Many characteristics comprise a philosophy of nursing. How would you respond to a co-worker with a differing philosophy that clashes with yours? What would this conversation look like?
Category: Nursing
Rene is a 40 year old man
Case
Rene has come in today for follow-up of his hyperglycemia. He has been using an OTC “magic pill” – taken po, qd that his co-worker gave him to use since about a week after his last visit (3 months ago). He has noticed a change in his symptoms – the polyuria and polydipsia have resolved. In the past two months, he has also noticed changes in his previously increased difficulties performing his ADLs – previously he had numbness and bilateral tingling of his lower extremities that he wasn’t sure the cause of.
He has a history of hypercholesterolemia and DM that were diagnosed earlier this year. His DOB is 11/19/1980 and his BMI is 36.9. He is concerned about his abdomen due to recent weight gain and he is worried about a “rash on his neck.” He thinks maybe he needs a biopsy since it might be “malignant melanoma,” which he has been reading about. His wife thinks he might be a hypochondriac but she is also worried that he has decided to take the “magic pill” instead of the antidiabetic he was prescribed. He has a glucometer and checks his sugar BID, post-prandial. He also describes occasional photophobia, was seen by an opthalmologist. His mother has diabetes, but she lives in the Philippines – he is unsure what her medications are but he thinks she might take insulin and everyone he knows that has taken insulin has problems with their kidneys and some have even had amputations
His physical exam was essentially normal, but significant for acanthosis nigricans, elevated blood pressure (this is the third visit with elevated blood pressure, indicating the presence of hypertension). He will have his labs ordered with the new diagnosis but also will have his A1C checked.
Discuss each of the bolded, italicized words as you discuss any aspect of this case you’d like to address as Rene’s PCP. And, always – have fun!
Questions
Advanced Pharmacology
1. What medications might you change or add today?
2. What are the main classes of medication for Rene’s conditions?
3. How might you start medications for Rene and over what period of time would you increase and why?
Advanced Pathophysiology
1. Be sure you understand each of the bolded, italicized words of this case.
2. As Rene’s PCP, select 5 bolded, italicized words (except antidiabetics, prescribed and acanthosis) and describe them in detail and their significance pathophysiologically.
Brainstorm
Have you watched the HW video on APA 7 Basics and Cover Page? (2) IF you were absent, have you watched the class recording? Do not continue to the assignment until these things are complete.
Step 1, Brainstorm: Think about your field of study as a master’s student. Use one of the two methods taught in class and find two news articles that report on relevant problems related to the industry associated with your master’s degree program (think about scandals within the last 5 years). Come up with two examples using the format below in a simple Word document, using APA 7 Basics and an APA 7 cover page learned through the HW video (see p. 20 in Foundations for a sample cover page)
Step 2, Create your Word Document and Answer Questions (it should look similar to p. 5 in Foundations):
FOR EXAMPLE: If my major is public health or even education, I would come up with something like Issue/Problem 1 below (MPH students, you cannot use this as your own). We have started one together in class, so you must complete what you started in class and find a second research problem proposal:
Issue/Problem 1: Depression and anxiety among young adults
1) People Involved: College students, parents
2) Link to Article: https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/college-students-and-depression
3) My Research Question: What have researchers learned about the impact of COVID 19 on depression and anxiety among young adult students?
An analysis of the Parkinson’s Disease
“Describe the disease and also complications symptoms of the disease of Parkinson’s Disease. How it can be treat with medication of Selegiline or other way can be treat.”
Allowing a patient to die and physician-assisted suicide.
Differentiate between allowing a patient to die and physician-assisted suicide. What are the legal implications of the two concepts? What moral implications do they have? Why are doctors reluctant to abide by patient or family wishes to stop life support machines?
The assessment of a patient with a disease
Describe the assessment of a patient with a disease of your choice, detailing the signs and symptoms (S&S), assessment, plan of care, and at least 3 possible differential diagnosis with rationales.
Mention the health promotion intervention for this patient.
What did you learn that can be beneficial for you as an advanced practice nurse?
Department manager at Happy Valley Medical Center
Part 1
You are a department manager at Happy Valley Medical Center. Over lunch one day several colleagues are discussing the new electronic health record (EHR). It’s obvious that there are mixed feelings about the EHR. One complaint is that there seems to be too many ways to enter the same information. Everyone at HVMC knows that you are an expert in healthcare terminologies
-In your post to this discussion, explain the concept of structured healthcare terminologies to your colleagues and describe how healthcare terminologies support optimal use of EHRs.
PART II: After posting your submission, read and respond to the postings of at least two classmates.
Why caregivers are considered patient advocates.
Explain why caregivers are considered patient advocates. When and how does one become a patient advocate? Discuss the legal implications of being a patient advocate. What resources can patient advocates access to help them perform their roles/responsibilities? Identify a minimum of three resources.
Adherence to diabetic treatment programs
Explain why adherence to diabetic treatment programs is so difficult for most people to achieve.
Many diabetics do not adhere to treatment programs as they do not get any severe symptoms until years later. This causes people to not fear diabetes which deters to follow a regimen. There are diabetics that do not monitor glucose levels and rely based on how they feel which is not always reliable. Many regimens require the obvious such as diet and exercise which is not always a possibility for many and/or taking proper medication. For those who do not have insurance, they can just afford vials of insulin.
Maria often complains of negative emotions, stress, and emotional pressures at work. Her colleague, Tandra, says that constant stress can trigger acute coronary events and advises her to meet a doctor. Support Tandra’s statements by citing the research on emotion and CHD.
Coronary heart disease (CHD) is known as the leading cause of death in the United States. Although diet can have a role in the cause of it, so can your emotions. Having high stress levels and suffering from depression can in fact lead to CHD. Research has shown that high levels of stres, trauma and acute stress can often lead to a heart attack. With depression, there are studies linked to the heart becoming inflamed which causes plaque to build up on the artery walls.
A human resources plan for an urgent care clinic.
Develop a human resources plan or strategy for an urgent care clinic.
At a minimum, your plan or strategy should consider the following:
Staffing
Recruitment
Retention
Development
Compensation