Discussion Question 1

Mike is a 46-year-old who presents with a complaint of “heartburn” for 3 months. He describes the pain as burning and it is located in the epigastric area. The pain improves after he takes an antacid or drinks milk. He has been taking either over-the-counter (OTC) famotidine or ranitidine off and on for the past 2 months and he still has recurring epigastric pain. He has lost 6 lb since his last visit.

Assessment

His examination is unremarkable. His blood pressure (BP) is 118/72. Laboratory values are normal complete blood count (CBC) and a positive serum Helicobacter pylori test.

1. What would you prescribe initially?
2. How long would you prescribe these medications?
3. What other possible meds could you prescribe to assist with the side effects from the medications prescribed?
4. How would the treatment vary if the patient has GERD instead?

Discussion Question 2

List differential diagnosis that would help confirm GERD while ruling out other diagnosis. Which medication is the best medication for treatment of GERD and why? What labs or other diagnostic tests that are used to confirm GERD? Your response should be at least 350 words.

 Please answer the following Discussion Question. Please be certain to answer the three questions on this week DQ and to provide a well-developed and complete answer to receive credit. Your main discussion answer needs to be at least 3 paragraphs in length with 3 references to justify your answer. Use APA format.

Also, please ensure to have read the assigned chapters for the current week. 

1. Describe quality and safety in Nursing.
2. Describe some quality issues in healthcare.
3. Describe some safety issues in Nursing.

 Instructions:

 Follow the discussion questions participation and submission guidelines.

·      Follow the 3 x 3 rule: minimum three paragraphs per DQ, with a minimum of three sentences each paragraph.

·      All answers or discussions comments submitted must be in APA format according to Publication Manual American Psychological Association (APA) (7th ed.)

·      Minimum of two references for each answer, not older than 2015.

Nursing Research:

QD1.  Discuss the characteristics and requirements that research tools should have on quantitative research to give validity to the study. Give some examples.

QD2.  Describe why you were to chose a specific method to select a sample over other methods. Defend the method you preferred.

Pathophysiology:

 QD1. Digitalis (e.g., digoxin, Lanoxin) is often prescribed for patients with atrial fibrillation. A common precaution prior to digitalis administration is to take an apical pulse.

a. Based on your understanding of the mechanisms of atrial fibrillation, why is taking a pulse by palpating the radial or other peripheral artery insufficient?

If there is a difference between the apical pulse and the radial pulse, discuss why the decision to administer or hold digitalis is based on the apical pulse rather than the radial or other peripheral pulse. In other words, why is the apical pulse considered “more accurate” in this situation?

QD2. A 10-year-old patient has developed cardiomyopathy and biventricular heart failure due to radiation and chemotherapy treatments received for pulmonary neuroblastoma. He has tachycardia, has tachypnea, and becomes winded and exhausted with minimal exertion.

1. How, if at all, would you expect the manifestations of this patient’s biventricular failure to differ from those in a patient with biventricular failure from a massive left anterior wall myocardial infarction (MI)?
2. How, if at all, would treatments for this patient’s biventricular failure differ from those for a patient with biventricular failure from a massive left anterior wall MI?

(1 post:)  In the video, “Motivation -leader and teamwork” the ants are working together by carrying an object and piling it up. At one point a huge leaf falls in front of one ant and he beings to panic. The one leader told everyone “we do not need to panic; we are all trained professionals” and advise them to go around the leaf (Bahumaid,2017). During the whole time each ant was going around the leaf, he cheered them on and gave them motivation to keep on going. The ants were so happy they made it around the leaf. When they made it around, the leader told them what a good job they did. The point of this video is that by working together, you can find other ways to do accomplish a goal. Sometimes to reach a goal you must find a different route to get there.

This video exemplifies teamwork in many ways. The first way is that everyone is helping each other to accomplish a common goal. Next is that when an issue arises and the team is unsure what to do, the leader is there to step in and help. The leader helps them complete the goal even though there was a hurdle in the way. Not only did the leader guide them down another path to complete the goal, but the leader was there to cheer them on. These are great skills for a leader to have, to collaborate and communicate with the time, finding an alternate route and to cheer them on from the sidelines because they may lack the confidence in something new.

In the article, “How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis” it talks about the relationship between teamwork and performance (Schmutz, 2019). The article states that, “teamwork as a major impact on the performance and it should be valued to maintain a positive outlook for the patient” (Schmutz, 2019). The article discussed, “ the importance of members of the team that have different backgrounds and having a different understanding on how something works” (Schmutz, 2019). This statement is so true. The leader in the video, could have had a different background, he could have been though something like this before. The leader found a different way to get to the top even though there was an obstacle in the way. In the working world, everyone is going to be coming from different backgrounds. Take our group we have now, we students from the generic RN, LPN’s and the Medics. Each of these groups bring something different to the table. Each of these groups has a different way of doing something that you may not have thought of. Having a diverse group of people can help lead to a different way of doing something and get the goal you have in mind.

References: 

Schmutz, J. B., Meier, L. L., & Manser, T. (2019). How effective is teamwork really? The relationship between teamwork and performance in healthcare teams: a systematic review and meta-analysis. BMJ open, 9(9), e028280. https://doi.org/10.1136/bmjopen-2018-028280 (Links to an external site.)

Ali Bahumaid. ( 2017, August 9). Motivation – leader and teamwork! animation video . YouTube. https://www.youtube.com/watch?v=9MO1aY1xC80

(2nd Post:) Teamwork in Nursing

Teamwork is one of the most important parts of being a successful organization, especially when it involves healthcare. To be a successful nurse in any setting, being able to work as a team is crucial. When teams coordinate care, they decrease the level of stress patients may experience and positively affect outcomes. In addition to easing patient concerns about treatments and procedures while raising efficiency, teamwork may reduce the number of issues related to nurse burnout. The short YouTube video, Team Work Inspirational Video, by PK Production, did a great job expressing the importance of teamwork by explaining that when you replace “I” with “We” even illness can become wellness (PK Production, 2019). Even in a patient’s darkest moments, if they feel safe around us and that us nurses are all working together to achieve the best possible outcome for this patient, it will make their experience that much more bearable. This video also went on to illustrate that we can do so much more when we just work together as a team. I loved how the video explained that sometimes we win, but sometimes we learn (PK Production, 2019). In any healthcare profession there will be trials, tribulations, and mistakes; what is important is learning from them.

Teamwork Defined.

            Teamwork is defined in many ways, however one I especially prefer is “the interaction of two or more professionals about behaviors, cognitions and attitudes, which contributes to reaching shared goals through interdependent performance” (Holmes, 2020). This is especially important in nursing because patient care is not a one-person job. As a nurse, we constantly work with different doctors, specialties, families, and departments, this makes working well with others and as a team crucial in having the best patient outcomes. In recent years, the World Health Organization has increased its focus on teamwork in inter-professional healthcare teams to improve patient safety (Holmes, 2020). In addition to giving patients the best possible experience when we care for them, optimizing patient safety is a key result of working well as a team.

Conclusion.

            Teamwork is essential in healthcare.  Fundamentals of teamwork include good communication and collaboration between co-workers reducing the risk something is overlooked, potentially leading to an error being made resulting in harm to the patient.  Nurses must possess a wide array of traits in addition to working well with others and as a member of a team, but teamwork is one of the most important ones.

References

Holmes, T. (2020, March 1). A qualitative study of how inter-professional teamwork influences perioperative nursing. Wiley Online Library. https://onlinelibrary.wiley.com/doi/full/10.1002/nop2.422 (Links to an external site.)

PK Production [YouTube]. (2019, April 3). Team Work Inspirational Video [Video]. YouTube. https://www.youtube.com/watch?v=xVk06wpq8zg&t=52s