A 10-year-old girl has come to the clinic with her mother for a routine health care maintenance visit. During the assessment, the nurse attempts to communicate with the youngster but notes the girl avoids eye contact, appears to slouch in the chair, and talks in a whisper. Many times, she looks at her mother before answering?

1. What should the nurse consider as potential reasons for this type of communication?
2. How should the nurse proceed with this child?
3. Identify nursing diagnoses that would be appropriate in this situation.

Research and economic opportunity that might be available within your health care setting that will provide ethical and cultural equitable improvements to the quality of care. Then, write a 2-4 page proposal for an initiative to take advantage of that opportunity, supported with economic data and analysis of the prospective benefits.

  

Mental health 

Part 1 

Motivational Interviewing

• Watch this video on motivational interviewing: https://www.youtube.com/watch?v=ZxKZaKFzgF8
• Write a one paragraph reflection on how you will use      this interviewing technique with clients.
• Find one research article, three free resources, CEU, or      Webinars to share with your classmates on Motivational Interviewing.
• Reflection: How can knowing this interviewing technique      help Nurses in planning health education?

PART 2 

Interviewing Teens for Psych Issues 

1. Take notes on the video https://www.youtube.com/watch?v=wNF1FIKHKEU interviewing adolescents on General Survey, Subjective and Objective data.

2. Analyze the data

3. Apply Maslow’s hierarchy of needs, Erikson, and Piaget’s theories.

4. If she was your client, what further assessments would you do? Referrals? Resources?

PART 3

De-escalating During an Interview:

• https://www.ncsbn.org/1658.htm High-risk behaviors and client      care from the administrator and regulatory administrator’s standpoint,      verbal de-escalation techniques, safety, interventions, what to do, and      what not to do. (video is 55 minutes long) 

Please 

INCLUDE FOUR REFRENCES

WRITE FROM NURSING PERSPECTIVE 

APA FORMAT and IN TEXT CITATION

NO CONSIDERATION FOR PLAGIARISM

DUE 12/3/2021 

Management of Patients With Oral and Esophageal Disorders 

1. George Smith, a 55-year-old patient is admitted to the intensive care unit after a thoracotomy approach was used for an esophagectomy to remove an early stage adenocarcinoma of the distal esophagus and gastroesophageal junction. The patient has a history of GERD and Barrett’s esophagus. The patient sought medical treatment for dysphagia with solid foods, feeling that there was a lump in his throat and substernal pain with swallowing and subsequent regurgitation of undigested food and the development of hiccups. The patient has no other medical problems. (Learning Objectives 6 and 7) 

1. Describe the esophageal cancer that the patient has and how it relates to his history of GERD and Barrett’s esophagus.
2. Explain the rationale for the early symptoms and late symptoms of esophageal cancer.
3. What course of cancer treatment should the nurse anticipate that the patient in this case study would have?
4. What nursing care should be provided for the patient in the intensive care unit in the early postoperative period?
5. Explain the care the nurse should provide when the patient begins to eat.

2. Mr. Owens is a 62-year-old man who underwent a neck dissection yesterday due to cancer of the mouth. You are the nurse assigned to care for Mr. Owens during his first postoperative day. Initial assessment finds Mr. Owens sitting up in bed; he is drowsy, but oriented ×3 when aroused. He has significant edema in his neck and mouth area, but does not appear to be in respiratory distress. His respiratory rate is 16 to 18, and his oxygen saturation is 96% on 40% oxygen via face tent. He has two peripheral IV lines both infusing Lactated Ringer’s solution at 75 mL/hr. Two Jackson Pratt drainage tubes are partially filled with serosanguinous drainage. (Learning Objective 5)

1. What is the rationale for the patient being placed in Fowler’s position after surgery?
2. The nurse notes that there has been 240 mL output in the drainage tubes during the first 24 hours after the surgical procedure. What should the nurse do?
3. Postoperatively, the nurse identifies that the patient is at risk for imbalanced nutrition, less than body requirements related to anorexia and dysphagia. The nurse instructs Mr. Owens to eat soft food and suggests that he tilt his head to the unaffected side to facilitate swallowing. What is the rationale for these instructions?
4. In reviewing Mr. Owens’ medical record, what findings in his health history are associated with development of oral cancer?

on the influence patient education has in health care using the experiences of a patient. Interview a friend or family member about that person’s experiences with the health care system. You may develop your own list of questions.

Suggested interview questions:

1. Did a patient education representative give you instructions on how to care for yourself after your illness or operation?
2. Did a health care professional, pharmacist, nurse, doctor, or elder counselor advise you on your medication, diet, or exercise?
3. Who assisted you at home after your illness or operation?
4. Do you know of any assistance services, i.e., food, transportation, medication, that would help you stay in your home as you get older?