. Explain what mechanisms are in place to achieve these objectives.

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Draft a research paper, which discusses how well managed care has achieved its objectives of ensuring quality of care, cost of care, and access to care, sometimes referred to as the “iron triangle” of health care. Explain what mechanisms are in place to achieve these objectives. Include in the paper your opinion as to whether all three (3) objectives can actually be achieved simultaneously. Also, be sure to support your conclusions with data and other evidence. You must use at least two (2) Managed sources. Must be in APA format with references

What others would say about you and about what your life meant to them after you died.  What would your friends, relatives and associates say about you at your funeral?  How did your life impact those who survive you?

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Directions: Please answer the questions below and be prepared to discuss them with a partner, small group, or with the class.  In this exercise you will look at life from the perspective of your own death.  You will write your own eulogy and epitaph.  Choose one of the two following perspectives:

 

1)    *As if you were to die tonight.  OR 2) as if you were to die sometime well into the future.

 

Eulogy: What others would say about you and about what your life meant to them after you died.  What would your friends, relatives and associates say about you at your funeral?  How did your life impact those who survive you?

 

Epitaph: The inscription you would like to have on your tombstone.  No More than 2 lines.  Include date of birth and date of death.

 

1.    Write your eulogy as you believe it might actually be said by the person who will miss you the most after you are dead.  Tell who would be saying this and what their relationship to you is. (You may use the back of this sheet if you need more room.)

 

Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.

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Jamie is a 3-month-old female who presents with her mother for evaluation of “throwing up.” Mom reports that Jamie has been throwing up pretty much all the time since she was born. Jamie does not seem to be sick. In fact, she drinks her formula vigorously and often acts hungry. Jamie has normal soft brown bowel movements every day and, overall, seems like a happy and contented baby. She smiles readily and does not cry often. Other than the fact that she often throws up after drinking a bottle, she seems to be a very healthy, happy infant. A more precise history suggests that Jamie does not exactly throw up—she does not heave or act unwell—but rather it just seems that almost every time she drinks a bottle she regurgitates a milky substance. Mom thought that she might be allergic to her formula and switched her to a hypoallergenic formula. It didn’t appear to help at all, and now Mom is very concerned.

Cases like these are not uncommon. The mother was concerned and thinking her daughter may have an allergy; she changed to a different formula. However, sometimes babies have immature GI tracts that can lead to physiology reflux as they adapt to normal life outside the uterus. Parents often do not consider this possibility, prompting them to change formulas rather than seeking medical care. As in the case study above, GI alterations can often be difficult to identify because many cause similar symptoms. This same issue also arises with adults—adults may present with symptoms that have various potential causes. When evaluating patients, it is important for the advanced practice nurse to know the types of questions he or she needs to ask to obtain the appropriate information for diagnosis. For this reason, you must have an understanding of common GI disorders such as gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis.

To prepare:

  • Review this week’s media presentation on the gastrointestinal system.
  • Review Chapter 33 in the Huether and McCance text. Identify the normal pathophysiology of gastric acid stimulation and production.
  • Review Chapter 35 in the Huether and McCance text. Consider the pathophysiology of gastroesophageal reflux disease (GERD), peptic ulcer disease (PUD), and gastritis. Think about how these disorders are similar and different.
  • Select a patient factor different from the one you selected in this week’s Discussion: genetics, gender, ethnicity, age, or behavior. Consider how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Reflect on how you would diagnose and prescribe treatment of these disorders for a patient based on this factor.
  • Review the “Mind Maps—Dementia, Endocarditis, and Gastro-oesophageal Reflux Disease (GERD)” media in the Week 2 Learning Resources. Use the examples in the media as a guide to construct a mind map for gastritis. Consider the epidemiology and clinical presentation of gastritis.

To complete:

Write a 2- to 3-page paper that addresses the following:

  • Describe the normal pathophysiology of gastric acid stimulation and production. Explain the changes that occur to gastric acid stimulation and production with GERD, PUD, and gastritis disorders.
  • Explain how the factor you selected might impact the pathophysiology of GERD, PUD, and gastritis. Describe how you would diagnose and prescribe treatment of these disorders for a patient based on the factor you selected.
  • Construct a mind map for gastritis. Include the epidemiology, pathophysiology, and clinical presentation, as well as the diagnosis and treatment you explained in your paper.

•Consider the following patient factors: genetics, gender, ethnicity, age, and behavior. Think about how these factors might impact the diagnosis and treatment of patients with chronic kidney disease.

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•Review Chapter 149 in Part 13 of the Buttaro et al. text in this week’s Learning Resources and other references . Reflect on the clinical presentation of chronic kidney disease.

 

•Think about how you might diagnose a patient with chronic kidney disease. Consider the role that patient history, physical exams, and diagnostics play in diagnosis.

 

•Reflect on potential treatment options for chronic kidney disease including the implications of prescribed drugs.

 

•Consider the following patient factors: genetics, gender, ethnicity, age, and behavior. Think about how these factors might impact the diagnosis and treatment of patients with chronic kidney disease.

 

 

 

To complete:

 

Write a 2- to 3-page paper that addresses the following:

 

•Describe the clinical presentation of chronic kidney disease.

 

•Explain how you might diagnose a patient with chronic kidney disease including the role that patient history, physical exams, and diagnostics play in diagnosis.

 

•Explain implications of potential treatment options for this disease including prescribed drugs.

 

•Describe how patient factors might impact the diagnosis and treatment of patients with chronic kidney disease.

 

 

 

Reminder: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.

 

 

 

Reference

 

Readings

 

•Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2013). Primary care: A collaborative practice (4th ed.). St. Louis, MO: Mosby.

 

◦Part 13, “Evaluation and Management of Genitourinary Disorders” (For review pp. 723–793)

 

 

 

Adams, D., de Jonge, R., van der Cammen, T., Zietse, R., & Hoorn, E. J. (2011). Acute kidney injury in patients presenting with hyponatremia. Journal of Nephrology, 24(6), 749–755.

 

National Kidney Foundation. (n.d.). Retrieved November 28, 2012, from http://www.kidney.org/index.cfm

Denies any other weakness, numbness, difficulty speaking or walking, syncope, or seizures. She finds that watching television particularly in the evening, is becoming a problem because her eyes “are tired” more. 

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CASE STUDY- TYPE 2 DIABETES
INITIAL HISTORY
• 52-year old black female.
• Diagnosed with type 2 diabetes 6 years ago but did to follow up with recommendations for care.
• Now complaining of weakness in her right foot and itching rash in her groin area.
Question 1: What questions would you like to ask her about her symptoms?

 

 

ADDITIONAL HISTORY
• Patient says her foot has been weak for about a month and is difficult to dorsiflex; feels numb.
• Denies any other weakness, numbness, difficulty speaking or walking, syncope, or seizures. She finds that watching television particularly in the evening, is becoming a problem because her eyes “are tired” more.
• Has had some increased thirst and gets up more often at night to urinate, sometimes excessively.
• Says she has a rash on and off for many years. It is worse when the weather is warm. It also occurs in her armpits. She gets some relief from salt baths. She occasionally gets a boil in these areas.
• Denies any chest pain, shortness of breath, edema, change in bowel habits, or skin ulcers.
Question 2: What other personal and family-related questions would you like to ask her about her diabetes?

 

 

DIABETES HISTORY
• Patient remembers being told her blood sugar was “around 200” when she was first diagnosed. She had gone for a work physical and felt fine at the time and saw no need for expensive drugs.
• Her mother and sister have diabetes. Both of them were diagnosed in their 40’s and are on pills and injections.
• Has been completely asymptomatic, except for rash, until the foot weakness.
• Has gained 18 pounds over the past year and eats a diet high in fats and refined sugars.
• Employed as banking executive and gets little exercise.
Question 3: What would you like to ask about her about her medical history?

 

 

 

PHYSICAL EXAMINATION
• Obese female in no acute distress.
• T= 37 C orally; P=80 and regular; RR=15 and unlabored; BP= 162/98 right arm (sitting); weight 84 kg.
Skin
• Erythematous moist rash in both inguinal areas, beneath both breasts, and in the axillae.
• No petechiae or eccymoses.
• Many dime-sized hyper pigmented spots located on the anterior shins
HEENT, Neck
• Pupils equal and round, fundi with mild arteriolar narrowing.
• Nares and tympanic membranes clear.
• Pharynx clear.
• Neck without bruits or thyromegaly.
Lungs, Cardiac
• Lungs clear to auscultation and percussion.
• Cardiac examination with distant heart tones, a regular rate and rhythm without murmurs or gallops.
Abdomen, Extremities
• Abdomen moderately obese with bowel sounds heard in all four quadrants; no abdominal bruits, tenderness, masses or organomegaly.
• Extremities without edema; arterial pulses are diminished in volume but palpable in both feet.
Neurologic
• Alert and oriented.
• Cranial nerves II through XII intact (including normal vision acuity with glasses).
• Limb strength 5/5 throughout except 2/5 on dorsiflexion of the right foot.
• Sensory perception to light touch diminished on the soles of both feet along the metatarsal bar
• Deep tendon reflexes 1+ and symmetric throughout.
• Gait normal except for accommodation to a right foot drop; negative Romberg test.
Question 4. What are the pertinent positives and negatives on the physical examination?

 

 

Question 5. What laboratory tests would you order now?
INITIAL LABORATORY RESULTS
• Serum electrolytes, including BUN and creatinine, calcium, and magnesium all within normal limits.
• Random glucose=253mg/dL (taken at 11 am).
• HgbA1c=9.1%
• Urine dipstick positive for glucose, negative for protein; microscopic without significant cellular or infectious findings.
• Wet prep of smear from skin rash consistent with fungal spores and mycelia.
• Electrocardiogram with evidence of early left ventricular hypertrophy (LVH) by voltage.

 

Please answer the case study questions.

Who is your target audience? Who would be most interested in your project findings, conclusions, and recommendations? Consider how the needs or dispositions of the intended audience may inform your choice of dissemination method.

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  • Reflect on your Practicum Project.
  • Speak with various individuals, especially those in your practicum setting, about presentations or poster sessions they have given and/or publications they have authored. Ask which organizations or journals they would recommend you consider for dissemination based on your Practicum Project topic.
  • Consider the following questions related to dissemination:
    • Who is your target audience? Who would be most interested in your project findings, conclusions, and recommendations? Consider how the needs or dispositions of the intended audience may inform your choice of dissemination method.
    • Which method of dissemination would you choose to convey the findings, conclusions, or recommendations from your Practicum Project? What are the relative benefits and challenges of giving a presentation, sharing your findings through a poster session, and/or publication?
    • Consider various nursing, health care, informatics, and leadership and management organizations and journals. What is one organization or journal you would select for your presentation or publication?
    • What are some potential challenges? Evaluate what you could do to promote the possibility that your presentation, poster, or manuscript would be accepted.
  • Conduct a search of the literature using the Walden Library and other reliable sources. Locate two or more articles published in peer-reviewed journals within the last five years that relate to your Practicum Project. These articles should demonstrate the significance of the topic for nursing leadership and management or nursing informatics. Note: These articles may also help you determine if your project findings are related to an area that will contribute to a more comprehensive literature base.

Post on or before Day 3 a brief description of your Practicum Project, including the anticipated outcomes and implications for nursing practice in your specialty area. Explain why your results warrant dissemination. Describe your target audience, and explain which method of dissemination you would use as well as the organization or journal you would choose for sharing findings related to your Practicum Project. Support your response with at least two citations from the literature.

MUST BE IN APA FORMAT NO TITLE PAGE NEEDED

I have a paper for First Aid class and the requirments for the paper are included in the attachment one of the question is reearch common emergencies that could occur in your area?

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I have a paper for First Aid class and the requirments for the paper are included in the attachment

one of the question is reearch common emergencies that could occur in your area?

How can the dimensions of diversity, such as age, race, ethnicity, gender, sexual orientation, and religion affect individual or collective healthcare needs and capabilities?

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Women have healthcare requirements in addition to those of men because of their biology and gender roles. Due to their gender roles, they are frequently responsible for the health and healthcare of others. The resources they need to care for others may create constraints on their ability to care for themselves.

Also, it is important to consider the workplace when considering women’s health issues because the position of women in the workforce has great impact on the healthcare they receive. Many businesses have recognized the need to create a more diverse workforce by selective hiring based on the need to increase selected groups in their workforce. Some businesses have been more proactive than others. For example, let’s consider that a business workforce’s diversity plan includes the following benchmarks:

  • Maintain women’s representation at a minimum of 60 percent.
  • Increase women’s representation in nontraditional occupations from 16 percent to 20 percent.
  • Increase women’s representation in senior positions (grade twelve and above or equivalent) from 28 percent to 35 percent.

On the basis of what you have learned so far, answer the following questions:

  • How can the dimensions of diversity, such as age, race, ethnicity, gender, sexual orientation, and religion affect individual or collective healthcare needs and capabilities?
  • Could the above statements constitute discriminatory hiring practices? Why or why not?
  • What would the implications of diversity-based policy development be in relation to healthcare needs?
  • Describe a workforce diversity plan using at least three dimensions of diversity. Additionally, explain how it relates to improved health-service delivery.

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal. Solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines.

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Combining Nurse Leader With Advocacy. Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

  1. Personal and professional accountability
  2. Career planning
  3. Personal journey disciplines
  4. Reflective practice reference behaviors/tenets

Discuss how you will use your current leadership skill set to advocate for change in your workplace.

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal. Solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines.