nursing

P5

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Eve Martinez
1 postsHello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.
Re:Topic 5 DQ 1
The vision for the Clinical Nurse Leader(CNL) role began in response to the quality and safety reports of the Institute of Medicine (IOM). As a nurse with advanced master’s level preparation and specialized health system clinical leadership competencies, the CNL is prepared for direct clinical leadership at the point of care to ensure that care delivery is safe, evidence-based, and targeted towards optimal quality outcomes for the cohort of clients served by the CNL. With specific regard to a culture of safety, a critical component of the CNL role centers on improving effective interdisciplinary communication and coordination at the point of care. One of the biggest challenges in our complex healthcare settings is effective and timely communication among multiple healthcare providers, including physicians, nurses, therapists, and consultants (Reid & Dennison, 2011). Without this communication, care can become fragmented for the patient and family, increasing their risk of harm. An important part of the CNL role is to fill this gap by insuring that patient and family needs are not only assessed, but also consistently communicated with all members of the healthcare team so that care can be more effectively coordinated. This communication and coordination is also vitally important as patients move from setting to another within the system because gaps in care are prone to occur during these moves. This coordination of care between settings, often referred to as ‘lateral integration,’ enables the CNL to serve not only as the patient advocate/care navigator, but more importantly, as the stop-gap professional to reduce fragmentation in care that may lead to lapses in the safety of the care provided. One of the early examples of the CNLs ability to provide strong evidence supporting point-of-care clinical leadership was the 12-bed hospital project at Baptist Hospital in Miami, Florida. Implementation of the CNL role, along with a work redesign, showed improved patient throughput, consistent scores in the top ten percent on Centers for Medicare and Medicaid Services (CMS) core measures, and high patient satisfaction. The 12-bed hospital model of care delivery, including the Clinical Nurse Leader, has been recognized by the Robert Wood Johnson Foundation as one of the most innovative and promising new care delivery models (Reid & Dennison, 2011).
Reid,. K., Dennison, P., (September 30, 2011) “The Clinical Nurse Leader (CNL): Point-of-Care Safety Clinician” OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 3, Manuscript 4.

Nursing

Shock is a clinical syndrome that is a result of inadequate tissue perfusion that creates imbalance between the delivery of and requirements for oxygen that support cell health.  Signs and symptoms of excess fluid volume or inadequate tissue perfusion characterize heart failure.
Address the Following:

  1. Describe the differences in the nursing management for patient diagnosed with hypovolemic shock, cardiogenic shock, and heart failure.
  2. Because heart failure can be a chronic condition, identify a priority teaching intervention for the patient with a new diagnosis of heart failure.

Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

Nursing

A 50-year-old male presents to the community clinic. He has just relocated to the area and has no primary provider. He is a long distance truck driver and requires a physical examination to maintain his continued employment.
Physical examination demonstrates a BMI of 33, blood pressure of 180/90 mm Hg, diminished femoral pulses and bilateral varicose veins with 1+ pitting edema in both ankles. He has a 30 year history of smoking two packs of cigarettes per day.
Initial Discussion Post:

  • What additional information is needed from the patient history and physical assessment to determine if this patient has arterial or venous insufficiency?
  • Compare and contrast evidence based nursing interventions for the patient diagnosed with arterial insufficiency and the patient diagnosed with venous insufficiency.

Base your initial post on your readings and research of this topic. Your initial post must contain a minimum of 250 words. References, citations, and repeating the question do not count towards the 250 word minimum.

NURSING

250 WORDS 2 REFERENCES WITHIN 5 YEARS (NURSING JOURNALS ONLY!! IN TEXT CITATIONS ARE A MUST!!
 
The Institute of Medicine (IOM) report, The Future of Nursing: Leading Change, Advancing Health has stimulated much discussion, both pro and con. Key Message 3 states: Nurses should be full partners, with physicians and other health care professionals, in redesigning healthcare in the United States (US). Offer your analysis on this key message.
 

  • Discuss the meaning of ‘full partners’
  • Explain initiatives implemented and/or are recommended to advance this key message
  • Discuss how the Affordable Care Act (ACA) supported the Future of Nursing initiatives
  • Discuss 2 initiatives that may be affected if the American Health Care Act is voted into law

nursing

LN is a twenty-six-year-old married woman who presents at the clinic with symptoms of dysuria, frequency, and urgency. Further history yields two days of these symptoms but no fever, chills, or flank pain. She describes a burning discomfort during and immediately following urination and feeling the need to void every half hour. There is no vaginal discharge, itching, or odor. She is not using birth control at this time. She requests “a urine culture and some sulfa pills.” When asked to explain, she says she has had many “bladder infections” over the past three years and “sulfa pills usually work.” She was evaluated approximately five years ago with an IV pyelography and cystogram, and “nothing was wrong.” All her vital signs are normal. Answer the following questions:

  • What additional information would you like to collect?
  • What is your working diagnosis?
  • What are the contributing factors to this potential diagnosis?
  • What treatment would you implement and why?
  • What type of follow-up would you recommend?