1. Students
2. This is your main assignment for this week.  Attached is a blank Care Plan template.  I will also included a case study that you will use to complete your Care Plan. Basically, a Care Plan is the Nursing Process, which we have studied over the past few week.  We will use the information that we learned to Assess the patient using subjective and objective data, formulate a nursing diagnosis, develop a plan of care for the patient, implement our plan, and then evaluate our plan.
3. We will discuss the CARE PLAN on the Webinar this week.  
4. The care plan details are as follows: Much of the information is given to you.  There is one diagnosis listed and you will need to develop a second diagnosis for this patient.    Make sure that you have three references in APA format.  If the information is included in the case study (example:  Nursing diagnosis, interventions, etc.) you can use them in your care plan.  This is your first care plan, so much of it is fill in the blanks.  Good luck and I will be glad to help you with this assignment. APA format.  If the information is included in the case study (example:  Nursing diagnosis, interventions, etc.) you can use them in your care plan.  This is your first care plan, so much of it is fill in the blanks.  Good luck and I will be glad to help you with this assignment. 
5. Attached is the care plan template.  Please submit to the drop box by the due date.

   A 48 year old male is admitted to the interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life.interventional holding area after having a cardiac cath. The patient received a cardiac stent in the right coronary artery (RCA) and the insertion site was angiosealed. The insertion site is soft, no bruising noted, or active bleeding. Pulses are palpable in bilateral lower extremities. A sandbag in on the site which has to stay for another 1.5 hours per md orders. The patient is complaining of discomfort in the groin area and rates his pain 8 on 1-10 scale. In addition, the patient and his wife have verbalized they desire (but feel they will not be able to) to manage the new medication regime and post-op care and are having difficulty understanding why it is so important to take these new medications and quit smoking since he already “has his problem fixed with the stent placement”. He states he is going to have problems integrating these new “rules” into his daily life because he works around people who smoke all the time and does not want these medications to interfere with his life.     

Nursing Diagnosis:

 -Acute Pain related to tissue trauma and prescribed post procedure immobilization as evidence by patient rating pain 8 on 1-10 scale.      Demographics:  White male, 48 years old.  Weight is 285 pounds, Height is 5’9″. Pt is married and his wife and 2 children are at the bedside.  Pt speaks fluent English.  He is Catholic.  He finished high school and 2 years of community college.  He is employed in an office with about 30 other employees.    Past medical history:  HTN, Hyperlipidemia, Smokes    

Current labs:  Glucose – 165, Sodium 140, Potassium 3.2, Chloride 98, BUN 15, Creatinine 0.8. 

Chest Xray – normal

Medications:  Select 3 medications for your care plan.  One should be for hypertenstion, 1 should be for pain while in the hospital, the 3rd one is of your choice (a medication that goes along with his diagnosis).    

Nursing Outcomes:

-The patient will rate his groin pain less than 5 on a 1-10 scale within in 2 hours from admission. 

-The patient and his wife will relate to the nurse that they feel like they can integrate the new medication and stop smoking regimen into their lifestyle before discharge.

-The patient and his wife will verbalize 4 benefits of quitting smoking for the heart by discharge.

-The patient and his wife will demonstrate and verbalize how to administer and take his new medications before discharge.

 

Nursing Interventions:

 

-The nurse will assist the patient with re-positioning techniques as needed to help alleviate pain.

-The nurse will educate the patient and his wife on 4 benefits of quitting smoking by discharge.

-The nurse will verbalized and demonstrate to the patient and his wife how the patient needs to take his new medications by discharge.  The patient and his wife will verbalize their understanding of the medications.

  Chapter 32: Constructive Dialogue and ERM: Lessons from the Financial Crisis Case and provide response for following questions.

1. What are the preconditions for conducting constructive dialogue in an organization?
2. Is effective risk management possible without constructive dialogue?
3. What are the forces that tend to undermine effective risk management in an organization?
4. Given its obvious value in helping an organization to understand the major risks that could prevent it from accomplishing its mission and objectives, why was the financial sector, including a risk-sensitive organization such as Goldman Sachs, so slow in adopting ERM?

You are required to respond to the questions thoroughly, in 250 -to-300 words for each question. Be sure to include at least three reference sources. APA rules for formatting, quoting, paraphrasing, citing, and listing of sources are to be followed.
 

 

As a professional nurse, you are expected to apply your expertise to patient care. On occasion, you will also be expected to share that expertise.

With evolving technology and continuous changes to regulations designed to keep up these changes, there is usually a need to share information and expertise to inform colleagues, leadership, patients, and other stakeholders.

In this Assignment, you will study a recent nursing informatics-related healthcare policy, and you will share the relevant details via a fact sheet designed to inform and educate.

To Prepare:

• Review the Resources on healthcare policy and regulatory/legislative topics related to health and nursing informatics.
• Consider the role of the nurse informaticist in relation to a healthcare organization’s compliance with various policies and regulations, such as the Medicare Access and CHIP Reauthorization Act (MACRA).
• Research and select one health or nursing informatics policy (within the past 5 years) or regulation for further study.

The Assignment: (1 page)

Create a 1-page fact sheet that your healthcare organization could hypothetically use to explain the health or nursing informatics policy/regulation you selected. Your fact sheet should address the following:

• Briefly and generally explain the policy or regulation you selected.
• Address the impact of the policy or regulation you selected on system implementation.
• Address the impact of the policy or regulation you selected on clinical care, patient/provider interactions, and workflow.
• Highlight organizational policies and procedures that are/will be in place at your healthcare organization to address the policy or regulation you selected. Be specific.

By Day 7 of Week 11

Submit your completed Policy/Regulation Fact Sheet.

Integumentary Function

K.B. is a 40-year-old white female with a 5-year history of psoriasis. She has scheduled an appointment with her dermatologist due to another relapse of psoriasis. This is her third flare-up since a definitive diagnosis was made. This outbreak of plaque psoriasis is generalized and involves large regions on the arms, legs, elbows, knees, abdomen, scalp, and groin. K.B. was diagnosed with limited plaque-type psoriasis at age 35 and initially responded well to topical treatment with high-potency corticosteroids. She has been in remission for 18 months. Until now, lesions have been confined to small regions on the elbows and lower legs.

Case Study Questions

1. Name the most common triggers for psoriasis and explain the different clinical types.

2. There are several types of treatments for psoriasis, explain the different types and indicate which would be the most appropriate approach to treat this relapse episode for K.B. Also include non-pharmacological options and recommendations.

3. Included in question 2

4. A medication review and reconciliation are always important in all patient, describe and specify why in this particular case is important to know what medications the patient is taking?

5. What others manifestation could present a patient with Psoriasis?

Sensory Function

C.J. is a 27-year-old male who started to present crusty and yellowish discharged on his eyes 24 hours ago. At the beginning he thought that washing his eyes vigorously the discharge will go away but by the contrary increased producing a blurry vision specially in the morning. Once he clears his eyes of the sticky discharge her visual acuity was normal again. Also, he has been feeling throbbing pain on his left ear. His eyes became red today, so he decided to consult to get evaluated. On his physical assessment you found a yellowish discharge and bilateral conjunctival erythema. His throat and lungs are normal, his left ear canal is within normal limits, but the tympanic membrane is opaque, bulging and red.

1.- Based on the clinical manifestations presented on the case above, which would be your eyes diagnosis for C.J. Please name why you get to this diagnosis and document your rational.

2.- With no further information would you be able to name the probable etiology of the eye affection presented? Viral, bacterial, allergic, gonococcal, trachoma. Why and why not.

3.- Based on your answer to the previous question regarding the etiology of the eye affection, which would be the best therapeutic approach to C.J problem.