With minimum of 300 words and 2 references each:

1) Research the delivery, finance, management, and sustainability methods of the U.S. health care system. Evaluate the effectiveness of one or more of these areas on quality patient care and health outcomes. Propose a potential health care reform solution to improve effectiveness in the area you evaluated and predict the expected effect. Describe the effect of health care reform on the U.S. health care system and its respective stakeholders. Support your post with a peer-reviewed journal article.

 

2) The Affordable Care Act was signed into law by President Barack Obama in March 2010. Many of the provisions of the law directly affect health care providers. Review the following topic materials:

1. “About the Affordable Care Act”
2. “Health Care Transformation: The Affordable Care Act and More”

What are the most important elements of the Affordable Care Act in relation to community and public health? What is the role of the nurse in implementing this law?

You are working with Dr. Lorenzen, who asks you to start interviewing Susan Johnston, a patient she knows well who is here to discuss recent symptoms of chest pain.

Before seeing the patient, Dr. Lorenzen asks you to review the differential diagnosis for chest pain. She reminds you, “There are many causes of chest pain including cardiac, gastrointestinal, pulmonary, musculoskeletal, and psychogenic causes.”

1. List below three potential causes of chest pain in each of the categories mentioned.

2. Discuss the history of present illness that you would take on this patient in preparation for the clinic visit. Include questions regarding Onset, Location, Duration, Characteristics, Aggravating Factors, Relieving Factors, Treatment, Severity (OLDCARTS).

3. Describe the physical assessment and diagnostic tools to be used for Ms. Johnston. Are there any additional you would have liked to be included that were not? 

4. What plan of care will Ms. Johnston be given at this visit; what is the patient education and follow-up?

please use apa style with references

 

Module 07 Content

1. You will perform a history of a neurologic problem that your instructor has provided you or one that you have experienced and perform an assessment of the neurologic system. You will document your subjective and objective findings, identify actual or potential risks, and submit this in a Word document to the drop box provided.

  

Title:

Documentation of problem based assessment of the neurological system.

Purpose of Assignment: 

Learning the required components of documenting a problem based subjective and objective assessment of neurological system. Identify abnormal findings.

Course Competency:

Apply assessment techniques for the neurological and respiratory systems.

Instructions:

Content: Use of three sections: 

o Subjective

o Objective

o Actual or potential risk factors for the client based on the assessment findings with description or reason for selection of them.

Format:

· Standard American English (correct grammar, punctuation, etc.)

Resources:

Chapter 5: SOAP Notes: The subjective and objective portion only

Sullivan, D. D. (2012). Guide

      

Subjective 

(4 Pts)

Missing   components such as biographic data, medications, or allergies. Symptoms   analysis is incomplete. May contain objective data.

Basic   biographic data provided. Medications and allergies included. Symptoms   analysis incomplete. Lacking detail. No objective data. 

Basic   biographic data provided. Included list of medications and allergies.   Symptoms analysis: PQRSTU completed. Lacking detail. No objective data.   Information is solely what “client” provided.

      

Objective

(4 Pts)

Missing   components of assessment for particular system. May contain subjective data.   May have signs of bias or explanation of findings. May have included words   such as “normal”, “appropriate”,
  “okay”, and “good”.

Includes all   components of assessment for particular system. Lacks detail. Uses words such   as “normal”, “appropriate”, or “good”. Contains all objective information. May have signs of bias or   explanation of findings. 

Includes all   components of assessment for particular system. Avoided use of words such as   “normal”, “appropriate”, or “good”. No   bias or explanation for findings evident Contains all objective information

Includes all   components of assessment for particular system. Detailed information   provided. Avoided use of words such as   “normal”, “appropriate”, or “good”. No   bias or explanation for findings evident. All objective information 

 

Points: 1

Points: 2

Points: 3

Points: 4

 

Actual or Potential Risk Factors

(2 pts)

Lists one to   two actual or potential risk factors for the client based on the assessment   findings with no description or reason for selection of them. Failure to provide any potential or actual   risk factors will result in zero points for this criterion.

Brief   description of one or two actual or potential risk factors for the client   based on assessment findings with description or reason for selection of   them.

Limited   description of two actual or potential risk factors for the client based on   the assessment findings with description or reason for selection of them.

Comprehensive,   detailed description of two actual or potential risk factors for the client   based on the assessment findings with description or reason for selection of   them.

   

 

Module 07 Discussion – New Admit

Discussion Topic

Activity Time:

2 hours; Additional Time for Study, Research, and Reflection: 1 hour

Scenario

As a nurse on a general medical floor, the RN has received a new admit. Review the client data provided.

• Richard Henderson
• 58 years old
• Male
• Admit diagnosis: GI bleed
• History: no surgical history
• Medical history: Gastritis & GERD
• Medications: Prilosec 40 mg PO daily, Atenolol 25 mg PO BID, Fiber daily, Alka Seltzer PO – states he takes this at least daily.

Report from physician’s office: Mr. Henderson arrived to the physician’s office today for a complaint of increasing abdominal pain. He states that he is now throwing up coffee-ground emesis. He states that he didn’t take his BP medication this morning because he was dizzy. The physician is admitting him with a diagnosis of GI bleed with an EGD scheduled for tomorrow. He is NPO, and has a 22G IV lock in the left forearm. Last set of vital signs BP 106/60 mm Hg, HR 98 beats/min, RR 20 breaths/min, Temp. 98.8 degrees F, P.O. 90% on room air. He last vomited about 45 minutes ago with a small amount of dark coffee-ground emesis. His pain is 4/10 at present. No pain medication is ordered at this time.

• Lab assessments ordered: CBC and chemistry panel
• CT of the abdomen shows no signs of free air (no perforation)

When he arrives to the floor, he is pale, nauseous, and his skin is cool and clammy. When he is transferred to the bed from the stretcher, he vomits a large amount of coffee-ground emesis and loses consciousness.

Instructions

In the discussion post, address the following:

1. While receiving report, what concerns do you have regarding the client report?
2. What type of shock is occurring?
3. What stage of shock is the client experiencing?
4. What is your next intervention and why?
5. What additional lab assessments would you anticipate?
6. Provide additional thoughts and insights.

In the initial posting provide one additional resource other than the required reading

 Distractions are everywhere. They may include cellphones, multiple alarms sounding, overhead paging, monitors beeping, and various interruptions that disrupt your clinical practice.

Give an example of an ethical or legal issue that may arise if a patient has a poor outcome or sentinel event because of a distraction such as alarm fatigue. What does evidence reveal about alarm fatigue and distractions in healthcare when it comes to patient safety?