Week 7 DQ 1

You have received a patient from the cardiac catheterization lab after an early morning emergent presentation for an acute myocardial infarction. The patient has an intra-aortic balloon pump indwelling, and the cardiologist placed a pulmonary artery catheter for hemodynamic monitoring. The patient is experiencing cardiogenic shock.Explain the treatment for suppressed cardiac output, suppressed cardiac index, and altered systemic vascular resistance.Recommend possible environmental and nutritional interventions for treating the patient.Recognize that the patient received emergent stenting and still requires bypass graphing once stabilized.Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

 
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Week 6: Discussion Board Posting and 2 replies

Integrate one nursing ethical principle the advanced practice nurse could use in the decision-making process for a potentially lifesaving procedures of who should be saved first, who lives, and who dies regarding allocation of scarce resources during a pandemicstudent 1 TaylsenGood morning, Professor and class. I apologize for the previous format. Here is a corrected version. Thanks.Integrating Ethical Principles Advanced Practice Nurses Could Use in Potentially Life Saving SituationsThe International Council of Nurses delivered the first code of ethics, which was approved by the Council of National Representatives (CNR) on July 10, 1953. CNR represents the organization deliberative entity, with bi-yearly meetings in different parts of the world to address ethical principles, perform necessary updates, and delve deep into reflections pertaining ethical codes in nursing (Oguisso et al., 2019). Like mentioned, bi-yearly reunions allow this body of deliberation to identify submerging issues in the ethics of nursing. Nevertheless, the ethical responsibilities in nursing have remained relatively constant thorough the years. The attached study provides a list with the content of the first International Code of Ethics for Nurses, with the three main responsibilities topping the list: “to preserve life, to alleviate suffering and to promote health” (Oguisso et al., 2019, p. 6). In life saving situations, nurses are mainly driven by principles concerning the preservation of life. The devastating effects of the pandemic certainly placed nurses in very difficult situations regarding decision-making of who should be saved first, who lives or dies given the lack of resources worldwide. For this reason, different factors are to be examined that would not impede the nurses’ adherence to ethical principles. A key factor refers to the availability and management of human resources because, given the adequate access of these means, minimization of the problem concerning a health care crisis where nurses are forced to withdraw care form the mostly ill and poorly prognosed is possible. “Failure to provide sufficient resources may compromise the right to healthcare, especially the right of critically ill patients in a situation like that caused by COVID-19” (Falcó et al., 2021, p.183).Who Gets to Live When Allocating Scarce Resources?A crucial factor in making tough life or death decisions during a pandemic with scarce resources are directly correlated to ethical principles of beneficence and respect for autonomy. Patients who needed to be admitted to the ICU, for instance, had to be extensively reviewed by the interdisciplinary team (the advanced nurse included) in order to make a decision whether to transfer the patient or let them go. This posed a huge challenge for healthcare professionals given the lack of knowledge of the disease, the lack of knowledge (oftentimes) of the patient’ wishes and the level of uncertainty associated with the complications caused by the virus. Criteria such as age, past medical history and fragility were all part of the guidelines to follow when confronted with ambiguous situations (Falcó et al., 2021). As a result, patients who were younger, lack comorbidities and had a better prognosis were more likely to survive because, for them, ventilators and the use of certain medications were available. Nurses had to stick to the guidelines provided by scientific societies and official organizations in order to label these patients based on acuity. Research shows that, when allocating scarce resources between two critically ill patients, triage policies aim to allocate to the individual with the best chances of survival (Buckwalter & Peterson, 2020). Again, the ethical principle of life preservation is clearly demonstrated here, ultimately aiming for the greater good, although it can be very saddening for the families of those with no chance of survival.ReferencesBuckwalter, W., & Peterson, A. (2020). Public attitudes toward allocating scarce resources in the COVID-19 pandemic. Plos One, 15(11), 1–20.https://doi.org/10.1371/journal.pone.0240651 (Links to an external site.)Falcó, P. A., Zuriguel, P. E., Via, C. G., Bosch, A. A., & Bonetti, L. (2021). Ethical conflict during COVID‐19 pandemic: The case of Spanish and Italian intensive care units. International Nursing Review, 68(2), 181–188.https://doi.org/10.1111/inr.12645 (Links to an external site.)Oguisso, T., Hiromi-Takashi, M., Fernandes de Freitas, G., Barrionuevo-Bonini, B., & Araújo da Silva, T. (2019). First international code of ethics for nurses. Texto & Contexto Enfermagem, 28, 1–11.https://doi.org/10.1590/1980-265X-TCE-2018-0140student 2CatalinaGood afternoon class and professor,The four fundamental concepts of healthcare ethics are justice, autonomy, beneficence, and nonmaleficence. When selecting who should be saved first, who should live, and who should die in connection to the distribution of limited resources during a pandemic, advanced practice nurses may use the nursing ethical concept of justice. Justice is defined as the provision of appropriate, unbiased, and equitable care to all patients. Justice entails more than just equality; it entails treating patients according to specific requirements under specified circumstances, without regard for the patients’ income, rank, or race (Rooddehghan et al., 2019). By adding the ethical principle of justice, nurse practitioners can focus on prioritizing patient care and making timely decisions based on patients’ needs. Healthcare practitioners on the front lines of assisting people during pandemics face a variety of professional responsibilities that might lead to ethical quandaries—addressing ethical concerns when organizing treatment and preparing for pandemic work may be advantageous (Muñoz-Rubilar et al., 2022).ReferencesMuñoz-Rubilar, C. A., Carrillos, C. P., Mundal, I. P., Cuevas, C. D. L., & Lara-Cabrera, M. L. (2022, February 10). The duty to care and nurses’ well-being during a pandemic. Nursing Ethics, 29(3), 527–539. https://doi.org/10.1177/09697330211041746Rooddehghan, Z., Nikbakht nasrabadi, A., Parsa Yekta, Z., & Salehiparsa yekta, M. (2019, December 1). Patient favoritism as a barrier to justice in health care: A qualitative study. Health, Spirituality and Medical Ethics, 6(4), 29–35. https://doi.org/10.29252/jhsme.6.4.29

 
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Week 1 Introduction & Discussion: Informatics and Patient SafeTy

Step 1Post the following to the discussion board:Your nameBrief background (for example, why did you decide to become a nurse?)Your current understanding of health informaticsWhat you hope to gain from this course

 
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Types of Therapeutic Diets

Please review article. Submit a 1 page summary on the different diets. Choose 3 and write a dialogue on how you would explain to a patient what diet they are on, why, what restrictions there are, etc.

 
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60 assignment 1

Topic: Teen pregnancy

 
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Week 2 Assignment Agency Synopsis

Identify regulatory agencies that regulate health and the health care system within the US, create a table listing your 5 regulatory agencies and address the following:Describe the agency, level of regulatory authority (local, state, federal), scope of regulatory authority, and role within the US healthcare system.Address relevance of the organization or the organization’s authority to the APRN/DNP graduate.Describe relevance to specialty area, area of practice, or setting of practice. For an example, mental health.Submission Requirements:In the table, write the 3 criteria above and respond to them.The table is to be complete and thorough. It should include all items indicated in the assignment.Incorporate at least 4 current (published within last five years) scholarly journal articles or primary legal sources (statutes, court opinions) within your work.Use current APA style 7 ed  with support from at least 4 academic sources which need to be journal articles or books from 2018 up to now. NO WEBSITES allowed for reference entry. Include doi, page numbers, etc. Plagiarism must be less than 10%.

 
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Healthcare Issue

Choose an issue you would like to explore(I prefer to choose a topic to be an issue to minimize the no-show and cancelation in the few hours left for the appointment. Which tool(s) would you use to measure the issue you choose and determine what adjustments might be made after receiving information from the tool?

 
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ADV HEALTH ASSESSMENT

To PrepareReview the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.Consider which of the conditions is most likely to be the correct diagnosis, and why.Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment.The Lab AssignmentChoose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources.

 
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Pn4

Your written assignment for this module is a worksheet that describes the following:An example of an evidence-based practice (EBP) projectHow EBP projects can improve patient careYou should be using complete sentences to answer the questions. Ensure that you are using correct grammar.

 
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Strategic Plan

Locate a strategic plan for in your long-term care facility. Evaluate your organization’s mission, vision and values statement. Review the plan and comment on how the objectives are being met or not and comment why? Is your organization aligning with its stated goals? Do you use this plan as a guide to monitor your progress towards goals? How do you think a strategic plan can be more effectively used?Mission Statement:Apple Rehab is a family owned and operated company that treats residents and staff like family too. Our leadership is not across the country, but rather in your backyard. When it comes to choosing the right rehabilitation program to meet your specialized needs, we understand you have a choice. With our in-house therapy company, we believe it is vital to have a strong, interactive team with our own therapists who are not attached to productivity, and thus have more time to participate in team meetings and best practices.Recognizing the critical need for a more human based approach to long-term care, Apple Rehab incorporates the philosophy of “Better Life” and has changed the language of long-term care to Long-Term Living, signifying our commitment to ensuring a full and enriching experience for residents who call Apple Rehab home. This philosophy is unique to Apple and operates on the premise that our residents are individuals and should be recognized as such.

 
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