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.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. 

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. 

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

Before beginning work on this discussion forum, please review the link “Doing Discussion Questions Right,” the expanded grading rubric for the forum, and any specific instructions for this topic.

Before the end of the week, begin commenting on at least two of your classmates’ responses. You can ask technical questions or respond generally to the overall experience. Be objective, clear, and concise. Always use constructive language, even in criticism, to work toward the goal of positive progress. Submit your responses in the Discussion Area.

 At one time or another we will have a need to access healthcare, whether it is for something major, minor, for ourselves or for others. Healthcare is a commodity that we all utilize. In this section we will discuss healthcare demand and all that it can entail.

• What makes demand in healthcare a complicated issue, and what are some of the components that may contribute to the level of demand?

To support your work, use your course and textbook readings and also use the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format.

 Your initial posting should be addressed at 150-300 words. Submit your document to this Discussion Area by the due date assigned. Be sure to cite your sources using APA format.

 Respond to your peers throughout the week. Justify your answers with examples, research, and reasoning. Follow up posts need to be submitted by the end of week.

Requirements:

1. This paper will be graded on quality of information, use of citations, use of Standard English grammar, sentence structure, and organization based on the required components.
2. Create this assignment using Microsoft (MS) Word, which is the required format for all Chamberlain documents. You can tell that the document is saved as a MS Word document because it will end in “.docx.”
3. Submit to the appropriate assignment area by 11:59 p.m. MT on Sunday of the week due. Any questions about this paper may be discussed in the weekly Q & A Discussion topic.
4. The length of the paper is to be no greater than three pages, excluding title page and reference page.
5. NOTE: You have the option of verbally presenting the content of your paper and uploading/sending the video to your instructor and posting it in the designated Week 8 threaded discussion. For the video option, you must still include a written introduction and conclusion, title page and reference list, per APA.
6. APA format (6th edition) is required in this assignment, including a title page and reference page. Use APA level 1 headings for the organizational structure of this assignment. Remember that the introduction does not carry a heading that labels it as a level heading in APA format. The first part of your paper is assumed to be the introduction. See APA manual for details. See resource under the course Library Guide, “Guidelines for Writing Professional Papers.” Use the suggested format and headings to organize your assignment.
   1. Include introduction (do not label as a heading in APA format)
   2. New Nursing Care Delivery Model and Patient Safety Goals
   3. Key Concepts
   4. Supporting Evidence
   5. Conclusion

Preparing the paper

As the nurse executive of your organization, you must reexamine your current nursing care delivery model (your current model is total-patient-care) and propose a new model to reduce costs and improve the quality of healthcare for your organization. Your staffing budget will remain fixed next year, and you had a recent visit by The Joint Commission which revealed some patient safety goal issues, which you must address. You are considering switching from a total-patient-care delivery model to a new patient care delivery model.

1. Clearly introduce your quality of healthcare assignment in the introduction paragraph. Include a sentence that states the purpose of your assignment.
2. Clearly identify and articulate a new nursing care delivery model to increase the economic (reduce costs) and quality outcomes for your organization. Discuss at least two patient safety goals to focus on, that you feel are needed, for your organization.
3. Clearly articulate how the key concepts of your new nursing care delivery model will reduce costs and improve the quality of healthcare in the organization you have chosen. Discuss how these key concepts relate to the contextual domain of the person-centred nursing leadership framework by McCormack and McCance (2017).
4. Include a minimum of three sources of scholarly, empirical evidence to support the nursing care delivery model to be implemented.
5. Provide concluding statements that should summarize your overall assignment content.
6. The paper will be three pages maximum, excluding title and reference page(s).

consider the following patient scenario:

A mother comes in with 9-month-old girl. The infant is 68.5cm in length (25th percentile per CDC growth chart), weighs 6.75kg (5th percentile per CDC growth chart), and has a head circumference of 43cm (25th percentile per CDC growth chart). 

Describe the developmental markers a nurse should assess for a 9-month-old female infant. Discuss the recommendations you would give the mother. Explain why these recommendations are based on evidence-based practice.

Topic: Respiratory Issues Complicated by Economic Disadvantage

A mother brings her 8-year-old child to the clinic, stating the child “just isn’t breathing right, doesn’t want to play, just lies on the couch — this happens all the time.”

The appearance of both mother and child is disheveled. The child’s wheezing can be heard across the room. When asked if the child is better at any certain time of the day, the mother responds, “It’s like this all the time and has been for the past year — we saw a doctor last year who diagnosed asthma but we don’t have any money for drugs or to come back to the clinic.”

Directions:

Present this Assignment as a PowerPoint presentation with at least 10 slides 

Be sure to complete the assignment as the NP treating this family, not as a third party.  

You will use the Narrative notes section of the presentation to include the majority of your evidentiary support of your treatment choices and education of family complete with in-text citations using APA formatting, remember if you use photos from outside sources, they must be cited below within the PowerPoint.  

• Identify the resources currently available in your state to support this family in the care of this child, including assistance programs for costs of health care follow-up and pharmaceutical treatment agents.
• Create a communication plan for mother and child for both prescriptive and non-prescriptive drug therapies.

Utilize your textbook to answer the above questions. Research resources available in your area to assist this family.                                                 Title: Edition: Author: Publisher: Book ISBN: Ebook ISBN:

Pharmacotherapeutics for Advanced Practice Nurse Prescribers 4th (2015)

Robinson, Marylou and Woo, Teri

F.A. Davis

978-0-8036-3827-3