What other assessments should be included for this patient? What questions should the nurse ask with regard to the abdominal pain?

/in /by

Kevin Valeri is a 64-year-old man who presents to the gastroenterologist’s office with constipation and abdominal bloating.

Subjective Data

  • Pain level is a 4/10 location = right lower abdomen
  • Retired Engineer
  • States he has been going to the bathroom with the help of laxatives, but not having regular movements
  • Appetite is decreased, some nausea
  • PMH: depression, anxiety, chronic constipation

Objective Data

  • Vital signs: T 37 degrees Centigrade, P 64, R 16, BP 124/58
  • Bowel sounds hypoactive in all four quadrants
  • Medications: Lamictal 200mg daily, Lexapro 10 mg daily
  • Weight = 210 lbs, last visit weight = 195
  1. What other assessments should be included for this patient?
  2. What questions should the nurse ask with regard to the abdominal pain?
  3. From the readings, subjective data, and objective data, what is the most probable cause of the abdominal pain?
  4. What should be included in the plan of care?
  5. What interventions should be included in the plan of care for this patient?
  6. APA FORMAT
  7. REFERENCE REQUEIRED:
  8. Jarvis, C. (2016). Physical examination & health assessment (7th ed.). Philadelphia, PA: Saunders.

     

    • Chapter 21: Abdomen
      • pp. 537–566 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)
    • Chapter 24: Male Genitourinary System
      • pp. 691–710 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)
    • Chapter 25: Anus, Rectum, and Prostate
      • pp. 721–731 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)
    • Chapter 26: Female Genitourinary System
      • pp. 737–763 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)

Collaboration is a term that has been used throughout the lesson. Cite an example from your practice experiences or your prelicensure clinical experiences of how teamwork could have been improved with collaboration.

/in /by
ll About Teamwork (graded)

There are two components to this topic. Please address each component in your response.

  1. Collaboration is a term that has been used throughout the lesson. Cite an example from your practice experiences or your prelicensure clinical experiences of how teamwork could have been improved with collaboration.
  2. Should the registered nurse be the leader in coordinating a patient’s plan of care? What are the advantages to such a model?

Discuss the change agents you need to recruit in order to successfully implement your change. Describe the roles of these change agents.

/in /by

Evaluate the performance of your organization or department. Identify an area that would significantly benefit from initiating a change. Write a paper (1,500-1,750 words) in which you describe the particular area you propose to address through a change initiative. Include the following for your company:

Discuss the issues in this area and the current outcomes as a result of the issues.
Describe the external and/or internal driving forces, contributing issues, and the people affected.
Evaluate the stakeholders involved and discuss how they will be affected by your change initiative.
Clarify your role and responsibility as a change leader. Discuss the leadership theory (or theories) you will use to guide the change process.
Discuss the change agents you need to recruit in order to successfully implement your change. Describe the roles of these change agents.
Utilize your change model to develop strategies: (a) Explain the relevance of this model to your organization; and (b) Present the strategic aspects using your model. Be sure to clearly define the purpose of each aspect, the people involved, and the actions that need to be taken.
Identify, or predict, the potential barriers to change. Discuss possible ways to overcome these obstacles, including methods for dealing with emerging or unforeseen circumstances that could impede implementation.
Describe the evaluation methods you will use to determine the level of success of your change initiative. Discuss what metrics or measureable determinates you will use.
Propose strategies to anchor change or support continuous change.
Establish how your change plan supports the organizational mission/goal, genuinely addresses stakeholder concerns, and will serve as an equitable contribution for the community or society overall.
-This assignment must utilize the attached change model where is states “utilize your change model.”

-Must have include citations and references in APA format

-1500 to1750 words

-The organization or unit has to be a hospital or nursing unit as it speaks about in the above directions

Analyze the implication of the Affordable Care Act on your decision to purchase insurance. Debate two (2) advantages and two (2) disadvantages of purchasing health insurance for your employees, as opposed to having your employees receive governmental insurance.

/in /by

Assignment 4: Health Insurance and the Affordable Care Act
Due Week 8 and worth 150 points

Suppose you have been tasked with purchasing health insurance for your organization that has fifty full-time employees.

Use the Internet or Strayer databases to research different types of health insurance.

Write a 2-3 page paper in which you:

  1. Suggest one (1) plan that you would use to purchase health insurance for your organization. Determine the extent to which employee lifestyle choices and health economics would factor in to your chosen plan. Provide a rationale for your response.
  2. Analyze the implication of the Affordable Care Act on your decision to purchase insurance. Debate two (2) advantages and two (2) disadvantages of purchasing health insurance for your employees, as opposed to having your employees receive governmental insurance.
  3. Use at least two (2) quality references. Note: Wikipedia and other Websites do not qualify as academic resources.

Your assignment must follow these formatting requirements:

  • Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
  • Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length.

The specific course learning outcomes associated with this assignment are:

  • Analyze the impact of healthcare financing and health insurance on healthcare access, quality, and cost.
  • Analyze the influence of health policy and health reform on healthcare access, quality, and cost in the U.S.
  • Use technology and information resources to research issues in healthcare policy, law, and ethics.
  • Write clearly and concisely about healthcare policy and law using proper writing mechanics.

 

Identify healh related issues relevent to the population you chose.  Use multiple resources, such that you chose 

/in /by

Identify healh related issues relevent to the population you chose.  Use multiple resources, such that you chose

(adolescents)  Use multiple resources such that you include at least 3 journal articles be sure to consider psychosocial needs, submit both your analysis and a summary in a 1-2 page document

 

Identify a new law or regulation that affects the practice of public health or community health nursing.

/in /by
  • Identify a new law or regulation that affects the practice of public health or community health nursing. Discover the sponsor of the action. Describe the sponsor of this new law or regulation. Using news reports, statements in the public record, personal telephone or other interview data, outline the reasons for the introduction of the change, based on the data collected from the sponsor. Summarize the impact the new law or regulation will have on consumers of healthcare. Support your responses with examples. Share the information and your thoughts about your findings in a 2- to 3-page document. Cite any sources in APA format

From the readings, subjective data, and objective data, what is the most probable cause of the abdominal pain?

/in /by

Kevin Valeri is a 64-year-old man who presents to the gastroenterologist’s office with constipation and abdominal bloating.

Subjective Data

  • Pain level is a 4/10 location = right lower abdomen
  • Retired Engineer
  • States he has been going to the bathroom with the help of laxatives, but not having regular movements
  • Appetite is decreased, some nausea
  • PMH: depression, anxiety, chronic constipation

Objective Data

  • Vital signs: T 37 degrees Centigrade, P 64, R 16, BP 124/58
  • Bowel sounds hypoactive in all four quadrants
  • Medications: Lamictal 200mg daily, Lexapro 10 mg daily
  • Weight = 210 lbs, last visit weight = 195
  1. What other assessments should be included for this patient?
  2. What questions should the nurse ask with regard to the abdominal pain?
  3. From the readings, subjective data, and objective data, what is the most probable cause of the abdominal pain?
  4. What should be included in the plan of care?
  5. What interventions should be included in the plan of care for this patient?
  6. APA FORMAT
  7. REFERENCE REQUEIRED:
  8. Jarvis, C. (2016). Physical examination & health assessment (7th ed.). Philadelphia, PA: Saunders.

     

    • Chapter 21: Abdomen
      • pp. 537–566 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)
    • Chapter 24: Male Genitourinary System
      • pp. 691–710 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)
    • Chapter 25: Anus, Rectum, and Prostate
      • pp. 721–731 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)
    • Chapter 26: Female Genitourinary System
      • pp. 737–763 (Structure, Function, Subjective and Objective Data, Documentation and Critical Thinking)

Should the registered nurse be the leader in coordinating a patient’s plan of care? What are the advantages to such a model?

/in /by
ll About Teamwork (graded)

There are two components to this topic. Please address each component in your response.

  1. Collaboration is a term that has been used throughout the lesson. Cite an example from your practice experiences or your prelicensure clinical experiences of how teamwork could have been improved with collaboration.
  2. Should the registered nurse be the leader in coordinating a patient’s plan of care? What are the advantages to such a model?

Does the patient’s psychosocial history affect how you might treat the case? What if the patient lived in a rural setting?

/in /by
Ear Pain Case Study

Subjective Data

Julia, a 3 year old preschool child, presents to the office with a complaint of left ear pain for 2 days. She is accompanied by her mother, Mary. She has had an intermittent fever and her maximum temperature at home was 101 F (axillary). The pain is worse sometimes when she is lying down. The pain is occasional relieved with the use of over-the-counter pain relievers. Julia has not had any vomiting or diarrhea. She has had a slight runny nose, but no cough.

Past medical history: Julia was born via vaginal delivery at 40 weeks’ gestation. She has not had any injuries or illnesses. Her developmental screening was within normal limits at last provider visit.

Social history: Julia lives at home with both parents. Her mother works as a teacher and her father is a commercial fisherman. The family has a pet cat. Julia’s father smokes a pack of cigarettes a day.

Family medical history: Unremarkable

Medications: Julia is currently taking Tylenol for the fever and ear pain.

Immunizations are up to date

Allergies: Penicillin (rash, itching and tongue swelling)

Objective Data

Julia is alert and quiet, sitting on her mother’s lap. She appears well hydrated and well nourished. Vital signs: temp 100 (axillary), HR 100, resp 26, wt. 14 kg.

Skin: Warm and dry to touch and free of lesions.

HEENT: Head is atraumatic and normocephalic. Pupils are equal, round and reactive to light and accommodation. There is not ocular discharge noted. Julia’s external ear reveals that the pinnae are normal, and there is no tenderness to touch on the external ear. On otoscopic exam, the right tympanic membrane (TM) is gray, in normal position, with positive light reflexes. Bony landmarks are visible and there is no fluid noted behind the TM. The left TM is erythematous and bulging with purulent fluid visible behind the TM. The TM is opaque with no light reflex or bony landmarks present. Both nostrils are patent. There is no nasal discharge and there is no nasal flaring. Julia’s mucous membranes are noted to be moist. She has 20 teeth present without evidence of caries. There are no lesions present in the oral cavity.

Neck: Supple with good range of motion. There are some shotty lymph nodes noted on the left side of neck. There is no erythema or tenderness of the nodes.

Resp: Breath sounds bilateral equal and clear to auscultation. Good rise and fall of rib cage. No retractions noted.

Cardiovascular: RRR no murmurs, rubs or gallops noted.

Abd: Soft, flat, non -tender to palpation. Bowel sounds present in all four quadrants. No hepatosplenomegaly present.

Please include the following:

  1. Diagnosis (rule in)
  2. Differential diagnosis ( rule out)
  3. What is the plan of treatment, referral and follow up care?
  4. Does the patient’s psychosocial history affect how you might treat the case?
  5. What if the patient lived in a rural setting?
  6. Are there any demographic characteristics that might affect this case?
  7. Are there any standardized guidelines that you should use to assess or treat the case?

THIS NEEDS TO BE IN APA FORMAT WITH CITATION NO OLDER THAN 5 YEARS PLEASE SEE RUBRIC AND FOLLOW EXACTLY HOW IT IS LAID OUT!!!!! PLEASE DO NOT HANDSHAKE IF THIS IS NOT FOR YOU!!!