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 Mr. M., 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

Mr. M., a 70-year-old male, has been living at the assisted living facility where you work. He has no know allergies. He is a nonsmoker and does not use alcohol. Limited physical activity related to difficulty ambulating and unsteady gait. Medical history includes hypertension controlled with ACE inhibitors, hypercholesterolemia, status post appendectomy, and tibial fracture status postsurgical repair with no obvious signs of complications. Current medications include Lisinopril 20mg daily, Lipitor 40mg daily, Ambien 10mg PRN, Xanax 0.5 mg PRN, and ibuprofen 400mg PRN.

Case Scenario

Over the past 2 months, Mr. M. seems to be deteriorating quickly. He is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly. He appears to be afraid and fearful when he gets aggressive. He has been found wandering at night and will frequently become lost, needing help to get back to his room. Mr. M has become dependent with many ADLs, whereas a few months ago he was fully able to dress, bathe, and feed himself. The assisted living facility is concerned with his rapid decline and has decided to order testing.

Objective Data

1. Temperature: 37.1 degrees C
2. BP 123/78 HR 93 RR 22 Pox 99%
3. Denies pain
4. Height: 69.5 inches; Weight 87 kg

Laboratory Results

1. WBC: 19.2 (1,000/uL)
2. Lymphocytes 6700 (cells/uL)
3. CT Head shows no changes since previous scan
4. Urinalysis positive for moderate amount of leukocytes and cloudy
5. Protein: 7.1 g/dL; AST: 32 U/L; ALT 29 U/L

Critical Thinking Essay

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

1. Describe the clinical manifestations present in Mr. M.
2. Based on the information presented in the case scenario, discuss what primary and secondary medical diagnoses should be considered for Mr. M. Explain why these should be considered and what data is provided for support.
3. When performing your nursing assessment, discuss what abnormalities would you expect to find and why.
4. Describe the physical, psychological, and emotional effects Mr. M.’s current health status may have on him. Discuss the impact it can have on his family.
5. Discuss what interventions can be put into place to support Mr. M. and his family.
6. Given Mr. M.’s current condition, discuss at least four actual or potential problems he faces. Provide rationale for each.

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.

Assignment Content

1. Imagine you have been hired to oversee the human resources department of a large hospital system. The hospital board of directors has requested that you provide a presentation to them on the strategies you want to implement in the human resources department that would benefit the hospital system as a whole.

   Create a Microsoft PowerPoint presentation with a minimum of 15 slides addressing human resources strategies within the health care industry for effective employee recruitment, selection, training, development, and performance appraisal.

   Include the following in your presentation:

   • Section 1
   • Identify five recruitment strategies or methods.
   • Indicate whether the strategy is internally or externally focused.
   • Describe the strategy and why it is appropriate to health care.
   • Section 2
   • Create a graphic differentiating between the following:
   • Job analysis
   • Job description
   • Job specifications
   • Examples of a graphic include flowcharts, Venn diagrams, graphs, and slides. There are a variety of tools in the Microsoft Office© Suite suitable for creating graphics. Additionally, .pdf, .jpg, and other file formats are acceptable.
   • Section 3
   • Explain why training and education are vital in health care.
   • Explain the importance of measuring competencies.
   • Describe the process for tracking and evaluating training effectiveness.
   • Describe performance appraisal standards within the health care industry.
   • Identify guidelines for effective performance appraisals.
   • Include possible barriers and their effect on the appraisal process.
   • Describe the due diligence of progressive discipline of employees within the health care field.
   • Include detailed speaker notes of at least 100 words per slide.

Calcium and Vitamin D supplementation are essential to bone health and the management of osteopenia and osteoporosis.  In the past few years, information regarding the potential risks of too much calcium (such as cardiovascular disease and/or events) have been emerging.  

• Using an article from a medical journal, evaluate and discuss the risks and benefits of calcium supplementation for a patient with a bone disease.
• What would you recommend for is a 59-year-old postmenopausal woman with a T-score of − 2.3. Her past medical history is unremarkable and she only takes a multivitamin with additional calcium and vitamin D. Her family history is remarkable for a mother who had osteoporosis and died of breast cancer and a father who has diabetes

Gout is a common form of inflammatory arthritis that is very painful. It usually affects one joint at a time (often the big toe joint). Although there is no cure for gout, it can be effectively treated and managed with medication and self-management strategies 

• A 45-year-old white man presents to your office complaining of left knee pain that started last night. He says that the pain started suddenly after dinner and was severe within a span of 3 hours. He denies any trauma, fever, systemic symptoms, or prior similar episodes. He has a history of hypertension for which he takes hydrochlorothiazide (HCTZ). He admits to consuming a great amount of wine last night with dinner
  • Provide an evaluation of the patient including possible risk factors and treatment options, including non-pharmacologic interventions
  • Would this patient be a candidate for prophylactic therapy?

Please post your initial response by Wednesday at midnight. Respond to one student from Wednesday at midnight to Sunday at midnight. All responses must be a minimum of 150 words, scholarly written, APA formatted, and referenced. A minimum of 2 references, other than your text, is required. Please refer to grading rubric for online discussion.

1) Include the following criteria for each identified concept (topic): The NCSBN NCLEX-RN Test Plan will support this process (detailed criteria listed below and in the Grading Rubric must match exactly). 

a) Each Concept (Topic)- 10 points/20%

i) Learning Needs: 

(1) Required Criteria:

(a) Identify the concept (topic) of opportunity. 

(b) Provide a description of how this aligns with the NCLEX-RN Test Plan as indicated by performance in the Individual Student ATI Assessment Trends Table. 

ii) Learning Strategies:

(1) Required Criteria:

(a) Identify a minimum of two learning strategies that you plan to implement to address your learning need.

iii) Learning Resources:

(1) Required Criteria:

(a) Identify a minimum of two resources that you will integrate into your NCLEX-RN Readiness plan to assist you with improving the identified learning need.