I’m working on a nursing case study and need support to help me understand better.

Health History

Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.

Intervention

The following medications administered through drug therapy control her symptoms:

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:

1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.

I’m working on a nursing multi-part question and need guidance to help me understand better.

1. Develop a research question to provide information about the research problem.
2. Based on your research question, do you believe it will best be answered by a qualitative or quantitative study ? Support your decision as to why you believe the answers would best be provided by the type of study you have chosen.
3. Select a middle-range theory and identify the application of nursing theories to your research problem.
   Conduct a literature review.
4. Based on your literature review answer the following questions:
   • If qualitative,
     • Identify the purpose of the study.
     • Briefly, describe the design of the study and explain why you think it is either appropriate or inappropriate to meet the purpose.
     • Identify ethical issues related to the study and how they were/were not addressed.
     • Identify the sampling method and recruitment strategy that was used.
     • Discuss whether sampling and recruitment were appropriate to the aims of the research.
     • Identify the data collection method(s) and discuss whether the method(s) is/are appropriate to the aims of the study.
     • Identify how the data was analyzed and discuss whether the method(s) of analysis is/are appropriate to the aims of the study.
     • Identify four (4) criteria by which the rigor of a qualitative project can be judged.
     • Discuss the rigor of this study using the four criteria.?
     • Briefly, describe the findings of the study and identify any limitations.
     • Use the information that you have gained from your critique of the study to discuss the trustworthiness and applicability of the study. Include in your discussion any implications for the discipline of nursing.
   • If quantitative,
     • Identify the purpose and design of the study.
     • Explain what is meant by ‘blinding’ and ‘randomization’ and discuss how these were addressed in the design of the study.
     • Identify ethical issues related to the study and how they were/were not addressed. ?
     • Explain the sampling method and the recruitment strategy was used.
     • Discuss how the sample size was determined – include in your discussion an explanation of terms used.
     • Briefly, outline how the data was collected and identify any data collection instrument(s).
     • Define the terms of validity and reliability, and discuss how the validity & reliability of the instruments were/were not addressed in this study and why this is important.
     • Outline how the data were analyzed.
     • Identify the statistics used and the level of measurement of the data described by each statistical test – include in your discussion an explanation of terms used.
     • Briefly, outline the findings and identify any limitations of the study.
     • Use the information that you have gained from your critique of the study to briefly discuss the trustworthiness and applicability of the study. Include in your discussion an explanation of the term statistical significance and name the tests of statistical significance used in this stud

     Please answer the questions below.

5. Regarding your presentation assignment, what did you learn about the research project?
6. Would you have approached the assignment differently? Why or why not?

I’m working on a nursing exercise and need support to help me understand better.

learning out come-explore the meaning of pregnancy and birth with culturally diverse clients and their families

1. identify factors that influence health and wellbeing of the childbearing family from a holistic perspective

2. explore health-related benefits, values, and hopes of child-bearing families, and integrate a plan of care, including cultural beliefs surrounding the perinatal experience ( identify factors that influence health and wellbeing from a holistic perspective)

. 3. recognize the role of family-centered care in the child-bearing experience (understand role of women and family as a expert in their care)

Promotion Children’s social and emotional development through preschool education

After reading and watching the content for this module, provide a minimum of 3-page response to the following prompts:

• What did you already know about social and emotional development in infants and toddlers?
• Did you learn anything new about what social and emotional learning is and how it influences later development?
• Do you think that adults underestimate the importance of appropriate social and emotional development in infants and toddlers?

Identify a healthcare stakeholder in your community and describe its role in promoting health. APA format required, one textbook reference and one scholarly journal no more than 5 years old

Title: Community and Public Health Nursing

Author(s): Rector, C. (2019).

Publisher, Edition: Edition: 9th ed.

ISBN: 13: 978-1-4963-7625-1

Write an essay about delivery models in health care. Include the following in your essay:

Address the triple aim as it relates to population health management and delivery models.

Discuss current trends in health care delivery models.

1. Describe how quality and safety impact delivery models in health care.
2. Include at least three peer-reviewed/academic references in your essay, including the HealthyPeople website.

Assessment 2 Instructions: Root-Cause Analysis and Safety Improvement Plan

• PRINT
• For this assessment, you can use a supplied template to conduct a root-cause analysis. The completed assessment will be a scholarly paper focusing on a quality or safety issue pertaining to medication administration in a health care setting of your choice as well as a safety improvement plan.As patient safety concerns continue to be addressed in the health care settings, nurses can play an active role in implementing safety improvement measures and plans. Often root-cause analyses are conducted and safety improvement plans are created to address sentinel or adverse events such as medication errors, patient falls, wrong-site surgery events, and hospital-acquired infections. Performing a root-cause analysis offers a systematic approach for identifying causes of problems, including process and system-check failures. Once the causes of failures have been determined, a safety improvement plan can be developed to prevent recurrences. The baccalaureate nurse’s role as a leader is to create safety improvement plans as well as disseminate vital information to staff nurses and other health care professionals to protect patients and improve outcomes.As you prepare for this assessment, it would be an excellent choice to complete the Quality and Safety Improvement Plan Knowledge Base activity and to review the various assessment resources, all of which will help you build your knowledge of key concepts and terms related to quality and safety improvement. The terms and concepts will be helpful as you prepare your Root-Cause Analysis and Safety Improvement Plan. Activities are not graded and demonstrate course engagement.Demonstration of Proficiency
  By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
  • Competency 1: Analyze the elements of a successful quality improvement initiative.
    • Apply evidence-based and best-practice strategies to address a safety issue or sentinel event pertaining to medication administration. ;
    • Create a viable, evidence-based safety improvement plan for safe medication administration.
  • Competency 2: Analyze factors that lead to patient safety risks.
    • Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
  • Competency 3: Identify organizational interventions to promote patient safety.
    • Identify existing organizational resources that could be leveraged to improve a safety improvement plan for safe medication administration.
  • Competency 5: Apply professional, scholarly, evidence-based strategies to communicate in a manner that supports safe and effective patient care.
    • Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
  • Professional Context
    Nursing practice is governed by health care policies and procedures as well as state and national regulations developed to prevent problems. It is critical for nurses to participate in gathering and analyzing data to determine causes of patient safety issues, in solving problems, and in implementing quality improvements.Scenario
    For this assessment, you may choose from the following options as the subject of a root-cause analysis and safety improvement plan:
  • The specific safety concern identified in your previous assessment pertaining to medication administration safety concerns.
  • The readings, case studies, or a personal experience in which a sentinel event occurred surrounding an issue or concern with medication administration.
  • Instructions
    The purpose of this assessment is to demonstrate your understanding of and ability to analyze a root cause of a specific safety concern in a health care setting. You will create a plan to improve the safety of patients related to the concern of medication administration safety based on the results of your analysis, using the literature and professional best practices as well as the existing resources at your chosen health care setting to provide a rationale for your plan.Use the Root-Cause Analysis and Improvement Plan [DOCX] template to help you to stay organized and concise. This will guide you step-by-step through the root cause analysis process.Additionally, be sure that your plan addresses the following, which corresponds to the grading criteria in the scoring guide. Please study the scoring guide carefully so you understand what is needed for a distinguished score.
  • Analyze the root cause of a patient safety issue or a specific sentinel event pertaining to medication administration in an organization.
  • Apply evidence-based and best-practice strategies to address the safety issue or sentinel event pertaining to medication administration.
  • Create a feasible, evidence-based safety improvement plan for safe medication administration.
  • Identify organizational resources that could be leveraged to improve your plan for safe medication administration.
  • Communicate in writing that is clear, logical, and professional, with correct grammar and spelling, using current APA style.
  • Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like but keep in mind that your Assessment 2 will focus on safe medication administration.
  • Assessment 2 Example [PDF].

Write a essay describing the electronic health records incentive programs, also known as meaningful use. It offers financial incentives and was designed to improve quality, safety, and efficiency of care through the use of electronic health records.

Describe the three stages of meaningful use and their measures.

Explain the challenges and barriers faced by facilities in implementing each stage of meaningful use. 

After studying Module 5: Lecture Materials & Resources, discuss the following:

Define presbycusis, name signs and symptoms, etiology and differential diagnosis.

Create 3 interventions-education measures with a patient with Presbycusis.

List, define and elaborate on three different retinal and macular diseases age-related.

Meiner, S. E., & Yeager, J. J. (2019).

• Chapter 17
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• Chapter 18
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• Chapter 19
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• Chapter 20
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Watch
None.Supplemental Materials & Resources

Visit the CINAHL Complete under the A-to-Z Databases on the University Library’s website and locate the article(s) below:

O’Keefe-McCarthy, S. (2009). Technologically-mediated nursing care: The impact on moral agency. Nursing Ethics, 16(6), 76-796.

Teutsch, S., & Rechel, B. (2012). Ethics of resource allocation and rationing medical care in a time of fiscal restraint: US and Europe. Public Health Reviews, 34(1), 1-10.