May 30, | nursing, med, NURS, Paper
NURS 5315 Advanced Pathophysiology Case Study
NURS 5315 Advanced Pathophysiology Case Study
NURS 5315 Advanced Pathophysiology
Case Study #2 – Fall 2018
Mr. James is a 62 year old male in a primary care practice being seen for a health maintenance visit (last visit was over 10 years ago). His only complaint of note is fatigue but generally feels well. He denies any limitations in “doing the things I like to do”, including yard work and fishing. He works full time as a supervisor for a commercial construction company. He is married and has 2 daughters. His oldest daughter is expecting their first grandchild. NURS 5315 Advanced Pathophysiology Case Study.
ORDER A CUSTOM-WRITTEN PAPER NOW
He has a history of “recreational” IV drug use when he was in his early 20s while he was in the military. Denies any drug use since that time. He indicates “minimal” alcohol use – generally no more than 2-3 beers or glasses of wine a week. He has no chronic illnesses and does not take any medicines on a regular basis. NURS 5315 Advanced Pathophysiology Case Study.
Physical exam:
Vitals: 38.1-97-18-183/139
Normocephalic. Alert & Oriented x3.
Eyes: PERL. No nystagmus, no icterus.
Neck: Supple, no cervical lymphadenopathy
Cardiovascular: Normal Rate and rhythm. No murmur, gallops. 2+/4+ radial, brachial, dorsalis pedis pulses bilaterally. No jugular venous distension. No edema.
Pulmonary: Lungs are clear. No dyspnea or orthopnea.
Abdomen: Soft and nontender, active bowel sounds. No liver enlargement; abdomen flat. No striae.
Skin: Warm and dry; no rashes. Multiple tattoos on both arms.
Rectal exam: Stool is brown, no rectal masses.
NURS 5315 Advanced Pathophysiology Case Study
Lab results:
CBC: WBC 9,000; RBC 5.10; Hemoglobin 15.3 g/dL Hematocrit 46%; 90; Platelets 152,000.
Electrolyte Panel: Sodium 136 mEq/L; Potassium 3.7 mEq/L; Creatinine 1.1 mg/dL; BUN 12 mg/dL; Glucose 115mg/dL
Alanine aminotransferase (ALT) 36
Aspartate aminotransferase (AST) 50
Bilirubin (total) 0.9 mg/dL
Hepatitis A IgM negative; IgG positive
Hepatitis B surface antigen negative; surface antibody positive; core antibody negative
Hepatitis C (HCV) antibody reactive (positive), Hepatitis C RNA positive with an undetectable viral load.
Respond to the following questions regarding the Case Study
1. The clinical scenario is most consistent with which type of hepatitis? You may list your answer below using a bullet point format. This does not have to be in a complete sentence. A citation is not required. (10 pts). NURS 5315 Advanced Pathophysiology Case Study.
2. What specific data in the clinical scenario supports your diagnosis? You may list your answers below using bullet point format. This does not have to be in a complete sentence. A citation is not required. (10 pts)
3. What is the most likely cause of this patient’s diagnosis you noted in Question 1? You may list your answer below using a bullet point format. This does not have to be in a complete sentence. A citation is not required. (10 pts). NURS 5315 Advanced Pathophysiology Case Study.
4. Describe key pathophysiologic concepts that relate to the diagnosis in question 1. To answer this question completely, you must answer all of the sub-questions below using complete sentences. Each sub-question may be answered in 1-6 sentences. ***Citations are required for each answer to each question using APA format. You MAY NOT use direct quotes.
a. How does Hepatitis lead to an increased risk of hepatocellular carcinoma? Describe how the virus affects the hepatocytes and may lead to cancer. ( 10 pts)
b. How does Hepatitis lead to cirrhosis of the liver? Describe the pathologic steps of how cirrhosis develops and how cellular changes can lead to liver failure. ( 10 pts). NURS 5315 Advanced Pathophysiology Case Study.
c. One of the negative sequela of liver failure is increased bleeding. Why do individuals with liver failure experience potentially life threatening bleeding? Describe how liver failure leads to coagulopathy. ( 10 pts)
d. Portal hypertension is also a negative sequela of liver failure. Describe how liver failure leads to portal hypertension AND how portal hypertension manifests. (10 pts)
5. Mr. James is concerned that he will transmit the virus to his new granddaughter after she is born.
What is the likelihood of transmitting the virus to his granddaughter? Provide a single sentence that includes your rationale. A citation is not required. (10 pts). NURS 5315 Advanced Pathophysiology Case Study.
APA Format
Information is presented in a scholarly manner (clear, grammatically correct) and reflects synthesis of information from sources. APA format is correctly used for citations and references. Submission follows assignment guidelines; does not exceed page limit. (15 pts). NURS 5315 Advanced Pathophysiology Case Study.
May 30, | nursing, med, NURS, Paper
Policy Analysis Summary Essay
NURS 8100 Week 11 Discussion 1: Policy Analysis Summary Essay
Discussion 1: Policy Analysis Summary
Health care policy can facilitate or impede the delivery of services. For the past several weeks, you have been engaging in an authentic activity by critically analyzing a specific health care policy and various aspects of the impact associated with its implementation Policy Analysis Summary Essay. A critical step in the policy process is communicating your findings with others. This week, you will share information from your policy analysis and its implications.
ORDER A PLAGIARISM-FREE PAPER HERE
To prepare for Discussion 1: Policy Analysis Summary:
Briefly summarize your policy analysis, focusing on the implications for clinical practice that may be most relevant or interesting for your colleagues. Include how evidence-based practice influenced the policy, policy options, or solutions. Policy Analysis Summary Essay.
By Day 3 of Discussion 1: Policy Analysis Summary
Post a 1- to 2-paragraph succinct summary of your policy analysis paper. Include at least two of the options or solutions for addressing the policy and the resulting implications for nursing practice and health care consumers.
Read a selection of your colleagues’ postings.
By Day 5 of Discussion 1: Policy Analysis Summary
Respond to at least two of your colleagues sharing insights or contrasting perspectives based on readings and evidence, and the practice implications of the policy.
Note: Please see the Syllabus and Discussion Rubric for formal Discussion question posting and response evaluation criteria.
Return to this Discussion in a few days to read the responses to your initial posting. Note what you learned and/or any insights you gained as a result of the comments made by your colleagues Policy Analysis Summary Essay.
Be sure to support your work with specific citations from this week’s Learning Resources and any additional sources.
NURS 8100 Week 11: Policy and Practice
As noted in Understanding Health Policy, “policies tend to evolve in a cyclical process of finding solutions that create new problems that require new solutions,” (p. 205). The tensions created by the pulls between quality care and cost containment, for instance, or between caring for the individual and concern with the common good, arise as new policies are introduced at all levels: national, state, local, and institutional. Policy Analysis Summary Essay When this occurs, new procedures may need to be implemented in the practice setting.
This week, you will reflect on the implications of health care policies for consumers and health care providers. You will also consider the reciprocal relationship between policy and practice as you explore how policy influences nursing practice and how evidence-based nursing practice influences policy. Additionally, you will propose a strategy for how nurses can advocate for themselves, their patients, and the profession through involvement in health care policy.
Note: This week you will complete the Discussion in a small group. Your instructor will notify you of your group assignment by Day 1 of this week.
Policy Analysis Summary Essay Learning Objectives
Students will:
Assess the implications of various policy options and solutions to consumers of health care and nursing practice
Outline current evidence that supports suggested options and solutions to a policy issue Policy Analysis Summary Essay
Propose an advocacy strategy nurses may employ to address a practice issue through the policy process
Photo Credit: [Ariel Skelley]/[Blend Images]/Getty Images
Policy Analysis Summary Essay Learning Resources
Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.
Required Readings
Bodenheimer, T., & Grumbach, K. (2016). Understanding health policy: A clinical approach (7th ed.). New York, NY: McGraw-Hill Medical.
Chapter 17, “Conclusion: Tensions and Challenges”This chapter concludes with final thoughts on the challenge of providing quality health care and controlling health care costs. The solution is likely to be resolved only by a collaborative approach, involving all health care stakeholders, and by health professionals taking the lead.
Howard, J., Levy, F., Mareiniss, D. P., Craven, C. K., McCarthy, M., Epstein-Peterson, Z. D., & et al. (2010). New legal protections for reporting patient errors under the Patient Safety and Quality Improvement Act: A review of the medical literature and analysis. Journal of Patient Safety, 6(3), 147-152.
Note: You will access this article from the Walden Library databases.
The authors studied the dissemination of information on the Patient Safety and Quality Improvement Act (PSQIA), a federal act that affords protection to those reporting medical errors. They found medical literature to be inadequate in this regard, and as a result, medical personnel were uninformed on their legal protections. This lack of information has become a barrier to policy implementation.
Jacobson, N., Butterill, D., & Goering, P. (2003). Development of a framework for knowledge translation: Understanding user context. Journal of Health Services Research & Policy, 8(2), 94–99.
Note: You will access this article from the Walden Library databases. Policy Analysis Summary Essay.
Lau, B., San Miguel, S., & Chow, J. (2010). Policy and clinical practice: Audit tools to measure adherence. Renal Society of Australasia Journal, 6(1), 36–40.
Note: You will access this article from the Walden Library databases.
The authors study the compliance to renal-care policies by health care professionals. They conclude with the necessity for nurses to support evidence-based protocols as well as to obtain continuing education on new protocols.
McCracken, A. (2010). Advocacy: It is time to be the change. Journal of Gerontological Nursing, 36(3), 15-17.
Note: You will access this article from the Walden Library databases.
The author proposes that nurses, as patient advocates, need to be more involved in the making of health care policy instead of reacting to policies that are constantly changing. The article provides a guide to help organize initial policy efforts.
Nannini, A., & Houde, S. C. (2010). Translating evidence from systematic reviews for policy makers. Journal of Gerontological Nursing, 36(6), 22–26.
Note: You will access this article from the Walden Library databases.
The article cites geronotological nurses as examples of those who are able to translate research into policy briefs that can be clearly understood by policy makers. Geronotological nurses are in this unique position because of their clinical experience and educational background.
Paterson, B. L., Duffet-Leger, L., & Cuttenden, K. (2009). Contextual factors influencing the evolution of nurses’ roles in a primary health care clinic Policy Analysis Summary Essay. Public Health Nursing, 26(5), 421-429.
Note: You will access this article from the Walden Library databases.
This article provides details on a study conducted in a nurse-managed clinic related to the changing roles of nurses. The authors found that nurses, in response to social, political, and economic forces, became involved in advocacy for the clinic through political action, government funding issues, and media relations roles.
Sistrom, M. (2010). Oregon’s Senate bill 560: Practical policy lessons for nurse advocates. Policy, Politics, & Nursing Practice, 11(1), 29-35. doi: 10.1177/1527154410370786
Note: You will access this article from the Walden Library databases.
The author uses the efforts by a nurse advocate in lobbying for an Oregon bill related to healthy food in public schools to illustrate nurse advocacy and policy making. The bill, developed in response to childhood obesity, did not immediately become law. The author concludes with the importance of considering the political environment when creating successful policy. Policy Analysis Summary Essay.
Spenceley, S. M., Reutter, L., & Allen, M. N. (2006). The road less traveled: Nursing advocacy at the policy level. Policy, Politics, & Nursing Practice, 7(3), 180-194. doi: 10.1177/1527154410370786
Note: You will access this article from the Walden Library databases.
Nurses have always been advocates at the patient-level of care, but the authors of this article promote the need for all nurses to become advocates at the policy level as well. They discuss factors that have kept nurses from getting involved with policy making and they provide strategies to resolve these challenges.
Wyatt, E. (2009). Health policy advocacy: Oncology nurses make a difference. ONS Connect, 24(10), 12-15.
Note: You will access this article from the Walden Library databases.
The author presents information on two nurses who have become health care policy advocates—one as a policy maker and one as an elected legislator. Both have been able to use their perspectives from their nursing careers to affect health policy.
Zomorodi, M., & Foley, B. J. (2009). The nature of advocacy vs. paternalism in nursing: Clarifying the ‘thin line.’ Journal of Advanced Nursing, 65(8), 1746-1752.
Note: You will access this article from the Walden Library databases Policy Analysis Summary Essay.
The authors attempt to distinguish the concepts of advocating for a patient and paternalism, or overriding a patient’s wishes. They provide clinical examples to illustrate the differences between these concepts, and they conclude with strategies to use in practice.
Required Media
Laureate Education, Inc. (Executive Producer). (2011). Healthcare policy and advocacy: Advocating through policy. Baltimore: Author.
Note: The approximate length of this media piece is 7 minutes.
In this media presentation, Dr. Joan Stanley and Dr. Kathleen White discuss how nurses can influence practice and engage in advocacy through the policy process Policy Analysis Summary Essay.
Optional Resources
Birnbaum, D. (2009). North American perspectives: POA, HAC and never events. Clinical Governance: An International Journal, 14(3), 242–244.
Policy Analysis Summary Essay Rubric Detail
Select Grid View or List View to change the rubric’s layout.
Name: NURS_8100_Week11_Discussion1_Rubric
Excellent
Good
Fair
Poor
RESPONSIVENESS TO DISCUSSION QUESTIONDiscussion post minimum requirements:
*The original posting must be completed by Wednesday, Day 3, at 11:59pm MST. Two response postings to two different peer original posts, on two different days, are required by Saturday, Day 6, at 11:59pm MST. Faculty member inquiries require responses, which are not included in the minimum number of posts. Your Discussion Board postings should be written in standard edited English and follow APA style for format and grammar as closely as possible given the constraints of the online platform. Be sure to support the postings with specific citations from this week’s Learning Resources as well as resources available through the Walden University online databases. Refer to the Essential Guide to APA Style for Walden Students to ensure your in-text citations and reference list are correct.
8 (26.67%) – 8 (26.67%)
Discussion postings and responses exceed the requirements of the Discussion instructions. They: Respond to the question being asked or the prompt provided; – Go beyond what is required in some meaningful way (e.g., the post contributes a new dimension, unearths something unanticipated); -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence. – Demonstrate significant ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning -Resources as well as additional resources and has read, viewed, or considered a sampling of colleagues’ postings; -Exceed the minimum requirements for discussion posts*.
7 (23.33%) – 7 (23.33%)
Discussion postings and responses meet the requirements of the Discussion instructions. They: -Respond to the question being asked or the prompt provided; -Are substantive, reflective, with critical analysis and synthesis representative of knowledge gained from the course readings and current credible evidence.re -Demonstrate ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Demonstrate that the student has read, viewed, and considered the Learning Resources and has read, viewed, or considered a sampling of colleagues’ postings -Meet the minimum requirements for discussion posts*.
Policy Analysis Summary Essay
6 (20%) – 6 (20%)
Discussion postings and responses are minimally responsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or -May (lack) lack in depth, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence; and/or -Do not adequately demonstrate that the student has read, viewed, and considered the Learning -Resources and/or a sampling of colleagues’ postings; and/or has posted by the due date at least in part. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not meet the minimum requirements for discussion posts*.
0 (0%) – 5 (16.67%)
Discussion postings and responses are unresponsive to the requirements of the Discussion instructions. They: – do not clearly address the objectives of the discussion or the question or prompt; and/or – Lack in substance, reflection, analysis, or synthesis but rely more on anecdotal than scholarly evidence. – Lack ability to generalize and extend thinking and evaluate theories or concepts within the topic or context of the discussion. -Do not demonstrate that the student has read, viewed, and considered the Learning Resources and/or a sampling of colleagues’ postings; and/or does not meet the minimum requirements for discussion posts*.
CONTENT KNOWLEDGE
8 (26.67%) – 8 (26.67%)
Discussion postings and responses: -demonstrate in-depth understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; – are well supported by pertinent research/evidence from a variety of and multiple peer- reviewed books and journals, where appropriate; -Demonstrate significant mastery and thoughtful/accurate application of content, applicable skills or strategies presented in the course.
7 (23.33%) – 7 (23.33%)
Discussion postings and responses: -demonstrate understanding and application of the concepts and issues presented in the course, presented with some understanding and application of concepts and issues presented in the course (e.g., insightful interpretations including analysis, synthesis and/or evaluation of topic; -are supported by research/evidence from peer-reviewed books and journals, where appropriate; and · demonstrate some mastery and application of content, applicable skills, or strategies presented in the course.
6 (20%) – 6 (20%)
Discussion postings and responses: – demonstrate minimal understanding of concepts and issues presented in the course, and, although generally accurate, display some omissions and/or errors; –lack support by research/evidence and/or the research/evidence is inappropriate or marginal in quality; and/or lack of analysis, synthesis or evaluation of topic – demonstrate minimal content, skills or strategies presented in the course. ——-Contain numerous errors when using the skills or strategies presented in the course
0 (0%) – 5 (16.67%)
Discussion postings and responses demonstrate: -A lack of understanding of the concepts and issues presented in the course; and/or are inaccurate, contain many omissions and/or errors; and/or are not supported by research/evidence; and/or lack of analysis, synthesis or evaluation of topic -Many critical errors when discussing content, applicable skills or strategies presented in the course.
Policy Analysis Summary Essay
CONTRIBUTION TO THE DISCUSSION
8 (26.67%) – 8 (26.67%)
Discussion postings and responses significantly contribute to the quality of the discussion/interaction and thinking and learning by: -providing Rich and relevant examples; discerning and thought-provoking ideas; and stimulating thoughts and probes; – -demonstrating original thinking, new perspectives, and extensive synthesis of ideas supported by the literature.
7 (23.33%) – 7 (23.33%)
Discussion postings and responses contribute to the quality of the discussion/interaction and thinking and learning by -providing relevant examples; thought-provoking ideas – Demonstrating synthesis of ideas supported by the literature
6 (20%) – 6 (20%)
Discussion postings and responses minimally contribute to the quality of discussion/interaction and thinking and learning by: – providing few and/or irrelevant examples; and/or – providing few if any thought- provoking ideas; and/or -. Information that is restated from the literature with no/little demonstration of critical thinking or synthesis of ideas.
0 (0%) – 5 (16.67%)
Discussion postings and responses do not contribute to the quality of interaction/discussion and thinking and learning as they do not: -Provide examples (or examples are irrelevant); and/or -Include interesting thoughts or ideas; and/or – Demonstrate of critical thinking or synthesis of ideas
Policy Analysis Summary Essay
QUALITY OF WRITING
6 (20%) – 6 (20%)
Discussion postings and responses exceed doctoral -level writing expectations. They: · Use grammar and syntax that is clear, concise, and appropriate to doctoral level writing; · Make few if any errors in spelling, grammar, and syntax; · Use original language and refrain from directly quoting original source materials; -provide correct APA · Are positive, courteous, and respectful when offering suggestions, constructive feedback, or opposing viewpoints.
5 (16.67%) – 5 (16.67%)
Discussion postings and responses meet doctoral -level writing expectations. They: ·Use grammar and syntax that is clear and appropriate to doctoral level writing; ; · Make a few errors in spelling, grammar, and syntax; · paraphrase but refrain from directly quoting original source materials; Provide correct APA format · Are courteous and respectful when offering suggestions, constructive feedback, or opposing viewpoints;.
4 (13.33%) – 4 (13.33%)
Discussion postings and responses are minimally below doctoral-level writing expectations. They: · Make more than occasional errors in spelling, grammar, and syntax; · Directly quote from original source materials and/or paraphrase rather than use original language; lack correct APA format; and/or · Are less than courteous and respectful when offering suggestions, feedback, or opposing viewpoints.
0 (0%) – 3 (10%)
Discussion postings and responses are well below doctoral -level writing expectations. They: · Use grammar and syntax that is that is unclear · Make many errors in spelling, grammar, and syntax; and –use incorrect APA format · Are discourteous and disrespectful when offering suggestions, feedback, or opposing viewpoints.
Policy Analysis Summary Essay
