3 Health Behavior Changes



Health Behavior Changes

[Name of the Writer]

[Name of the Institution]

Health Behavior Changes

Introduction

In life, there are some changes that every person needs to adopt for enjoying good and physically fine health. Changes in life are most likely to be adapted according to the stage or stage in life as well as according to the routine activities in daily life. Bringing positive and highly important changes in life "which may be a physical change or mental or psychological changes" puts extremely good impacts on an individual's life and living. For me, the most important, crucial and behavior changes which are needed to be brought in my life or I would like to make are; 1). To Adjust Sleep, 2). Reduce Body Weight and Increase my Height.

By discussing the reason or answering the question of why I need or want to make these behavioral changes. I would like and want to make these changes to make my life more comfortable in terms of physical fitness, physical activeness and to have an impressive and well-looking personality. Having a good and well-looking personality is an important thing for me to consider because it may help me in my professional life and career.

Body

Going to details, the main three changes which will be made in the coming or next year is to adjust my sleeping timings and settle it according to my daily or routine activities. The second this I will be adapting in the coming year is to reduce my weight or loss weight while the third change is to increase my height a bit. In the class, I have been with many benefits of mentioned changes and how they can affect my personality and life positively.

The process which will be involved in making these changes include “but may be different in special circumstance or situations”.

For the goal of adjusting sleep timing, I would be working on defining all of my daily activities and major responsibilities (if any) and I would be defining and setting timings for each activity. Those activities would be prioritized which usually happen in my daily life. So in this way, I would have proper timing and schedule that would I would be totally free to go to bed or what are my actual sleeping hours. For reducing or losing weight, the process highly includes jogging after lunch and dinner through which I could lose my weight up to 7 kg till the end of the coming month. For this habit the timing of jogging (each one "after lunch and dinner") will 25 to 35 minutes. Sometimes or in a special situation, the timings of jogging can be changed as on the situation. Like in case of eating fast food or a bit heavy food the jogging time after that particular lunch or dinner maybe 30 to 50 minutes. These things will be decided on the mood as well as on the case which I would have at hand. Beyond that, I will also be trying to keep away myself from fast food and for this change (weight loss) I have already worked on decreasing the use of fast food from last 4 to 5 months.

For the purpose of increasing height, I will be increasing the current running time up to 20 minutes per day as well as I will do proper set up for hanging up my body, etc. the target is to increase the height up to 3 inches in coming two months.

Conclusion

It has been concluded that these changes will be very fruitful and beneficial for my health and physical activeness but it cannot be ignored that some barriers might come in adopting these changes. These barriers may be lack of timing because of a busy life and it is difficult to change food preferences etc. for eliminating or handling these barriers, I will need to put myself in a bit tight situation for some day or weeks to adapt these changes then I will not have any issue going with them.

311 Groupn R Power Point Discussion

Title page

PowerPoint discussion

The unionization of CNAs and the segregation of LPNs is directly related to the increase in pressure-related ulcers. Certified nurse assistants and Licensed Practical Nurse have direct role in improving the quality of care and overall health status. This is because the CNAs and LPNs have complete knowledge about the nursing care standards required for managing patients of pressure-ulcers CITATION Cla184 \l 1033 (Berridge, Tyler, & Miller, 2018). CNAs and LPNs are aware of the quality indicators and capable of using them for reducing pain, catheter use and self-care. The professional nurses have adequate experience of dealing with the patients of different age groups and different conditions. They are capable of following regulations and healthcare guidelines that increases the quality. They help patients in daily activities such as eating, getting dressed and taking medications. The rate of pressure-ulcers can be reduced if the hospitals hire CNAs and LPNs. They care capable of addressing patients needs individually that adds to their enhanced health.

Effective inter-professional team reduces incidence of pressure ulcers because it allow healthcare providers to wok in a coordinated way. The team communication about the symptoms, causes and condition of the patients. Every team member is assigned individual task that adds to the efficiency CITATION KNC13 \l 1033 (Corazzini, Anderson, Mueller, Thorpe, & McConnell, 2013). The team work appropriately by maintaining patient’s records, identifying vital signs, administrating medications, performing test procedures and recording the improvements. The inter-professional team reduced the incidents of pressure-ulcers because they can inform the doctors about the seriousness of the patient’s condition on right time. This prevents them from unnecessary delays and improved the possibilities. Patients receive constant medical care and immediate response from the team members that reduces the likelihood of negative outcomes.

References

BIBLIOGRAPHY Berridge, C., Tyler, D. A., & Miller, S. C. (2018). Staff Empowerment Practices and CNA Retention: Findings From a Nationally Representative Nursing Home Culture Change Survey . Journal of Appl Gerontol , 37 (4), 419–434.

Corazzini, K. N., Anderson, R. A., Mueller, C., Thorpe, J. M., & McConnell, E. S. (2013). Licensed practical nurse scope of practice and quality of nursing home care. Nurs Res , 62 (5), 315-24.

311 W10 IP Scenerio

311 W10 OP Scenario

Your Name

Institution

IP Scenario

Clostridioides difficile

Clostridioides difficile (C. diff) is an infection where C. diff bacteria causes colitis and diarrhea. The infection spread through the hands of health care personnel. In most health care units, the infection spread due to lack of hand hygiene practices CITATION AOr18 \l 1033 (A Oren, 2018). Also, cleaning patient wards can prevent this infection from spreading. Key players who can prevent this kind of carelessness are centers for disease control and prevention (CDC), hospital management, nursing staff, and government departments. In addition to C. diff, much other health-related infection can be reduced by focusing on hand hygiene. C. diff mostly spread within the health care unit through the hands of medical professionals and nursing staffs. There are strict regulations and guidelines on hand and ward hygiene set up by government and centers for disease control.

Scenario

In the Interprofessional (IP) scenario provided for this assignment, the author is a part of a team responsible for providing health care and also keeping the floor clean and infection-free. The team includes supervisor (author), other IP team members, MD/DO. PT, Primary care nurses, nursing supervisor. The infection of C. diff is spread in private patient rooms 102 and 104. As a first response to C. diff detection, these two rooms have been completely isolated. Four patients in room 102 and 104 are infection with C. diff, advance care should take place when dealing with these patients. According to CDC guidelines, health care staff should keep the infected patients in isolation and follow the strict rule for hand hygiene. C. diff, in a hospital environment, can be very dangerous as it can spread through the ward and eventually throughout the hospital. Anyone with a weak immune system can easily get infected with C. diff upon contact with an infection. The hospital being a place where weak individuals are in abundant, possess a great risk of spreading C. diff if not handled with care. Room 102 and 104 are occasionally visited by MD and rehab staff. MD and rehab staff often show carelessness regarding C. diff by not following hand hygiene regulations and guidelines. MD and rehab staff also visited room 106, where a patient is suffering from diarrhea. Cultures have been taken from suffering patient in room 106, and the results from the lab are pending. Being a member of the IP team, the author suspects that the patient in room 106 is also suffering from C. diff. Moreover, carelessness of MD and rehab staff may be the reason for spreading C. diff infection to room 106.

Hand hygiene

This paper will emphasize on the infection of C. diff, identifies the risk involved, and how to resolve the issues caused by it. There is no doubt that hand hygiene reduces the risk of cross-transmission of C. diff. Infections like C. diff are common adverse events resulting either from staying in the hospital. The infection can spread to other patients through the hands of health care staff. The can be avoidable through infection control measures. Hand hygiene is the most important measure which can prevent the spread of the infection throughout the clinic. Only 50 to 70 percent of medical personnel comply with hand hygiene recommendations CITATION DPi00 \l 1033 (Pittet, 2000). There are several ways to clean hand. Alcohol-based hand sanitizers are most effective for reducing germs on the hands of health care providers. In addition to using hand sanitizers, hands should be cleaned with soap and water whenever there is a sign of visible dirt on the hands of health care workers. According to CDC regulations, health care professionals should follow underlining rules to prevent diseases like C. diff from spreading within the hospital.

Washing hands with soap and water when;

Hands are wet

After caring for a person with diarrhea

Before and after having a meal

After exposure to spore CITATION JMB99 \l 1033 (Boyce, 1999)

Cleaning hand with alcohol-based hand sanitizers when;

Right before touching the patient

Before performing aseptic tasks

Before moving from soiled part of the patient's body to the dry part of his/ her body

After contact with blood or contaminated surface

Immediately after glove removal

After touching a patient CITATION JMB99 \l 1033 (Boyce, 1999)

These regulations should always be followed by a health care unit, even if there is no patient with infection is in the facility.

Approach

As the report of a patient in room 106 is not yet received from a laboratory, immediate prevention actions which include isolation should take place. Players who are responsible should be called and addressed to take extra precaution when entering leaving the infected rooms. Proper hand hygiene should be practiced within the healthcare unit. And if someone is observed not following proper care, they should be penalized. There should be no carelessness in health care. Patient, their relative, and health care personnel should be educated on the effect of poor hand hygiene. As there is a socio-political environment present in the clinic, hospital management can also be involved in the matter. As mentioned before, there are regulation present which addresses these kinds of health-related issues, and there is a huge penalty if a health unit is caught violating the regulations. The risk of getting penalized will raise concern for the hospital management and will surely take action against the violation of hand hygiene, which causes C. diff to spread within the hospital. If involving hospital management is not enough, a regulating body can also be contacted to address the matter.

Health care is not a joke, one should not be afraid to take action against the violation of health care. If the report of the patient from room 106 is positive, then disciplinary action can take place against the violators.

References

BIBLIOGRAPHY A Oren, M. R.-A. (2018). Clostridium difficile and Clostridioides difficile: Two validly published and correct names. Anaerobe.

Boyce, J. (1999). It is time for action: improving hand hygiene in hospitals. Annals of internal medicine.

Pittet, D. (2000). Improving compliance with hand hygiene in hospitals. Infection Control & Hospital Epidemiology.

311 W12 IP Scenerio Discussion Response

Title page

Discussion

Group purple

The nurse remained goal-oriented by simultaneously respecting the views of her team-members. Nurse manages to overcome conflicting situations that could distract her from her goal. Her professional goals convinced her to promote healthy and safe environment for the students within the school facility. By respecting the views of her team-members she provided a positive and interactive learning environment for the students. This helped her to accomplish her goals of providing intervention for acute chronic illness, communicable diseases and mental health to the students. She also managed to educate students about the signs and symptoms of pregnancy. By respecting views of others she managed to understand the concerns of members and use her skills for collaborating with them.

There could be many productive ways of removing personal bias from workplace. Establishing team goals is an effective methods by which worker can remove personal bias. The organization or the manager can set measurable goals that will promote neutrality. The goals can be measured quarterly and the outcomes can be shared with each worker. This is an effective way of allowing each member to see his or her strength and weakness. They will accept their mistakes and determine where improvements are needed. This is an effective strategy that promotes transparency and convince employees that they are judged according to their performance.

Nurses possess unique skills that give them ability to effectively mitigate differences in opinion. Cultural competency or cultural awareness is to dominant skills that allow nurses to understand others. This skill allow them to work with the people from different cultures and respect their viewpoints. Their awareness of cultural differences helps them in mitigating difference in opinion. Adaptation skills also help nurses in sorting differences because they understand cultural diversity. Nurses are taught to work and respect the people from different cultural backgrounds. Cultural awareness is also helpful in avoiding conflicting situations. This is a unique skill that allow nurses to understand attitude of patients and co-workers thus leading to a positive culture.

Fall prevention group

Falling is a serious problem because it causes injury. Older people are more likely fall because they fail to maintain balance due to weak muscles. Falls can result in serious injuries so they must be prevented. Physical injury and functional decline are common outcomes of falling. Hip fractures, knee fractures and fractures at other body parts are commonly reported problems. Falling is serious because it causes bruise, open wound or excavation of blood. In serious cases sprain and joint dislocation are experienced. People are unable to move properly and it take months to recover. Older people often fail to regain same level of physical health that declines their mobility. This results in declined social and physical activities. It causes brain injury that can lead to short-term memory loss or dementia. People fall to recall things and it takes time to recover.

Interdisciplinary team (Geriatrician, RN, PT, OT) work together to prevent falls in the future. Geriatrician can review the condition of patients and identify those who can fall. They can prescribe medications for the patients such as sedatives that will keep them relaxed and prevent them from falling. Tranquilizers can be given for calming patients. Nurses can schedule the routine activities like toileting and remove barriers that could cause fall. Physical therapists can explain exercises that will help patients to build muscle endurance. They will engage patients in conversations and Occupational therapist will assess the physical condition and educate patients on walking and mobility.

References

AHRQ. (2017, September ). Best Practices for Fall Prevention . Retrieved from Agency for Healthcare Research and Quality: https://www.ahrq.gov/professionals/systems/hospital/fallpxtraining/workshop/module3/mod3-slides.html

Van Pelt, J. (2012). Keeping Teen Moms in School — A School Social Work Challenge. Social Work Today, 12(2). Retrieved from https://www.socialworktoday.com/archive/031912p24.shtml.

311 W14 Discussion

Discussion: Nursing Today and Tomorrow

[Author’s name]

Discussion: Nursing Today and Tomorrow

Introduction

Assessment of the current positioning is important to propose practical domains in the form of Future of Nurses’ report recommendations. This form of consideration eventually helps to identify specific areas that require improvement. The broad idea of Future of Nurses report comprised of various recommendations. It is vital to examine one specific form of the recommendation to figure out the actual implications according to the expectations ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"5Cy8ezZA","properties":{"formattedCitation":"(Reinhard & Hassmiller, 2012)","plainCitation":"(Reinhard & Hassmiller, 2012)","noteIndex":0},"citationItems":[{"id":1246,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/8MSDID2U"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/8MSDID2U"],"itemData":{"id":1246,"type":"article-journal","title":"The future of nursing: Transforming health care","container-title":"The Journal AARP International","author":[{"family":"Reinhard","given":"Susan"},{"family":"Hassmiller","given":"Susan"}],"issued":{"date-parts":[["2012"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Reinhard & Hassmiller, 2012). Here, the focus is to consider the approach of enhancing interprofessional collaboration as the recommendation to assess nurses’ role in future.

Discussion

The basic purpose of “Future of Nurses’ report recommendations” is to propose necessary changes in nurses’ roles, responsibilities, and education to achieve the objectives of healthcare in future. Fostering interprofessional collaboration is characterized as the necessary condition to enhance their healthcare services for patients in future. It is critical for the nurses to enhance their cooperation level with all the stakeholders to ensure the proper delivery of healthcare services. It is vital to determine whether this form of recommendation is appropriate and realistic when it comes to the consideration of nursing as a profession.

Collaboration is one necessary practical measure for the nurses to ensure the necessary form of improvements in case of the healthcare system. Cooperation at the interprofessional level is an appropriate condition to achieve team objectives ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fpgsuZx2","properties":{"formattedCitation":"(Martin, Ummenhofer, Manser, & Spirig, 2010)","plainCitation":"(Martin, Ummenhofer, Manser, & Spirig, 2010)","noteIndex":0},"citationItems":[{"id":1247,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/ALKVARK3"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/ALKVARK3"],"itemData":{"id":1247,"type":"article-journal","title":"Interprofessional collaboration among nurses and physicians: making a difference in patient outcome","container-title":"Swiss medical weekly","volume":"140","issue":"3536","author":[{"family":"Martin","given":"Jacqueline S."},{"family":"Ummenhofer","given":"Wolfgang"},{"family":"Manser","given":"Tanja"},{"family":"Spirig","given":"Rebecca"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Martin, Ummenhofer, Manser, & Spirig, 2010). Offering better opportunities for collaboration is a critical step to improve the overall healthcare process. Advance involvement of nurses in case of quality improvement initiatives is one appropriate and practical measure. This practical option is useful to ensure the success of the particular recommendation of fostering interprofessional association.

Conclusion

In a nutshell, it is critical to consider that application of certain recommendations is an essential practical step to attain the better forms of Future on Nurses report. Fostering interprofessional collaboration is a mandatory practical measure to meet the changing requirements of healthcare services in case of future developments. It is one appropriate and realistic idea of consideration to improve the role of nurses as influential healthcare providers.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Martin, J. S., Ummenhofer, W., Manser, T., & Spirig, R. (2010). Interprofessional collaboration among nurses and physicians: Making a difference in patient outcome. Swiss Medical Weekly, 140(3536).

Reinhard, S., & Hassmiller, S. (2012). The future of nursing: Transforming health care. The Journal AARP International.

311 W14 Discussion Response

Discussion Response

Name

Affiliation

Date

Discussion Response

Amanda’s Post:

Amanda's post highlights the importance, as well as the distinctiveness, of the nursing profession in unique aspects. She has described her struggle with accepting her role and position in the nursing field while coming to terms with the fact that it is a deliberate choice and not just an effort of being associated with the profession. The FOM recommendation emphasized by her highlights the basis of her logical reasoning that nurses should be partners of physicians as they are playing a strategic role in the development of the field. The post has been presented in a convincing and exceptional manner. It helps to identify the fact that nursing is emerging as a distinct and progressive profession (IOM, 2011). Nurses are no longer considered as only the assistants of the physicians, as they are playing a crucial and instrumental role in redesigning of the health care institutes, thus creating their own position and contributing to the value and autonomy of their profession.

Kelly’s Post:

Kelly has highlighted one of the most crucial points in her discussion post which is training of the nurses according to the latest trends and changes in the profession. Science is making an advancement with every passing day and the researchers are discovering and inventing new diseases and their cures. The nurses can only remain updated if they practice their education to every possible extent, in addition to working with the physicians, nurse practitioners, managers and other people in the field to explore new cases and concepts. Nursing is the field in which innovation is quite important and nurses cannot only rely on their education for it. Kelly has shared her point in quite a convincing manner that nurses should utilize every possible opportunity of gaining experience and knowledge by working on new cases, in labs and with professionals, only then they would be able to reach a level of making change in the health care department (Redman, Pressler, Furspan, & Potempa, 2015).

References

Institute of Medicine (US). Committee on the Robert Wood Johnson Foundation Initiative on the Future of Nursing. (2011). The future of nursing: Leading change, advancing health. Washington, DC: National Academies Press.

Redman, R. W., Pressler, S. J., Furspan, P., & Potempa, K. (2015). Nurses in the United States with a practice doctorate: Implications for leading in the current context of health care. Nursing outlook, 63(2), 124-129.

311 W7 Discussion Response

311 W7 Discussion Response

[Name of the Writer]

[Name of the Institution]

311 W7 Discussion Response

I am agreed to your opinion that the “seven alternatives” is kind of joke. It does not reflect professionalism from any angle. For instance, diffidence-based medicine alternative claims that the doctor should do something to save his pride. He should not feel guilty for doing nothing ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"V47AHFRf","properties":{"formattedCitation":"(Isaacs & Fitzgerald, 2001)","plainCitation":"(Isaacs & Fitzgerald, 2001)","noteIndex":0},"citationItems":[{"id":794,"uris":["http://zotero.org/users/local/mlRB1JqV/items/Y8JR4M3N"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/Y8JR4M3N"],"itemData":{"id":794,"type":"article-journal","title":"Seven Alternatives to Evidence-Based Medicine","container-title":"The Oncologist","page":"390-391","volume":"6","issue":"4","source":"theoncologist.alphamedpress.org","abstract":"The Oncologist is a journal devoted to medical and practice issues for surgical, radiation, and medical oncologists.","DOI":"10.1634/theoncologist.6-4-390","ISSN":"1083-7159, 1549-490X","note":"PMID: 11524559","journalAbbreviation":"The Oncologist","language":"en","author":[{"family":"Isaacs","given":"David"},{"family":"Fitzgerald","given":"Dominic"}],"issued":{"date-parts":[["2001",8,1]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Isaacs & Fitzgerald, 2001). It means that the doctor is giving priority to himself rather than his work where patients and their health should be the doctor's or nurse's first priority. In this field, numbers of occasions come when nurses have to control their personal thoughts or emotions for better decision. This is why I found your point correct that healthcare decisions should be based on evidence-based practice. It helps to learn different techniques and to experience different situations for decision making professionally ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"WWhPtUT0","properties":{"formattedCitation":"(\\uc0\\u8220{}Importance of Ethics in Nursing | LSUA Online,\\uc0\\u8221{} n.d.)","plainCitation":"(“Importance of Ethics in Nursing | LSUA Online,” n.d.)","noteIndex":0},"citationItems":[{"id":795,"uris":["http://zotero.org/users/local/mlRB1JqV/items/EHQAM5UE"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/EHQAM5UE"],"itemData":{"id":795,"type":"webpage","title":"Importance of Ethics in Nursing | LSUA Online","container-title":"Louisiana State University of Alexandria Online","abstract":"Ethics are fundamental to nursing. All nurses should respect their patients, maintain patients' dignity and protect patients' rights.","URL":"https://online.lsua.edu/articles/healthcare/importance-of-ethics-in-nursing.aspx","language":"en","accessed":{"date-parts":[["2019",7,3]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Importance of Ethics in Nursing | LSUA Online,” n.d.). You are also right on the point that time changes practices but definitely, it does not affect our skills. New practice comes with more benefits but the old practices also help us on different occasions. Experience is the most important thing in our profession, therefore, every situation whether good or bad support us to learn something new which we can use in the future. The comparison with other professionals was significant to understand the seriousness of the work. We can make someone's life better by analyzing our decisions.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Importance of Ethics in Nursing | LSUA Online. (n.d.). Retrieved July 3, 2019, from Louisiana State University of Alexandria Online website: https://online.lsua.edu/articles/healthcare/importance-of-ethics-in-nursing.aspx

Isaacs, D., & Fitzgerald, D. (2001). Seven Alternatives to Evidence-Based Medicine. The Oncologist, 6(4), 390–391. https://doi.org/10.1634/theoncologist.6-4-390

311 W7. Amanda's Response Post

Amanda's response post

Author

Institution

Amanda's response post

Amanda’s post that placed criticized Isaacs and Fitzgerald’s report concerning evidence-based medicine. The report “Seven alternatives to evidence-based medicine” written by Isaacs and Fitzgerald discussed all the possibilities in clinical decision making save evidence-based medicine. One of the seven alternatives put forward by Isaacs and Fitzgerald is Diffidence-based medicine. Amanda, in her post, lacerated all the seven alternatives especially the diffidence-based medicine which explains the attitude of diffident doctor. In addition, the report of Isaacs and Fitzgerald was compared with Dr. Reinfrank’s work and Dr. Reinfrank’s work was declared more rational in the post.

My first reaction to the post that it is hardly possible for any physician to adopt methods for clinical decision to save evidence-based medicine. All the alternatives presented by Isaacs and Fitzgerald sound absurd, however, the alternatives are presented following an extensive study and experimentation, so all the alternatives cannot be ignored outrightly ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gr6hGD6h","properties":{"formattedCitation":"(Heneghan et al., 2017)","plainCitation":"(Heneghan et al., 2017)","noteIndex":0},"citationItems":[{"id":616,"uris":["http://zotero.org/users/local/jsvqEXt1/items/AV63BKHJ"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/AV63BKHJ"],"itemData":{"id":616,"type":"book","title":"Evidence based medicine manifesto for better healthcare","publisher":"British Medical Journal Publishing Group","source":"Google Scholar","author":[{"family":"Heneghan","given":"Carl"},{"family":"Mahtani","given":"Kamal R."},{"family":"Goldacre","given":"Ben"},{"family":"Godlee","given":"Fiona"},{"family":"Macdonald","given":"Helen"},{"family":"Jarvies","given":"Duncan"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Heneghan et al., 2017). Further, the argument presented in the post that compared the nursing profession with science sounds rational because the worsening health condition of a patient must be the main concern of physician, surgeons, and nurses ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qRtXBOH2","properties":{"formattedCitation":"(Heneghan et al., 2017)","plainCitation":"(Heneghan et al., 2017)","noteIndex":0},"citationItems":[{"id":616,"uris":["http://zotero.org/users/local/jsvqEXt1/items/AV63BKHJ"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/AV63BKHJ"],"itemData":{"id":616,"type":"book","title":"Evidence based medicine manifesto for better healthcare","publisher":"British Medical Journal Publishing Group","source":"Google Scholar","author":[{"family":"Heneghan","given":"Carl"},{"family":"Mahtani","given":"Kamal R."},{"family":"Goldacre","given":"Ben"},{"family":"Godlee","given":"Fiona"},{"family":"Macdonald","given":"Helen"},{"family":"Jarvies","given":"Duncan"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Heneghan et al., 2017).

The only word I can write in my reaction to the comparison between Dr. Reinfrank’s work and Isaacs and Fitzgerald’s report is “Biases”. The whole argument built in the post regarding Dr. Reinfrank is biased. It seems the writer is impressed with the personality of Dr. Reinfrank and had never critically analyzed Dr. Reinfrank’s work. Albeit, “good moves” the idea by Dr. Reinfrank sounded really great owing to his choice of words. However, how your words would be perceived depend upon the reader and his thinking patterns and experiences. Your words would neither perceived by others the same way someone else did, nor the thinking patterns of every person are identical.

Rationality must prevail in every profession. Doing nothing is no choice. Seven alternatives given by Isaacs and Fitzgerald are all based upon the human attitude and not on scientific reason. No logical reason was provided by Isaacs and Fitzgerald in their report as to why clinical professionals resort to such methods in the absence of evidence-based medicine.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Heneghan, C., Mahtani, K. R., Goldacre, B., Godlee, F., Macdonald, H., & Jarvies, D. (2017). Evidence based medicine manifesto for better healthcare. British Medical Journal Publishing Group.

311 W7. Discussion Post

W7. Discussion Post

Author name

Affiliations

Clinical decisions need to be evidence-based as far as possible. Evidence-based practice is the use of scientifically generated evidence that is combined with the implicit knowledge of the proficient practitioner. Practitioners are using the best available research results while making different decisions. However, Isaacs & Fitzgerald (2001) have proposed Seven Alternatives’ to EBP that can be used by practitioners when they have no evidence on which to base a clinical decision. This paper will discuss the ‘Seven Alternatives’ to EBP that can be used by a health care provider while making different decisions.

There can be the use of Eminence-Based Medicine which is the use of experience in decisions. The experience has more worth than any amount of evidence. Alternatively, practitioners can make use of Vehemence -Based Medicine, which is the substitution of volume for evidence. Elegance and verbal eloquence are also influential alternatives for evidence and can be used under Eloquence-Based Medicine ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"p0aTVqqD","properties":{"formattedCitation":"(Isaacs & Fitzgerald, 2001)","plainCitation":"(Isaacs & Fitzgerald, 2001)","noteIndex":0},"citationItems":[{"id":2396,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/TTITE2N4"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/TTITE2N4"],"itemData":{"id":2396,"type":"article-journal","title":"Seven alternatives to evidence-based medicine","container-title":"The oncologist","page":"390-391","volume":"6","issue":"4","author":[{"family":"Isaacs","given":"David"},{"family":"Fitzgerald","given":"Dominic"}],"issued":{"date-parts":[["2001"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Isaacs & Fitzgerald, 2001). Practitioners can also leave the decision in the hands of the Almighty and make use of Providence-based Medicine. Moreover, the other alternative can be diffidence-Based Medicine in which a doctor must do something in order to look for the answer. Similarly, fear of litigation can be incorporated into treatment that will let practitioners towards over investigation and overtreatment. The last alternative is Confidence-Based Medicine, which can only be used by surgeons.

A health care provider who is implementing one of the “Seven Alternatives’ to EBP also makes the best decisions despite having any scientific evidence as to the basis of their decision. For example, Dr. Keating who practices internal medicine and has introduced a character, “Dr. Reinfrank” in his article. Dr. Ralph used to have "morning report" instead of using scientific evidence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"rrkAmP42","properties":{"formattedCitation":"(Keating, 2003)","plainCitation":"(Keating, 2003)","noteIndex":0},"citationItems":[{"id":2397,"uris":["http://zotero.org/users/local/KZl8ZL3A/items/4Q8IK5FF"],"uri":["http://zotero.org/users/local/KZl8ZL3A/items/4Q8IK5FF"],"itemData":{"id":2397,"type":"article-journal","title":"PLAYING IN THE MAJORS","author":[{"family":"Keating","given":"Herbert J."}],"issued":{"date-parts":[["2003"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Keating, 2003). During the report, he used to hear patients' clinical stories from the night before. Then he provides his instructive feedback in a Socratic style. It was a very successful method of instructing students who were going to be professional. These kinds of characters are preferable when one is lacking with scientific evidence.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Isaacs, D., & Fitzgerald, D. (2001). Seven alternatives to evidence-based medicine. The Oncologist, 6(4), 390–391.

Keating, H. J. (2003). PLAYING IN THE MAJORS. Retrieved from https://www.courant.com/news/connecticut/hc-xpm-2003-07-13-0307130177-story.html

311 W8. Discussion Post

311 W8. Discussion Post

[Name of the Writer]

[Name of the Institution]

311 W8. Discussion Post

There is little doubt that nursing is one of the most challenging professions in the whole world. Every day, nurses come across different incidents that drain them both physically and emotionally. Be it a nurse working in a trauma center or a nurse administering treatment to a patient on the bedside, both require strong commitment and dedication. No matter where a nurse is currently serving, it requires them to be physically strong and emotionally stable to cope with the stress of the job.

As a nurse posted in a school, it requires not only strong dedication and determination, but it also demands to be empathetic and compassionate towards the students. A student might be experiencing different issues or might have incurred an injury that could negatively affect their studies and grades. Hence, the nurse serving in the school has an important role to play.

Every now and then, I come across many heart-wrenching incidents or hear many distressing stories that shake me to the core. However, there is one incident which had stressed me a lot.

There was a girl named Sara. Sara was a cheerful and bright young student. One day Sara came into my office distressed. She appeared quite upset which was very unlikely of her. She asked to close the doors of the room and listen to her carefully. As soon as the doors were shut, Sara burst into tears. At first, I thought there might be an agonizing injury she had suffered to be the reason for the tears.

She said, in a painful voice, not to disclose this conversation with anyone. Not with her mother, who is a teacher at the same school. As a professional nurse, what unfolded next demanded strong adherence to ethical principles of nursing.

Sara was sexually abused by her father.

As much as it appears distressing to you distressed me too. However, I tried my best to convey an empowering response. I wanted her to let out the emotions that she has been hiding for, only God knows, how long. I remained patient as she talked of the harrowing incident. Furthermore, I assured her to get her every possible help she needs. I tried not to ask any details of the heinous crime as it might have hurt her more given the relationship between her and the perpetrator.

As Sara was describing through what she has been going through, I took some notes. The reason for this is, in case a police report is filed, I might become a witness that could prove to be decisive in a court of law.

As this crime is punishable in any court of law, I didn’t decide to call the police. I asked Sara to muster up the courage and call the police herself. Had I called the police without her consent, it might have hurt her more (Jordan, 2015).

Furthermore, once Sara completed her story, I started to guide her. Guiding her was the only option as she asked not to discuss this with anyone.

I recommended Sara to seek medical assistance following this incident. There were significant chances that she might have had become pregnant or contracted sexually transmitted disease like HIV. Additionally, I recommended her to get herself medically examined. The medical report would assist her should she decide to sue the perpetrator.

As this incident must have affected her mentally and drained her emotionally (Steinmetz & Gray, 2017). These kinds of incidents often compel the victims to end their lives by committing suicide as they might feel helpless (Steinmetz & Gray, 2017). I suggested her to go to any sexual assault crisis center. By going to a sexual assault crisis center would help her get over this despicable incident.

References

Jordan, J. (2015). Justice for rape victims? The spirit may sound willing, but the flesh remains weak. In Crime, victims and policy (pp. 84-106). Palgrave Macmillan, London.

Steinmetz, S., & Gray, M. J. (2017). Treating emotional consequences of sexual assault and domestic violence via telehealth. In Career Paths in Telemental Health (pp. 139-149). Springer, Cham.

321 Infants Case Study Part 1 Discussion Response

321 Infants case study part 1 discussion response

[Name of the Writer]

[Name of the Institution]

321 Infants case study part 1 discussion response

Response 1

Hello Tajah, I read your post and I must say that you did a very good job of explaining different strategies to calm the infants in just a few sentences. I also agree that the problem-oriented approach is best suited in the current case scenario as the immediate focus should be to make the babies stop cry and then assessing other factors that cause them to cry nonstop (Algranati & Dworkin, 1992).The methods you have explained to calm the baby by rubbing their back does make them stop crying however I would like to add that distraction is another way that makes babies stop crying, for instance, you can shift them from one room to another or turn on the calm music, and, etc. While discussing communication techniques it is indeed important to evaluate the behavioral cues as infants cannot speak yet with their facial expressions one can determine whether they are in distress or just hungry. However, the tone of voice influences them a lot as children are very good at sensing feelings and will react accordingly.

Response 2

Hi Amanda, after reading your post I must say that you have discussed the case study in a complete and precise way that is highly informative. As you have used a comprehensive approach that considers multidimensional factors and assesses these factors regarding any problem I also agree that this approach is very well suited as crying is the natural phenomena because children cannot speak so they will communicate via crying. I also agree with your initial assessments such as hunger, rashes caused by diapers, etc can be the reason due to which the baby cry and providing them stimulation with toys will help in reducing the anxiety of being away from their mother. In your post, you have mentioned about your diagnosis that is disorganized infant behavior I also agree with your diagnosis (Carpenito-Moyet, 2006) however it is no doubt the best approach to provide an infant with food, toys and changing their diapers as by fulfilling their needs they will feel safe and secure.

References

Algranati, P. S., & Dworkin, P. H. (1992). Infancy problem behaviors. Pediatrics in review, 13(1), 16-22.

Carpenito-Moyet, L. J. (Ed.). (2006). Nursing diagnosis: Application to clinical practice. Lippincott Williams & Wilkins.

321 W10 Fluid And Electrolyte Case Study

321 W10 Fluid and Electrolyte Case Study

Your Name

Institution

Fluid and Electrolyte

Case Study

Case: A 65-year-old female is admitted to your unit complaining of nausea, vomiting, and diarrhea for the past three days. Her history is unremarkable except hypertension, for which she takes hydrochlorothiazide. She relates feeling exhausted and having leg cramps which interfere with her sleeping. Notable assessment findings include T. 38.6 C, AP 102 and irregular, B.P. 90/50; absent bowel tones, poor muscle tone, and skin turgor.

Laboratory data includes:

K+ 2.9 mEq/L, Na+ 137 mEq/L, Cl- 97 mEq/L, and WBC 20,000/ul.

ECG shows irregular heart rate

Physician's orders include:

•IV D50.9%NaCl with 20 mEq KCl/L to infuse at 90cc/hr.

•40 mEq of KCl IV over the next 2 hours

•K+ level 30 minutes after 40 mEq IV KCl has infused

• Bedrest: May use bathroom

• NPO

Questions

What fluid and/or electrolyte disturbances does this client have?

According to the client's laboratory result, her potassium level is 2.9 mEq/L, sodium level is 137 mEq/L, chloride level is 97 mEq/L, and the white blood cell count is 20,000/ul. The client has hypokalemia and hypovolemia. Hypokalemia is a medical condition in which potassium level in a patient's blood drops. The normal range of potassium in the blood is 2.5 to 5.0 mEq/L, and the potassium level in this patient is 2.9mEq/L. Hypovolemia is a condition in which the patient’s blood volume is lower than average. Normal number of white blood count is 4,500 to 10,000. According to the laboratory's result, the white blood cell count in the patient is 20,000/ul, this number is higher than the normal range.

2.Which electrolyte disturbance is of most concern with this client?

Potassium level in the patient's body is very low as per normal level. Hypokalemia disturbance is of most concern with this client. In hypokalemia, the potassium level in the blood of a person falls lower than normal.

3.Underline the signs and symptoms that can result from this electrolyte disturbance

Hypokalemia can make muscles feel, twitch, weak, or even paralyzed

Hypokalemia may also cause digestive problems, due to low potassium level brain does not send relay signals to digestive system muscles.

Poor digestion system also cause absent bowel tones

Low potassion may result in a faster and harder beating of the heart. In this case, the Apical pulse of the patient is 102

Hypokalemia may also cause muscles to ache and stiff

Low potassium level can make the patient feel numbness and tingling in his/her feet, arms, and legs

Patients with hypokalemia are often tired and exhausted.

Hypokalemia also cause the skin to tugor because of excessive diarrhea

Potassium also helps the brain to send signals to the lungs; these signals helps in the contraction and expansion of the lungs CITATION FJG98 \l 1033 (Gennari, 1998). Low potassium level may also cause difficulty in breathing. As a result, the heart beats faster and harder.

Low potassium level, along with difficulty in breathing results in irregular heart rate.

4.What do you suspect as the cause(s) of this electrolyte disturbance?

There can be various factors that can cause hypokalemia in a patient. According to this case study, excessive vomiting can be a cause of hypokalemia in this patient. Moreover, potassium wasting diuretic therapy and no replacement for potassium in her body can also be the cause of hypokalemia. In addition to vomiting, excessive diarrhea may also cause hypokalemia CITATION FJG98 \l 1033 (Gennari, 1998). Chronic kidney disease can also cause the potassium level in the blood of a patient to drop. Low level of folic acid in women be the reason for hypokalemia. Excessive alcohol usage can also become a reason for potassium level to drop in blood.

5.What type of solution is D5NS with 20mEq KCl/L?

D5NS is a hypertonic solution suggested by the physician for treating a client's hypokalemia CITATION PFM95 \l 1033 . D5NS is a hypertonic solution with a high quantity of solute (potassium) in it. This hypertonic with a large quantity of potassium is given to the patient because of her low potassium level. Frequent dosage of hypertonic solution can increase the overall potassium level in a patient’s blood CITATION PFM95 \l 1033 (PF Moon, 1995). The hypertonic solution will cause the symptoms of hypokalemia to lesse with time.

6.Would you question any of these orders? Why?

Yes, I would question the physician’s order. The physician has ordered to give hypertonic solution (IV D50 9 percent Sodium chloride with 20mEq KCl/L), and 40 mEq of potassium chloride is administered after 2 hours of giving the hypertonic solution. Although 40mEq is a high value of potassium, this does not specify the level of potassium to dilute in the fluid. 2 hours is not enough to evaluate the potassium level in a patient’s body CITATION LSW08 \l 1033 (Weisberg, 2008).

7.List safe administration principles for IV potassium

Always follow the policies of an organization regarding the hypertonic dosage. Listed administrative principles/ guidelines should be followed by health care personnel for injecting hypertonic solutions.

Frequently administer the potassium level in the blood of the patient.

Do not completely rely on IV push as it will be dangerous for patient’s health

Do no dilute an excessive amount of potassium in a fluid.

Follow standards for the recommended amount of KCl to be used

Don't give a high amount of hypertonic every hour. Hypertonic should be given less than 10 mEq.hr

Do not insert KCl directly into the container, always remove the container then add KCl. This will avoid a high concentration of KCl in the fluid.

Always use an infusion pump

References

BIBLIOGRAPHY García-Palmieri, M. (1962). Reversal of hyperkalemic cardiotoxicity with hypertonic saline. American heart journal.

Gennari, F. (1998). Hypokalemia. New England Journal of Medicine.

PF Moon, G. K. (1995). Hypertonic saline-dextran resuscitation from hemorrhagic shock induces transient mixed acidosis. Critical care medicine.

Weisberg, L. (2008). Management of severe hyperkalemia. Critical care medicine.

321 W12 Discussion Response

321 W12 discussion response

[Name of the Writer]

[Name of the Institution]

321 W12 discussion response

Response 1

Hello, Gabriella, I read your post and I must say that you did an excellent job. The questions and answers technique helped a lot in grasping the case study you have described. Type 2 diabetes is a chronic condition that is associated with weaker sugar metabolism. In most common cases the body is incapable of making enough insulin however in some cases the body resists the effects of insulin. As you have mentioned in your case study that the woman you choose changed her eating habits I would like to add that many studies have shown that changing the lifestyle can help in controlling diabetes. While discussing the causes of diabetes many factors lead to diabetes except genes. The factor you have discussed is the over-weight (obesity) which is indeed a greater issue that causes lots of diseases. In the case study as you have mentioned that taking a controlled portion of meal helped the women reduce weight I also agree that controlled food portion not only help the people with their weight loss but it also covered their nutritional requirement that is necessary for maintaining good health. However, motivation is required to follow this balanced diet routine and as well as nutritionist guidance is necessary to avoid any future health risks (Abbott, 1997).

Response 2

Hello Vanessa, first of all, I would like to commend you on the efforts you did to explain the nutritional information and how it is related to an individual’s health. Hypertension is a long term medical condition in which the blood pressure in the arteries is always high. People having HTN should have a balanced diet so that they can prevent heart and kidney diseases associated with high blood pressure. In your assessment, you have selected your father which is a plus point as children are aware of their parent’s health and their eating habits. As you have mentioned that the reason for your father’s disease is eating disorders that he suffered during his childhood I would like to add that certain other factors are also involved in causing HTN such as stress, lack of physical activity and genetics, etc. However, it is important to diagnose the disease in early-stage to avoid future health risks. The methods you have mentioned to diagnosis HTN helps not only in diagnosing HTN but also providing the information about the nutritional information about the person. However, it is also important to understand the type of HTN for effective diagnosis and treatment (Redon, 2001). It is, therefore important to check the blood pressure regularly and maintain a healthy lifestyle as a balanced diet is the key to reduce all the health issues.

References

Abbott, R. (1997). Food and nutrition information: a study of sources, uses, and understanding. British food journal, 99(2), 43-49.

Redon, J. (2001). Hypertension in obesity. Nutrition, metabolism, and cardiovascular diseases: NMCD, 11(5), 344-353.

321 W12 Nutritional Assessment

Nutritional assessment

Nutritional assessment is a way of interpreting and collecting information before making a decision about the nutritional status of a person for knowing health issues a person may suffers with. For the current analysis (nutritional assessment) I would make a report on my younger brother as many changes are being noticed in his health and diet. Key observations are given below:

Nutritional status of the person

Nutritional status of a person includes both external factors (food safety, social and cultural factors). On the other hand, internal factors include physical activity, sex, age and nutrition etc.) My younger brother is sixteen years old and is facing few of the nutritional issues. Being in the growing phase of life his nutritional needs are totally against what he used to eat. He is facing issue of nutritional deficiency. Since last year, he suddenly started getting fat, even he tried losing weight, despite exercise and dieting, he failed to lose weight. Then sudden an unplanned drop of weight was observed. He is underweight now. His height also stopped at a point. He is not growing as his other age fellows are growing. It has been observed that most essential nutritional components are missing in his diet as most of the time, he takes junk food that lacks key nutritional components that are important for proper growth. High amount of calories and sugar intake gives us an indication that he may be suffering from diabetes as suddenly he comes in the list of underweight adults. For the last couple of months, fatigue has been observed.

Nutritional components (undervalued or over-valued)

There are numbers of nutritional components that are missing in his nutrition. Most common nutritional deficiencies that have been observed in my younger brother are of calcium, fiber, iron, victim E and magnesium. As already mentioned being a youngster one of the most fascinating thing for him is the junk food. As there are various under-valued components mentioned above, likewise there are some nutritional components that are over-valued as well. Over-valued nutritional components are salt, sugar, calories and fat etc. (Aparicio-Ugarriza,et,al,2019, p. 1-17).

Medical conditions

Though he is living a normal life but since early childhood he was suffering with some eating disorders i.e. bulimia nervosa, anorexia nervosa and binge eating disorder. Since last year, he started gaining some extra weight and tried some inappropriate ways of losing weight. In last four months he is facing a problem of unplanned weight loss that has now become a problem for him.

Sensory alterations

Sensory alterations are the changes noticed in a person’s reception and perception of a thing. No major sensory alterations has been witnessed (loss of hearing or losing sense of smell) but a minor change has been reported. For the last four months, he is making a complaint about the blurring of his eye-sight.

Diagnosis

There are various diagnostic tests that could be used for knowing the nutritional health of my younger brother. Following are the diagnostic tests that would provide us more information about his health status:

First his height and weight must be calculated for measuring his body mass index (BMI). Calculate the final score.

Secondly amount of unplanned weight loss must be calculated, calculate the score.

Any of his mental and physical health condition should be identified. Calculate the score.

Calculate the scores of all the above three calculations for having a final score.

Blood and sugar tests should be done.

All of the above mentioned diagnosis would give us some additional information about the nutritional status and health conditions of my youngster brother.

References

Aparicio-Ugarriza, R., Cuenca-García, M., Gonzalez-Gross, M., Julián, C., Bel-Serrat, S., Moreno, L. A., ... & Mouratidou, T. (2019). Relative validation of the adapted Mediterranean Diet Score for Adolescents by comparison with nutritional biomarkers and nutrient and food intakes: the Healthy Lifestyle in Europe by Nutrition in Adolescence (HELENA) study. Public health nutrition, 1-17.

321 W13 Infants Case Study

321 W13 Infants Case Study

[Name]

[Institution]

Author Note

321 W13 Infants Case Study

Question 1

Which assessment technique you would employ to assist in determining the situation (comprehensive, problem-oriented, or focused) and why?

Usually, comprehensive care and problem-oriented care is used to treat patients, especially ones that need to be looked after on a one-on-one basis. However, these measures include care not only required by the patient but also requested by the patient in question. While dealing with young infants, especially those that are acting fussy, it is better to use focused care. It focuses on the means of solving the issue rather than the end and focuses on providing them with the care that they need ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fbj5VW1t","properties":{"formattedCitation":"(Ros\\uc0\\u233{}n, Persson, & Persson, 2017)","plainCitation":"(Rosén, Persson, & Persson, 2017)","noteIndex":0},"citationItems":[{"id":530,"uris":["http://zotero.org/users/local/5VyEEXyp/items/F4LCHJNA"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/F4LCHJNA"],"itemData":{"id":530,"type":"article-journal","title":"Challenges of patient-focused care: Nurses’ descriptions and observations before and after intervention","container-title":"Nordic Journal of Nursing Research","page":"27-32","volume":"37","issue":"1","author":[{"family":"Rosén","given":"Helena"},{"family":"Persson","given":"Rebecca Gagnemo"},{"family":"Persson","given":"Eva"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Rosén, Persson, & Persson, 2017). With regard to the babies, given the fact that they cannot be questioned on the type of care they need, focused-care is the best alternative among the options at hand.

Question 2

Identify what assessment data are pertinent and what critical thinking measures you took to arrive at these conclusions.

Given that the children are not even a year old, the sort of case they required should be focused on easing their problems while looking for a long-lasting cure. It keeps their specific needs above that of the desired health outcomes. The decisions being made here should be derived from healthcare decisions and quality measurements. Patients, along with their family, are partners in terms of the patient’s healthcare providers. These patients do not need to be treated from a clinical perspective alone, but also from an emotional perspective. They need to be cared for in ways that are rather different than normal patients, considering their age and their affliction.

Question 3

Hypothesize a nursing diagnosis (or collaborative) and support.

Crying is a rather common physiological behavior among infants. Between the ages of 6 to 8 weeks, babies have a tendency to cry as much as two to three times every 24 hours. However, excessive crying and being fussy is often referred to as ‘colic’ among infants and their caretakers. In most babies, colic eases up at 3 months of age. However, in 90% of the babies, the condition can last up to 9 months of age. Add in the lack of sleep, increased hunger and frustration with unexplored surroundings would only add to the fussiness of infants that already cry for more than 3 hours in a day. Given the stated scenario, this is the initial diagnosis of the infants ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"gWjomfVv","properties":{"formattedCitation":"(Al Saadoon, Rizvi, Khan, Shuaili, & Mamari, 2018)","plainCitation":"(Al Saadoon, Rizvi, Khan, Shuaili, & Mamari, 2018)","noteIndex":0},"citationItems":[{"id":531,"uris":["http://zotero.org/users/local/5VyEEXyp/items/G2GVVNDC"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/G2GVVNDC"],"itemData":{"id":531,"type":"article-journal","title":"Prevalence and Associated Factors of Infantile Colic among Omani Babies","container-title":"Clin Res Open Access","volume":"4","issue":"3","author":[{"family":"Al Saadoon","given":"M."},{"family":"Rizvi","given":"S."},{"family":"Khan","given":"I."},{"family":"Shuaili","given":"A. K. A."},{"family":"Mamari","given":"M. A. A."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Al Saadoon, Rizvi, Khan, Shuaili, & Mamari, 2018).

Furthermore, in case the infants are not colic, the matter becomes rather more serious, with the babies possibly suffering from one or more serious problems. This includes headache, stomachache, diabetes, anemia, asthma, infections, head injury, and even autism and abnormal brain development ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ewnKSgnn","properties":{"formattedCitation":"(Turner & Palamountain, 2015)","plainCitation":"(Turner & Palamountain, 2015)","noteIndex":0},"citationItems":[{"id":534,"uris":["http://zotero.org/users/local/5VyEEXyp/items/9E2QYPZQ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/9E2QYPZQ"],"itemData":{"id":534,"type":"article-journal","title":"Infantile colic: Clinical features and diagnosis","container-title":"UpToDate. UpToDate","author":[{"family":"Turner","given":"Teri Lee"},{"family":"Palamountain","given":"S."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Turner & Palamountain, 2015).

Question 4

Identify one goal and one expected outcome for this situation.

The one expected goal of this situation is to treat the possible diagnosis of treating the infants for colic. Colic is a common ailment among 9-month-old infants. However, being fussy and irritable is not just a symptom of infants being colic, but it can also result in a number of various other illnesses, each more serious than the one before, especially in case of 9-month-old infants. These illnesses include headache, stomachache, diabetes, anemia, asthma, infections, head injury, and even autism and abnormal brain development ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"OxSGfP98","properties":{"formattedCitation":"(Turner & Palamountain, 2015)","plainCitation":"(Turner & Palamountain, 2015)","noteIndex":0},"citationItems":[{"id":534,"uris":["http://zotero.org/users/local/5VyEEXyp/items/9E2QYPZQ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/9E2QYPZQ"],"itemData":{"id":534,"type":"article-journal","title":"Infantile colic: Clinical features and diagnosis","container-title":"UpToDate. UpToDate","author":[{"family":"Turner","given":"Teri Lee"},{"family":"Palamountain","given":"S."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Turner & Palamountain, 2015). However, the expected outcomes of this situation would be to ensure that the children are suffering from something treatable, that does not have long-term consequences such as colic, rather than a disease with serious implications.

Question 5

Describe the best communication technique that you would use with these two infants to illustrate caring and patient-centered care.

Effective communication is an essential part of patient-centered care, especially in terms of infant patients and their families. The physicians, traditionally, hold a position of respect and authority in society, however, opening communicating with the physician may become difficult for the family of patients. Thus, the physician should invite the parents of the patient to discuss the information openly. Both parties should feel at ease to address the vital concerns regarding the patient and yet be forthcoming for the patient’s wellbeing.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Al Saadoon, M., Rizvi, S., Khan, I., Shuaili, A. K. A., & Mamari, M. A. A. (2018). Prevalence and Associated Factors of Infantile Colic among Omani Babies. Clin Res Open Access, 4(3).

Rosén, H., Persson, R. G., & Persson, E. (2017). Challenges of patient-focused care: Nurses’ descriptions and observations before and after intervention. Nordic Journal of Nursing Research, 37(1), 27–32.

Turner, T. L., & Palamountain, S. (2015). Infantile colic: Clinical features and diagnosis. UpToDate. UpToDate.

332 W10 Synchronous Reflection



332 W10 Synchronous Reflection

[Name of the Writer]

[Name of the Institution]

332 W10 Synchronous Reflection

Discussion

Ischemia

Ischemia is a condition in which blood flow towards the heart reduces (Ibanez et.al, 2015). It restricts the heart from receiving enough oxygen to work properly (Ibanez et.al, 2015). Reduced oxygen supply causes partial or complete blockage of the heart's arteries (Ibanez et.al, 2015). Ischemia diminishes the heart's capacity to pump blood. Apart from causing abnormal heartbeat patterns, Ischemia can result in a heart attack (Ibanez et.al, 2015). Treating Ischemia aims at improving blood supply towards the heart. Furthermore, patients with more serious condition need to undergo angioplasty or bypass surgery (Ibanez et.al, 2015). Symptoms for Ischemia include chest pain on the left side. Rapid heartbeat and shortness of breath even after doing a simple physical activity are also the symptoms Ischemia. Individuals suffering from diabetes, high blood pressure, high cholesterol are at increased risk due to Ischemia (Ibanez et.al, 2015). Furthermore, obese individuals can experience serious complications due to Ischemia. Complications that arise due to Ischemia include heart attack due to the blockage of the coronary artery (Ibanez et.al, 2015). Furthermore, the abnormal heartbeat can make the heart weaker. These complications might prove deadly if not treated over time.

Absolute Refractory Period

The action potential is a transmission process in which neurons broadcast signals all over the body (Tackmann & Lehmann, 1974). The action potential is a process in which neurons are fired (Tackmann & Lehmann, 1974). The resting membrane potential of a neuron is measured at – 70 millivolts (Tackmann & Lehmann, 1974). At -55 millivolts, the stimulus initiates to polarize the neuron (Tackmann & Lehmann, 1974). The neural membrane remains open throughout action potential which allows passage of positively charged ions into the cell and negatively charged ions out of the cell (Tackmann & Lehmann, 1974). The action potential is the period from -55 to +30 millivolts (Tackmann & Lehmann, 1974). A specific phase during the action potential is called the absolute refractory period (Tackmann & Lehmann, 1974). During the absolute refractory period, despite the strength of a stimulus applied on a neuron, it cannot initiate another action potential (Tackmann & Lehmann, 1974). The total lifetime of the absolute refractory period begins from immediately after action potential and lasts after the peak of the action potential has been reached (Tackmann & Lehmann, 1974). Once, the absolute refractory period has been attained, the beginning of the relative refractory period (Tackmann & Lehmann, 1974).

References

Ibanez, B., Heusch, G., Ovize, M., & Van de Werf, F. (2015). Evolving therapies for myocardial ischemia/reperfusion injury. Journal of the American College of Cardiology, 65(14), 1454-1471.

Tackmann, W., & Lehmann, H. J. (1974). Refractory period in human sensory nerve fibers. European neurology, 12(5-6), 277-292.

332 W10 Synchronous Reflection Option B

Title page

Synchronous reflection

Gastritis, differentiate between acute and chronic gastritis?

Acute gastritis is a condition in which the lining of the stomach gets swelled or inflated. The common causes include non-steroidal anti-inflammatory drugs. corticosteroid is also a prominent cause of acute gastritis. The pain felt by the patient is temporary and lasts for few bursts. The patient who has experienced kidney failure is more likely to develop acute gastritis. Chronic gastritis is more severe condition and the pain is sharp. It is difficult to bear the pain for the patients and lasts for longer CITATION Hea19 \l 1033 (Healthline, 2019). The common causes of chronic gastritis include long-term use of medications, excessive consumption of alcohol, existence of pylori bacteria, certain illness such as kidney failure and a weak immune system. The common symptoms of chronic gastritis are nausea, vomiting, bloating, indigestion and loss of appetite.

Peptic Ulcer. Who is at risk? What is associated? What is H. pylori?

Peptic ulcer is a condition of duodenal ulcers. It is sore on the lining of the stomach and the patient undergo severe pain. Long-term use of non-steroidal anti-inflammatory drugs and ibuprofen is the dominant cause of peptic ulcer CITATION VPr14 \l 1033 (Prabhu & Shivani, 2014). It is more common among people who are having ages of 70 years or above. The common causes include unclean food, water and unhygienic conditions. Contact with infected person also increases the risks of peptic ulcer. H. Pylori is a type of bacteria that enters the body and targets the digestive track. It is common and experienced by one-third of the world population. Peptic ulcer is linked to H. Pylori bacteria because it affects the digestive track. The presence of H. Pylori increases the risks of chronic gastritis if it remains untreated. Long-term use of certain medicines causes development of H. Pylori bacteria that also results in gastritis.

References

BIBLIOGRAPHY Healthline. (2019). What is acute gastritis? . Retrieved 07 28, 2019, from https://www.healthline.com/health/gastritis-acute#risk-factors

Prabhu, V., & Shivani, A. (2014). An Overview of History, Pathogenesis and Treatment of Perforated Peptic Ulcer Disease with Evaluation of Prognostic Scoring in Adults. Ann Med Health Sci Res , 4 (1), 22–29.

332 W11 Synchronous Refelcytion Option B

Synchronous Reflection

[Author’s name]

Synchronous Reflection

Osteoarthritis, and Rheumatoid Arthritis

Osteoarthritis (OA) and Rheumatoid Arthritis (RA) are recognized as two well-known diseases that cause the issues of joint pain and stiffness in the human body. Inflammation in the joints is the specific condition that prevails in case of both these health concerns. Detailed consideration of both these diseases of joints reveals that there is the prevalence of many differences and similarities. It is important to critically examine various aspects associated with OA and RA to identify the better approaches of treatment.

Osteoarthritis (OA)

It is established as the most common form of the issue of arthritis that greatly affects the body functioning of millions of people. This specific health condition appeared when the element of protective cartilage start damaging over time ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"4LFkx1gi","properties":{"formattedCitation":"(Michael, Schl\\uc0\\u252{}ter-Brust, & Eysel, 2010)","plainCitation":"(Michael, Schlüter-Brust, & Eysel, 2010)","noteIndex":0},"citationItems":[{"id":1221,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/CU8E34VQ"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/CU8E34VQ"],"itemData":{"id":1221,"type":"article-journal","title":"The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee","container-title":"Deutsches Arzteblatt International","page":"152","volume":"107","issue":"9","author":[{"family":"Michael","given":"Joern W.-P."},{"family":"Schlüter-Brust","given":"Klaus U."},{"family":"Eysel","given":"Peer"}],"issued":{"date-parts":[["2010"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Michael, Schlüter-Brust, & Eysel, 2010). This specific issue of joints mostly affects the features of hands, knees, spine, and hips.

Signs and Symptoms

Pain

Issues in the form of flexibility

Stiffness

Tenderness

A greater form of sensation

Puffiness

Bone outgrowths

Etiology

Weight

Injury

Genes

Overuse of joints

Risk Factors

Sex

Older age

Injuries of joints

Overweightness

Issues in genetics

Bone distortions

Due to metabolic health concerns

Rheumatoid Arthritis (RA)

The health issue of RA recognized as the one common disorder of joint that prevails in the form of a long-term autoimmune problem. Warm, swollen, and painful joints are the significant aspects associated with this particular health issue ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"0teogV4O","properties":{"formattedCitation":"(Nielen et al., 2004)","plainCitation":"(Nielen et al., 2004)","noteIndex":0},"citationItems":[{"id":1222,"uris":["http://zotero.org/users/local/7Hi3kAOD/items/DUN3CGBQ"],"uri":["http://zotero.org/users/local/7Hi3kAOD/items/DUN3CGBQ"],"itemData":{"id":1222,"type":"article-journal","title":"Specific autoantibodies precede the symptoms of rheumatoid arthritis: a study of serial measurements in blood donors","container-title":"Arthritis & Rheumatism: Official Journal of the American College of Rheumatology","page":"380-386","volume":"50","issue":"2","author":[{"family":"Nielen","given":"Markus MJ"},{"family":"Schaardenburg","given":"Dirkjan","non-dropping-particle":"van"},{"family":"Reesink","given":"Henk W."},{"family":"Van de Stadt","given":"Rob J."},{"family":"Horst‐Bruinsma","given":"Irene E.","non-dropping-particle":"van der"},{"family":"Koning","given":"Margret HMT","non-dropping-particle":"de"},{"family":"Habibuw","given":"Moud R."},{"family":"Vandenbroucke","given":"Jan P."},{"family":"Dijkmans","given":"Ben AC"}],"issued":{"date-parts":[["2004"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Nielen et al., 2004). The problem of RA mostly prevails in case of hands and wrist. The problem of RA starts damaging human’s body when the immune system mistakenly starts damaging the body’s tissues.

Signs and Symptoms

Tender and swollen joints

Stiffness of joints

Fever

Tiredness

Loss of appetite

Etiology

It appeared when the immune system attacks the synovium.

Inflammation

Damage cartilage and bones related to the joint.

Risk Factors

Sex

Genetics

Age

Obesity

Smoking

Inappropriate contact with the environment.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Michael, J. W.-P., Schlüter-Brust, K. U., & Eysel, P. (2010). The epidemiology, etiology, diagnosis, and treatment of osteoarthritis of the knee. Deutsches Arzteblatt International, 107(9), 152.

Nielen, M. M., van Schaardenburg, D., Reesink, H. W., Van de Stadt, R. J., van der Horst‐Bruinsma, I. E., de Koning, M. H., … Dijkmans, B. A. (2004). Specific autoantibodies precede the symptoms of rheumatoid arthritis: A study of serial measurements in blood donors. Arthritis & Rheumatism: Official Journal of the American College of Rheumatology, 50(2), 380–386.

332 W12 Synchronous Reflection

Submitted by

Professor

Affiliation

Date

Huntington Disease - Causes, Signs and Symptoms

It is a neurological pathological disease that is hereditary and characterized by the appearance of periodic muscle twitches or cramps. The first prerequisites of this process appear, as a rule, in 30-50 years. For the onset of the disease, chorea is most characteristic - erratic, uncontrolled, involuntary convulsive movements of the arms and legs (Bates, Dorsey, Gusella, Hayden & Wild, 2015).

As a rule, the first symptoms of the beginning chorea are noticed not by the patient himself, but by his relatives and friends, as the affected person has a sharp change in mood, causeless attacks of anxiety, anxiety, rage, the appearance of depression , etc. This disease progresses slowly, but inevitably, as a result of which symptoms such as; speech disorder, Choreic hyperkinesia, Intellect disorder, acute excitability, dementia and sleep disorders (Bates, Dorsey, Gusella, Hayden & Wild, 2015).

Alzheimer's vs dementia- Causes, Signs and Symptoms

Dementia is a collective name for a number of different conditions, of which Alzheimer's is the most common. The higher functions of the brain are divided into three parts - emotional (emotions), conative (will, planning and execution) and cognitive (memory, perception and language)(Chui, Victoroff, Margolin, Jagust, Shankle, & Katzman,2002).

Alzheimer's disease is a progressive brain disease with symptoms caused by damage to certain areas of the brain. Alzheimer's disease can be diagnosed even before dementia on the basis of a typical symptom. Alzheimer's disease begins with memory impairment, and memory is the most severely impaired function of memory and data processing (cognition) throughout the disease. Impairment of performance is closely related to memory and data processing problems. Behavioral symptoms vary in different stages of the disease. Deviations in the natural course of the disease refer to comorbidities or environmental factors that alter the course of the disease and must be identified and treated”(Ritchie & Lovestone, 2012).

The most common causes of dementia are; nervous disease, vascular changes in the brain, physical injury, tumor, inflammation etc. The most common signs and symptoms of Alzheimer's disease are creeping symptoms and slow deterioration, memory problem, learning difficulty, difficulties in recognizing and interpreting along with emotional and behavioral disorders.

References

Bates, G. P., Dorsey, R., Gusella, J. F., Hayden, M. R., Kay, C., Leavitt, B. R., ... & Wild, E. J.

(2015). Huntington disease. Nature reviews Disease primers, 1, 15005.

Chui, H. C., Victoroff, J. I., Margolin, D., Jagust, W., Shankle, R., & Katzman, R. (2002).

Criteria for the diagnosis of ischemic vascular dementia proposed by the State of California Alzheimer's Disease Diagnostic and Treatment Centers. Neurology, 42(3), 473-473.

Ritchie, K., & Lovestone, S. (2012). The dementias. The Lancet, 360(9347), 1759-1766.