Nursing  clinical diagnostic paper

Diagnostic and Clinical Reasoning Paper AssignmentThe purpose of this assignment is to provide you the opportunity to expand the scope of your clinical documentation and your thought processes relative to complex patient care cases.1. Select a patient encounter from your current clinical experience.2. The patient encounter you select should be one of the more complex patient cases that you have experienced with your current clinical patient population. Given that you are to select complex cases, this assignment may not be completed for a ‘general health, well child, well woman, routine OB, routine physical exam (etc.)’ type of encounter.You will need to identify which patient encounter you are expanding your documentation for by including the Typhon Case ID # under your name on the title page of your paper.3. For this assignment you will utilize the same SOAP format that you do for your ‘expanded’ Typhon encounters. Construct this assignment ensuring that you adhere to the writing guidelines provided in the 6th edition APA manual.Below is the overview of the required elements for this assignment:*Title Page(Page 1):Follow APA guidelines for running head on page 1, and include Medical Diagnosis, Student Name, Typhon Case ID #, and Date.*Subjective(Start of Page 2):Follow APA guidelines for running head on page 2 and subsequent pages.CC:chief complaint – What are they being seen for? This is the reason that the patient sought care, stated in their own words, or paraphrased.HPI:history of present illness – use the “OLDCART” approach for collecting data and documenting findings. [O=onset, L=location, D=duration, C=characteristics, A=associated/aggravating factors, R=relieving Factors, T=treatment, S=summary]PMH:past medical history – This should include past illness/diagnosis, conditions, traumas, hospitalizations, and surgical history. Include dates if possible.Allergies:State the offending medication/food and the reactions.Medications:Names, dosages, and routes of administration.Social history:Related to the problem, educational level/literacy, smoking, alcohol, drugs, HIV risk, sexually active, caffeine, work and other stressors. Cultural and spiritual beliefs that impact health and illness. Financial resources.Click on the link below to explore the CDC’s information on the ‘social determinants of health’.https://www.cdc.gov/socialdeterminants/Family history:Use terms like maternal, paternal and the diseases and the ages they were deceased or diagnosed if known.Health Maintenance/Promotion:Immunizations, exercise, diet, etc. Remember to use the United States Clinical Preventative Services Task Force (USPSTF) guidelines for age appropriate indicators. This should reflect what the patient is presently doing regarding the guidelines.Click on the link below to access information about current guidelines.https://www.uspreventiveservicestaskforce.org/Review of Systems (ROS):this is to make sure you have not missed any important symptoms, particularly in areas that you have not already thoroughly explored while discussing the history of present illness. You would also want to include any pertinent negatives or positives that would help with your differential diagnosis. For acute episodic (focused) visits (i.e. sprained ankle, sore throat, etc.) you may be omitting certain areas such as GYN, Rectal, GI/Abd, etc. While the list below is provided for your convenience it is not to be considered all-encompassing and you are expected to include other systems/categories applicable to your patient’s chief complaint.General: May include if patient has had a fever, chills, fatigue, malaise, etc.Skin:HEENT: head, eyes, ears, nose and throatNeck:CV: cardiovascularLungs:GI: gastrointestinalGU: genito-urinaryPV: peripheral vascularMSK: musculoskeletalNeuro: neurologicalEndo: endocrinePsych:*Objective:Physical Examination (PE):either limited for a focused exam or more extensive for a complete history and physical assessment. This area should confirm your findings related to the diagnosis. For acute episodic (focused) visits (i.e. sprained ankle, sore throat, etc.) you may be omitting certain areas such as GYN, Rectal, Abd, etc. All SOAP notes however should have physical examination of CV and lungs. While the list below is provided for your convenience it is not to be considered all-encompassing and you are expected to include other systems/assessments applicable to your patient’s chief complaint. Ensure that you include appropriate male and female specific physical assessments when applicable to the encounter. Your physical exam information should be organized using the same body system format as the ROS section. Appropriate medical terminology describing the objective examination is mandatory.VS: vital signs, height and weight, BMIGen: general statement of appearance, if there is any acute distress.Skin:HEENT: head, eyes, ears, nose and throatNeck:CV: cardiovascularLungs:Abd: abdomenGU: genito-urinaryPV: peripheral vascularMSK: musculoskeletalNeuro: neurological examPsych:Diagnostic Tests:This area is for tests that werecompleted during the patient’s appointmentthat ruled the differential diagnosis in or out (e.g. – Rapid Strep Test, CXR, etc.).*Assessment:(number each diagnosis)Diagnosis/Diagnoses:Start with the presenting chief complaint diagnosis first. Number each diagnosis. A statement of current condition of all other chronic illnesses that were addressed during the visit must be included (i.e. HTN-well managed on medication). Remember the S and O must support this diagnosis. Pertinent positives and negatives must be found in the write-up.*Plan:(number each plan specific to each diagnosis)These are the interventions that relate to the above diagnosis and address the following aspects (they should be separated out as listed below):Diagnostics:labs, diagnostics testing – tests that you planned for/ordered during the encounter that you plan to review/evaluate relative to your work up for the patient’s chief complaint.Therapeutic:changes in meds, skin care, counselingEducational:information clients need in order to address their health problems. Include follow-up care. Anticipatory guidance and counseling.Consultation/Collaboration:referrals, or consult while in clinic with another provider. If no referral made was there a possible referral you could make and why? Advance care planning.*Clinical Decision MakingThe next section summarizes your critical thinking, decision-making and diagnostic reasoning skills that provides you the platform to expand on your identified Typhon patient encounter. It is a reflection of the thought process you used in caring for the patient. Follow the directions under each section andlabel each area as appropriate. All information should be in your own words.Pathophysiology:Include information in regard to the pathophysiology related to the main diagnosis or illness process. This will help to understand how the S and O supported the diagnosis you assigned.Do not copy and paste from credible sources. Paraphrase source information as you construct your discussion of the pathophysiology and ensure that you provide in-text and reference citations for the source.Pharmacology:OR(***Alternate – Therapy information):Choose one drug that was prescribed at this visit or that is taken chronically by the patient to review. Please include the name of the drug (generic and brand), class, action, excretion, side effects and interactions, why this particular drug is being prescribed for this particular patient, what is this drug intended to treat, (specifically antibiotics, what organisms are we treating?). What other drug could be chosen instead that would work, if any? Keep in mind the cost and convenience for the patient.***NOTE:Since the patient encounter you select for this assignment is supposed to be one of the most complex encounters you have with this course population, the likelihood exists that you will have a pharmacologic agent to discuss for this assignment requirement. However, if there are no pharmacologic agents to utilize then choose a non-pharmacologic element of the therapeutic plan (e.g. this could be hyperbaric therapy, water therapy, relaxation training, biofeedback, PT, OT, Counseling [e. g. nutritional, emotional, behavior modification, etc.]or a Complementary Alternative Medical regimen [e.g. nutritional therapy, a spiritual intervention, Emotional Freedom Therapy (EFT), journaling, visual imagery, progressive relaxation, Cranial Electrical Stimulation (CES), etc.]Do not copy and paste from credible sources. Paraphrase source information as you construct your discussion and ensure that you provide in-text and reference citations for the source.Clinical Diagnostic Reasoning:Include in this section:1. Differential diagnosesInclude a list of all of the diagnoses you considered for your list of ‘differential diagnoses. This list may extend beyond the diagnoses identified in the ‘A’ section of the paper.2. Priority diagnosis discussionDiscuss the key assessment [history and physical exam] findings that resulted in the identification of the priority diagnosis/diagnoses indicated in the ‘A’ section of the paper3. Rationale for key elements of the plan of careAs an advanced practice student you need to explore the evidence relative to the patient’s care needs and be able to document the rationale for the elements of the plan.Briefly provide rationales for the key elements of the plan of care [e.g. if a particular HTN medication is prescribed then reference the current JNC guidelines, if a particular antimicrobial is prescribed provide the source referenced for the decision, etc.]Provide a rationale for any care aspect included in the plan that is not consistent with the care approaches found in your course materials, EBP, CPGs or encompassed in the ‘community standard of care’.When using credible sources to support your discussion do not copy and paste from the sources. Paraphrase source information as you construct your discussion and ensure that you provide in-text and reference citations for the source.Ethical and or Cultural Concerns:Identify any ethical or cultural issues related to this patient’s care. Include how these concerns were addressed.Discuss the following:1. Review the provisions of the ANA Code of EthicsChoose at least one of the provisions of the Code and discuss how your experience with the patient encounter aligns with the tenants of the provision OR how you advocated for the patient during the encounter to ensure your actions aligned with the tenants of the provision.Link to gain access to the ANA Code of Ethics – you will need to scroll down to ‘Select One’ [option] to progress to the page where you will have full access to the Code:https://www.nursingworld.org/practice-policy/nursing-excellence/ethics/code-of-ethics-for-nurses/2. Discuss actual or potential cultural implications for this encounter – from the patient’s cultural perspective or your cultural perspectiveLinks to articles that explore the issue of cultural concerns in health care:https://www.redorbit.com/news/health/1372127/transcultural_nursing_its_importance_in_nursing_practice/https://journals.lww.com/academicmedicine/Fulltext/2003/06000/A_Strategy_to_Reduce_Cross_cultural.6.aspxhttps://pdfs.semanticscholar.org/3e50/d2758210e1bd345ccf16fcf8dfcd2b1b5ec9.pdfBarriers to Care:Construct a discussion that summarizes the barriers/potential barriers your patient faces relative to their ability to seek or receive healthcare services and exploration of at least 3 of the applicable ‘social determinants of health’ for your patient.Discuss the Following:1. The actual and potential barriers you identified for your patientYour discussion needs to include observations about access to care, financial barriers, and non-financial barriers beyond access. Be sure to provide in-text citations as appropriate for APA style guidelines in your discussion to support the literature that you reviewed in identifying the actual/potential barriers.Links to article exploring barriershttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC3393009/https://academic.oup.com/fampra/article/23/3/325/475515https://www.careatc.com/ehs/3-common-barriers-to-quality-medical-care2. Three priority social determinants of health for your patientYour discussion needs to include exploration of the three social determinants of health that you identified as having the most significant impact on your patient’s health care and health status. Be sure to provide in-text citations as appropriate for APA style guidelines in your discussion to support the literature that you reviewed in identifying the social determinants of health.Link to CDC’s information on Social Determinants of Healthhttps://www.cdc.gov/socialdeterminants/3. Health care policy or advocacy initiatives relevant to your patient’s careInclude in your discussion at least one health care policy or initiative that you identified in the literature as having the potential to positively impact the identified actual/potential barriers or priority social determinants of health for your patient.Resources for your ‘search’ include the Herzing Library, Google Scholar, PubMed, and/or the Virginia Henderson Repository https://www.nursingrepository.org/*Evidence based practice:Evidence-Based Practice (EBP) is a thoughtful integration of the best available evidence, coupled with clinical expertise. As such it enables health practitioners to address healthcare questions with an evaluative and qualitative approach. EBP allows the practitioner to assess current and past research, clinical guidelines, and other information resources in order to identify relevant literature while differentiating between high-quality and low-quality findings. Evidence-Based Practice includes the application of evidence and the evaluation of the outcomes to guide future practice.This section is a 1-2 paragraph summary ofallthe scholarly evidence utilized to complete this assignment.New resources, topics or ideas should not be introduced.Discuss the following:1. Formulate a well-built question.What clinical questions and terms did you use to direct your search in the library database?2.  Identify articles and other evidence-based resources that answer the question. Identify all sources (APA citations) used that informed your decision making in this particular case.3. Critically appraise the evidence [research study, evidence based or clinical practice guidelines, published care standards, etc.] to assess its validity. Comment on the quality of the research or evidence based practice guidelines used. What is the level of evidence? How credible is it? Is it a just a recommendation or an expected standard of care?4. Apply the evidence and evaluate for areas of improvement.   How valuable was the evidence in understanding and directing the care in this case? How did it influence your decision making? Were you able to assess the outcome? If so, are changes needed?*Self-Reflection:Reflection on decision making:  This is an area where you look over the data gathered and after a careful review of the available resources (i.e. text books, reference readings) will provide a reflection of what might have been added or deleted that would have made this note more conclusive or complete. This is not an area to critique the preceptor. Discuss areas could you have changed? What areas might you have added, perhaps additional questions you should have asked in the ROS, or additional areas you may have assessed for in the PE?Advanced Practice Practitioner Role Analysis:Identify the specific person that drove this plan of care and developed the management, while including detail in how you advocated for the patient. It is entirely possible, and desirable, that you drove the development of the plan of care.  Include how an individualized approach was applied to this patient’s care. Also include how you identified your advocacy for the role of the Nurse Practitioner.*Reference Page:Follow APA guidelines for constructing all reference page citations and ensure you used APA style for all in-text citations.

 
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Nursing  nur

ScenarioAs a manager on a medical surgical unit, part of the job responsibility includes chart audits.A trend noted during the most recent audit was the overuse of the term “dementia.” The nurse manager notes that there may be a lack of understanding between the types dementia as related to neurological diseases.The nurse manager developed a survey to evaluate the staff’s understanding of the different types of dementia. As a result of the survey, you have been asked to create a PowerPoint presentation to increase the nurse’s awareness of the types of dementia a presentation was created.InstructionsChoose one of the following topics for a focused presentation:Alzheimer’sParkinson’sVascular DementiaThe presentation should include the following:PathophysiologyEtiology & incidenceHealth promotion and maintenanceHistory/Risk factorsPhysical signs and symptomsChanges in cognitionChanges in behavior & personalityChanges in self-management skillsDiagnostics: laboratory and imaging assessmentPlanning and implementationInterprofessional Collaborative CarePsychosocial integrityMedicationsSafety considerationsUsing Ignatavicius and one additional resource, develop a presentation to enhance the nurses’ knowledge of the differences between types of dementia and delirium. Be sure to document your source(s) in your presentation.

 
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Nursing  Essent of Evidence-Based Pract

Creating a Culture of Evidence-Based PracticeAn abundance of evidence can be found on almost any medical issue or health topic. Often, the availability of information is not the concern, but rather nurses struggle with how to convey the evidence to others and change practices to better reflect the evidence. Deep-rooted organizational cultures and policies can make some resistant to change, even to changes that can vastly improve the quality, effectiveness, and efficiency of health care. However, there are many strategies that nurses can employ to bring about changes to practice.In this Discussion, you focus on how to create an organizational culture that supports evidence-based practice.To prepare:· Review the information in this week’s Learning Resources. Examine the various suggestions for promoting an organizational culture that embraces the use of EBP.· Reflect on your own organization’s (or one in which you have worked) support of evidence-based practice. Examine how culture and policies impact the adoption of changes to practice based on evidence. What barriers exist?· Consider the models and suggestions for promoting evidence-based practice featured in this week’s Learning Resources. Identify models and suggestions that would work well in your organization.· Reflect on the significance of evidence-based practice in health care. What responsibility do nurses have to promote EBP and change practices to better reflect evidence and research findings?· Reflect on how nurses can disseminate findings from evidence-based practice research.Required ReadingsPolit, D. F., & Beck, C. T. (2017). Nursing research: Generating and assessing evidence for nursing practice (10th ed.). Philadelphia, PA: Wolters Kluwer.Chapter      30, “Disseminating Evidence: Reporting Research Findings”In this chapter, the focus is on actually reporting on the research      findings and how to determine the best approach for reaching the desired      audience. The chapter also includes tips on how to organize the      information and describes what is usually included in such reports.Aitken, L. M., Hackwood, B, Crouch, S., Clayton, S., West, N., Carney, D., & Jack, L. (2011). Creating an environment to implement and sustain evidence based practice: A developmental process. Australian Critical Care, 24(4), 244–254.This article describes a multi-dimensional EBP program designed to generate sustainable improvement in patient care and patient outcome. The text details the program’s strategies for implementation along with achievements and lessons learned.Barnsteiner, J. H., Reeder, V. C., Palma, W. H., Preston, A. M., & Walton, M. K. (2010). Promoting evidence-based practice and translational research. Nursing Administration Quarterly, 34(3), 217–225.In this text, the authors highlight established systems and structures designed to supply staff with resources to translate research and deliver EBP. Additionally, the article explicates a multitude of initiatives designed to disseminate evidence to the point of care.Cullen, L., & Adams, S. L. (2012). Planning for implementation of evidence-based practice. Journal of Nursing Administration, 42(4), 222–230.This article provides several models for implementing evidence-based practice within an organization. It introduces four different phases through which an implementation should progress, and provides examples of each.Estrada, N. (2009). Exploring perceptions of a learning organization by RNs and relationship to EBP beliefs and implementation in the acute care setting. Worldviews on Evidence-Based Nursing, 6(4), 200–209.In this article, the authors detail a survey design study conducted to determine the relationship between a learning organization’s characteristics and the beliefs of registered nurses with respect to EBP. In addition, the study examines the impact of EBP beliefs on registered nurses’ implementation of EBP.Fineout-Overholt, E., Williamson, K. M., Kent, B., & Hutchinson, A. M. (2010). Teaching EBP: Strategies for achieving sustainable organizational change toward evidence-based practice. Worldviews on Evidence-Based Nursing, 7(1), 51–53.The authors of this text suggest multiple strategies for integrating the EBP paradigm at the organizational level. The text provides rationale for why educators should also consider change at the individual level as an effective conduit for disseminating the EBP paradigm at the organizational level.Munten, G. van den Bogaard, J., Cox, K., Garretsen, H., & Bongers, I. (2010). Implementation of evidence-based practice in nursing using action research: A review. Worldviews on Evidence-Based Nursing, 7(3), 135–157.This text reviews 21 action research studies to determine what is known about using action research to implement evidence-based practice. The authors explicate the promising features and flaws that were common across the action research studies they used.Satterfield, J. M., Spring, B., Brownson, R. C., Mullen, E. J., Newhouse, R. P., Walker, B. B., & Whitlock, E. P. (2009). Toward a transdisciplinary model of evidence-based practice. The Milbank Quarterly, 87(2), 368–390.This article presents the primary issues and challenges in EBP across numerous health disciplines. The authors then posit a transdisciplinary EBP model designed to incorporate the strengths and diminish the flaws of each discipline’s EBP model.Steurer, L. M.(2010). An evidence-based practice scholars program: One institution’s journey toward excellence. Journal of Continuing Education in Nursing, 41(3), 139–143.The author of this article details the efforts of an EBP scholars program that was designed to teach an overview of EBP, along with the skills necessary to improve patient outcomes. In addition to the program’s development and implementation, the article highlights lessons learned.MediaLaureate Education (Producer). (2012k). Translating evidence into practice. Baltimore, MD: Author.Dr. Kristen Mauk discusses the outcomes of her DNP project in this video. She explains how nurses in the rehabilitation unit where she conducted her project used the results of her project to improve their practices.Laureate Education (Producer). (2012c). Disseminating findings. Baltimore, MD: Author.In this video, Dr. Kristen Mauk offers advice for nursing students and practitioners in disseminating the findings of their research and evidence-based practice projects. She identifies many options for dissemination that are available to nurses.

 
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Nursing  nursing informatics

Title (Cover) page – APA 7th ed formattedIntroduction: Defines the topic and sets the context for the literature review, including the author’s perspective or point of view on the topic, how they have defined the scope of the topic (including what’s not included), and how the review will be organized. It can point out overall trends, conflicts in methodology or conclusions, and gaps in the research.Body (content) of LR: three (3) or more scholarly evidence-based articles organized into major topics and subtopics. These groupings may be by subject, (e.g., globalization of Nursing Informatics), type of research (e.g., case studies), methodology (e.g., qualitative), genre, chronology, or other common characteristics. Within these groups, the author can then discuss the merits of each article and provide analysis and comparison of the importance of each article to similar ones as they relate to your topic.Conclusion of the main findings.  The conclusion makes clear how this review of the literature supports (or not) the research to follow, and may point the direction for further research. The conclusion can point out overall trends, conflicts in methodology or conclusions, and gaps in the research.topics for your consideration:Current & historical perspective of nursing informatics r/t nursing educationCurrent & historical perspective of nursing informatics r/t nursing clinical practiceCurrent & historical perspective of nursing informatics r/t nursing administrationCurrent & historical perspective of nursing informatics r/t nursing researchImpact of information technology national trends has on NI practiceImpact of information technology national events has on NI practiceNI role in the clinical systemImpact of pandemic on HIPPAEthical considerations amid pandemic and HIPPASecurity issue as the r/t healthcare team collaboration & NISocial media in healthcare education & practiceMobile tools in healthcare education & practiceStandardized NI practiceConnection between NI and nursing ethic’sCurrent & historical perspective of nursing informatics r/t nursing education challengesNursing informatics competencyNursing infomatics certificationHealth Care management and technology adoptionE-Learning in Health Care settingsDecision modeling and natural language processingImproving patient satisfaction scores by using dataHealth information safety and securityHealthcare CybersecuritymHealthArtificial intelligence as it relates to nursing informatics

 
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Nursing  health information

Discussion:Evaluate the importance of health information exchanges and interoperability in terms of the deployment of the Nationwide Heath Information Network in the United States.350 words

 
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Nursing  Topic 4 DQ 2

Reflect on the analysis of the sin of suicide and, thus, euthanasia from the topic readings. Do you agree? Why or why not? Refer to the lecture and topic readings in your response.

 
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Nursing  Influence of communication in patient care.

Describe how providing culturally appropriate care is a challenge for the advanced practice nurse. The phenomena of communication according to Giger and Davidhizar’s model can shape care.How Giger and Davidhizar’s model can shape care? Or how this theory applies to care?Describe appropriate ways to communicate with patients from various cultures.Mention strategies that you can use to communicate appropriately to patients.How communication influences patient care?Should be a minimum of 350 words, scholarly written, no older than 5 years, use APA 7 formatted, and referenced.  A minimum of 2 references is required.

 
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Nursing  Mental Health issues

1.  What challenges have you encountered in working with patients with mental health issues? How do you feel these challenges will be different in a community health setting?  Would it be easier or more difficult and why?2.  Discuss scenarios in which the community health nurses might encounter ethical issues related to mental health.  Give some examples and explain.APA format, word document,Arial 12 fontat least 2 evidence based references no older than 5 yearsA minimum of 500 excluding the first and references page are required.

 
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Nursing  Professional development

Remember to include an introduction paragraph which contains a clear and comprehensive purpose statement which delineates all required criteria, and end the assignment Part with a conclusion paragraphUsing the Academic Success and Professional Development Plan Template in which you began to work on in Week 1, and have continued working on through this course, in Part 5, you will create a fully developed and accurate curriculum vitae (CV) based on your current education and professional background.· Clearly identify and accurately state in detail your professional development goals.· Clearly and accurately state in detail how to accurately and appropriately align one or more of your professional development goals with the University’s emphasis on social change.Note: Add your work for this Assignment to the original document you began in the Week 1 Assignment, which was built off of the Academic Success and Professional Development Plan Template.

 
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Nursing  Week 6

As you have noted in this course and in your practice, nurses have an integral role in promoting a just culture focused on patient safety in their health care organizations. Determining resources to prevent error and improve patient safety can often be a battle, and this scenario illustrates how one organization makes strides to make sure resources are available in the interest of patient safety. As you review the scenario, consider the nurse’s role in promoting a just culture in your practice setting.By Day 3Post a description of the role of the staff nurse for promoting quality in a high-performing health care organization. Define the organizational culture of your health care organization, or one with which you are familiar, and identify the leadership style of the CEO and CNO in your organization. Explain how your senior leadership supports—or does not support—changes that require financing/budget to support patient safety. Describe the strategies you might be able to implement to move your health care organization to a high-performing organization.Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level.

 
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