 2013). One more thing is the fact that medication must be given to start from probably the lowest. For instance, a medication which may receive when one day really should be chosen with a drug which is provided 3 times one day. 

To conclude, identifying polypharmacy is able to help to get much better results in the aged individuals consequently, can help enhance the lifetime of the individuals. To review the medicine of the individuals may additionally assist the aged individuals to stay away from the results of utilizing a variety of prescriptions (polypharmacy) (Duerden et al., 2013).
 

–Use at least 2 evidenced-based, peer-reviewed references no older than 5 years. APA 6th format. 

–This the original homework if you needed:

• Discuss two (2) common risk factors for polypharmacy. Give rationale for each identified risk factor.
• Discuss two interventions you can take as a Nurse Practitioner in your clinical practice to prevent polypharmacy and its complications.