Instructions for Answer to 2 Question

1- After Each DQ (question), write down references

2- 300 minimum words for every DQ, you can go up to 800 words but answer should be complete.

3- 2-3 Peer Reviewed/ scholarly references for each question

4- References should be within 4 years

5- I am in acute care nurse practitioner program.

6- The response to the DQ is expected to be a minimum of 300 words. A minimum of two peer reviewed/ scholarly  resources are expected. These need to be appropriate for a clinical professional to guide decisions about patient care. If a textbook is used for one of these responses, the other needs to be journal or professional-level website. The references need to be correctly formatted, as do the citations for those references.  “ Question words” don’t count towards 300 minimum count”

This case study documents an ongoing interaction between a wife and her husband who live in a spacious home in a gated community.

When Dan (now 80) and Jane (now 65) began dating more than 15 years ago, both were emotionally charged to begin their lives anew. Well-educated and financially secure, they had a lot in common. Dan was a protestant minister, and Jane’s deceased husband had been a protestant minister. Both had lost their spouses. Jane’s first husband had suffered a catastrophic cerebral aneurysm 2 years earlier. Dan had conducted the funeral service for Jane’s husband. Dan’s wife had died of terminal cancer a little over a year earlier. Dan’s first wife had been a school counselor; Jane was a school teacher. Both had children in college. They shared a love for travel. Dan was retired but continued part-time employment, and Jane planned to continue teaching to qualify for retirement. Both were in great health and had more than adequate health benefits. Within the year they were married. Summer vacations were spent snorkeling in Hawaii, mountain climbing in national parks, and boating with family. After 7 years, Dan experienced major health problems: a quadruple cardiac bypass surgery, followed by surgery for pancreatic cancer. Jane’s plans to continue working were dropped so she could assist Dan to recover and then continue to travel with him and enjoy their remaining time together. Dan did recover—only to begin to exhibit the early signs and symptoms of Alzheimer’s disease. One of the early signs appeared the previous Christmas as they were hanging outdoor lights. To Jane’s dismay, she noted that Dan could not follow the sequential directions she gave him. As time passed, other signs appeared, such as some memory loss and confusion, frequent repeating of favorite phrases, sudden outbursts of anger, and decreased social involvement. Assessments resulted in the diagnosis of early Alzheimer’s disease. Dan was prescribed Aricept, and Jane began to prepare herself to face this new stage of their married life. She read literature about Alzheimer’s disease avidly and organized their home for physical and psychological safety. A kitchen blackboard displayed phone numbers and the daily schedule. Car keys were appropriately stowed. It was noted that she began to savor her time with Dan. Just sitting together with him on the sofa brought gentle expressions to her face. They continued to attend church services and functions but stopped their regular swims at their exercise facility when Dan left the dressing room naked one day. Within the year, Jane’s retired sister and brother-in-law relocated to a home a short walk from Jane’s. Their intent was to be on call to assist Jane in caring for Dan. Dan and Jane’s children did not live nearby so could only assist occasionally. As Dan’s symptoms intensified, a neighbor friend, Helen, began to relieve Jane for a few hours each week. At this time, Jane is still the primary dependent-care agent. She prides herself in mastering a dual shower; she showers Dan in his shower chair first, and then, while she showers, he sits on the nearby toilet seat drying himself. Her girlfriends suggested that this was material for an entertaining home video! Although Jane is cautious in her care for Dan, she often drives a short distance to her neighborhood tennis court for brief games with friends or spends time tending the lovely gardens she and Dan planted. During these times, she locks the house doors and leaves Dan seated in front of the television with a glass of juice. She watches the time and returns home midway through the hour to check on Dan. On one occasion when she forgot to lock the door while she was gardening, Dan made his way to the street, lost his balance, reclined face-first in the flower bed, and was discovered by a neighbor. Jane has given up evenings out and increased her favorite pastime of reading. Her days are filled with assisting Dan in all of his activities of daily living. And, often, her sleep is interrupted by Dan’s wandering throughout their home. At times, when the phone rings, Dan answers and tells callers Jane is not there. Jane, only in the next room, informs him “Dan, I am Jane.” Friends are saddened by Dan’s decline and concerned with the burdens and limitations Jane has assumed as a result of Dan’s dependency.

Critical thinking activities

1. Examine this case study through the dependency cycle model (Fig. 14.3). The outer arrows show a progression through varying stages of dependency. The inner circle represents who can be involved in the dependency cycle. Where are Jane and Dan in this cycle?

2. Using the basic dependent-care system model (Fig. 14.4), assess Dan and Jane. Identify the basic conditioning factors (BCFs) for each. What is the effect of Dan’s BCFs on his self-care agency? Is he able to meet his therapeutic self-care demands? Continue on to diagnose Dan’s self-care deficit and resulting dependent-care deficit. Now assess Jane’s self-care system.

3. Design a nursing system that addresses Jane’s self-care system as she increases her role as dependent-care agent for Dan.

Watson’s Caring Theory, a grand theory in nursing, is the underlying framework for United States University College of Nursing’s programs.  Identify a theory within her framework. Clearly identify how she defines the concepts and propositions between them. Report them to the class.  Using the readings for the week, discuss why her work is considered a grand theory.

Expectations

Initial Post:

• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA format from within the last 5 years

• Discussion 2
• In the lecture for the week, a theory was identified. “Knowledge as a component of the sociocultural orientation basic conditioning factor enhances prevention of hazards” is a theory from a major nursing framework.  Identify the framework and provide an example of how other applications of this theory may occur in nursing practice. For example, you may say that education may enhance the reduction of free throw rugs in an elderly persons home which will prevent falls.  Tie the concepts together by clearly defining them and how they could be measured.

Expectations

Initial Post:

• Length: A minimum of 250 words, not including references
• Citations: At least one high-level scholarly reference in APA format from within the last 5 years

Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). 

INSTRUCTIONS:

For each of your peer’s posts, discuss other applicable preventative guidelines for one of the patients from the initial scenario. Provide a link to patient education relating to this additional guideline that your peer would find interesting and helpful.

Note: DO NOT CRITIQUE THEIR POSTS, DO NOT AGREE OR DISAGREE, just add informative content regarding to their topic that is validated via citations. 

– Utilize at least two scholarly references per peer post. 

Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.

– Minimum of 250 words per peer reply.

Background: I live in Florida, I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work in a Psychiatric Hospital.

Module 03 Discussion – What Would You Do?

Consider the scenario below, then follow the instructions underneath it to complete the discussion. If appropriate, support your position with credible resources/examples/evidence and provide APA references.

Mr. D

Mr. D is a 90-year-old man who was admitted to the hospital with complaints of nausea, vomiting, left arm pain, and chest pain. An electrocardiogram (ECG) is performed, and he is diagnosed as having a myocardial infarction.

Mr. D has a long history of comorbidities including hypertension, diabetes, and congestive heart failure (CHF). With this in mind, the physician asks Mr. D if he wants life-sustaining measures taken (e.g., CPR, mechanical ventilation, etc.) should he experience cardiopulmonary arrest.

Mr. D tells the physician that he wants all measures taken to save his life.

Imagine that you are the nurse assigned to provide care to Mr. D, and address the following:

1. Considering Mr. D’s advanced age, what are the benefits/risks associated with providing life-sustaining measures?
    
2. What factors should you consider based on the Mr. D’s age and health history?
    
3. If Mr. D were your family member, how would you respond to his decision?