Cardiovascular Alterations
At least once a year, the media report on a seemingly healthy teenage athlete collapsing during a sports game and dying of heart complications. These incidents continue to outline the importance of physical exams and health screenings for teenagers, especially those who play sports. During these health screenings, examiners check for cardiovascular alterations such as heart murmurs because they can be a sign of an underlying heart disorder. Since many heart alterations rarely have symptoms, they are easy to miss if health professionals are not specifically looking for them. Once cardiovascular alterations are identified in patients, it is important to refer them to specialists who can further investigate the cause.
Consider the following scenario:
A 16-year-old male presents for a sports participation examination. He has no significant medical history and no family history suggestive of risk for premature cardiac death. The patient is examined while sitting slightly recumbent on the exam table and the advanced practice nurse appreciates a grade II/VI systolic murmur heard loudest at the apex of the heart. Other physical findings are within normal limits, the patient denies any cardiovascular symptoms, and a neuromuscular examination is within normal limits. He is cleared with no activity restriction. Later in the season he collapses on the field and dies.
To Prepare
Review the scenario provided, as well as Chapter 25 in the Huether and McCance text. Consider how you would diagnose and prescribe treatment for the patient.
Select one of the following patient factors: genetics, ethnicity, or behavior. Reflect on how the factor you selected might impact diagnosis and prescription of treatment for the patient in the scenario.
Post a description of how you would diagnose and prescribe treatment for the patient in the scenario. Then explain how the factor you selected might impact the diagnosis and prescription of treatment for that patient.
Required Readings
** Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis, MO: Mosby.
Chapter 23, “Structure and Function of the Cardiovascular and Lymphatic Systems”
This chapter examines the circulatory system, heart, systemic circulation, and lymphatic system to establish a foundation for normal cardiovascular function. It focuses on the structure and function of various parts of the circulatory system to illustrate normal blood flow.
Chapter 24, “Alterations of Cardiovascular Function”
This chapter presents the pathophysiology, clinical manifestations, evaluation, and treatment of various cardiovascular disorders. It focuses on diseases of the veins and arteries, disorders of the heart wall, heart disease, and shock.
Chapter 25, “Alterations of Cardiovascular Function in Children”
This chapter examines cardiovascular disorders that affect children. It distinguishes congenital heart disease from acquired cardiovascular disorders.
** Hammer, G. G. , & McPhee, S. (2014). Pathophysiology of disease: An introduction to clinical medicine. (7th ed.) New York, NY: McGraw-Hill Education.
Chapter 11, “Cardiovascular Disorders: Vascular Disease”
This chapter begins with an overview of the vascular component of the cardiovascular system and how the cardiovascular system is normally regulated. It then describes three common vascular disorders: atherosclerosis, hypertension, and shock.
**American Heart Association. (2012). Retrieved from http://www.heart.org/HEARTORG/
**Million Hearts. (2012). Retrieved from http://millionhearts.hhs.gov/index.html
**National Heart, Lung, and Blood Institute. (2012). Retrieved from http://www.nhlbi.nih.gov/
Instructor Requirements
As advanced practice nurses, we are scholars, nurse researchers and scientists. As such, please use Peer-Reviewed scholarly articles and websites designed for health professionals (not designed for patients) for your references. Students should be using the original citation in Up
to Date and go to that literature as a reference. The following are examples (not all inclusive) of resources/websites deemed inadmissible for scholarly reference:
1. Up to Date (must use original articles from Up to Date as a resource)
2. Wikipedia
3. Cdc.gov- non healthcare professionals section
4. Webmd.com
5. Mayoclinic.com
– This work should have Introduction and Conclusion
– It should have at least 3 current references
– APA format
– At least 2 pages, references page not included
Assignment: Change Paper Assignment Overview In this assignment, you will assess a current semi-direct or indirect nursing situation that is in need of change. Observe a healthcare environment, focusing on areas of the nursing process that are inefficient, unsafe, or problematic in nature. Diagnose the problem and choose a nursing change theory that suits the change(s) you want to make. Propose a detailed plan based on your chosen change theory, explaining how to implement change. Develop criteria to evaluate the effectiveness of the plan and include a timeline for your change proposal. Finally, reflect on how your change affects the nursing profession. Assignment Details: Perform the following tasks: Complete the reading assignment and the interactive lesson before attempting this assignment. Assess a current semi-direct or indirect nursing situation that is in need of change. o Observe your healthcare environment, focusing on areas of nursing process that are inefficient, unsafe, or problematic in nature. o Diagnose the problem and choose a nursing change theory that suits the change you want to make. o Propose a detailed plan based on your chosen change theory, explaining how to implement change. o Develop criteria to evaluate the effectiveness of the plan and include a timeline for your change proposal. o Reflect on how your change affects the nursing profession. Write a 3-5 page paper following the criteria below: o Your paper should include primary sources and include at least two peerreviewed nursing journal articles. o Citations should be in your own words and not direct quotes. o Include a title page, running head, appropriate headings, and reference page. o The paper should be double spaced, written in Times New Roman, 12-point font, follow APA style format, and cite all sources correctly. Include the proper file naming convention: NUR204_wk9_assn_jsmith_mmddyyy. Grading: Criteria Excellent (3pts) Good (2pts) Needs Improvement (1pt) Pts. Research – Cited 4 or more reliable sources. – Sufficient information provided to support topic. – Research in-depth, revealing new insight. – Cited 4 or more reliable sources. – Adequate information provided to support topic. – Research is superficial. – Missing citations or unreliable sources used. – Information does not support research topic. – Research is not relevant to paper. NUR204: Week 9 Assignment Page 2 ` Content – Appropriate topic is chosen that relates directly to the nursing process. – Proposed plan contains specific ideas for change. – Change theory is included and proposal follows theory. – Timeline is included for change proposal. – Reflection is provided. – Appropriate topic is chosen that relates directly to the nursing process. – Proposed plan is included but missing specifics. – Change theory is included and proposal follows theory. – Timeline is incomplete – Reflection is not relevant to nursing process. – Inappropriate topic is chosen that is unrelated to nursing process. – Proposed plan is inconsistent and missing specifics. – Change theory is missing or inappropriate. Plan does not follow theory. – Timeline is missing. – Reflection is missing. Grammar/Spelling – Consistent and appropriate writing style. – No spelling/grammar errors. – Length is 3-5 pages using Times New Roman, 12-point font – Writing is consistent and appropriate. – Grammar/spelling errors are minor. – Length is less than 3 pages or Times New Roman, 12-point font not used. – Writing is inconsistent and inappropriate. – Significant grammar/spelling errors. – Length less than 3 pages or Times New Roman, 12-point font not used. References/APA – All sources properly cited using APA format. – Includes title page, running head, page numbers, proper paragraphs, and reference page. – All sources properly cited using APA format with minor errors (punctuation). – Includes title page, running head, page numbers, and reference page with minor errors in paragraph format. – Sources not cited correctly. – Missing elements such as title page, running head, and reference page.
This benchmark assignment assesses the following programmatic competencies:
2.3: Develop leadership skills to collaborate on interprofessional teams in the provision of evidence-based, patient-centered care.
5.2: Apply professional, ethical, and regulatory standards of practice in the provision of safe, effective health care.
One way informatics can be especially valuable is in capturing data to inspire improvements and quality change in practice. The Agency for Healthcare Research and Quality (AHRQ) collects data related to adverse events and safety concerns. If you are working within a practice setting to implement a new electronic health record (EHR) system, this is just one of the many considerations your team would need to plan for during the rollout process.
In a paper of 1,250-1,500 words, address the following questions related to the advanced registered nurse’s role during this type of scenario:
You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Discuss what role you believe that HIM( Health information Management) professionals should have in reducing and eliminating ADE’s ( adverse drug events).
Include in-text citations and references in APA 6th Edition format.
Only 250 words
This week’s graded topics relate to the following Course Outcomes (COs).
We begin our journey into discovering the new world of research and evidence-based practice (EBP) by exploring our past. After completing the required readings and lesson, answer the following:
Hello Class,
Why should nurses incorporate research? How could it (or does it?) impact your nursing practice? Think about these questions as you complete the assigned readings this week. Our profession was founded by Florence Nightingale, who was not just our nursing pioneer, but a researcher, too. In the last few years, we have seen many trends pushing nurses to have a professional practice based on evidence. With that as our beginning, consider our week’s discussion:
1. How has research evolved since Florence Nightingale?
2. How are research and EBP different and how does research support EBP?
3. Unfortunately, despite the positive impact research and EBP has, there have been major cases of research misconduct. Please choose one historical case and how you would engage in ethical treatment of a research participant.
Professor’s comment: This week, we will meet the following course outcomes:
You may begin posting in this thread no sooner than the first Sunday of week one. Posts prior to this time will not receive credit. I look forward to your thoughts! Dr. Smailes
references: Houser, J. (2018). Nursing research: Reading, using, and creating evidence (4th ed.). Burlington, MA: Jones & Bartlett Learning.
This textbook is available as an e-book and can be accessed from the module view.
Required Resources
Read/review the following resources for this activity:
Introduction
History is the choice made by humanity through time. These choices have fostered the world that we live in today. In a similar sense, learning does not just “just happen” to you. You must be actively engaged in the learning process by making choices to devise strategies to maximize your potentials, reflect on the strategies that worked and those that didn’t, and modify these strategies moving forward. I want all of you to earn an A in this class!
Instructions
For this journal entry, envision yourself having received an A at the end of the class. Imagine yourself looking back over the class and describe the strategies you used to earn that A. Here are some items for you to consider in your response:
Complete this assignment in a Word document.
Writing Requirements (APA format)
Overview
· Develop a data table that illustrates one or more underperforming clinical outcomes in a care environment of your choice. Write an assessment (3 pages) in which you set one or more quantitative goals for the outcomes and propose a change plan that is designed to help you achieve the goals.
Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, it is recommended that you complete the assessments in this course in the order in which they are presented.
Knowing what is the best practice for our patients is very important in providing safe and effective care. Understanding best practices can help nurses identify areas of care that need to be improved. To identify areas of need, nurses must use evidence from various sources, such as the literature, clinical practice guidelines (CPG), professional organization practice alerts or position papers, and protocols. These sources of evidence can also be used to set goals for improvement and best practices with an eye toward improving the care experience or outcomes for patients.
The challenge facing many care environments and health care practitioners is how to plan for change and implement changes. For, if we cannot effectively implement changes in practice or procedure, than our goals of improving care will likely amount to nothing. This assessment focuses on allowing you to practice locating, assessing, analyzing, and implementing change strategies in order to improve patient outcomes related to one or more clinical goals.
This assessment will take the form of a data table to identify areas for improvement and to set one or more outcome goals, as well as a narrative describing a change plan that would help you to achieve the goals you have set.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
· Competency 1: Design patient-centered, evidence-based, advanced nursing care for achieving high-quality patient outcomes.
· Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
· Competency 2: Develop change strategies for improving the care environment.
· Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
· Justify the specific change strategies used to achieve desired outcomes.
· Competency 3: Apply quality improvement methods to practice that promote safe, equitable quality of care.
· Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
· Competency 4: Evaluate the efficiency and effectiveness of interprofessional care systems in achieving desired health care improvement outcomes.
· Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
· Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
· Communicate change plan in a way that makes the data and rationale easily understood and compelling.
· Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Assessment Instructions
· Scenario
Consider the current environment. This could be your current care setting, the care settings presented in the Vila Health: Using Evidence to Drive Improvement or Vila Health: Concept Maps as Diagnostic Tools media, or a care setting in which you are interested in working.
For the setting that you choose you will need to have a data set that depicts sub-optimal outcomes related to a clinical issue. This data could be from existing sources in the course (Vila Health: Using Evidence to Drive Improvement), a relevant data set that already exists (a data set from the case study you used as a basis for your Concept Map assessment, or from your current place of practice), or an appropriate data set that you have created yourself. (Note: if you choose to create your own data set, check with your instructor first for approval and guidance.)
After you have selected an appropriate data set, use your understanding of the data to create at least one realistic goal (though you may create more) that will be driven by a change strategy appropriate for the environment and goal.
Potential topics for this assessment could be:
· Consider ways to help minimize the rate of secondary infections related to the condition, disease, or disorder that you focused on for your Concept Map assessment. As a starting point you could ask yourself, “What could be changed to facilitate safety and minimize risks of infection?”
· Consider how to help a patient experiencing traumatic stress or anxiety over hospitalization. As a starting point you could ask yourself, “How could the care environment be changed to enhance coping?”
Once you determine the change you would like to make, consider the following:
· What data will you use to justify the change?
· How can the team achieve this change with a reasonable cost?
· What are the effects on the workplace?
· What other implementation considerations do you need to consider to ensure that the change strategy is successful?
· How does your change strategy address all aspects of the Quadruple Aim, especially the well-being of health care professionals?
· Once the change strategy is implemented, how would you evaluate the efficiency and effectiveness of the care system if the desired outcomes are met?
Instructions
Your assessment submission should include a data table that illustrates the current and desired states of the clinical issue you are attempting to improve through your application of change strategies. Additionally, you will need to explain the rationale for your decisions around your chosen change strategies, as well as how the change strategies will be successfully implemented. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your change strategy addresses all of them. You may also want to read the Change Strategy and Implementation scoring guide and Guiding Questions: Change Strategy and Implementation to better understand how each grading criterion will be assessed.
· Develop a data table that accurately reflects the current and desired states of one or more clinical outcomes.
· Propose change strategies that will help to achieve the desired state of one or more clinical outcomes.
· Justify the specific change strategies used to achieve desired outcomes.
· Explain how change strategies will lead to quality improvement with regard to safety and equitable care.
· Explain how change strategies will utilize interprofessional considerations to ensure successful implementation.
· Communicate the change plan in a way that makes the data and rationale easily understood and compelling.
· Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style.
Additional Requirements
· Length of submission: 3 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive.
· Number of references: Cite a minimum of 3–5 sources of scholarly or professional evidence that supports your goal setting, proposed change strategies, quality improvement, and interprofessional considerations. Resources should be no more than five years old.
· APA formatting: Use the APA Paper Template linked in the Resources. An APA Template Tutorial is also provided to help you in writing and formatting your analysis. No abstract is required.
Part Two:
This assignment will be at least 1500 words or more
This week you will reflect upon the effects of the nursing shortage to answer the following questions:
Assignment Expectations:
Research the health-illness continuum and its relevance to patient care. In a 750-1,000 word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
1. Describe the characteristics of the aging process. Explain how some of the characteristics may lead to elder abuse (memory issues, vulnerability, etc.). Discuss the types of consideration a nurse must be mindful of while performing a health assessment on a geriatric patient as compared to a middle-aged adult.
2.
End-of-life care becomes an issue at some point for elderly clients. Even with the emergence of palliative care programs and hospice programs, most elderly people do not die in their own home as is their preference. What are the reasons for this trend? Discuss what you can do as a nurse to support your clients regarding end-of-life care in accordance with their wishes. Support your response with evidence-based literature.