Write a short (50-100-word) paragraph response for each question. This assignment is to be submitted as a Microsoft Word document.

1. Give examples of psychosocial factors that affect the health care professional and the effect those factors could have on patient education.
2. Give examples of psychosocial factors that affect the patient and the effect those factors could have on patient education.
3. Explain what is meant by personality styles and give examples of approaches that could be used to help the patient. Include self-perception as a factor.
4. List the steps in adjustment to illness and how the patient copes with each step.
5. Explain the health professional’s role in teaching the patient at different life stages.
6. Define the role of the family in patient education.
7. How might the family influence the compliance of the patient and what measures can the health care professional use in communication with the family?

  

Created short paragraph (50-100 word minimum) response for each question and addressed each part of the question. (the question does not count toward the word count) –/ 10 points 

• Research section: Demonstrated accuracy, thoughtful detail and intelligence with each answer and was written in own words and had original thought. -10 pts

• Critical thinking Section: Original Examples are provided to explain answer. (Example:) Student has original and critical thinking:-10 pts

• Created APA formatted document. 

i. Included APA title page. 1/

ii. Included APA in-text citations – 5/

iii. APA reference page at the end. –3 pts/ 9 points total

• Homework has questions written out, numbered and are in order. ( See student Success center for details on APA formatting) – 1 point

Hi Dr Kyzar and class

Whether the author identified the scope of evidence synthesis

            The scope of the evidence synthesis is focused on the issue of patient falls with injuries and the challenges related to the prevention of falls within the acute cares settings. The author has identified this scope by drawing pieces of evidence from various authors. The evidence drawn from the previous studies indicates that the issue of patient falls is a major adverse event that interferes with the quality of healthcare services that are being provided to the patients within the acute care settings for example nursing homes and healthcare facilities. The study reveals that the detrimental effects caused by the issues of patients’ falls are associated with serious bruises, trauma, fractures, and death of the patients when it is not prevented at the right time (Araujo, et al., 2017).

            The evidence also supports the focus of the author by revealing that the issue of falls is a common problem that is being experienced by elderly patients. It shows that one in every three individuals more than 65 years old suffer from at least one fall every year. This is associated with either alone of combined factors such as environmental factors, social factors, psychological factors. Therefore, the author has managed to gather the literature that helps in addressing the research area that is to say the issue of patient falls. The author has managed to synthesize the literature by comparing the literature studies referenced in this work. The author has managed to assess and interpret to help in concluding on the issue of patients’ falls and how it is becoming an issue within the acute care and to the healthcare providers (Araujo, et al., 2017).

Whether stronger paraphrased sentences are included to help in supporting the contemporary sources of research evidence

              Through providing the description, summary, analysis, and identification of the key concepts; there is successful paraphrasing of the sentences to help in supporting the sources of the research evidence. The evidence from one of the research evidence used i.e. (Gygax Spicer, 2017) shows the issue of falls to be a common problem amongst elderly individuals due to the factors that are either combined or occurring singularly. These factors include social, environmental, and psychological factors. This evidence is supported by the paraphrased sentence which states that the etiology of falls among their elderly patients is as a result of attempting to get out of the bed without any form of assistance from the team of healthcare providers such as nurses. The issue is further increased by other causative factors such as diseases, impulsiveness, urgency, medications, and lack of knowledge about the hospital environment. Another issue that is paraphrased to support the evidence from the research is the turnover problem among healthcare providers. Due to the inadequate number of healthcare providers such as nurses to spend more time with the patients, these elderly remains to be highly exposed to the risk of falls as a result of the low ratio of nurse to the patient (Gygax, 2017).

 Whether the facts presented are related to the practice problem that has been presented in an objective way

            The facts presented in the article through research evidence and conclusion from the research findings have been done objectively and they are based on the issue of patient falls and injuries and fall prevention. One of these facts is that the issue of patient falls is a common problem within acute care facilities such as nursing homes and hospitals. They are linked to some of the preventable factors related to the social, environmental, and psychological factors. Due to the reduction in the ability to perform most of the ADLs, elderly patients are considered to be high-risk individuals who require help from the nurses to overcome the issue of falls which increases the risks of preventable injuries and deaths. These patients also experience the side effects of the medications, illness, impulsiveness, and urgency thus exposing them to a high risk of falls when effective interventions are not developed (Araujo, et al., 2017).

            The other key fact linked to the issue of fall prevention is the lack of adequate nurses to help patients with their needs such as pottying and movement within the hospital. Due to the lack of knowledge about the hospital environment as well as lack of adequate to respond to their needs immediately, elderly patients remain highly exposed to severe bruises, fractures, traumas, and preventable deaths (Araujo, et al., 2017).

Whether the author uses sources to support the ideas and claims

            The argument presented by the author is supported by the evidence from past studies. According to the argument from the author, the issue of falls among patients occurs as a result of their attempts to get out of bed without any form of assistance from the nurses. The author also argues that patients’ falls is also associated with the urgency, illness, medication being used by the patients, impulsiveness, and unfamiliarity with the hospital environment in addition to the increase in the turnover of the nurse staffing which reduces the number of nurses in the hospitals.

            These arguments are supported by the research evidence used by the author. According to Gygax Spicer (2017), one to three persons of ages 65 years and above do suffer from at least one fall every year as a result of multiple factors that are linked to social, environmental, and psychological factors. The issue of illness, impulsiveness, urgency, and medication as presented by the author is the social and psychological factors that are demonstrated in the research evidence. The issue of a low number of patients is an environmental factor within the hospital facility. This increases the level of exposure of these patients to the risk of falls (Gygax, 2017). According to the author, patients always attempt to get out of their bed without any assistance from the nurses. Due to the lack of knowledge about the environment of the hospitals, the majority of them fall. De Medeiros Araujo et al (2015) shows that such falls expose them to mild and severe bruises, fractures, traumas, and even deaths. The few numbers of nurses in the facility imply that there would be no nurses left to keep an eye on other patients who might require help with pottying and bathing (de Medeiros Araujo, et al., 2017).

Whether this exemplar is a true synthesis of the evidence

            The exemplar presented is a true synthesis of the evidence concerning the issue of patient falls and the complex nature of preventing such falls. Even though the presentation is majorly based on the arguments based on the research evidence, the information presented is a true reflection of what is happening in acute care settings. Even though efforts have been made to help in addressing the issue of patient falls, the evidence synthesis further confirms that addressing this issue is still complicated as a result of the high turnover that leads to the low number of nurses to care for the growing number of patients who are seeking services for their chronic conditions. The low number of nursing staff makes it impossible to implement the nursing hourly rounds and this complicates the interventions of efforts being made to ensure that there is the successful process of implementing the nursing hourly rounds (Araujo, et al., 2017).

            The issue of patient falls is also associated with the problems caused by the medication and the psychological issues of the patients. The reduction in physical strength and mental well-being results in the reduction of the ability of the patients to perform their ADLs such as bathing. In acute care, these patients require help from the patients with the roles such as bathing and pottying. Due to the lack of adequate nurses, it makes it hard for these patients to have their needs rendered at the right time. Therefore, they are forced to get out of bed with no form of help from the nurses. Due to their reduced physical and mental ability as well as lack of knowledge about the hospital environment, they find themselves falling on the ground thus exposing them to mild to severe bruises, fractures, trauma, and death. Therefore, the effective process of addressing the issue of patients’ falls requires the process of dealing with the complications within the facility at first for example addressing the issue of lower nurse-patient ratios and improvement in the hospital environment by increasing the number of caregivers within the wards while nurses are busy caring for other patients (Araujo, et al., 2017).

References

Araujo, J. N., Fernandes, A. P., Moura, L. A., Santos, M. M., Ferreira Junior, M. A., & Vitor, A. F. (2017). Validation of nursing outcome content Fall prevention behavior in a hospital environment. http://www.repositorio.ufc.br/handle/riufc/23831

de Medeiros Araujo, C. X., de Lima Silva, V., Guerra, G. C., Ferreira, A. H., de Araujo Barbosa, S. J., & de Araujo Junior, A. A. (2017). Quality of life, integrative community therapy, family support, and satisfaction with health services among elderly adults with and without symptoms of depression. Psychiatric Quarterly, 88(2), 359-369. https://doi.org/10.1007/s11126-016-9453-z

Gygax, S. J. (2017). The Got-A-Minute Campaign to Reduce Patient Falls with Injury in an Acute Care Setting. MedSurg Nursing, 26(5).

 For the assignment, you will select one quantitative research study and one qualitative study related to the field of nursing and write a summary of each study.  Each summary must be accurate, succinct, and clear. 

The topic is PRE-ECLAMPSIA

Ensure the following questions are addressed in each summary:

1. What type of research is it (quantitative, qualitative, and design)?
2. What was the research question(s) or hypothesis?
3. What is the sample, the sample size, and sample attributes?
4. What was the setting of the study?
5. What were the researcher’s findings? (Identify one.)  You must submit the research study articles along with your summaries.

• Each summary should be between 150–250 words. 
• Use current APA format to style your paper and to cite your sources.

 Based on this case study answer the questions below in APA Style, more than 300 words, and please cite 3 or more references .

“Mrs. Walsh, a woman in her 70s, was in critical condition after repeat coronary artery bypass graft (CABG) surgery. Her family lived nearby when Mrs. Walsh had her first CABG surgery. They had moved out of town but returned to our institution, where the first surgery had been performed successfully. Mrs. Walsh remained critically ill and unstable for several weeks before her death. Her family was very anxious because of Mrs. Walsh’s unstable and deteriorating condition, and a family member was always with her 24 hours a day for the first few weeks. The nurse became involved with this family while Mrs. Walsh was still in surgery, because family members were very anxious that the procedure was taking longer than it had the first time and made repeated calls to the critical care unit to ask about the patient. The nurse met with the family and offered to go into the operating room to talk with the cardiac surgeon to better inform the family of their mother’s status. One of the helpful things the nurse did to assist this family was to establish a consistent group of nurses to work with Mrs. Walsh, so that family members could establish trust and feel more confident about the care their mother was receiving. This eventually enabled family members to leave the hospital for intervals to get some rest. The nurse related that this was a family whose members were affluent, educated, and well informed, and that they came in prepared with lists of questions. A consistent group of nurses who were familiar with Mrs. Walsh’s particular situation helped both family members and nurses to be more satisfied and less anxious. The family developed a close relationship with the three nurses who consistently cared for Mrs. Walsh and shared with them details about Mrs. Walsh and her life. The nurse related that there was a tradition in this particular critical care unit not to involve family members in care. She broke that tradition when she responded to the son’s and the daughter’s helpless feelings by teaching them some simple things that they could do for their mother. They learned to give some basic care, such as bathing her. The nurse acknowledged that involving family members in direct patient care with a critically ill patient is complex and requires knowledge and sensitivity. She believes that a developmental process is involved when nurses learn to work with families. She noted that after a nurse has lots of experience and feels very comfortable with highly technical skills, it becomes okay for family members to be in the room when care is provided. She pointed out that direct observation by anxious family members can be disconcerting to those who are insecure with their skills when family members ask things like, “Why are you doing this? Nurse ‘So and So’ does it differently.” She commented that nurses learn to be flexible and to reset priorities. They should be able to let some things wait that do not need to be done right away to give the family some time with the patient. One of the things that the nurse did to coordinate care was to meet with the family to see what times worked best for them; then she posted family time on the patient’s activity schedule outside her cubicle to communicate the plan to others involved in Mrs. Walsh’s care. When Mrs. Walsh died, the son and daughter wanted to participate in preparing her body. This had never been done in this unit, but after checking to see that there was no policy forbidding it, the nurse invited them to participate. They turned down the lights, closed the doors, and put music on; the nurse, the patient’s daughter, and the patient’s son all cried together while they prepared Mrs. Walsh to be taken to the morgue. The nurse took care of all intravenous lines and tubes while the children bathed her. The nurse provided evidence of how finely tuned her skill of involvement was with this family when she explained that she felt uncomfortable at first because she thought that the son and daughter should be sharing this time alone with their mother. Then she realized that they really wanted her to be there with them. This situation taught her that families of critically ill patients need care as well. The nurse explained that this was a paradigm case that motivated her to move into a CNS role, with expansion of her sphere of influence from her patients during her shift to other shifts, other patients and their families, and other disciplines” Critical thinking activities 1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011). 2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care? 3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice

No less than three nursing diagnoses

Fully developed care plan

What is the priority nursing education this patient needs with rationale

Nursing interventions

Remember no less than 2 references

Patient A.B. a 69 year old White mail visited his local clinic for a check up as lately he was feeling lethargic and has gained 22 lbs in the past year. He also has episodes of nocturia. He has being diagnosed with Type 2 diabetes for 5 years. However, he was diagnosed with Borderline diabetes since 1997, but never took it seriously and made no lifestyle changes. He has symptoms of hyperglycemia for the past 2 years. He does not check his glucose daily. He has never had a foot examination.

AB carbohydrate intake daily most times consists of eating at least three slices of bread with each meal and eating pasta meals at least 3 times a week. He likes his wife to cook Italian meals no less than 3-4 times a week. He drinks a glass of red wine with dinner every day. He stopped smoking 10 years ago. He exercises on occasion, maybe once or twice a month.

A.B. takes Atorvastatin 10mg daily. Gluburide 2.5mg daily. However, he reports he stopped taking the Glyburide about 6 months ago as it was making him feel dizzy whenever he took it. He has not notified his PCP about not taking the Glyburide.

Physical Examination

Constitutional: Alert and oriented to person, place, time and situation. He is well groomed.  He is 5 feet 2 inches and weighs 178 pounds.

Eyes: Pupils round, reactive to light. EOM intact. Fundi clear.

Hearing: No deficit noted

Mouth: Mucosa moist. Upper and lower dentures.

Heart: Rate and rhythm regular. No murmur.

Lungs: Clear to auscultation

Neurological assessment: Diminished vibrating sense to the forefoot, absent ankle reflexes. Monofilament felt only above the ankle.

Vascular: No carotid bruits. Femoral, popliteal and dorsalis pedalis pulses 2+ bilaterally.

His Immunization is updated. He has erectile dysfunction and takes Sildenafil.

Vital signs: BP= 150/87, P= 88, RR= 20, T= 97.8, Oxygen Sat= 98%

Laboratory Results:

Glucose (fasting) = 178mg/dl

Creatinine = 1.0mg/dl

Blood Urea Nitrogen = 18mg/dl

Sodium = 141 mg/dl

Potassium = 4.3 mg/dl

Total Cholesterol = 162 mg/dl

HDL Chol = 43mg/dl

LDL Chol = 84 mg/dl

Triglycerides = 177 mg/dl

AST = 14 IU/L

ALT = 19 IU/L

Alkaline Phosphotase = 56 IU/L

A1C = 8.1%