Health Resources and Services Administration (HRSA) and National Quality Forum (NQF)

For the initial post review the home page of your assigned organization and make your initial post by answering the questions listed below.

1. What is the organization’s mission?
2. Is the organization a governmental, accreditation, or regulatory agency?
3. Is the information collected for internal or external stakeholders?
4. List five quality improvement measures found on the organization’s website. 

Provide a thoughtful and complete initial response that is a minimum of two to three paragraphs

No plagiarism 

Two references 

I need a 2 or 3 sentence comment on each paragraph

Paragraph 1

As a nurse our responsibility is to make sure our patients understand what we educate them on because that causes better outcomes for the patients we care for. Strategies we can implement besides learning styles is looking at the patient has a whole. Nurses should like and consider the emotional, the physical, the spiritual and how willing they are to learn and if encouragement is needed to complete the plan of care or help the patient understand what they need to know prior to discharge. Another strategy is starting to teach the patient as soon as they are admitted because now and especially in a hospital the patient is admitted and then discharged in such a short time that we don’t get to teach as much as we should anymore. I personally feel behavioral objectives should consistently be used because anytime health promotion/teaching is part of the plan of care then this typically is going to lean towards the changing the of unhealthy habits or even adding in healthier habits.

Paragraph 2

The nurse has many roles and responsibility during a shift. The nurse is a friend, a confidant, an advocator; but one of the most important roles is a health educator. Nurses providing quality, individualized, education can increase patient outcomes (Smith & Zsohar, 2013). The teaching is not just for the patients but their caregivers as well. The patient’s caregivers can be family, friends, or hired personal staff. Before teaching should begin, it is important for the nurse to address any language or cultural barriers that could affect the patient’s ability to learn. It is vital to ensure the patient and caregivers have their seeing or listening devices on prior to delivering education. From personal experience, it is quite frustrating to teach the patient and caregivers only to find out their hearing aids were not in place. The formulate an individualized care plan, the nurse needs to assess the patient’s current knowledge about the disease and address any misconceptions the patient may have about their disease (Ashton & Oermann, 2014). This can be done by asking open-ended questions about their current knowledge of their medications or the knowledge they have about their disease process. The patient may not believe something is happening internally because he/she is not physically injured or they do not physically feel anything wrong. Patient’s may know the disease process but not the repercussions of not following their care plan. For example, a Type 1 diabetic not monitoring their blood sugar daily. The patient may not be aware of what can happen systemically. Assessing the patient’s willingness to learn. The Type 1 diabetic could be a teenage girl with apprehensions about monitoring blood sugar at school. The apprehension can affect the patient’s optimal outcome. The nurse will have to modify the approach when teaching this patient. Behavioral objectives would need to be utilized for this patient due to the at-risk behaviors which could lead to deteriorating health condition

Assignment: Adaptive Response

As an advanced practice nurse, you will examine patients presenting with a variety of disorders. You must, therefore, understand how the body normally functions so that you can identify when it is reacting to changes. Often, when changes occur in body systems, the body reacts with compensatory mechanisms. These compensatory mechanisms, such as adaptive responses, might be signs and symptoms of alterations or underlying disorders. In the clinical setting, you use these responses, along with other patient factors, to lead you to a diagnosis.

Consider the following scenarios:

Scenario 1:

Jennifer is a 2-year-old female who presents with her mother. Mom is concerned because Jennifer has been “running a temperature” for the last 3 days. Mom says that Jennifer is usually healthy and has no significant medical history. She was in her usual state of good health until 3 days ago when she started to get fussy, would not eat her breakfast, and would not sit still for her favorite television cartoon. Since then she has had a fever off and on, anywhere between 101oF and today’s high of 103.2oF. Mom has been giving her ibuprofen, but when the fever went up to 103.2oF today, she felt that she should come in for evaluation. A physical examination reveals a height and weight appropriate 2-year-old female who appears acutely unwell.  Her skin is hot and dry. The tympanic membranes are slightly reddened on the periphery, but otherwise normal in appearance. The throat is erythematous with 4+ tonsils and diffuse exudates. Anterior cervical nodes are readily palpable and clearly tender to touch on the left side. The child indicates that her throat hurts “a lot” and it is painful to swallow. Vital signs reveal a temperature of 102.8oF, a pulse of 128 beats per minute, and a respiratory rate of 24 beats per minute.

Scenario 2:

Jack is a 27-year-old male who presents with redness and irritation of his hands. He reports that he has never had a problem like this before, but about 2 weeks ago he noticed that both his hands seemed to be really red and flaky. He denies any discomfort, stating that sometimes they feel “a little bit hot,” but otherwise they feel fine. He does not understand why they are so red. His wife told him that he might have an allergy and he should get some steroid cream. Jack has no known allergies and no significant medical history except for recurrent ear infections as a child. He denies any traumatic injury or known exposure to irritants. He is a maintenance engineer in a newspaper building and admits that he often works with abrasive solvents and chemicals. Normally he wears protective gloves, but lately, they seem to be in short supply so sometimes he does not use them. He has exposed his hands to some of these cleaning fluids but says that it never hurt and he always washed his hands when he was finished.

Scenario 3:

Martha is a 65-year-old woman who recently retired from her job as an administrative assistant at a local hospital. Her medical history is significant for hypertension, which has been controlled for years with hydrochlorothiazide. She reports that lately, she is having a lot of trouble sleeping, she occasionally feels like she has a “racing heartbeat,” and she is losing her appetite. She emphasizes that she is not hungry like she used to be. The only significant change that has occurred later in her life is that her 87-year-old mother moved into her home a few years ago. Mom had always been healthy, but she fell down a flight of stairs and broke her hip. Her recovery was a difficult one, as she has lost a lot of mobility and independence and needs to rely on her daughter for assistance with activities of daily living. Martha says it is not the retirement she dreamed about, but she is an only child and is happy to care for her mother. Mom wakes up early in the morning, likes to bathe every day, and has always eaten 5 small meals daily. Martha has to put a lot of time into caring for her mother, so it is almost a “blessing” that Martha is sleeping and eating less. She is worried about her own health though and wants to know why, at her age, she suddenly needs less sleep.

To Prepare

• Review the three scenarios, 
• Identify the pathophysiology of the disorders presented in each of the three scenarios, including their associated alterations. Consider the adaptive responses to the alterations.
• Review the examples of “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in this week’s Learning Resources. Then select one of the disorders you identified from the scenarios. Use the examples in the media as a guide to constructing a mind map for the disorder you selected. Consider the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.

To Complete

Write a 2- to 3-page paper excluding the title page, reference page and Mind Map that addresses the following:

• For each of the three scenarios explain the pathophysiology, associated alterations and the patients’ adaptive responses to the alterations caused by the disease processes.  You are required to discuss all three scenarios within the paper component of this assignment.
• Construct one mind map on a selected disorder presented in one of the scenarios. Your Mind Map must include the epidemiology, pathophysiology, risk factors, clinical presentation, and diagnosis of the disorder, as well as any adaptive responses to alterations.
• APA citation 3 to 4 references within 5 years

 “School-age children are eager learners and understand cause and effect. Including the school-age child in their care is welcomed by this age group. They should be actively involved in making decisions regarding their healthcare.” Choose Erickson’s, Piaget’s, or Kohlberg’s stages of development and describe what the nurse might expect in a school-age child. Explain how knowledge of development helps the nurse in assessment.