CAse study4

 Esophageal Reflux Case Studies A 45-year-old woman complained of heartburn and frequent regurgitation of “sour” material into her mouth. Often while sleeping, she would be awakened by a severe cough. The results of her physical examination were negative. Studies Results Routine laboratory studies Negative Barium swallow (BS), p. 941 Hiatal hernia Esophageal function studies (EFS), p. 624 Lower esophageal sphincter (LES) pressure 4 mm Hg (normal: 10–20 mm Hg) Acid reflux Positive in all positions (normal: negative) Acid clearing Cleared to pH 5 after 20 swallows (normal: <10 swallows) Swallowing waves Normal amplitude and normal progression Bernstein test Positive for pain (normal: negative) Esophagogastroduodenoscopy (EGD), p. 547 Reddened, hyperemic, esophageal mucosa Gastric scan, p. 743 Reflux of gastric contents to the lungs Swallowing function, p. 1014 No aspiration during swallowing Diagnostic Analysis The barium swallow indicated a hiatal hernia. Although many patients with a hiatal hernia have no reflux, this patient’s symptoms of reflux necessitated esophageal function studies. She was found to have a hypotensive LES pressure along with severe acid reflux into her esophagus. The abnormal acid clearing and the positive Bernstein test result indicated esophagitis caused by severe reflux. The esophagitis was directly visualized during esophagoscopy. Her coughing and shortness of breath at night were caused by aspiration of gastric contents while sleeping. This was demonstrated by the gastric nuclear scan. When awake, she did not aspirate, as evident during the swallowing function study. The patient was prescribed esomeprazole (Nexium). She was told to avoid the use of tobacco and caffeine. Her diet was limited to small, frequent, bland feedings. She was instructed to sleep with the head of her bed elevated at night. Because she had only minimal relief of her symptoms after 6 weeks of medical management, she underwent a laparoscopic surgical antireflux procedure. She had no further symptoms. Critical Thinking Questions 1. Why would the patient be instructed to avoid tobacco and caffeine? 2. Why did the physician recommend 6 weeks of medical management? Case Studies Copyright © 2018 by Elsevier Inc. All rights reserved. 2 3. How do antacid medication work in patients with gastroesophageal reflux? 4. What would you approach the situation, if your patient decided not to take the medication and asked you for an alternative medicine approach? 

40ABCD

Introduction

Nurses at the baccalaureate level in all practice areas are involved in nursing informatics through interaction with information management and patient care technologies. Nurses must not only demonstrate knowledge of and skills in health information and patient care technologies, but also how to use these tools at the bedside and organizational levels. Moreover, nurses need to recognize how information gathered from various health information sources can impact decision making at the national and state regulatory levels.

Preparation

To successfully prepare for this assessment, you will need to complete these preparatory activities:

· Review assessment resources and activities.

· Conduct independent research on the nursing knowledge and skills necessary to interact with health information and patient care technology.

· Focus your research on current resources available through peer-reviewed articles, professional websites, government websites, professional blogs, wikis, job boards, and so on.

· Consult the 
BSN Program Library Research Guide for help in identifying scholarly and authoritative sources.

· Interview peers in your network who are considered information technology experts.

· Ask them about how information technology advances are impacting patient care at the bedside, at the organizational level, and beyond.

Scenario

For this assessment, assume you are a nurse attending a meeting of your state’s nurses association. A nurse informaticist conducted a presentation on her role and its impact on positive patient and organizational outcomes in her workplace. You realize that your organization is undergoing many technological changes. You believe this type of role could provide many benefits to your organization.

You decide to pursue proposing a nurse informaticist role in your organization. You speak to your chief nursing officer (CNO) and human resources (HR) manager, who ask you to prepare a 4–5 page evidence-based proposal to support the new role. In this way, they can make an informed decision as to whether the addition of such a role could justify the return on investment (ROI). They need your proposal before an upcoming fiscal meeting.​ 
This is not an essay, but instead, it is a proposal to create a new Nurse Informaticist position.

One important part of this assessment is the justification of the need for a nurse informaticist in a health care organization and references from relevant and timely scholarly or professional resources to support the justification for creating this nurse informaticist position. The term justify means to show or prove that the nurse informaticist position brings value to the organization. This justification must include evidence from the literature to support that this position will provide a return on investment for the organization.

Proposal Format

The chief nursing officer (CNO) and human resources (HR) manager have asked you to include the following headings in your 
proposal and to be sure to address the bullets following each heading:

Nursing Informatics and the Nurse Informaticist

· What is nursing informatics?

· What is the role of the nurse informaticist?

Nurse Informaticists and Other Health Care Organizations

· What is the experience of other health care organizations with nurse informaticists?

· How do these nurse informaticists interact with the rest of the nursing staff and the interdisciplinary team?

Impact of Full Nurse Engagement in Health Care Technology

· How does fully engaging nurses in health care technology impact:

· Patient care?

· Protected health information (security, privacy, and confidentiality)?

· In this section, you will explain evidence-based strategies that the nurse informaticist and interdisciplinary team can use to effectively manage patients' protected health information, particularly privacy, security, and confidentiality. Evidence-based means that they are supported by evidence from scholarly sources.

· Workflow?

· Costs and return on investment?

Opportunities and Challenges

· What are the opportunities and challenges for nurses and the interdisciplinary team with the addition of a nurse informaticist role?

· How can the 
interdisciplinary team collaborate to improve quality care outcomes through technology?

Summary of Recommendations

· What are 3–4 key takeaways from your 
proposal about the recommended nurse informaticist role that you want the CNO and the HR manager to remember?

· This is the section where the justification for the implementation of the nursing informaticist role is addressed. Remember to include evidence from the literature to support your recommendation.

Additional Requirements

·
Written communication: Ensure written communication is free of errors that detract from the overall message.

·
Submission length: 4–5 double-spaced pages, in addition to title and references pages.

·
Font: Times New Roman, 12 point.

·
Citations and References: Cite a 
minimum of three current scholarly and/or authoritative sources to support your ideas. In addition, cite a 
minimum of one current professional blog or website to support your central ideas. 
Current means no more than five years old.

·
APA formatting: Be sure to follow APA formatting and style guidelines for citations and references. For an APA refresher, consult the 
Evidence and APA page on Campus.

public health

 Give an example of community health needs assessment (CHNA) data from the organization where you have Practicum or Public Health clinical. Identify what their top findings were. 

U 8 551

 

A 49-year-old female is discussing age-related changes with the nurse practitioner. She states that she is having irregular periods and “hot flashes.”

  1. What other assessment data would substantiate the diagnosis of menopause?
  2. What type of therapy would you expect this patient to receive? Why?

instructions: It is a discussion post, APA format, 1 page in length is fine. Must have 3 references.

DPwk2

After you complete this week’s readings, including the Clinical Microsystems Greenbook,
describe one reading that relates most closely to your project topic and how this
microsystem will help you develop your change project.

More than 300 words.

This one will be done after the current one.

Nursing homework help

Module 03 Written Assignment – Agencies for Quality

Top of Form

Bottom of Form

Module 03 Content

1.

Top of Form

Explore one of the agencies for quality improvement listed in this module's lecture. Write a one-page summary of what the agency does, who it affects, and how it is utilized.

Submit your completed assignment by following the directions linked below. Please check the 
Course Calendar for specific due dates.

Save your assignment as a Microsoft Word document.

Bottom of Form

reply

After completing the Foundation of Nursing Leadership self-assessment, I discovered my leadership style aligns with “laissez-faire.” I value the autonomy of my team members and believe that integrating the opinions of other nurses is paramount. This approach significantly influences my decision-making in nursing care, ensuring collaborative and well-rounded decisions. To further hone my leadership skills, I am committed to continuous learning, actively seeking feedback, fostering mentorship relationships with seasoned nursing leaders, and practicing regular self-reflection. Through these strategies, I aim to become an adaptable leader, adept at navigating the intricate realm of healthcare.

Self Care activity

Setting boundaries and making self-care a priority is extremely important when practicing as a nurse. Discuss methods of self care that you have found to be effective when dealing with an emotional reaction to a situation.

Once you have selected a topic, post a discussion about why that self-care technique is beneficial, how it helps you, how it can benefit your nursing practice, and why self-care is so important when caring for individuals with mental illness. 

250 words or less simple discussion

sociology project 2

Purpose: The purpose of this assignment is to introduce Mills’
Sociological Imagination as well as to describe a personal
situation that you select to serve as the main topic of the
Sociological Imagination essay that you will submit in week 10.
The topic is left to your discretion and is preferably a situation that
stands out in your life, or about which you can write 4-6 pages.

This assignment is the first step to the essay that you will work to
complete throughout the term. You are required to submit only
the Introduction part, and should have the following:

Introduction: Write a paragraph introducing C.W. Mills’s
Sociological Imagination and give a general overview of how
you’ll be applying it to the personal situation that you will discuss
in your paper. To do this, first, describe sociological imagination.
Then, clearly specify your topic by providing a brief description
(1-2 sentences) of the personal situation that you have selected.
Next, identify three chapters that will be utilized to draw
sociological concepts from that you will use to analyze your
personal situation. Lastly, identify one sociological theory from the
text that you will use to analyze your personal situation (e.g.,
conflict theory or symbolic interactionism).

Use APA format throughout the paper including for the Title page,
and references and in-text citations.

Blog

 blog on evidence-based practice in the healthcare organization where you practice. (psychiatry)Drawing on your understanding of EBP and your firsthand observations within your organization, include the following content in your blog: