Identify 1 public health issue that you think it is important for nurses to advocate for. Why do you think it is important, what change would you like to see take place, and who would you direct your advocacy efforts to in order to make that change?
Please put at least 3 references with in-text citations
Name: Cara Jett
Age: 34 years
Provider: R. Mcbride NP
Allergies: NKA
Admit weight: 102 Ibs (46.3kg)
BMI: 17.5
Code status: full code
I just can’t eat. Every time I do, I have horrible pain in my stomach. My family keeps
accusing me of having an eating disorder. It’s not that I don't want to eat. It's that I can’t
without pain and diarrhea!
4/12
1345
Nursing Note: Client presents for ongoing stomach pain after eating. Current BMI of
17.5. Last recorded BMI from 3 years ago was 22.2. States pain has been ongoing for
several years, more severe as of late yesterday. Client skipped lunch today. Current
abdominal pain is 2/10. States that she has tried using over-the-counter pain relievers to
help with the abdominal pain, but this has not been successful. Rates 2/10 RLQ
abdominal pain.
4/12
1355
Neuro/Cognitive: Alert and oriented x4.
Cardiovascular: Regular heartbeat with S1 and S2 heard. No edema present. Capillary
refill <3 seconds. Bilateral pedal and radial pulses +3.
Respiratory: Lungs clear bilaterally.
Gastrointestinal: Abdomen flat, firm, hyperactive bowel sounds x 4 quadrants. Tender
in RLQ. Denies nausea. Last bowel movement was 1045 today. Loose, brown, mucous
looking – per client. Three loose stools today so far.
Genitourinary: Continent. No pain or burning when urinating
Musculoskeletal: Muscle atrophy present. +5 strengths for all extremities. Tenting
present on arm and collarbone.
Psychosocial: Anxious. Becomes tearful several times during visit. States her family is
accusing her of having an eating disorder.
5/7
1435
Nursing Note: Follow-Up Appointment with Gastrointestinal Specialist
Diagnosis: New Crohn’s disease.
Follow-up appointment after colonoscopy and upper GI procedure. Had a CT scan of the
abdomen completed after the procedure. Rates 4/10 abdominal pain. Client is taking
prednisone and metronidazole as prescribed by primary care provider for Crohn's
disease.
Date Temp HR RR BP SpO2 O2
4/12 1345 96.8 °F
(36.0 °C)
78 18 102/54 100% RA
5/1 0945 97.2 °F
(36.2 °C)
64 12 94/45 89% RA
5/1 1000 97.2 °F
(36.2 °C)
69 12 104/50 92% RA
5/1 1015 97.2 °F
(36.2 °C)
72 14 110/52 94% RA
5/7 1430 98.6 °F
(37.0 °C)
88 18 138/78 99% RA
Date Diagnostic Test Findings
5/1
1015
Upper GI
Colonoscopy
No abnormal findings.
Small ulcer found in the transverse portion of the large intestine with
evidence of more in the small intestine. Further testing, including an
MRI, is highly suggested.
5/5
1500
CT Scan of
Abdomen
Impression: Thickening of the wall of the small intestine present.
Three small abscesses noted by entrance to the colon correlating with
recent gastric studies. No fistula apparent.
5/1
0945
Endoscopy Center Nursing Note:
Client has completed an upper GI study and a colonoscopy with no noticeable
complications. Vitals stable. Drowsy but easily woken. Oriented x4.
5/1
1000
Endoscopy Center Nursing Note:
Vitals remain stable. Client drank 60mL of clear soda and two bites of graham cracker.
Swallow and gag reflex present. Mild 2/10 throat discomfort present. Driver present and
atbedside.
5/1
1015
Endoscopy Center Nursing Note:
Client discharged to home in care of mother, Nancy. Follow-up appointment made.
Step 2: Your initial post should be 2-3 paragraphs in length.
The four principles, especially in the context of bioethics in the United States, has often been critiqued for raising the principle of autonomy to the highest place, such that it trumps all other principles or values. How would you rank the importance of each of the four principles? How do you believe they would be ordered in the context of the Christian biblical narrative? Refer to the topic Resources in your response.
Please see attachment
Judaism Discussion
After studying
Module 3: Lecture Materials & Resources
, as well as reviewing the
Judaism Resources
page, discuss the following:
In your reading of
Chapter 10 – Encountering Judaism: The Way of God’s People as well as the other readings for the week, you have gained a better understanding of central themes of Judaism. As you learned more about the religion, you may have noticed the many similarities that Judaism shares with Christianity as the relationship between the two religions rather unique. Christianity is rooted in Judaism historically, scripturally, liturgically, and even theologically. No two major world religions have so much in common. Below are a handful of the common elements shared by these two religions, however it is important to note that even though these religions share several common elements, they articulate them differently. Last week, we expounded upon how some of these themes are understood in the context of Catholicism and now you will describe how they are understood in Judaism.
Select the two themes below and present the Jewish teaching on the chosen theme.
· Jewish Understanding of God
· Freedom and Free Will
Each selected theme must:
· Each theme must Be explained in at least two paragraphs
· Incorporate at least 2 direct quotations with accompanying in-text citations from either the required weekly readings or a resource found on the “Judaism Resources” page linked below
please see attached
Name: Linda McCarthy
Age: 86 years
Provider: K. Townsend MD
Codestatus: DNI
BMI: 24.1
Allergies: penicillin, atorvastatin, red dye, latex
Admitweight: 145 lbs (65.8kg)
Linda McCartchy had a rough night. She was pretty restless and only slept two hours.
This morning she was having an issue with her hearing aids not working. They kept
whistling. I went to change the batteries, but she was out of them. Her family will be
bringing them in later today.
Nursing Assessments and notes
11/1
0700
Neuro/Cognitive: Alert and oriented to person and place. She intermittently
confused and called staff by the names of her children. Speech raspy. 4/5
strength in all extremities.
Cardiovascular: S1 and S2 heart sound present. Heart rate regular and even.
No edema was noted. Pedal pulses +2, radial pulses +3. Capillary refill less
than 3 seconds.
Respiratory: Even, regular, unlabored. Lung sounds wheezing through all
lung fields. Chronic dry cough. Wears 2 L via nasal cannula chronically.
Gastrointestinal: BS present x 4 quadrants. Abdomen soft, non-distended,
non-tender. Last bowel movement 2 days ago.
Genitourinary: Occasional stress incontinence.
Integumentary: Scattered bruising. Various stages of healing.
Sensory: Hard of hearing. Wears hearing aids and glasses.
11/1
0730
ADLs: Independent with utensil holders
Activity: Ambulated 100 feet with a roller walker
11/1
0830
Nursing Note: Client resting quietly in bed. Looking out the window, not
responding to staff prompts for verbal interaction. Moves all extremities
appropriately. Morning medications were administered without difficulty. Able
to state name but unsure of her birthday. Up in the hall with physical therapy.
Shuffling gait with use of a rolling walker.
11/1
1100
Nursing Note: RN called to bedside. The client stated that the staff took her
favorite earrings. Earrings were found in the client’s tissue box at the bedside.
11/1
2015
Nursing Note: Client evening hygiene offered. The client begins yelling, “No!
No! No!” as staff offer to assist with teeth brushing and denture care. Attempts
were made to deescalate the client and place her hearing aids so that she
could hear the conversation. The client begins attempting to hit and bite staff.
Client sitting in bed. Staff leave room to reduce stimulation.
11/1
2015
Neuro/Cognitive: Alert, oriented to self only. She believes it is 1965 and that
there are strangers in her house. Client calling out for her mother. Extremely
hard of hearing with hearing aids in place.
11/2
0700
Nursing Note: The client is awake in bed, staring around her room, rubbing
her eyes, and frequently yawning. Noted to have redness and purulent
drainage from right eye. Provider notified; prescriptions received.
11/2
0900
Nursing Note: Appetite poor, ate 5 small bites only, Drank a cup of juice.
Weight down. Will encourage protein supplement drinks between meals.
Date Intake Source & Amount
11/1 0700 Oral 240 mL
11/1
0900
Client Information:
Medical History: Presbyopia, bilateral cataracts, Alzheimer’s dementia,
hearing loss, hypertension, hyperlipidemia, osteoarthritis, ambulatory
dysfunction, chronic obstructive pulmonary disease
Medications:
● Rivastigmine 6 mg by mouth twice daily
● Lisinopril 20 mg by mouth daily
● Ezetimibe 10 mg by mouth daily
● Simvastatin 40 mg by mouth daily
● Docusate sodium 100 mg by mouth daily
● Polyethylene glycol 17 g by mouth daily – diluted in 8 oz of beverage
● Duloxetine 60 mg by mouth daily
● Artificial tears 1-2 drops into eyes PRN for dry eyes
● Oxygen 2L/NC PRN for difficulty breathing
11/2 0730 Prescriptions:
● Ciprofloxacin ocular ointment 0.5-inch right eye three times
daily
You are caring for a patient that has a high pain tolerance due to chronic pain and does not look like they are in pain. What would you do if they asked for more pain medication?
Step 1 Read the article.
Review the article, Managing Generational Diversity in the Hospital SettingLinks to an external site.
Step 2 Post your response to the discussion board.
Respond to the following question and, if appropriate, include personal experience as part of your answer.
Step 3 Read other students’ posts and respond to at least two of them by Friday at 11:59pm Mountain Time.
Use your personal experience, if it’s relevant, to support or debate other students’ posts. In your responses, provide one other example of how, as a manager, you would assist to meet patient/family needs. If differences of opinion occur, debate the issues professionally and provide examples to support opinions.
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