It is necessary for an 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.

Prepare this assignment according to the guidelines found in the APA Style Guide,

  

Program/policy evaluation is a valuable tool that can help strengthen the quality of programs/policies and improve outcomes for the populations they serve. Program/policy evaluation answers basic questions about program/policy effectiveness. It involves collecting and analyzing information about program/policy activities, characteristics, and outcomes. This information can be used to ultimately improve program services or policy initiatives.

Nurses can play a very important role in assessing program/policy evaluation for the same reasons that they can be so important to program/policy design. Nurses bring expertise and patient advocacy that can add significant insight and impact. In this Assignment, you will practice applying this expertise and insight by selecting an existing healthcare program or policy evaluation and reflecting on the criteria used to measure the effectiveness of the program/policy.

To Prepare:

• Review the Healthcare Program/Policy Evaluation Analysis Template provided in the Resources.
• Select an existing healthcare program or policy evaluation or choose one of interest to you.
• Review community, state, or federal policy evaluation and reflect on the criteria used to measure the effectiveness of the program or policy described.

The Assignment: (2–3 pages)

Based on the program or policy evaluation you selected, complete the Healthcare Program/Policy Evaluation Analysis Template. Be sure to address the following:

• Describe the healthcare program or policy outcomes.
• How was the success of the program or policy measured?
• How many people were reached by the program or policy selected?
• How much of an impact was realized with the program or policy selected?
• At what point in program implementation was the program or policy evaluation conducted?
• What data was used to conduct the program or policy evaluation?
• What specific information on unintended consequences was identified?
• What stakeholders were identified in the evaluation of the program or policy? Who would benefit most from the results and reporting of the program or policy evaluation? Be specific and provide examples.
• Did the program or policy meet the original intent and objectives? Why or why not?
• Would you recommend implementing this program or policy in your place of work? Why or why not?
• Identify at least two ways that you, as a nurse advocate, could become involved in evaluating a program or policy after 1 year of implementation.

 

Directions for Part 2

1. For this part of the direct care project, you will be creating a PowerPoint presentation based on the topic and problem identified in Part 1. If you chose air quality as your topic, you will present on the Air Quality Flag Program. If you chose substance use, you will present the SBIRT intervention model.

If you have chosen substance use, you will present to at least 3 practicing RN’s. You can present all at one time or individually. If you chose air quality, you will present to at least one organization leader. See the Direct Care Project module for FAQs.

1. Each topic has separate directions.

Download the Planning Your Presentation Directions for your corresponding topic.

Air Quality

• Air Quality Flag Program: Planning the Presentation Instructions (Links to an external site.)

Substance Use

• SBIRT : Planning the Presentation Instructions (Links to an external site.)

1. View the Direct Care Project Part 2 Tutorial (Links to an external site.).
2. Download the template below and create a PowerPoint presentation for your selected group.
3. Create speaker notes for the PowerPoint presentation. These will assist you as you present and will be part of your assignment submission.
4. Utilize your own words and paraphrasing for all presentation content.
5. The presentation should be no fewer than 8 and no more than 15 slides. This does not include the introduction and reference slides.
6. Submit presentation in PDF for instructor approval. See Submitting PowerPoint Notes Pages in PDF format (Links to an external site.).

• You will present the PowerPoint to your audience, not the PDF, as you do not want the speaker notes to show to your audience members.

1. Note: You may not present until your presentation has been approved by your instructor.
   • Review comments about your presentation from your instructor in Grades. Please see the Viewing Feedback on Assignments job aid in Resources. Your instructor will indicate what (if any) revisions are needed in your presentation and if it is approved to present as-is or once revisions are made.

**You may be instructed to resubmit depending on the revisions needed.

1. After your presentation is approved, see Week 5: Direct Care Project Part 3: Implementing Your Presentation. This is where you will find:

• Attendance form
• Pre-survey
• Post-survey

***The surveys you will give your audience pre and post presentation are already developed. You will submit the attendance form with the Part 4 submission and utilize the survey data in the Part 4 assignment. ***

Templates and Links

Click on the links below to download and view the resources for your project.

PowerPoint Presentation Template (Links to an external site.)

Air Quality Flag Program (Links to an external site.) (website)

SBIRT (Links to an external site.) (website)

Best Practices

• Please use your browser’s File setting to save or print this page.
• Include your name and date on the title slide.
• Check for spelling and grammar errors prior to final submission.
• Use bullet points instead of long sentences or paragraphs
• Include graphics, photographs, colors, and themes.
• Use the rubric as a final check prior to submission to ensure all content is clearly addressed.

Scholarly Sources and Citations

• Minimum of 3 references. See Presentation Instructions for references needed.
• Cite all resources in APA format on the slide where content occurs. Cite in lower corner/footer as prompted on template.
• Reference slide is in template. Hanging indent is not required.

PLEASE FOLLOW THE INSTRUCTIONS BELOW

4 REFERENCE

ZERO PLAGIARISM

TOPIC:Non–Rapid Eye Movement Sleep Arousal Disorders

The power of sleep to heal the body cannot be underestimated. Most research indicates that 7–8 hours of sleep are a minimum that people need to stay healthy. Clients who come to the PMHNP’s office frequently complain of sleep problems. It is estimated that 10–20% of patients report some type of sleeping problem.

In this Discussion, you will analyze the diagnostic criteria and evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders.

Learning Objectives

Students will:

• Analyze diagnostic criteria for sleep/wake disorders
• Analyze evidence-based psychotherapy and psychopharmacologic treatment for sleep/wake disorders
• Analyze criteria for referring clients to primary care physicians for treatment of sleep/wake disorders
• Compare differential diagnostic features of sleep/wake disorders

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

To prepare for this Discussion:

• By Day 5 of Week 9, your Instructor will have assigned you a sleep/wake disorder, which will be the focus of your original post for this Discussion.
• Review the Learning Resources.

By Day 3

Post:

• Explain the diagnostic criteria for your assigned sleep/wake disorder.
• Explain the evidenced-based psychotherapy and psychopharmacologic treatment for your assigned sleep/wake disorder.
• Describe at what point you would refer the client to their primary care physician for an additional referral to a neurologist, pulmonologist, or physician specializing in sleep disorders and explain why.
• Support your rationale with references to the Learning Resources or other academic resource.

By Day 6