Ask five nurses the following question.  Ask the question without explanation or expansion.  Tell them you are doing a class project and need the following question answered.  There are no right or wrong answers. “What is the purpose of nursing?” Ask five lay persons the exact same question in the exact same manner.  Summarize your findings and report to the class. When you complete this project, you will have just completed your first qualitative research project.  Albeit an abbreviated one, but nonetheless, a qualitative study.

Expectations

Initial Post:

• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA from within the last 5 years

  

Family Assessment:

 Purpose: Holistically assessing a family and the individual family members in relation to family structure, developmental stages, and family relationships helps the student to understand how each individual affects the family as a whole and how the family affects each individual. The student will also gain an insight into how important a family’s health is to the health of its individual members.

 Assignment: 

Contact a family and perform a family assessment. This can be completed in-person, or via virtual or phone interview. Below are areas that must be included. This paper is to be written in APA format with a title page, introductory and conclusion paragraphs, paragraph headings and sub-headings, proper formatting, proper in-text citations and a separate reference page. The Functional Health Patterns sections can be written in paragraph form or bullet points. In the end, your final paper should be at least 30 pages.

You need to have at least 4 resources cited in your paper/care plans and referenced in the reference page. 1 can be your text book, 1 can be a care plan book, the other 2 must be Evidence Based Practice articles related to the work you did with the family.

ALL sections MUST have subheading and clearly responds to the question!

Each section should be at least 2 pages. 

section 1 FAMILY PROFILE (20) 

· This needs to include the following:

· And introduction / introducing the family and the importance of a nursing family assessment. 

· A genogram needs to be used to illustrate the following information: age, sex, and current health status of each family member. The genogram should include every member of the household and any living outside the household who is included in the assessment.

· Description of family stage (Duvall’s) and individual members’ current developmental stages/tasks (Erickson’s at the least) 

· Family type? (i.e., nuclear, extended…..) and why you chose this type

Section 2 – FAMILY AND NURSING THEORIES (10)

This needs to include the following:

· Using the nursing theories or family theories described in your book choose one theory that best fits this family.

· Describe the theory chosen. Example the family systems theory 

· Apply this theory to the family you assess and describe how this family fits into the concepts and ideas presented by this theory.

Section 3 –Gordon’s Functional Health Patterns

As it applies to the family 

Section 4– HEALTH PERCEPTION–HEALTH MANAGEMENT PATTERN (5)

Subjective Data

• Describe your family’s general health during the past few years.

• Has your family been able to participate in its usual activities (work, school, sports)?

• Describe what your family does to try to stay healthy (diet, exercise, etc).

• From whom does your family seek health care? When?

• Describe how your family members check their health status (ex. eye exams, dental exams, breast exams, testicular exams, medical checkups).

• Describe any behaviors in your family that are considered unhealthy.

• Who cares for family members who are or who become ill?

• How would you know if a family member were ill? 

· Description of beliefs about health and illness including complementary, alternative, and culturally-based values. 

· Environmental assessment for safety in the home relevant for the age and characteristics of family members

Section 5 NUTRITIONAL–METABOLIC PATTERN (5)

Subjective Data

• Describe typical breakfast, lunch, supper, and snacks that you eat as a family.

• What type of drinks do you usually have during the day and at night?

• How would you describe your family’s appetite in general?

• How often does your family seek dental care? Are there any dental problems in your family?

• Does anyone in your family have skin rashes or problems with sores healing? Explain.

• Who usually prepares the family meals? Who shops for groceries?

Section 6— ELIMINATION PATTERN (5)

Subjective Data

• How often do family members have bowel movements? Urinate?

• Are laxatives used in your family? Explain.

• Are there problems with disposing of waste or garbage?

• Describe any recycling you do.

• Does your family have pets (indoor or outdoor)? How are their wastes disposed?

• Do you have problems with insects in your home? Explain.

Section 7— ACTIVITY–EXERCISE PATTERN (5)

Subjective Data

• Describe how your family exercises. Frequency?

• How does your family relax?

• What does your family do for enjoyment?

• Describe a typical day of activities in your family (work, school, play, games, meals, hobbies, house cleaning, yard work, cooking, and exercise).

Section 8—- SLEEP–REST PATTERN (5)

Subjective Data

• When does your family generally go to bed and awaken? Do family members go to bed and arise at different times? Explain.

• Does your family seem to get enough time to sleep? To rest and relax?

• Do any family members work at night? How does this affect other family members?

Section 9—-SENSORY-PERCEPTUAL PATTERN (5)

Subjective Data

• Are there any hearing or visual problems that affect your family members?

• Are there any deficits in a family member’s ability to taste and smell that affect how food is prepared for the family?

• Does pain seem to be a family problem? Explain. How is this managed?

• What is the usual form of pain relief used by family members?

Section 10— COGNITIVE PATTERN (5)

Subjective Data

• Who makes the major family decisions? How?

• Describe the highest educational level of all family members.

• Does your family understand any illnesses and treatments that affect any of your family members?

• How does your family enjoy learning (ex. reading, watching television, attending classes)?

• Are there any problems with memory in the family? Explain.

Section 11– SELF-PERCEPTION–SELF-CONCEPT PATTERN (5)

Subjective Data

• Describe the general mood of your family (ex. sad, happy, eager, depressed, anxious, and relaxed).

• Do you consider yourselves to be a close family? How do you spend time together? Is this time satisfying?

• Do family members share any common goals? Explain.

• What does the family enjoy doing most together?

• How does your family deal with disagreements?

• How do your family members express their affection, feelings, and/or concerns? Are they allowed to do so freely? Explain.

• Does your family seem to discuss problems that affect individual members?

• How does your family deal with change?

Section 12— ROLE–RELATIONSHIP PATTERN (5)

Subjective Data

• Describe how your family members support each other, show affection, and express concerns.

• Describe any problems with relationships between family members.

• Describe your family resources (financial, community support systems, family support systems).

• How active is your family in your neighborhood and/or community?

• Explain family responsibilities for various household chores (washing, cooking, driving, lawn maintenance, etc).

• Explain how discipline is used in your family. How are family members rewarded? Describe any aggression and/or violence that occurs in your family.

Section 13— SEXUALITY–REPRODUCTIVE PATTERN (5)

(Please do not skip this section. As a nurse you will have to ask uncomfortable or private questions at times.)

Subjective Data

If appropriate: Are sexual partners within home satisfied with sexual relationship and activities? Describe any problems.

• Are contraceptives used?

• Is family planning used? How?

• Are parents comfortable answering questions and explaining topics related to sexuality to their children?

Section 14— COPING–STRESS TOLERANCE PATTERN (5)

Subjective Data

• What major changes have occurred in your family during the past year (eg. divorce, marriage, family members leaving home, new members coming into home, death, illness, births, accidents, change in finances and/or occupation)? 

• How does your family cope with major stressors (ex. exercise, discussion, prayer, drugs, alcohol, violence)?

• Who in the family copes best with stressors?

• Who has the most difficult time coping with stress?

• What are the family’s strengths/weaknesses?

• What are the family resources/social supports?

• How does the family perceive their ability to problem solve and cope?

• Who outside the family (ex. friends, church, support groups) seems to help your family most during difficult times? 

Section 15— VALUE–BELIEF PATTERN (5)

Subjective Data

• What does your family consider to be most important in life?

• What does your family want from life?

• What rules does your family hold most important?

• Is religion important in the family? What religion are family members? What religious practices are important to the family? Is a relationship with God important to the family?

• What does your family look forward to in the future?

• From where do the family’s hope and strength come?

Section 17— Issues and Problems (20) 

With identified issues and problems, describe your process to develop, implement, and evaluate interdisciplinary care management plans using NANDA diagnosis, intervention and outcome measures. This includes the following criteria:

· 1-Describe the issues and problems you see this family facing based on your assessment information. Discuss why you think these are issues for the family, including the assessment data that brought you to this conclusion
•2-Provide descriptions about how you educated and/or facilitated health-related behavior changes while incorporating family’s perceived needs and interests.
• 3-Describe how you collaborated with the family in addressing complex situations and challenges. How did you all work together to come up solutions?
• 4-Describe how you coordinated referrals as well as how you ensured effective communication among services/agencies involved in providing services to family. You must provide at least 1 referral.
• 5-Periodically evaluate effectiveness of your referrals, interventions, and education. Call the family a week or more after initial assessment to see if they have made any changes. 

 Section 16— Plan of Care (20) 

• Develop two family care plans using template based on identified issues and problems. A minimum of 3 interventions with evidenced-based rationales is required for each. Also, a short and long term goal are required for each care plan. PLEASE use the template provided.

Section 17—- Final Synthesis (10)

Must include the following criteria:
1. A summary of your identified family themes, problems/issues, teaching, interventions and evaluations. Discuss your evaluation of the interventions from your care plans- Did the family do them? How have they changed? Was it positive of negative? If they didn’t follow your interventions or they had negative outcomes, explain why.
2. A summary about how your therapeutic relationship progressed with the family.
3. Your reflection on the meaning of this experience and this process of learning and describe what you learned.

 

APA Format, Grammar, and References (10)

· 10 points for proper APA format of paper, citations, and references

· Proper grammar is used throughout

· Correct amount of references cited

Total points: 150

  

Rubric for Family Assessment   Assignment

Points 120

  

Criteria 

Points Received

 

Family Profile

(20 points)

All     required narrative information present.

Genogram     includes all required information

20     points

Missing     information about developmental stages, tasks and family type.

Genogram     contains only half of the required information

10     points

No     information about stages, tasks, type included.

No     Genogram is included 

0     points

 

Theories

(10 points)

Theory     described in detail and relates to family

10     points

Theory     described fairly and minimally relates to family

5     points

No     theory described

0     points

 

Gordon’s Family Functional Health Patterns

(5 Points each)

Subjective     ()

 

Health     Perception – Health Management Patterns

 

Nutritional/Metabolic

 

Elimination     

 

Activity/Exercise

 

Sleep/Rest

 

Sensory/Perceptual

 

Cognitive     

 

Self-Perception/Self-Concept

 

Role/Relationship

 

Sexuality/

Reproductive

 

Coping/Stress     Tolerance

 

Value/Belief

 

Issues and Problems 

(20 points)

20     points-Includes all 5 criteria

15     points- Includes 3-4 of the criteria

10 points- includes 2 of the criteria

5 points- includes 1 of the criteria

Includes     0 criteria

0 points

 

Plan of Care

(20 points)

Includes     two family care plans using the template and based on identified issues     with proper NANDA nursing diagnoses

20 points

Includes     one family care plans using the template or the care plans are not based on     identified issues or nursing care plans not properly written or NANDA

10     points

Does     not include a care plan 

0     points

 

Final Synthesis

(10 points)

Includes     all 3 criteria

10 points

Includes     only 2 of the criteria

5     points

Does     not include any of the criteria

0     points

 

APA and Grammar

(10 Points)

1     point for each APA or grammar mistake, up to 10 points total

 

Total: 

Possible Total 150

   

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mrs. J., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Te

• Develop a 4–7-page business case for the initiative you proposed in Assessment 1. Examine feasibility and cost-benefit considerations over a 5-year period, analyze ways to mitigate risks, and complete a cost-benefit analysis.
  Note: Each assessment in this course builds upon the work you have completed in previous assessments. Therefore, you must complete the assessments in the order in which they are presented.
  SHOW LESSAs a master’s-level health care practitioner, you are expected to consider a number of factors when analyzing the feasibility of a new initiative. For example, you must consider the various types of risk (such as patient safety, physical plant, financial, or reputation), as well as the present and future value of the service line or economic opportunity in which you are investing. You must also balance your ethical and moral responsibility to provide quality care to patients and populations with your responsibility to protect your organization’s assets and economic viability in the near and long terms.
  Competency Map
  CHECK YOUR PROGRESSUse this online tool to track your performance and progress through your course.
• Toggle DrawerResources
• Assessment InstructionsDevelop a business case for the economic initiative you proposed in Assessment 1. Examine the feasibility and cost-benefit considerations of implementing your proposed initiative over the next five years. Analyze ways to mitigate risks and complete a cost-benefit analysis.
  Note: Remember that you can submit all, or a portion of, your draft business case to Smarthinking for feedback before you submit the final version for this assessment. If you plan on using this free service, be mindful of the turnaround time of 24–48 hours for receiving feedback.
  Requirements
  The requirements for your business case, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, be sure to note the requirements for document format and length and for supporting evidence.
  • Analyze the potential economic opportunities and risks associated with your proposed initiative. 
    • How do the potential opportunities benefit your organization or care setting?
    • How could potential risks pose a threat to the financial security of your organization or care setting?
    • How do the potential economic opportunities compare to the potential economic risks?
  • Propose ethical and culturally sensitive solutions that address the risks associated with your initiative to the future economic security of your organization or care setting. 
    • Which risks are potentially the most significant for your organization or care setting? 
      • How could you modify your proposed initiative to mitigate those risks?
      • How have other organizations and experts in the field dealt with similar risks?
    • How do ethics and equality factor into your proposed solutions? 
      • Are your solutions unfairly burdening or disadvantaging any specific groups?
    • How will this proposal affect community health care delivery outcomes? 
      • What makes this a great opportunity for economic growth?
      • What potential issues should be considered?
  • Analyze the economic costs and benefits of your proposed initiative over a five-year period. 
    • Use the Cost-Benefit Analysis Template [XLSX] for your calculations. Add the worksheet to your business case as an appendix.
    • Does your analysis warn against specific aspects of your proposed initiative?
    • How would you recommend that your findings be incorporated into decisions about the feasibility of your proposed initiative?
  • Propose ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of your initiative. 
    • What costs are you most likely to be able to control or reduce? 
      • How would you go about ensuring this?
    • How could controlling or reducing these costs affect the benefits of your proposed initiative? 
      • What strategies could you employ to maintain or maximize these benefits, while controlling or reducing costs?
    • How do you plan to ensure that any cost controls or benefit reductions are ethical and equitable?
  • Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence you used to support your business case. 
    • This criterion applies to any evidence you cited throughout your business case. Your evidence should be persuasive and relevant to your findings, proposals, and recommendations. Consider one or more of the following questions when citing support evidence: 
      • How is the evidence relevant to your organization or care setting?
      • How is the evidence relevant to your proposed economic initiative?
      • How does the evidence illustrate a solution that has been successful in the past?
      • How does the evidence illustrate that an initiative or solution is likely to be a net benefit to the organization or care setting?
  • Write concisely and directly, using active voice. 
    • Proofread your document before you submit it to minimize errors that could distract readers and make it more difficult for them to focus on the substance of your business case.
  • Apply current APA formatting to in-text citations and references.
  • Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:
  • Assessment 2 Example [PDF].
  • ADDITIONAL REQUIREMENTS
    Your assessment should also meet the following requirements:
  • Format: Format your business case using APA current style. Use the APA Style Paper Template [DOCX]. An APA Style Paper Tutorial [DOCX] is also provided to help you in writing and formatting your business case. Be sure to include: 
    • A title page and references page. An abstract is not required.
    • A running head on all pages.
    • Appropriate section headings.
  • Length: Your business case should be 4–7 pages in length, not including the title page and references page.
  • Supporting evidence: Cite 4–5 authoritative and scholarly resources to support your business case. Be sure that your sources include specific economic data.
  • Note: Faculty may use the Writing Feedback Tool when grading this assessment. The Writing Feedback Tool is designed to provide you with guidance and resources to develop your writing based on five core skills. You will find writing feedback in the Scoring Guide for the assessment, after your work has been evaluated.
    Portfolio Prompt: You may choose to save your business case to your ePortfolio.
    Competencies Measured
    By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment scoring guide criteria:
  • Competency 1: Analyze the effects of financial and economic factors (such as cost-benefit, supply and demand, return on investment, and risks) in a health care system on patient care, services offered, and organizational structures and operation. 
    • Analyze the potential economic opportunities and risks associated with a proposed initiative.
    • Analyze the economic costs and benefits of a proposed initiative over a five-year period.
  • Competency 2: Develop ethical and culturally equitable solutions to economic problems within a health care organization in an effort to improve the quality of care and services offered. 
    • Propose ethical and culturally equitable ways of keeping costs under control, while maximizing the benefits of an initiative.
  • Competency 3: Justify the qualitative and quantitative information used to guide economic decision making to stakeholders and colleagues. 
    • Justify the relevance and significance of the quantitative and qualitative economic, financial, and scholarly evidence used to support a business case.
  • Competency 4: Develop ethical and culturally equitable economic strategies to address dynamic environmental forces and ensure the future security of an organization’s resources and its ability to provide quality care. 
    • Propose ethical and culturally sensitive solutions that address the risks associated with an initiative to the future economic security of the organization or care setting.
  • Competency 5: Produce clear, coherent, and professional written work, in accordance with Capella writing standards. 
    • Write concisely and directly using active voice.
    • Apply APA formatting to in-text citations and references.