Identify two appropriate topics for client education

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1. INTRODUCTION
The intrоduction of the essaу must contextualises the assignment and identifies the aim of the assignment.
CRITERIA ONE: Context

2. Using scholarlу literature рrovide a clear overview of the chosen client’s chronic
condition/illness;

3. Uses scholarly literature to clearly describe two (2) actual and/or рotential health
concerns for the client;

CRITERIA TWO: Education
4. Clearly Identify two (2) appropriate topics for client education (one topic for each
health concern).

5. Using scholarly literature, clearly explains how each topic addresses the actual and/or potential health concern for the client and how each topic will assist the client to self-manage their chronic condition and optimise their health.
CRITERIA THREE: Application
6. Using scholarly literature, clearly describes two (2) specific, appropriate client education strategies that the Registered Nurse would use to teach the chosen education topics (one strategy for each topic). Includes details of how the education will be structured and delivered.
(i.e. method/tool used, setting for education, participants to be involved, etc).

7. Using scholarly literature clearly justify your decision to use each education strategy with the
particular client.

8. CONCLUSION
● Has a concluding paragraph that summarises the overall assignment
● Does not introduce any new information or references in the conclusion

9. Reference List – 15 dated within last 7 years -on a separate page using APA 6th edition
NOTE: ● Use a client /patient-centred and/or family-centred approach that optimises individual self-management and promotes active participation of the individual and family in illness management. ● You must support all sections of your essay with scholarly literature from the past 10 years that have DOI numbers.

Compulsory text books required to be used:

1. Nursing and Midwifery Board of Australia, 2016.

2. Medical-surgical nursing: critical thinking for person-centred care – Priscilla LeMone, MyiLibrary 2017
Book Required resource Chapter readings will be listed within the course site
Online Resource

3. Clinical psychomotor skills: Assessment tools for nurses (Revised 6th ed.) – Joanne Tollefson, Elspeth Hillman 20179780170398275

4. Chronic care nursing: a framework for practice – Judith Anderson, Linda Deravin-Malone 20161316600742,9781316600740

PRESENTATION GUIDELINES:
Please ensure that your submitted assignment includes:
1. Title Page with Essay Name & wordcount (2000 words exactly)
2. Present your essay, correctly formatted as per the academic standards spacing, page number, etc, AND a correctly formatted reference list according to APA 6th edition. You do not need to include the marking criteria with your submission.
3. Assemble all pages into one document. Format file is to be MS Word.

CASE STUDY – Is the medications correct dosage?
– Vitals within paremeters?

Anna Lenska
Mrs Anna Lenska is a 68 year old retired woman who, for the past 6 months, has been a client of the Community Health Service for treatment of an ulcer on her right lower leg. She has a history of hypertension and Type 2 diabetes requiring oral hypoglycaemics.
Anna is widowed, lives alone and has no immediate family. Her neighbour usually takes her to do her shopping. Her leg ulcer has been dressed twice weekly by community Registered Nurses in accordance with the wound specialist nurse’s instructions. The leg ulcer is slowly healing.
It is 7.30am and you, the community Registered Nurse, arrive at Anna’s home for the wound assessment and dressing change. Upon arrival, Anna complains that she is feeling a “bit faint” and asks you to check her blood sugar level (BSL). The BSL reading is 3.5 mmol/L. You follow the recommendations for hypoglycaemia, and Anna begins to feel better and her BSL increases to 6.2mmol/L.
On talking with Anna, you discover that she has not been eating well because her neighbour has been away and she has not been able to get out to do the shopping. She has been wearing an old pair of closed toe shoes as her other more comfortable shoes had become too broken down to wear. She also says she sometimes forgets to take her medications.
Current vital signs:
Temperature 36.5C, Blood Pressure 160/90 mmHg, Pulse 84 beats/min, and Respiratory Rate 15 breaths/min
Current medications:
● Metformin 1g PO daily
● Metoprolol 25mg PO BD

TASK: 2000 words essay address the following criteria whilst referring to Marking Criteria:
1. INTRODUCTION
The introduction of the essay must contextualises the assignment and identifies the aim of the assignment.
CRITERIA ONE: Context

2. Using scholarly literature provide a clear overview of the chosen client’s chronic
condition/illness;

3. Uses scholarly literature to clearly describe two (2) actual and/or potential health
concerns for the client;

CRITERIA TWO: Education
4. Clearly Identify two (2) appropriate topics for client education (one topic for each
health concern).

5. Using scholarly literature, clearly explains how each topic addresses the actual and/or potential health concern for the client and how each topic will assist the client to self-manage their chronic condition and optimise their health.
CRITERIA THREE: Application
6. Using scholarly literature, clearly describes two (2) specific, appropriate client education strategies that the Registered Nurse would use to teach the chosen education topics (one strategy for each topic). Includes details of how the education will be structured and delivered.
(i.e. method/tool used, setting for education, participants to be involved, etc).

7. Using scholarly literature clearly justify your decision to use each education strategy with the
particular client.

What was the hardest part about sifting through nutrition information?

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Perform a quick Internet search, using Google or another major search engine. Select a search term related to nutrition science (for example, diet, organic, sodium) and see what kind of results you receive. When considering a term to select, think about single words rather than phrases. In some cases your search term may contain two words (for example, unsaturated fat). Avoid phrases like “which diet will help me lose weight the fastest” or “top 10 foods to make me healthy.”
Write a short essay (at least 250 words), using complete paragraphs and appropriate organization. Avoid incomplete sentences or bulleted lists (except for your search term and how many results were obtained). Check your spelling and grammar before submitting. References are required in APA format.
Please provide the following information (listed in bulleted form):
• your search term
• how many results you obtained
Then review some of these sources, going no further than three pages into the search result. Critically evaluate the websites you have selected. Find one website that you consider a reliable/credible source and one that you consider false, misleading, or non-factual. Keep in mind that when searching for credible sources you should also determine if your source would be appropriate to use as a scholarly reference (to support your discussions and homework assignments). Please provide the following for BOTH the credible and non-credible choices:
• the name of the website and the link
• the author or group providing this information
• Is this a reliable/credible source? If so, how do you know? OR Is this a non-credible source? If so, how do you know?
• What was the hardest part about sifting through nutrition information?

What is the difference between fat-soluble and water-soluble vitamins in deficiency and toxicity levels?

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At least 2 paragraphs on each with references.
1. What is the difference between fat-soluble and water-soluble vitamins in deficiency and toxicity levels? How do deficiencies and toxicities occur for each?
2. Case study: Tonya is 5′ 3″ tall, weighs 151 pounds, and is 38 years old. Her waist circumference is 37″. Her life is busy but sedentary. She simply does not have the time or energy to stay with an exercise program after working all day as a receptionists and caring for her two socially active children. She would like to lose about 20 pounds but knows dieting doesn’t work for her—all the diets she has tried in the past have left her hungry and feeling deprived. Losing weight has taken on greater importance since her doctor told her that both her blood pressure and glucose levels are at “borderline” high levels.
• What is her BMI? Assess her weight based on BMI.
• Estimate her total calorie requirements using the rule-of-thumb method of calculating BMR and adding calories for a sedentary lifestyle. How does it compare to the level of calories recommended in Table 7.3 of your text for a woman her age with a sedentary lifestyle? Which calorie level do you think is most accurate? Why?
• How many calories would she need to eat to lose 1 pound of weight per week if her activity level stays the same? Two pounds per week? Is a 2-pound weight loss per week a reasonable goal?
• To help her avoid feeling hungry while eating fewer calories, what foods would you recommend she consume more of? She knows she should drink fewer soft drinks. What advice would you give her to help her do that?

Identify religious and cultural influences that affect your dietary choices

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Maintain a food diary for three days using MyFitnessPal, or a similar diet app. Download a list of common diet apps here. Click for more options (2) Write a nutritional self-assessment paper. In your paper, you will analyze your eating habits, food patterns, and nutrition intake. Maintaining your diary: You will use the MyFitnessPal food diary app to record everything that goes into your digestive system over the course of three days. Record everything you eat and drink, and record the name and dosage of any medications that you take, including vitamins, minerals, and herbal supplements. It is preferable to record your food intake for at least one non-school day or one non-weekday (for example, Thursday, Friday, Saturday, or Sunday, Monday, Tuesday). This way, you will see how your eating habits change with your schedule. It is important that you take time each day to record your food, drink, and drug intake rather than relying on your memory. An honest, detailed diary will help you gain a better understanding of yourself personally and professionally. Take screenshots of your MyFitnessPal food diary to include in your analysis paper. At the end of the three days, print the final report in MyFitnessPal to include with your written paper. Instructions for the Written Assignment: Food Diary and Nutritional Self-Assessment Paper* *(This paper is confidential; it is not shared. It is for learning purposes only.) In your written paper, include the following. These are guidelines to help you write your paper, please refer to your rubric to see how you will be graded for this assignment. 1. Calculate your weight based on the BMI formula and the Hamwi method. Include your calculations in your paper. • Analyze your place on the BMI and Hamwi scales in terms of health. Based on these numbers, how healthy are you? • Use at least one source other than your class text to provide documentation and references to support your position. 2. Analyze your nutritional intake. Compare your intake of food and nutrients to the recommended RDA. Refer to the nutrient report spreadsheet percentages that you recorded. 1. Where do most of your calories come from fats, proteins, or carbohydrates? Provide examples. 2. Do you see any excesses or deficiencies among any of the nutrients? Explain. 3. What patterns do you see? 4. Would you classify your diet as well-balanced based on this information? Why or why not? 5. Provide nutritional information for all foods contained in our food diary including the serving size, amount consumed, total calories, total fat calories, total carbohydrates calories, total protein calories, grams of sodium, vitamins, and minerals in the nutrient spreadsheet. Provide detailed situational information including where you were when you were eating the food, what you were doing, and why you chose to eat what you ate (convenience, habit, intentional, etc.). 3. Provide an analysis of each nutrient listed on the nutrient spreadsheet: CHO, PRO, Fat, Na, phos, K, calcium, vit A, vit C, and iron.) How close to the RDA were you for each nutrient? Which nutrients did you over consumer, which ones were missing? See page 9 of the SAMPLE PAPER to see how you should analyze your nutrient in-take. 4. What medications are you taking and what are their nutritional side effects? Do they need to be taken with food/away from food, at night only, day? If you do not take any medications, please state so in your paper. Include at least 1 reference to support position. 5. Reflect on the emotions you recorded each time you ate. Analyze how your feelings affected your nutrition and how your nutrition affected your mood. • Do you see any patterns? Explain. Page | 1 • Did your activity level have any effect on your mood or nutrition choices? Explain. • Are these three days indicative of your normal emotions, or are these three days unique? Explain. • Did you eat more after not eating all day, or did you choose less healthy foods? 6. Identify and explain physical and/or medical conditions (chronic pain, disease, allergies, mental health, and disability) that affect your diet, nutrient, or drug intake. If you have no medical conditions, you may choose a friend or family member to describe. (Please maintain confidentiality.) • How much influence does your physical/medical condition have on your nutritional choices? • How much influence does your physical/medical condition have on your activity level? • What conclusions can you draw between the diet and the medical condition? 7. Identify religious and/or cultural influences that affect your dietary choices. If you have no religious and/or cultural influences, you may choose a friend or family member to describe. (Please maintain confidentiality.) • Do any of them positively affect your health? Provide specific examples and situations. • Do any of them negatively affect your health? Provide specific examples and situations. • Discuss both positives and negatives, if none, then state none. 8. Develop a diet plan that best suits your actual dietary needs based on your height, weight, BMI, culture, religion, activity level, overall health, and drug use. Use SMART goals (specific, measurable, attainable, realistic, and time frame): • What calorie, nutrient, and drug intake changes will you make? Explain. • What lifestyle changes will you specifically make, if any? • Does your activity level need to change? If so, how? • Explain how the diet plan will benefit you. • Explain how you plan to implement the changes you want to make. • Provide at least one academic source/reference in support of your diet plan. 9. 3 SMART GOALS: Define one realistic short-term diet plan goal (3 weeks) and two realistic long-term diet plan goals (6 months). 1. Note: You may not use daily vitamins to replace a nutrient as one of your goals. Your goals must be related to real foods and activities. • What obstacles do you anticipate in meeting your goals? Explain.

Describe four cardiovascular conditions that may lead to heart failure

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Use the following Case Scenario, Subjective Data, and Objective Data to answer the Critical Thinking Questions.

Case Scenario

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

Is very anxious and asks whether she is going to die.

Denies pain but says she feels like she cannot get enough air.

Says her heart feels like it is “running away.”

Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

Height 175 cm; Weight 95.5 kg

Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58

Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation

Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%

Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

IV furosemide (Lasix)

Enalapril (Vasotec)

Metoprolol (Lopressor)

IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

Develop an accurate medication list for your patient

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1- We need to reassure Mrs. J to decrease her anxiety. Lab work, chest x-ray and ECHO will be needed. She will need a septic work-up and qualifies for a sepsis alert, however with signs and symptoms of congestive heart failure she may need an inotropic infusion instead of fluid bolus to correct her hypotension. She may have developed pneumonia from the flu virus and could possibly have a pleural effusion. The rationale for each of the medications ordered are as follows (U.S. National Library of Medicine, 2015)

Lasix -for pulmonary edema – frothy blood-tinged sputum

Enalapril – an ACE inhibitor is given for heart failure; it works by decreasing vascular resistance – watch for further hypotension

Metoprolol – a betablocker is for hypertension and heart failure; it slows the heart rate and relaxes veins – again watch for hypotension

IV morphine is usually for pain, but in this case, it is for the anxiolytic properties and vasodilation (Naito, Kohno, & Fukuda, 2017).

Four cardiovascular conditions that cause heart failure are coronary artery disease, myocardial infarction, myocarditis, and congenital heart defects (American Heart Association [AHA], 2017). One condition is coronary artery disease caused by fatty deposits and cholesterol that clog arteries. This can lead to the arteries that feed heart muscle becoming closed off resulting in heart muscle damage. Second, a myocardial infarction happens when an artery that feeds the heart muscle is blocked causing lack of oxygen. This ultimately results in death of the muscle and pump failure. The blockage can be from a blood clot that traveled to the heart or from arteriosclerosis. Another condition is myocarditis. It is caused by an infection that attacks the heart muscle resulting in pump failure. Finally, congenital heart defects can result in heart failure because the heart is malformed. The malformation makes the heart work harder and the blood may not flow in an efficient manner (AHA, 2017).

For the most part, being active and eating a healthy diet are important factors to reduce the risks of developing heart failure. Taking prescribed medications are very important to help improve heart function and reduce the heart’s work load. For congenital heart defects, the patient may need surgery to correct the malformation; or sometimes, a heart transplant may be required.

For medication safety,

Develop an accurate medication list for your patient. This medication list should be in words the patient can understand and include the name, dose, time for administration and the reason for each medication. Encourage the patient to take ownership of her medications and keep the list up to date. Take it to every appointment no matter who the doctor is. Also, include any over the counter medications and check for interactions with prescription medications.

Have the patient use only one pharmacy for all of her prescriptions. The pharmacist will be able to identify any risks or issues with contraindications or double medications for the same disease.

Have your patient use a pill dispenser or other reminder system. The pill dispenser will not only keep the medications straight but will help the patient know whether she took her medications for the day.

Ask your patient to bring her medications (the actual bottles) at least once a year for evaluations. This will allow for evaluation of dosages, expired medications, etc. This will also allow you to help the patient dispose of medications that are no longer used or needed. This will prevent the patient from accidentally taking the wrong pills.

References

American Heart Association. (2017). Causes of heart failure. Retrieved from https://www.heart.org/en/health-topics/heart-failure/causes-and-risks-for-heart-failure/causes-of-heart-failure

Naito, K., Kohno, T., & Fukuda, K. (2017, July). Harmful impact of morphine use in acute heart failure. Journal of Thoracic Disease, 9(7), 1831-1834. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5542994/

U.S. National Library of Medicine. (2015). Medline plus- trusted health information for you. Retrieved from https://medlineplus.gov/druginformation.html

2-Your post is very knowledgeable and in thorough detail. As you have mentioned in your post about Morphine , is a vasodilator and reduces the workload on the heart and improving blood flow to the heart. Morphine can help to slow the respirations and alleviate dyspnea and anxiety (WebMD, 2019 ). Morphine can be used for pulmonary edema, heart failure and in Myocardial infarction as well. I still remember MONA from nursing school stands for Morphine, Oxygen, Nitroglycerin and Aspirin treatments for Myocardial Infarction.

3-Yes ! that is right, polypharmacy is a very serious problem in elderly patients. They get easily confused over their medications. Even with a little stress whether physical or mental, they easily get confused and start missing their meds or can consume too much to relieve their symptoms. Which will leads them to very critical health issues. So it is health care professionals responsibility to educate them about all the medications they are taking. They should always have all the written information about all their medications and an emergency call number for help.

4-Ms. J is showing the symptoms of Acute bilateral ventricular heart failure and pulmonary edema (Copstead & Banasik , 2013). Clinical signs of heart failure are an S3 heart sound and the PMI at the 6th Intercostal space, as normal is at the 5th and this indicates a shift with the enlarged heart. Crackles in the lungs, + cough, frothy blood tinged sputum, hypoxemia, and dyspnea are signs of pulmonary edema and left sided failure. The bilateral jugular vein distention and hepatomegaly are two signs of right sided failure. This patient is very critical but manageable and already admitted in Intensive care settings. My priorities would be oxygenate her ASAP and resume all stat medications to make her comfortable. As she is on room air and her SPO2 is 82% only. I will get an order from MD to put her on “Non Invasive Ventilation” OR BIPAP and call RRT to initiate it right away. Initiating NIV, is a non-pharmacological approach may improve outcomes for patients with heart failure . With this NIV she needs to be sitting in high fowler position and complete bed rest until stable, cardiac monitor, foley’s catheter insertion to monitor I & O strictly. She also needs to send all her initial blood work for instance, elytes, CBC, cardiac enzymes and liver enzymes with blood culture.

Medically, she is given morphine and lasix which are perfect treatment for CHF and pulmonary edema. Lasix is a loop diuretic will increase her U/O which will decreases the preload or workload on the heart. She already has foley catheter to monitor her output. Morphine is a vasodilator and reduces the workload on the heart and improving blood flow to the heart. Morphine can help to slow the respirations and alleviate dyspnea and anxiety (WebMD, 2019 ). She is getting Enalapril, is an ace inhibitor which works by relaxing blood vessels and decreasing blood volume which results in lowering the blood pressure and oxygen demand. Metoprolol is a beta blocker and improves the heart’s ability to relax, decreases heart rate and blocks stress hormones that can cause the heart to enlarge and weaken over time. If metoprolol does not help with her Afib, physician can also prescribe her an Antiarrhythmic such as amiodarone 150 mgs bolus IV following with infusion as per standard protocol.Which is very effective for Afib. However, her BP is a kind of border line needs to be monitored. While she is on beta blocker or Antiarrhythmic. As she is on strict bed rest and she is already in uncontrolled Afib HR 132/ mnt she is at high risk of developing DVT. She needs Low molecular heparin, dose according to her weight as DVT prophylaxis. For being on BIPAP she needs to be NPO so that she does not aspirat her gastric contents. She also needs gastric prophylaxis to reduce gastric acid production such as ranitidine or pantoprazole.

Four cardiovascular conditions that may lead to congestive heart failure are Coronary Artery Disease, Hypertension, previous myocardial infarction, and valvular disorders. Coronary artery disease results primarily from atherosclerosis which causes a narrowing in the arterial lumen. This causes the heart to work harder and can result in risk for thrombus or myocardial infarction (American Heart Association, n.d.). Hypertension will cause an increase in pressure to the heart over time if uncontrolled and eventually the heart will weaken and not function (American heart Association, n.d.). These conditions can be improved by educating patients on risk factors and lifestyle changes and by talking their prescribed medications on regular basis. Educating them on smoking cessation programs, healthy diet and maintain daily regular activity and maintain normal weight makes a difference in their treatment . People needs to learn that, being overweight can cause the heart to work harder than normal and cause sleep apnea too. People needs to be Educated on the long term effects of obesity and some ways to help with their weight loss.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

1. Help and teach the patient on keeping an exact record or a list of all over the counter and herbal medications as well as all the vitamins and minerals that the patient is taking. So as to lessen the opportunity of MD’s requesting prescription that may have drug interaction.

2. Teach the patient on the significance of picking one primary doctor so as to lessen polypharmacy.

3. Help and instruct the patient on guaranteeing appropriate dosage and recurrence are trailed by utilizing a medicine organizer.

4. Guarantee the patient is taught on every single new medications, indications, potential reactions and potential collaborations.

Reference :

American Heart Association (n.d.). Causes and risk for heart failure. Retrieved from https://www.heart.org

Copstead , L., & Banasik , J.L. (2013). Pathophysiology (5 th ed.). St. Louis, MO: Saunders

WebMD (2019). Heart failure questions and answers. Retrieved from https://www.webmd.com

Reply | Quote & Reply

Feb 18, 2019 06:45 PM0 Like

5-Strong work mentioning, strict i & o’s. This is an a really important aspect in heart failure patients to prevent further fluild overload. Mrs. J will also need to be taught what her dry weight is, and the importance of taking her weight everyday upon discharge.

6-Ms. J i s showing signs of biventricular heart failure (Copstead & Banasik , 2013). Crackles in the lungs, + cough, frothy blood tinged sputum, hypoxemia, and dyspnea are signs of pulmonary edema and left sided failure. The bilateral jugular vein distention and hepatomegaly are two signs of right sided failure. Additional clinical signs of heart failure are an S3 heart sound and the PMI at the 6 th Intercostal space, as normal is at the 5 th and this indicates a shift with the enlarged heart.

This patient is unstable which requires an Intensive care setting. Initial interventions would require addressing her hypoxia and dyspnea. Initiate oxygen due to her hypoxia per the physician order and adjust as needed to get her oximetry >90%. Place her in upright position in bed to help alleviate dyspnea. Administer ordered meds (IV Lasix and IV morphine) would be a priority. Cardiac monitoring is critical to monitor her hemodynamic status. Assess for cardiac output by assessing skin for temperature and color, mental status, urine output, and peripheral perfusion. Assess for clinical signs of improvement in her heart failure by auscultating lungs and heart and checking for any peripheral edema or jugular distention (Riley, 2015). Assessing this patient’s response to medications given and if her anxiety is reduced by the interventions. If not, then it would be important to discuss with the physician to order an antianxiety medication as well.

Lasix, enalapril, metoprolol, and morphine are all used on this patient and are common for heart failure. Lasix is a diuretic and works to remove excess fluid from the body by increasing renal blood flow and blocking sodium and chloride reabsorption. This decreases the preload or workload on the heart. Enalapril is an ace inhibitor which works by relaxing blood vessels and decreasing blood volume which results in lowering the blood pressure and oxygen demand. Metoprolol is a beta blocker and improves the hearts ability to relax, decreases heart rate and blocks stress hormones that can cause the heart to enlarge and weaken over time. Morphine is a vasodilator and reduces the workload on the heart and improving blood flow to the heart. Morphine can help to slow the respirations and alleviate dyspnea and anxiety (WebMD, 2019 ) .

Four cardiovascular conditions that may lead to congestive heart failure are Coronary Artery Disease, Hypertension, previous myocardial infarction, and valvular disorders. Coronary artery disease results primarily from atherosclerosis which causes a narrowing in the arterial lumen. This causes the heart to work harder and can result in risk for thrombus or myocardial infarction (American Heart Association, n.d.). Hypertension will cause an increase in pressure to the heart over time if uncontrolled and eventually the heart will weaken and not function as well (American heart Association, n.d.). Inteventio s n to both of these conditions include educating on risk factors and lifestyle changes. Educate on smoking cessation programs, healthy diet and activity and taking meds such as antihypertensives and cholesterol lowering meds as prescribed. Myocardial infarctions ( MI) are caused by a sudden blockage to the myocardium which can cause scarring and lead to poor functioning and result in ineffective pumping. Valvular disorders result from stenosis which is a decrease in blood flow or regurgitation when the valve fails to close properly. Educating people on the signs/symptoms of an MI and valve disorders are important for early detection and treatment.

There are many risks to the elderly for taking multiple medications. The following are interventions I would suggest.

Instruct patient to carry a list of medications including over the counter to all physicians. Consulting physicians may not be aware of all the meds that are prescribed by the other physicians.

Instruct patient on all meds and side effects. Write out generic and brand name and include dosage, frequency and reason to take.

Teach patients or a family member to use a pill caddy to prefill weekly meds to encourage compliance and that are correctly taking meds

Instruct patients and families on risk to falls. Patient taking multiple meds are at a higher risk to fall.

Analyze the different and overlapping general roles of physicians and nurses as they apply to professional credentialing and subsequent patient safety and satisfaction

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“Professional Legal Issues with Medical and Nursing Professionals” Please respond to the following: (2 pages with references please)

Analyze the different and overlapping general roles of physicians and nurses as they apply to professional credentialing and subsequent patient safety and satisfaction. Determine the major ways in which these overlapping roles may help play a part in health professional credentialing processes and conduct, and identify and analyze the ethical role these influences play in health care.
Analyze the major professional roles played by physicians and nurses as they apply to physicians’ conduct in the medical arena and to nurses in the role of adjuncts to physicians. Evaluate the degree and quality of care that physicians, nurses, and medical technologists provide in their primary roles, including, but not limited to, patient safety and satisfaction as required in 21st Century U.S. hospitals.

Information Management and Allied Professional Issues” Please respond to the following: (2 references please)

Analyze the primary problems associated with information management, and analyze the primary issues associated with patient confidentiality. Determine the major ways in which these overlapping responsibilities play a part in enforcing Health Insurance Portability and Accountability Act (HIPAA) mandates.
Analyze the different problems with allied professional responsibilities and overlapping general roles as they apply to a multidisciplinary approach to patient care. Ascertain the principal ways in which the allied professional responsibilities in question synchronize with the management of patient information within 21st Century U.S. hospitals.

What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?

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Ethical Concerns

As an advanced practice nurse, you will run into situations where a patient’s wishes about his or her health conflict with evidence, your own experience, or a family’s wishes. This may create an ethical dilemma. What do you do when these situations occur?

In this Discussion, you will explore evidence-based practice guidelines and ethical considerations for specific scenarios.

Scenario 1:

A single mother has accompanied her two daughters, aged 15 and 13, to a women’s health clinic and has requested that the girls receive a pelvic examination and be put on birth control. The girls have consented to the exam but seem unsettled.

Scenario 2:

A 17-year-old boy has come in for a check-up after a head injury during a football game. He has indicated that he would like to be able to play in the next game, which is in 3 days.

Scenario 3:

A 12-year-old girl has come in for a routine check-up and has not yet received the HPV vaccine. Her family is very religious and believes that the vaccine would encourage premarital sexual activity.

Scenario 4:

A 57-year-old man who was diagnosed with motor neuron disease 2 years ago is experiencing a rapid decline in his condition. He prefers to be admitted to the in-patient unit at a hospice to receive end-of-life care, but his wife wants him to remain at home.

To prepare:

Selectthree scenarios, and reflect on the material presented throughout this course.
What necessary information would need to be obtained about the patient through health assessments and diagnostic tests?
Consider how you would respond as an advanced practice nurse. Review evidence-based practice guidelines and ethical considerations applicable to the scenarios you selected.
Questions to be addressed in my paper:

The explanation of the health assessment information required for a diagnosis of your selected patients (include the scenario numbers).
Explain how you would respond to the scenario as an advanced practice nurse using evidence-based practice guidelines and applying ethical considerations. Justify your responses.
Summary with Conclusion

REMINDERS:

1) 2-3 pages (addressing the 3 questions above excluding the title page and reference page).

2) Kindly follow APA format for the citation and references! References should be between the period of 2011 and 2016. Please utilize the references at least three below as much as possible and the rest from yours.

3) Make headings for each question.

What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing

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In a formal paper of 1,000-1,250 words you will discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.” Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development. What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?

Explore the Campaign for Action webpage (you may need to research your state’s website independently if it is not active on this site): http://campaignforaction.org/states

Review your state’s progress report by locating your state and clicking on one of the six progress icons for: education, leadership, practice, interpersonal collaboration, diversity, and data. You can also download a full progress report for your state by clicking on the box located at the bottom of the webpage.

In a paper of 1,000-1,250 words:

Discuss the work of the Robert Wood Johnson Foundation Committee Initiative on the Future of Nursing and the Institute of Medicine research that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
Identify the importance of the IOM “Future of Nursing” report related to nursing practice, nursing education and nursing workforce development.
What is the role of state-based action coalitions and how do they advance goals of the Future of Nursing: Campaign for Action?
Summarize two initiatives spearheaded by your state’s Action Coalition. In what ways do these initiatives advance the nursing profession? What barriers to advancement currently exist in your state? How can nursing advocates in your state overcome these barriers?

A minimum of three scholarly references are required for this assignment.

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.