Category: Nursing

Write a response to the original peer discussion on  Hypovolemic shock. Attached are the files with details. Reference and in-text citation needed. 

Discussion 1
You are currently seeing a 60-year-old female with a past medical history of hypertension, mild obesity, and hypothyroidism. You have diagnosed her with chronic fatigue syndrome.
1. What further assessment would the nurse practitioner need?
2. What are the immunologic or rheumatologic diagnosis?
3. What are some differential diagnoses to consider?
4. What imaging and labs are indicated to confirm your diagnosis?
5. What are the non-pharmacological and pharmacological treatment plans?
6. What education and risk information will be beneficial for the patient?
7. What will be the follow up and possible referral options?
Discussion 2
A 37-year-old female has been seen for chronic pain management. Since a motor vehicle accident 2 years ago, the pain was limited to her neck and upper back, but it has gradually spread and now she reports diffuse pain that is unrelenting. The pain is interrupting her sleep, and when she awakes, she does not feel rested. “I am exhausted all of the time,” she states. This condition is now having an adverse effect on her work and family life. She has used up all of her allowable time off from work and is concerned that she will lose her job. A physical exam reveals an otherwise healthy-appearing female, and a musculoskeletal exam is positive for tender points at the posterior cervical spine, bilateral shoulders, bilateral elbows, and hips.
1. What further assessment would the nurse practitioner need?
2. What are the immunologic or rheumatologic diagnosis?
3. What are some differential diagnoses to consider?
4. What imaging and labs are indicated to confirm your diagnosis?
5. What are the non-pharmacological and pharmacological treatment plans?
6. What education and risk information will be beneficial for the patient?
7. What will be the follow up and possible referral options?

Which learning theories and principles do you think are most useful to the advanced practice nurse (APN) in providing high quality health care to clients, and why?
Submission Instructions:
Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.

The rubric is attached, between 10-12 pages, in APA 7 format.  Can make up a fictitious patient. Powerpoint presentation as well. 

Create an outline for your comprehensive assessment of how your selected cultural group’s beliefs and practices might impact healthcare decision-making, treatment adherence, your communication, your interventions, and your education to align with the patient’s cultural values and preferences. 
– Asian culture

Use full sentences. Also use application, analysis and synthesis. Include the case
study in your submission and answer the questions below that are in bold.  The write-up needs to be typed with
appropriate grammar and supporting evidence to your statements, including an
(APA) tile page and reference page.
Part One
Some Milestones:
Age:  6 years old
Birth weight: 2720 g (5lb 15oz)
Length: 52 cm 
Head circumference: 32cm 
Duration of Labor: 7 ½ hours (born at 36 weeks –
no special care necessary)
Smiled: 5 ½ weeks
Turned over: 14 weeks
Sat up alone: 29 ½ weeks
First step: 42 weeks
Walking: 12 months
Slept through night: 2 yrs
Speech: Sentences – 2 ½ yrs
First word: Light
The client’s
parents had for some time noticed that he was different from other children. In
fact, they had spent many nights agonizing over the fact that he did not appear
to show or reciprocate love, that he lacked expression or expressiveness, that
he seemed to prefer his own company and that he appeared frustrated and puzzled
by a whole range of social conventions.
As a baby, the
client’s mother reports he often cried for hours at a time and appeared to be
hypersensitive to noises. He was not easily consolable. When not crying, at
other times he would appear thoughtful and solemn or he would giggle
occasionally when tickled.  He did not
appear to enjoy being cuddled. He used a pacifier into his 3rd year.
He would either have the pacifier in his mouth or other objects. He did not
like to play with toys his parents bought him and did not appear to watch or
enjoy watching television shows.  He did
like to play with pots and pans and could watch the pan lids spin endlessly for
hours.
The client has
a 2-year-old brother. At times, the client appeared to tolerate brother’s
presence and may have enjoyed his company at times, but had to be monitored
most of the time due to the client being aggressive towards the brother. The
client’s mother often had to separate client from brother and it required her
to physically turn the client’s head toward her to have a discussion. She
stated that the client rarely would make eye contact with family or peers.
Early Schooling Period
The client had
considerable difficulty in his first pre-school. According to the mother, his
teacher was quite strict and a stickler for rules. She got easily angered by him
when he got out of line, was aggressive, or did not act according to the social
norms for a child his age.  He had
difficulty sharing with other children at the pre-school and would act
aggressive both towards the teacher and the other students at times. He was
labeled as a bully by the teacher.
Current School
Client has
been tested and appears to be in the average range academically. He did not
have any reading disabilities, but did have difficulty initially grasping new
concepts and required multiple avenues to learn. He is drawn to patterns and
visual representations.
Client
presents as a good looking child with regular features. He is above average
height and walks and runs with a slightly stiff gait. He continues to avoid eye
contact and often sits with a mask-like expression. By initial impression, he appeared
to be quite a normal six year old, but when continuing to prompt him in
conversation it became obvious that his social communication was idiosyncratic.
Conversations are very one-sided and he speaks quickly, almost frenetically, at
times.
1.      Which milestones are indicative of normal or abnormal development
for this client?
2.      What differentials and diagnosis would you give him based upon the
information you currently have?  Provide
rationale.
Part Two
Four months
after your initial interview, you sense that the client’s parents are feeling
more relieved to have a diagnosis and appear to have gained a growing awareness
of the symptoms and issues related to his diagnosis. Client’s mother admits to
you that she is relieved that his behaviors were not a result of poor parenting
skills.
Client’s
mother has had some bitter experiences with other mothers, fathers and
schoolteachers who have been quick to blame her and her spouse for
over-indulgence or lack of parenting skills. One mother actually offered to
take client home with her for a week and said that he would come back a changed
boy.
3.     
What would you say to the parents at this time?  (Use your own words.)
4.     
Discuss what treatments you would suggest/offer to the
client and his family (pharm and nonpharm).
5.     
What are your
feelings about this case and this patient? 
Share your “personal” feelings/thoughts about treating a patient with
these circumstances.  This is more of a
reflection or introspective statement.

**The organization is the Syracuse VA Medical Center (Department of Veteran Affairs)**
In a brief one to two-page paper, address the following:
Describe how the organization is committed to service excellence and which principles of excellence they exhibit.
Identify the organization’s values and mission.
Describe the service culture in the organization.
Discuss examples of processes and procedures which help to build and improve the culture of service in the organization.
What does the organization do to develop its leaders?
In what ways is employee engagement fostered?
What types of service communication methods are used?
In what ways does the organization reward for success?
Discuss the importance of improving accountability, rewarding success, and encouraging employee engagement in the organization.
Provide a conclusion that thoroughly summarizes the findings. 

In 
a 5–7 page written assessment, assess the effect of the patient, family, or population problem you’ve previously defined on the quality of care, patient safety, and costs to the system and individual. In this assessment, you’ll assess the effect of the health problem you’ve defined on the quality of care, patient safety, and costs to the system and individual. Plan to spend at least 2 direct practicum hours working with the same patient, family, or group. During this time, you may also choose to consult with subject matter and industry experts.
To prepare for the assessment:
Review the assessment instructions and scoring guide to ensure that you understand the work you will be asked to complete and how it will be assessed.
Conduct research of the scholarly and professional literature to inform your assessment and meet scholarly expectations for supporting evidence.
Requirments: The assessment requirements, outlined below, correspond to the scoring guide criteria, so be sure to address each main point. Read the performance-level descriptions for each criterion to see how your work will be assessed. In addition, note the additional requirements for document format and length and for supporting evidence.
Explain how the patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Cite evidence that supports the stated impact.
Note whether the supporting evidence is consistent with what you see in your nursing practice.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect the problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Describe research that has tested the effectiveness of these standards and/or policies in addressing care quality, patient safety, and costs to the system and individual.
Explain how these standards and/or policies will guide your actions in addressing care quality, patient safety, and costs to the system and individual.
Describe the effects of local, state, and federal policies or legislation on your nursing scope of practice, within the context of care quality, patient safety, and cost to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual.
Discuss research on the effectiveness of these strategies in addressing care quality, patient safety, and costs to the system and individual.
Identify relevant and available sources of benchmark data on care quality, patient safety, and costs to the system and individual.
Document the time spent (your practicum hours) with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.
Additional Requirements
Format: Format your paper using APA style. APA Style Paper Tutorial [DOCX] is provided to help you in writing and formatting your paper. Be sure to include:
A title page and reference page. An abstract is not required.
Appropriate section headings.
Length: Your paper should be approximately 5–7 pages in length, not including the reference page.
Supporting evidence: Cite at least 5 sources of scholarly or professional evidence that support your central ideas. Resources should be no more than five years old. Provide in-text citations and references in APA format.
Proofreading: Proofread your paper, before you submit it, to minimize errors that could distract readers and make it more difficult for them to focus on its substance.
Compentency Measure: By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:
Competency 3: Transform processes to improve quality, enhance patient safety, and reduce the cost of care.
Explain how a patient, family, or population problem impacts the quality of care, patient safety, and costs to the system and individual.
Propose strategies to improve the quality of care, enhance patient safety, and reduce costs to the system and individual and document the practicum hours spent with these individuals or group in the Capella Academic Portal Volunteer Experience Form.
Competency 5: Analyze the impact of health policy on quality and cost of care.
Explain how state board nursing practice standards and/or organizational or governmental policies can affect a patient, family, or population problem’s impact on the quality of care, patient safety, and costs to the system and individual.
Competency 8: Integrate professional standards and values into practice.
Use paraphrasing and summarization to represent ideas from external sources.
Apply APA style and formatting to scholarly writing.

Change in an Organization
This chapter involves change and the response to change in an organization. If you feel uncomfortable already you probably are in the majority. Let’s read the scenario below and try to understand why change is so difficult. 
Scenario: Imagine the days before COVID when we were all in a classroom. Do you remember back then? Well, think about where you decided to sit in a classroom. Did you find that you usually chose the same seat in most of the classrooms that you were in? If not, then what usually made you choose the seat that you decided to sit in? Now if you were to sit in a seat in the first class, how likely were you to sit in the same seat after that? Have I made a point? So change is hard, and we all have gone through some kind of change, small or large, in our lives at school, at our workplace, and at home.
Instructions:
Read the information above and then answer the following questions:
Describe what the circumstances were at your workplace when you had to change something
How did you adjust to the change?
Were there colleagues that could not adjust to the change?
Why do you think, in terms of change theory, that there were colleagues that could not adjust?
Your paper should be:
One (1) page
Typed according to APA 7 th Writing StyleLinks to an external site. for margins, formatting and spacing st

Reflection is an essential aspect of growth and development. Take the time to think deeply about your course projects and use your reflections to guide your future nursing practice. Produce a 100–200 word reflection on the Week 7 Leadership Assessment assignment you completed in BSNR 300.
Think about the Week 7 Leadership Assessment assignment you completed in BSNR 300.
What were some of the challenges you faced while completing this project? How did you overcome these challenges?
Looking back, what were some of the key insights you gained from your projects? How did these insights influence your nursing practice?
How did you grow as a nursing student while completing this project? What new skills or knowledge did you gain?
How did this project change the way you think about nursing practice? What new perspectives did you gain?
What advice would you give to future nursing students who will complete this project?
What steps will you take to continue your growth and development as a nurse that relate to this project?