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Tina Jones Health History transcript, documentation and objective data

Tina Jones Health History transcript, documentation and objective data
Tina Jones Health History transcript, documentation and objective data
Transcript

Started: Jul 17, 2022 | Total Time: 189 min

All Lines (161)Interview Questions (144)Statements (5)Exam Actions (12)

 Height: 170 cm

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07/17/22 1:35 AM MDT

 Weight: 90 kg

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07/17/22 1:35 AM MDT

 BMI: 31

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07/17/22 1:35 AM MDT

 Random blood glucose: 238

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07/17/22 1:35 AM MDT

 Temperature: 101.1 F

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07/17/22 1:35 AM MDT

 Blood pressure: 142/82

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07/17/22 1:35 AM MDT

 Respiratory rate: 19

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07/17/22 1:35 AM MDT

 O2 sat: 99%

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07/17/22 1:35 AM MDT

 Heart rate: 86

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07/17/22 1:35 AM MDT

Hello Tina my name is xxx and I’m your nurse today

Greet

07/17/22 1:35 AM MDT

Hey.

Can you confirm your name

Question

07/17/22 1:35 AM MDT

Tina Jones.

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What brings you in today

Question

07/17/22 1:36 AM MDT

I got this scrape on my foot a while ago, and I thought it would heal up on its own, but now it’s looking pretty nasty. And the pain is killing me! Tina Jones Health History transcript, documentation and objective data

I am so sorry you’re going through that

Empathize

07/17/22 1:36 AM MDT

Thanks for understanding.

What additional symptoms have you experienced (Clarified to Do you have any other symptoms?.)

Question

07/17/22 1:36 AM MDT

I mean, it’s all red and swollen, and there’s pus, it feels hot, it hurts like hell… It’s got all that going on. (Clarified to if I have other symptoms.)

Can you rate your current pain level on a scale of zero to ten

Question

07/17/22 1:37 AM MDT

I’d say a 7. It hurts a lot, and the pain pills haven’t kicked in yet.

What pain pills have you taken

Question

07/17/22 1:37 AM MDT

It’s called tramadol.

What dose of Tramadol

Question

07/17/22 1:37 AM MDT

I’m not 100% sure, but I think they’re 50 milligrams.

How often do you take Tramadol

Question

07/17/22 1:37 AM MDT

I’ve been taking the Tramadol morning, noon, and night. [AUDIO COMING SOON]

When was the last time you took Tramadol

Question

07/17/22 1:38 AM MDT

This morning I took two pain pills right before I came here, at around 8:30.

Does a Tramadol typically work for your pain Tina Jones Health History transcript, documentation and objective data

Question

07/17/22 1:38 AM MDT

Yeah, the pain pills help, but only for a few hours.

Can you describe your pain

Question

07/17/22 1:38 AM MDT

It’s throbbing and like, sharp if I try to put weight on it.

How did you hurt your foot

Question

07/17/22 1:38 AM MDT

I was going down the back steps, and I tripped. . . I caught the railing, but I guess I kind of turned my ankle a little bit. And I scraped up my foot on the edge of the step.

How’s your foot been draining any liquids

Question

07/17/22 1:39 AM MDT

Yeah, there’s definitely pus.

What color is the pus

Question

07/17/22 1:39 AM MDT

It’s… white or maybe off-white.

What have you done to treat your foot after the accident (Clarified to How have you been treating your foot?.)

Question

07/17/22 1:39 AM MDT

I made sure to clean it and just keep it bandaged. And I put Neosporin on it. (Clarified to what I did for my foot at home.)

How effective was the Neosporin

Question

07/17/22 1:40 AM MDT

Well, I had to come back to get my foot checked out even though I used the ointment. [AUDIO COMING SOON]

Are you able to walk

Question

07/17/22 1:40 AM MDT

No, I can’t. I can’t put any weight on it without like, shooting pain.

What pre-existing medical conditions do you have

Question

07/17/22 1:42 AM MDT

Well, in terms of general health stuff, I have asthma and diabetes.

When were you diagnosed with diabetes

Question

07/17/22 1:42 AM MDT

I was diagnosed when I was 24.

What medications did you take for your diabetes

Question

07/17/22 1:42 AM MDT

It was Metformin.

Do you still currently take Metformin

Question

07/17/22 1:42 AM MDT

I don’t take anything for my diabetes anymore.

What made you start taking medication for your diabetes (Clarified to What made you stop taking your diabetes medication?.)

Question

07/17/22 1:43 AM MDT

I guess I just got sick of feeling sick and gassy all the time, and it was overwhelming, remembering to take pills and check my sugar. I feel a lot better now that I’m just eating healthier than I did when I was taking the pills. (Clarified to what happened that caused me to stop taking my diabetes medication.)

Diabetes is a very serious condition that has to be treated very carefully

Educate

07/17/22 1:44 AM MDT

Sure, I think I understand what you mean.

Do you monitor your blood glucose

Question

07/17/22 1:44 AM MDT

I have a monitor at home, but to be honest I don’t really use it that often. It’s such a hassle to check my blood sugar, and my diabetes is under control right now so I don’t really need to.

What is your current diet like

Question

07/17/22 1:44 AM MDT

It’s pretty good, I think. I’m not a huge health nut or anything.

Have you had any change in your appetite

Question

07/17/22 1:45 AM MDT

Yeah, lately I’ve definitely been much hungrier than usual.

Has there been any change in your weight

Question

07/17/22 1:45 AM MDT

Yeah, I’ve lost some weight recently.

How frequently do you urinate

Question

07/17/22 1:45 AM MDT

I don’t know. Every hour or two when I’m awake?

 
Documentation / Electronic Health Record

Document: Provider Notes

Document: Provider Notes

Student Documentation
Model Documentation

Identifying Data & Reliability
Ms. Tina Jones is a pleasant 28 year old African American female who presents to the clinic today to establish primary care. She also has a complaint of a right foot injury that occurred during a fall that happened two days ago. She is the primary and sole source of the interview. She is very knowledgable and easy to comprehend. She is alert and oriented X 4 and maintains eye contact throughout the interview Tina Jones Health History transcript, documentation and objective data.

Ms. Jones is a pleasant, 28-year-old obese African American single woman who presents to establish care and with a recent right foot injury. She is the primary source of the history. Ms. Jones offers information freely and without contradiction. Speech is clear and coherent. She maintains eye contact throughout the interview.

General Survey
Ms. Jones is alert and oriented. She answers questions accurately and is dressed appropriately. She doesnt exhibit any strange speech or behaviors. She doesnt appear to be under any distress.

Ms. Jones is alert and oriented, seated upright on the examination table, and is in no apparent distress. She is well-nourished, well-developed, and dressed appropriately with good hygiene.

Chief Complaint
Scrape on right foot with pain and symptoms of infection

“I got this scrape on my foot a while ago, and I thought it would heal up on its own, but now it’s looking pretty nasty. And the pain is killing me!”

History Of Present Illness
Ms. Jones greater foot about a week ago while being outside barefoot. She reported to the ER the night she injured her foot, where they gave her a prescription for Tramadol and treated the wound. She also received an x-ray. Her symptoms began to worsen two days ago. She began to notice increased pain, purulent drainage, warmth and swelling around the wound. She’s unable to put weight on the injured foot without sharp shooting pain. She has been changing the bandage and cleaning the wound with soap and water twice-daily. She also reports using Neosporin and peroxide occasionally.

Ms. Jones reports that a week ago she tripped while walking on concrete stairs outside, twisting her right ankle and scraping the ball of her foot. She sought care in a local emergency department where she had x-rays that were negative; she was treated with tramadol for pain. She has been…
 
 

 
Objective Data Collection: 1 of 1 (100.0%)

Hover To Reveal…

Hover over the Patient Data items below to reveal important information, including Pro Tips.

Found:
 Indicates an item that you found.

Available:
 Indicates an item that is available to be found.
Tina Jones Health History transcript, documentation and objective data

Category

Scored Items
Experts selected these examinations as essential components of objective data collection for this patient.

Patient Data
Not Scored
Thorough examinations will yield better patient data. The following actions reveal the objective data of the patient’s case.

Wound Treatment

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Finding:
Inspected wound

Finding:
Measured wound: 2 cm x 1.5 cm, 2.5 mm deep
(Found)
Pro Tip: Measuring a patient’s wound will help you track whether it worsens or heals in future visits.
Example Question:

Finding:
Swabbed wound and sent to lab for C & S
(Found)
Pro Tip: Sending a culture of wound drainage to a medical lab will help you choose the best antibiotic for that microbe type, and can rule out dangerous infections such as MRSA.
Example Question:

Finding:
Cleansed and irrigated wound with normal saline and applied dry sterile dressing Tina Jones Health History transcript, documentation and objective data.

199+ Best Critical Thinking Essay Topics For College Students

199+ Best Critical Thinking Essay Topics For College Students
Writing a critical essay can be pretty intricate, especially if you don’t have a good critical thinking essay topic. An ideal critical thinking essay is centered on a solid thesis statement, a good critical thinking essay topic, and an outstanding analysis of the selected topic.  Although challenging, choosing the appropriate critical thinking essay topic is the first step toward writing an impeccable critical thinking essay. 
When writing a critical analysis essay, the writer evaluates, interprets, and analyzes a piece of literature, a historical event, an argument, or a social phenomenon. Critical essays necessitate in-depth research, and they are built around facts and showcase critical thinking. A critical thinking essay is crucial since it allows students to boost their research skills.
In this blog, we have prepared a list of well-curated critical thinking essay topics that will help you develop your ideas. But first, let’s delve into how to choose a critical essay topic. 
How to Choose Critical Thinking Essay Topics
Choosing an appropriate critical essay topic might sound daunting, but it is an integral part of the essay writing process, and there is no other way around it. But the good news is that you have limitless essay topics for critical thinking essays to choose from. But how do you do that?
Here are some crucial tips to help you select a good critical essay topic.

Select a captivating and compelling topic
Only choose a topic that you have enough evidence to back it up
Your critical essay topic should be informative. You must bring something new to the existing knowledge.
Do not fret over changing a critical essay topic if you find that your topic is unreliable. Change to another critical essay topic. The earlier, the better.
Remember that you are presenting only facts in a critical essay and not your opinion in a critical essay.
Ensure that you can source credible, relevant, and up-to-date information to back up your arguments.
Before you begin writing, discuss a bit of your chosen critical thinking essay topic.
Ask friends and family what they think about your critical thinking essay topic. 

Tips & Hacks on How to Write the Best Critical Essay
Like any other five-part essay, a critical essay begins by selecting a critical essay topic.  You are supposed to choose a fascinating and informative critical essay topic. Your main duty as a critical essay writer is to tell the reader that what you are discussing is valid, and the reader should keep on reading to the end.
But how can you write a critical essay that will keep your reader hooked to the end? Use the simple tips listed below to help you write an outstanding critical essay. 

Read. Read. Read

For years, books agave been the best sources of information. Books are readily available. Books open the world to a whole new perspective, enlarge our imagination and experience, and shape how we think.
Look for some books on the critical essay topic you are interested in. Choose a few questions from the book and use that as a foundation of your critical essay topic.

Look for credible sources

There are millions of sites only, but not each is worth looking into. There are many other sites where you can find critical essay topics. To find a topic that you find exciting and straightforward. Delve into the several published sources about the subject and explore what the previous writers have said about the topic.
A critical response essay topic could grab the reader’s attention and have them interested in the daily issues that affect our daily lives. 

Speak to your close friends 

We all have friends from different backgrounds and different ages. You can have someone your grandmother’s age as your best friend, or even your mom can be your best friend. Talk to the people close to you and let them share their personal lives and what they wish they could change about the world.
Explore how different generations perceive various issues. A critical essay topic that discusses how different ages perceive certain cases is worth looking into. 

Explore the field

If you can take a trip out of your home town. Then please do so. Visit museums, streets, and other public venues and speak to people. You will gain exposure to several ideas and perspectives. You will get a chance to exchange ideas and unearth several issues worth mentioning in your essay.

Stay informed

You have to stay updated on whatever is in the relevant field. There is no shortage of news sites and other publications that focus on specific problems. Take advantage of this and help explain the real issues in your critical essay.
Chaos on the problem and get down to writing about an issue that has garnered much attention recently. If the journalist has covered it, the topic is worth looking into. 
First-Class Critical Thinking Essay Topics

Is the criticism of gays in society justified?
Why is it important to analyze every situation in life?
One person can change the world: How true is that statement
Explain why several government policies fail to work in the U.S
What is the impact of the author’s background in creating a masterpiece?
Explain how misconceptions impact our desires
Investigate the role of mass media in mitigating problems like poverty and illiteracy
Investigate critical problems associated with overpopulation
Highlight the differences and similarities between the first and second world war
Analyze the effectiveness of the judicial system in its quest to control the use of drugs
What’s the distinction between love in medieval times and love now?
What is the role of fairy tales in affective learning?
Explain why people are reluctant to accept the concept of environmental improvement
Are children necessary for the continuation of the human race?

Special Critical Thinking Essay Topics

Explore the trends in critical thinking
Evaluate courses at the university by using the tools of critical thinking
An in-depth evaluation of transformation tools
Humility, courage, autonomy, and integrity are tools used in the transformation of the mind. Go further in detail and examine other transformational tools and how a student can understand them and use them in their everyday lives.
Explain the key differences between education quality and applied education
Explain the meaning of critical thinking in our world today
The significance of critical thinking in the world today
What is philosophy? Critically deduce the scope of philosophy, including branches, characteristics, and relevance.
Explain the scope of creative thinking regarding critical thinking
Explore the breadth of critical thinking
Explore the benefits of applied critical thinking to organizations and businesses today
Personal reflections on critical thinking

Sports Critical Essay Topics

What is the importance of indoor and outdoor activities?
Health problems related to excessive video gaming.
Why should animals not be used in sports?
The link between sports and academic performance.
Should sports betting be legal?
College football players should get paid.
Can two good teams have a boring game?
What is the impact of violent video games on children?
Why should violent sports be banned?
Why should cheerleading be considered a sport?

Historical Critiques Essay Topics  for students

Define xenophobia, review its history and explain how it affects our daily life
Look at the history of the first countries of Canada and their effect on Canada we currently know.
Examine the prevalence of poverty in the U.S and explain how it leads to homelessness
What are the likely impacts of changing gender roles
Describe islamophobia and discuss how it affects the lives of American Muslims.
Describe the impact of racism on black people’s mental health in the United States.
Demonstrate the effect social media and technology have on human interaction and socialization.
Review the history of the slave trade and highlight the impact of the abolition
Demonstrate the characteristics of a diverse nation
What is the effect of drug use and addiction on adolescents in the United States?

Top-Notch Critical Thinking Topics For Papers

Examine the scope of fallacies as they relate to creative and critical thinking
Evaluate the link between critical thinking and money
Explain how personal fashion impacts one’s identity
Define the link between reflective analysis and critical thinking
High-End Critical Thinking Paper Topics
What is the connection between job satisfaction and team member turnover rate?
Examine the impact of social media on human psychology
What is the role of critical thinking in the world today?
Give reasons why education should be free.
Analyze the importance of individuality, self-knowledge, and self-worth in critical thinking
What’s the distinction between applied education and education quality?
Which is better between city life and country life?

35 Latest Topics For Critical Thinking Essay

Why can’t we give up fast food?
Mutual aid is important in society.
Can a black hole swallow our planet?
Why are people skeptical about environmental improvement?
Do people need to be checked in metropolitan areas?
Is office work better than working at home because of real communication with people?
The significance of reflective thinking in a society capped by technology and social media
Does order in your house mean order in life?
Can we live forever?
Is food a need or a special ceremony for body and soul?
Meetings: need or not?
Do women have a certain age for marriage?
Explain the rationale behind clear, objective thinking
What are the arguments in critical thinking? Explain the scope of statements such as deductive reasoning and inductive reasoning
Can a person be happy without a partner?
Should problem-solving skills be a measure of one’s intelligence?
Do talismans help and protect?
Write a paper detailing your reflections on academic situations
Always religion is humility and virtue?
Significance of multiculturalism in our world today
Why do people believe nature is a free market?
High heel shoes: beautiful and dangerous.
Criticism can be offensive to people.
What are fallacies? Explain the range of fallacies concerning critical and creative thinking.
Should we analyze every situation in life?
Explore the many ways a student can use the lessons learned in critical thinking classes in real-life situations
How to stop the sale of drugs?
How to learn to plan your budget?
Does a small child need a lot of money?
Support the existence of wisdom and quality education with facts, reason, and claims
The modern world has many temptations.
Problems with overpopulation.
Explore the stages in research as deduced by a critical thinker
Why are certain animals more faithful and kinder than people?
Do Native Americans live in reservations now?

Critical Thinking Essay Questions

Who is to be blamed for homeless people?
What is the connection between corruption and asterism?
What are the main causes of environmental degradation around the world?
What are the most beneficial environmental conversation techniques?
Examine the impact of social media on the mental health of a teenager
Demonstrate whether anorexia nervosa is associated with many health risks.
Should kids watch horror movies?
Why is the game of basketball so popular?
What is the importance of socialization?
Discuss why some animals are more gentle and trustworthy than humans.
Weigh the pros and cons of getting a college degree.
Discuss the effectiveness of a balanced diet for our health.
Compare traditional learning and virtue learning.
The most serious health risk from anorexia nervosa.
What is the impact of corruption on third-world countries?
Effective sleep habits for everyone.
Describe the importance of medical insurance, the reasons for its necessity, and the various disadvantages.
What is philosophy? Critically deduce the scope of philosophy, including branches, characteristics, and relevance.

Critical Thinking Topics For Debate

Consider the spectator experience when it comes to mind sports.
Distinguish between online and offline relationships.
Conduct an assessment of the efficacy of standardized tests.
Investigate the advantages and disadvantages of district zoning
Why are humans so convinced that nature operates on a free market basis?
Consider the following five ways in which technological advancement has altered the course of human life
Weigh the pros and cons of attending a private or public school
Contrast recorded and lived music
Native American independence issues
Discuss the compatibility between environmentalism and capitalism
Emphasize the most significant risk factors for lung cancer and how to alleviate them
Vegan foods that are not healthy
Discuss the importance of a healthy lifestyle
Describe the effects of championing feminism on social media platforms
Analyze and evaluate how the development of the industry impacts students constantly striving to join it
Consider the obstacles Native Americans faced in their quest for self-determination.
What effect does a well-balanced diet have on the health of a child?
Consider why painkillers are required and some of their potential side effects.
Conduct research into the benefits and drawbacks of genetic engineering and genetically modified organisms (GMOs).
Define global warming and the effects it has on human life
Describe the media’s role in the development and prevention of crime

Original Critical Essay Topics Ideas

Crime among neighbors.
Secrets of the great canyon.
Children and video games.
Women in politics.
The discoverers of America.
Work and laptop.
Banking investments.
Exploring the pyramids: do not disturb the pharaohs.
Euthanasia and religion.
Domestic violence.
Revoke strong prison sentences for criminals.
Sport in college.
Is it possible to improve the financial situation of the country?
Inflation in the economy.
Football fans at the championships.
Road traffic.
TV and our minds.
Vikings and their achievements.
Athletes and dope.
Flora, fauna, and man.
Racism in society.
Human factor.
Sex change.
The impact of technology.
Olympic gods.

Environment Based Critical Thinking Essay Topics:

Why processed food may be detrimental to your health
Explain hurricanes and how they affect the environment.
Explain the effects of globalization and why it is the most significant economic phenomenon at this time
Choose any social issue you want to discuss and find an effective solution. 
Are the celebrities effective in disseminating pro-environment ideologies?
Examine the negative impact of the lottery industry and justify why it should be banned
Is there any effect of the environment on psychological well-being?
Synthesize the Italian food custom and highlight different symbolism in it
What is the distinction between economic liberalism and economic nationalism?
Consider the following five ways in which technological advancement has altered the course of human life.

Critical Thinking Topics For Students

What’s the distinction between the caste system and the class system in society?
Analyze how the increase or decrease of carbon dioxide is harmful to the quality of life on earth
How can students’ cognitive abilities be developed?
Investigate the role of society in advancing negative emotions like hatred in human beings
Justify why democratic governments are regarded as the best at meeting citizens’ needs
Investigate why plants that grow in the tropical region
Discuss the factors that contribute to anarchy in a culture comprised of diverse cultures and religions.
Evaluate the basics of critical thinking
Investigate the origin of gender imbalance between men and women in developed economies
What is the impact of the composition of air in a particular region on a person’s health?
Why is it crucial to encourage and support women from their members of the opposite sex?
What is the importance of the marriage institution and society as a whole?

Critical Thinking Essay Topic Ideas On Technology:

What is the role of technology in transforming the lives of human beings?
Advantages and disadvantages of enhanced technology in the current world.
The integration of robots into the lives of humans.
Analysis of Apple iPhone.
How has technology improved the health sector?
The impact of technology on fashion trends.

Critical Essay Topics About Movies and TV

What are the reality TV shows that are so popular?
Choose the most popular game show and analyze it in detail.
Provide analysis on a movie that won an Oscar this year.
Choose a book you have recently read and provide a detailed analysis of its movie adaptation.
What are the pros and cons of classic movie remakes?
Choose any film that you have watched and describe the takeaways in it.
Why are talk shows very popular today?
Conduct a detailed analysis of any educational movie that you have watched.
Describe the main theme in current TV shows.
Provide a detailed analysis of one of the best comic book series.

Critical Essay Topics for College Students

Why, 30-40 years ago, were the principles and laws of society different?
Is contemporary art strange?
Does technology ruin society?
Styles are mixed.
Genetics and its secrets.
Can we help our planet?
Does alcohol always create problems?
Do we need children only for the continuation of our race?
Does inpatient treatment help?
Is every star a separate galaxy?
Why is it important for us to look good?
Children and parents: relationships.
One person can change the world.
TV zombies, people?
Why do we love TV shows?
Criticism of gays in society.
How do we understand love now and in medieval times?
Why does the opinion of other people stop us?
Developments and achievements. Do we need it?
Is there fresh air outside your apartment?
Is a stylish image success in everything?
How to get rid of bad habits? Why do we have it?
Is modern medicine a breakthrough?
Misconceptions affect our desires.
Are we ready to risk and make exploits?

Critical Thinking Essay Topic Ideas On Sports:

Salaries are given to top sportspeople.
What are the methods to control racism in sports?
Use of drugs by the sports players.
Write an analysis of sports on the internet.
How can you relate corruption to sports?
The strategies to get success in the field of sports.

Critical Evaluation Essay Topics

Analyze the cultural value of the pyramids of Giza
What is the impact of deforestation of tropical forests on the environment?
Investigate how environmentalism and capitalism compare to each other
Review the effectiveness of standardized tests.
Highlight the best places to visit in Europe and explain why they are so unique
Discuss the effects of global warming.
Examine the concept of same-sex marriage from a Christian point of view
Examine how moves portray a historical figure
Analyze the viewer’s experience of mind sports.
Synthesize the attributes of an epic summer movie
Evaluate the pros and cons of attending public and private schools.
How the internet has changed the world.
What are the pros of having a college degree?
What is the connection between religion and morality?
What’s the distinction between traditional and online relationships?
What are the side effects of painkillers?
Discuss the effect of technology on the health care industry
What is the impact of social media bullying on one’s mental health, and how can the problem be resolved?
Examine the correlation between economic growth and the environment
Evaluate events that defined economic development in the U.S since 1900
Compare and contrast live performances and recorded music.
Discuss the pros and cons of genetic modification.
Analyze the long term impact of colonialism as observed in the world today
How is the global climate-related to capitalism

World-Class Critical Essay Topics

What factors influence women’s and men’s decisions to undergo gender transition??
Examine the effect that nanotechnology has on human life.
Consider euthanasia from a religious perspective.
Why is it beneficial for humans to exhibit ethics?
How does divorce affect the mental health of a child?
What are the ramifications of robots displacing human labor??
Analyze the impact of inflation on the economy of a country
What are the benefits and drawbacks of cosmetic surgery?
What effect does domestic abuse have on children’s mental health?
Justify why businesses spend so much money on advertising.
Examine the concept of same-sex marriage from a Christian point of view

Critical Thinking Essay Ideas Based On Economics:

Discuss the effectiveness of the American economic system.
Discuss the economic importance of microbes in human life.
How do students effectively spend their money?
Discuss any financial disaster from the past ad its reason.
How does inflation affect economic growth?
What is the connection between literacy and economic growth?

Critical Essay Topics on Social Issues

What are the advantages of eating healthy food?
Police brutality and how to stop it.
Provide alternatives to anti-poverty programs.
Choose any social issue you want to discuss and find an effective solution. 
Advantages and disadvantages of eating fast foods.
The effectiveness of the media in solving issues like illiteracy and poverty.
How to stop the war in the middle east?
How effective is the legal system in combating drug abuse?
Craft a research paper on the impact of social media on mental health
The long-lasting impact of colonialism.
Analyze why some of the governmental policies are ineffective in the US.

Bottom Line 
Thanks to the intricate questions surrounding our daily lives, you have several critical essay topics to choose from. Any critical essay topic can have disadvantages and advantages for animals, nature, people, or the entire planet. If you want to write a critical essay, you need to analyze the selected topic and discuss the advantages and disadvantages of the situation.
Are you unable to write your critical essay? Do not fret. We have professional writers waiting to handle your critical essay. Just place your order now.

pdsa model of change in nursing essay

pdsa model of change in nursing essay
pdsa model of change in nursing essay
Quality/Safety Improvement Model
Quality/Safety Improvement Model

Name:
Institution:

Abstract

Medical errors depict a severe public wellbeing issue and pose a risk to the security of patients. As health centers introduce an ‘error’ as a research and clinical need, the response to maybe the most crucial inquiry remains indefinable: How can you define a medical error? To diminish therapeutic faults, exact measurements of its occurrences, founded on definite, and predictable definitions, are critical essentials for successful actions. In spite of having a growing literature and research body to study on errors in medicine, few undertakings have measured or defined the issue unswervingly. Rather, analysts have embraced substitute measures of error that to a great extent rely on antagonistic patient injury or outcomes (that is outcome-dependent). pdsa model of change in nursing essay. An absence of institutionalized classification and the utilization of various and overlapping meanings of medical error have barred data analysis, synthesis, collaborative work, and assessment of the effects of alteration in health care conveyance. The essential goal of this audit is to highlight the requirement for a robust, wide-ranging and collectively acknowledged meaning of therapeutic error that unambiguously incorporates the crucial areas of error causative ness and catches the defective procedures that cause errors, independent of result.
BUY A PLAGIARISM-FREE PAPER HERE
Quality/Safety Improvement Model

Introduction

The issue of patient safety plays a significant role in health care. The prominence of the issue is fueled by the intensifying body of research that demonstrates a high frequency of medical error combined with a couple broadcasted therapeutic error cases that have over the years raised a public concern over the issue of patient safety in the contemporary health care conveyance. Medical faults can be said to be avoidable adverse effect or event of care. They are a leading cause of many deaths in several parts of the world and even in most cases exceed the deaths caused by vehicle accidents, heart failure, or even breast cancer (Palmieri et al., 2008). They comprise of incomplete or erroneous treatment or diagnosis, and incorrect execution of an appropriate care method. Errors caused by humans have been involved in about 80 percent of adversative happenings that happen in complex healthcare units. The dominant part of medical errors emanates from faulty systems and inadequately composed procedures versus incompetent practitioners or poor practices.

According to a study conducted by Gitomer, the vulnerability of medicine to error is turning out to be deceptive (2005). The research revealed that the errors are more prevalent in intensive care units whereby nurses are involved in the medical recovery of the error (that is recognizing, interposing, and correcting them) and preventing adverse effects. Despite the fact that medical practitioners have been identified for preventing errors from occurring, only lately have approaches for error retrieval been designated in the literature. Analysis that have recently shown that failure results from a system and human failures have given people a call to action to start systematically addressing the issue. pdsa model of change in nursing essay.
Problem of Discussion

The issue of medical errors was recently brought to the public following a series of deaths caused by health systems and human faults. Several reports introduced the issues of health safety into the awareness of the people and stressed on four key points. That medical errors are costly and frequent, they are caused by systems, can be prevented and safety enhanced, and medication-connected adverse events are the primary causes of injuries. Recent attempts have been made to think about what can be done to achieve the next level of health safety (Gitomer, 2005). Medical experts have recommended that the security of patients depend more on averting overwhelming incidents by improving systems as it relies on increasing people’s ability to the point of health care to eliminate dangerous situations by recognizing those errors.

To minimize the occurrence of medical mistakes, medicinal service providers should identify their causes, device measures, and quantify the success of improvement endeavors. In addition, exact estimations of the occurrence of error founded on precise and steady definitions, are crucial essentials for powerful actions. pdsa model of change in nursing essay. Unfortunately, what is viewed as a medical error has been affected by contrasting settings and purposes, for example, quality control, legislation, research, insurance, statutory regulations, morals, and legal action. Subsequently, an absence of institutionalized terminology and the utilization of various and covering meanings of restorative error has hindered data analysis and synthesis, evaluation, and collaboration of the effect of changes on medicinal services delivery (Thomas &Brennan, 2011). Researchers have adopted surrogate error measures, such as critical incidents, preventable adverse activities, violations, slips, iatrogenic illness, potentially compensable occurrence, and noxious episodes pdsa model of change in nursing essay.

Aim

Programs to reduce Medication Errors

The objective of this discussion is to study programs, which have over the years proved to be effective in the reduction of medical errors. The systematic nature of medication errors involves a multi-disciplinary approach. Programs projected in the medical literature need the involvement of drug manufacturers, pharmacists, communication efforts, as well as information systems (personnel, software/hardware) of hospital staff to minimize medication errors. Technological programs to offer solutions to the medication errors will continue to transpire as healthcare continues with their efforts to improve quality and safety in all health aspects of healthcare delivery (Cohen, 2007). Despite that there is evidence of the advantages and improvement in centers due to the implementation of such programs, inquiries continue to arise. There have been writings showing the business case of programs, such as the MFI (Model for Improvement) and PDSA (Plan-Do-Study-Act) tools pdsa model of change in nursing essay. To recognize the full advantages of these approaches, implementations should be combined with adequate training and support, engaged at all levels, easy to utilize, counterpart prevailing protocols, and tools within the organization and be a part of the all-inclusive Quality Care Program (QCP) or Quality Improvement (QI).

Intended Improvement

Utilization of MFI and PDSA as project Management Resources

Conveying changes in the quality and security of healthcare remains a worldwide challenge. Currently, Quality improvement (QI) systems, for example, the MFI and PSDA cycles have been utilized as part of an endeavor to drive such enhancements. The system is used as a part of medicinal services change; nevertheless there is a small overall assessment of how the strategy is connected (Schilling & Joint Commission Resources, Inc., 2009). This paper proposes a hypothetical structure for surveying the nature of the use of MFI and PDSA cycles and investigates the superiority and steadiness of PDSA cycle presentation against this basis as recognized in several peer-review journals. pdsa model of change in nursing essay.

It is important to bring into practice several quality improvement techniques and tools, which enable the identification of ineffectiveness and inefficiency in the health services and propose the practical changes that can be brought to the system. One of the most recommended tools is the Model for Improvement (MFI) and Plan-Do-Study-Act (PDSA), which comprises of a standard theoretical accounting, supported by the Institute of Healthcare Improvement (IHI) and National Health Service (NHS) as a primary approach to promoting and fostering exertions in quality management (John Corrigan &Donaldson, 2007) pdsa model of change in nursing essay. It incorporates execution appraisal and the utilization of evidence-based discoveries as a method for affecting the desired change in the medicinal services division, a zone where the need for security and quality change cannot be disregarded.

IHI endorses the MFI as an approach to guide improvement activities. It was developed by Associates in Process Improvement, is a very simple, yet very influential implement for accelerating medical error recovery. The tool is advantageous in that it does not replace any other change models that health centers may have adopted but is meant to increase growth. It has over the years been implemented successfully by numerous health care firms in many nations to advance many distinct medical procedures and effects pdsa model of change in nursing essay.

The MFI has two major parts, which include the Plan-Do-Study-Act (PSDA) cycle meant to test changes in the health settings. The cycle is important as it guides the change test to determine if it is an improvement. The other part is the three central questions, which are addressed in any order. The MFI and PSDA tool requires an organization to include the right people in the procedure improvement team to ensure that the medical error is alienated. Teams tend to differ in composition and size. Therefore, each organization can focus on building a team that suits its own requirements (Barach &Small, 2010). pdsa model of change in nursing essay. To implement the tools, an organization should first set its aims. The goals should be measurable as well as time-specific and should be able to outline the particular patient population, or any other system that may be affected.

Outcome Measure to delineate the Goal

Increased enthusiasm for patient wellbeing, error elimination, and the nature of human services has prompted the improvement of various execution measures (procedures and results) to assess frameworks of consideration. pdsa model of change in nursing essay. In considering precise results measures, it is unclear that national post-mortem examination rates keep on declining in light of the way that post-mortems have generally served as the “best quality level” in the quality certification of therapeutic consideration. Progresses in therapeutic innovation, including complex imaging systems, percutaneous biopsy, fine needle yearning, and a large number of new research center strategies, have strengthened symptomatic carelessness and have prompted the discernment that post-mortem examinations are no longer essential (Thomas & Brennan, 2011). Despite the fact that new indicative procedures can give definitive clinical data, these strategies can likewise add to False-positive and false negative conclusions and do not apparently diminish the rate of misdiagnosed as found via post-mortem examination.

Nevertheless, doctors have persuaded themselves and their patients that new therapeutic innovation has come to such an abnormal state of symptomatic exactness that the post-mortem is out of date. The fact of the matter is that when the last result is demise, the autopsy still remains the best accessible instrument for assessing symptomatic exactness (Stamatis, 2011). In this manner, when appropriately utilized, post-mortem information has a colossal potential for the distinguishing proof of correctable orderly mistakes in indicative processes. When medical errors occur and if physicians are blamed, then the society develops a preventive culture and 3 sorts of strategies may follow: an endeavor to (1) “execute the person,” (2) “distort the information, corrupt the standard, get control of the unsafe procedure,” and (3) “diverse attention”(Stamatis, 2011).

Critical Analysis of the Value of the Tool to Supporting the Initiative pdsa model of change in nursing essay.

In spite of expanded interest in examination of the change of medication errors, evidence of sustainable QI intercession remains blended, proof of viable QI intercessions stays blended, with numerous deliberate audits inferring that interventions are just compelling in particular settings. To comprehend these discoveries, it is imperative to appreciate that conveying changes in medicinal services require the modification of procedures within complex social frameworks that change after some time in anticipated and unanticipated ways. Research discoveries highpoint the persuasive impact that local context can have on the achievement of an intervention and, in that capacity, “single bullet” medications are not anticipated to convey predictable enhancements (Joint Commission Resources, Inc., 2009). Rather, viable intermediations should be multi-faceted, complex, and developed iteratively to adjust to the publics and react to unexpected obstacles and inadvertent effects. pdsa model of change in nursing essay. Finding powerful QI systems to bolster iterative improvement to evaluate and test interpositions to care is important for high-value and high-quality delivery care in financially constrained settings.

MFI and PSDA tools provide a technique for structuring iterative advancement of variation, either as an impartial strategy or as a significance aspect of more extensive QI methodologies, for example, Total Quality Management (TTM), Lean, Continuous QI, or Six Sigma. Despite expanded utilization of QI strategies, the indication basis for their adequacy is reduced and under-theorized (McLaughlin & Kaluzny, 2014). MFI and PDSA cycles are regularly a focal component of QI activities; however, a couple of formal target assessments of their viability or application have been conveyed out (Cohen, 2007). Some MFI and PDSA methodologies have been exhibited to result in massive changes in consideration and patient effects while some have shown no changes at all.

Tool- Major Discussion

Healthcare centers need to be ready to learn how to use the MFI tool, and especially, how to undertake continuous and systematic procedures for trusting and implementing improvements to eliminate medical faults by applying the PSDA improvement cycles. Their primary focus is to instill the two models in their daily practices. pdsa model of change in nursing essay. Each advancement activity chosen by experts should be a prospect to persuade them to consider a data-driven and a systematic methodology to testing, implementing, and supporting change (Stamatis, 2011). A significant part of presenting a culture of quality is through enabling the practice to change its attention from individuals to procedures. Health organizations can get hindered in looking for people to blame for less than optimal results, a model that can produce a problem-focused and a punitive work context. Medical experts can employ the MFI and PSDA tools to aid practices in proposing a changed to thinking about their system and how they can modify them to increase productivity.

The MFI and PDSA cycles are straightforward yet powerful models that assist in developing of practices. One of the most ultimate methodologies to doing this is to urge the practice to undergo the control of completing a change structure in light of the MFI (Graham, 2005).The minor demonstration of finishing the structure aids in strengthening the thought and fabricates the inward discipline and ability to utilize a characterized procedure for testing and embracing changes to the typical course of business.

The MFI and PDSA models work hand-in-hand and are the standard used QI approaches in healthcare. The MFI utilizes a rapid cycle processes, which are the PDSA cycles to test the impacts of minimal changes, make them, and eventually spread the efficient transformation through the practice or the institution. The PDSA users follow a recommended four-stage cyclic study approach to acclimatize to changes geared towards improvements. In the first stage, which is plan, change to lead the growth is developed, the second stage “do” is whereby the change is tested, while the “study” stage scrutinizes the success of that particular change (Graham, 2005). The final stage, which is “act” recognizes adaptation and the process can lead to the formation of a new cycle (See Appendix 1). You may not achieve the expected results when changing the methods, so it is efficient and safer to test out progress on a small group afore making them the solutions. Utilizing the PDSA cycles is essential as it enable individuals to test out modifications before the final implementation and offer stakeholders with an opportunity to see if that change will work. pdsa model of change in nursing essay.

The PDSA cycle encompasses testing the new changes for instance, try the contemporary ways of giving drugs to patients or even attempting to use new patient data sheet with a designated patient groups before introducing that change to all healthcare systems. It is essential to test change before applying it as it saves time, money, and risk, it is secure and less disruptive for staff and patients, and usually there is less resistance (Speroff & O’Connor, 2014).The following are the recommended ways of how to test the PDSA models:-

• An arrangement of various cycles to test thoughts. One can adjust these from the administration change direct, so there is proof that the change meets expectations

• Test on a small group of people. For instance, begin with a patient or a physician at one evening facility and expand the rates as you improve the thoughts

• Test the projected change with individuals who have faith in the change. Try not to attempt to change individuals into tolerating the adjustment at this step

• Just actualize the thought when convinced that you have considered and tried all the conceivable methods for accomplishing the change

• The MFI, model on the other hand, starts by asking three main questions:

• What is the organization trying to achieve?

• How will one know if a modification is a progress? pdsa model of change in nursing essay.

• What are the changes that we choose that results in improvement? (See Appendix 2)

QI members, therefore, present and examine changes deliberated to attain the aims of development using sequential PDSA cycles till they achieve the change that the organizations believe will eliminate medication errors (Thomas & Brennan, 2011). By answering the above three questions, teams will be focused towards setting vibrant and engrossed goals. These objectives require clinical leadership and should emphasis on issues that raise concern. The statement objectives should be bold in its aims, be consistent with goals, and should have clear and predictable targets. For instance, to reduce errors in cancer treatment, health practitioners should focus on improving access, diagnosis speed, treatment speed as well as the patient care of individuals who are susceptible of suffering from bowel cancer. The reduction of medical errors using the MFI model cab be achieved by initiating booked appointments and admissions, minimizing the time from referral to initial exact treatment to not more than 15 weeks, and lastly, guaranteeing that 80% of patients are deliberated by the multidisciplinary team.

How to realize if the modification is a progress after applying the MFI and PSDA models

Physicians should quantify results, for example, diminishment in the period a patient needs to hold up so as to answer this inquiry. In the event that they make an improvement, this ought to influence the measures and exhibit over time if the transformation has prompted feasible adjustment (Fain, 2013). The steps in this model are instruments for learning and showing change, not for judgment. Every task group ought to gather information to exhibit whether changes result in change. They should report change monthly on time arrangement diagrams known as ‘run charts’ or measurable procedure control graphs. There are numerous probable changes that a team can make. Though, scientific literature evidence and past advancement programmes propose that there are fewer chances that are likely to lead to improvement. It is probable that numerous PDSA cycles could be running simultaneously or sequentially (See Appendix 3 and 4 respectively).

To accomplish effective change endeavors in a given erroneous health care system framework the MFI and PDSA models accentuates the need to select the most appropriate personnel, which is critical to the general change in quality procedure. Just as the incorporation of different health care providers with fluctuated training levels and executive sponsors is vital to the development of a successful team, so is the consideration of team members acquainted with the different components of the procedure needing change (Boaden et al., 2008). pdsa model of change in nursing essay The decision of these members depend on the requirement for the group to speak to four distinctive key zones of specialization in the given human services foundation: every day authority of the organization, official sponsorship, clinical administration, and specialized abilities. It is not until the decision of colleagues is deliberately and precisely impacted, that achievement will be acknowledged in the manageability and usage of the proposed enhancements in quality.

Thinking of the consistent choice of the significant goals of the change extend typically takes after the group’s determination when utilizing the MFI and PDSA device for quality change. The apparatus proposes the definition of objectives that are reasonable, achievable, time cognizant, quantifiable, and particular. For the change’s achievement of value undertakings, outside and inner monetary backing is essential as it encourages mere execution of the task, investigation of the outcomes and reasonable usage of the proposed changes (See Appendix 5).

With an end goal to answer this quality change instrument’s inquiry of how the proposed change can promote upgrades in quality, a hypothetical bookkeeping of the measures identifying with the structure, procedure and results is recommended as it gives a guideline to the group’s usage learning of the association needing the change (Fain, 2013). By doing this, significant structure changes are sure to be, and this may, in the long run, lead to a decent result. The estimation method most regularly utilized is the utilization of procedure measures, and this is basic, particularly given that most ventures of enhancing quality are organized with the fundamental point of changing a predetermined defective system. In addition, a method for measuring the spontaneous ramifications of the foreseen change is additionally a need for the quality change group. The procedure’s determination and result means go before a relatively dreary methodology of gathering pattern information (Langley et al., 2009). This information accumulation technique mostly depends on relevant choices, for example, to where the information will be gotten, the amount of information ought to be gathered, the recurrence with which it will be examined, the venture orchestrators, and how the outcomes will be introduced to the venture’s partners.

Further investigation of the MFI and PDSA uncovers that after the doable change thoughts have been chosen, trying of these progressions begins quickly. It additionally stresses the need to investigate all the conceivable picked up thoughts considering that all sequences do come full circle into upgrades yet rather, all enhancements emerge from specific changes. The last and most imperative step of the MFI and PDSA quality change instrument is the execution and sustainment of the proposed modification thoughts (Gitomer, 2005). It incorporates the foundation of a demonstrated rundown of proposals that can be controlled to offer ascent to broad framework changes considered for enhancing social insurance results pdsa model of change in nursing essay.

Conclusion

MFI and PDSA are practices that every medical practitioner should become familiar with and feel comfortable using them. They are essential tools for organizations or individuals trying to advance quality, especially in health institutions. In the clinical context, doctors are focused on minimizing waiting times in emergency divisions, improving safety standards compliance in surgical and medical units, and lessening infections through increased hand washing acquiescence. The success of using the tools involves participation, communication, and organization of the entire medical team by ensuring that all units are ready to implement the changes. The MFI and PDSA models are a successful and famous instrument that are utilized to deliberately accomplish positive results as for upgrades in quality pdsa model of change in nursing essay. It is additionally apparent from the content that change in quality is to a great extent subject to five achievement components: advancing and keeping up a society of dynamism and well-being, including significant partners, a building up a comprehension of the current issue, testing of the recommended change thoughts, and a dynamic checking of the discoveries with respect to reporting and execution in endeavors to keep up the coveted change. Every one of these components has been analyzed in the analysis of these tools.

References

Barach P., & Small S. D. (2010). Reporting and preventing medical mishaps. Lessons from non medical near miss reporting, 320, 759-763.

Boaden R., Harvey G., Moxham C., & Proudlove N. (2008). Quality improvement: theory and practice in healthcare. NHS Institute for Innovation and Improvement. University of Warwick: Coventry UK.

Cohen M. R. (2007). Medication Errors (2nd Edition). Washington, DC: American Pharmacist’s Association.

Fain, J. A. (2013). Reading, Understanding, and Applying Nursing Research. Philadelphia: F.A. Davis Company.

Gitomer R. S. (2005). Improving access, quality of care, and patient satisfaction in a general internal medicine practice. Journal of Clinical Outcomes Management, 12(5), 245-249.

Graham, N. O. (2005). Quality in health care: Theory, application, and evolution. Gaithersburg, Md: Aspen Publishers. pdsa model of change in nursing essay.

John L.T., Corrigan J.M., & Donaldson M. (2007). To Err is Human: Building a Safer Health System. Washington, DC: National Academy Press.

Joint Commission Resources, Inc. (2009). Cost-effective performance improvement in behavioral health care. Oakbrook Terrace, IL: Joint Commission Resources.

Langley G. L., Nolan K. M., Nolan T.W., Norman C. L., & Provost L. P (2009). The Improvement Guide: A Practical Approach to Enhancing Organizational Performance (2nd edition). San Francisco: Jossey-Bass Publishers.

McLaughlin, C. P., & Kaluzny, A. D. (2014). Continuous quality improvement in health care: Theory, implementation and applications. Gaithersburg, Md: Aspen Publishers, Inc.

Palmieri, P. A., DeLucia, P. R., Ott, T. E., Peterson, L. T., & Green, A. (2008). The anatomy and physiology of error in averse healthcare events. Advances in Health Care Management. Advances in Health Care Management, 7, 33—68.

Schilling, L., & Joint Commission Resources, Inc. (2009). Implementing and sustaining improvement in health care. Oak Brook, IL: Joint Commission Resources.

Speroff T., & O’Connor G. T. (2014). Study designs for PDSA quality improvement research. Quality Management in Healthcare, 13, 17-32.

Stamatis, D. H. (2011). Essentials for the improvement of healthcare using Lean & Six Sigma. Boca Raton: CRC Press pdsa model of change in nursing essay.

Thomas E., & Brennan T. A. (2011). Errors and adverse events in medicine: an overview. In: Vincent C, editor. Clinical risk management: enhancing patient safety, 1, 31-43.
 

Quality Improvement Project for Patient Prescription Record

The aim of this quality improvement project is to ensure that nurses record in the designated box on patients Prescription and administration record (to be referred to as: Kardex) if High Dose Antipsychotics Monitoring is Applicable YES or NO (to be referred as: applicable Y/N) and subsequently if yes, that the High Dose Antipsychotic Therapy monitoring form (to be referred to as: Monitoring form and the Early Warning Signs (EWS) Form have been activated for completion. The purpose of this is to secure patient safety from the side effects of the medication.

There is widespread evidence which clearly links antipsychotic medication contributing to physical health problems such as cardiovascular problems, weight gain, endocrine problems, metabolic syndrome and sudden death (Gumber et al, 2010; Churchword et al, 2009; Tyson et al, 1999). Many premature deaths of people with serious mental illness are due to poor medical care that fails to monitor risk factors which may be due to side effects of medication (Cohen & Hove, 2001). A council report by the Royal College of Psychiatrists (2006) revealed that past audits of high dose antipsychotic prescribing for in- patients showed poor adherence to monitoring recommendations. All patients on high dose antipsychotic treatment must be monitored. These guidelines attempt to clarify the identification of patients on high dose antipsychotics, factors to be taken into account before such prescribing and the documentation required when antipsychotics are prescribed in high dose; furthermore it is a policy requirement of Forth Valley that this documentation is completed for these patients (Forth Valley, 2011) pdsa model of change in nursing essay.
The charge nurse highlighted a concern when evaluating the patients Kardex audit, it showed 100% non-compliance for the completion of the Yes/No response for high dose antipsychotics monitoring. Subsequently when the patients are receiving high dose antipsychotics, there was inconsistency of the completion of the Therapy monitoring form and EWS form. A recent audit of patient Kardexes confirmed the charges nurse finding (see Pareto chart, Appendix B).
To begin the process of the quality improvement project, a general ward meeting was held and attended by all staff in the ward that was on shift. During the meeting the charge nurse highlighted the recent findings of the Kardex audit. pdsa model of change in nursing essay. Concerns were raised that many areas on the Kardex were not being completed, and reminded staff nurses that this is not acceptable and needs to be improved. As a nurse it is extremely important to keep accurate documentation, good record keeping is an fundamental part of nursing practice, and is necessary to the delivery of safe and effective care (Nursing and Midwifery Council, (NMC) 2010).
As an attempt to focus the quality improvement project more specifically the results of the audit were presented using a Pareto chart (Appendix B). The data confirmed the areas on the Kardex which were not being completed however, high dose antipsychotic monitoring Yes/No was the highest at 100% non-completion, therefore it was agreed that a new strategy would be implemented to improve this. McLaughlin and Kaluzny (2006) state that the defect focused on does not necessarily need to be the greatest frequency to be improved first, but attention should be given to that defect that may have a devastating result, such as an adverse event or even death. However the defect in this instance was the highest and potentially could cause an adverse event.

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Following the meeting a questionnaire (Appendix C) was devised and completed anonymously by the pharmacists, consultants and staff nurses to identify the root causes of why this area on the Kardex was not completed. A fishbone diagram was used to illustrate the findings (Appendix D). When populating the fishbone diagram with the data, it was clear to see that there were many reasons that each member of the multidisciplinary team had not completed the applicable area on the Kardex. Role confusion was a common theme from each member of the team. Hill-Smith et al (2012) claims that this is not unusual within multi-disciplinary teams and that respectful communication and clear instructions is of high importance in the delivery of high quality clinical care pdsa model of change in nursing essay. Therefore based on these findings PDSA one was developed (Appendix G1). This tested whether the nurse attending the MDT meeting completes the Applicable Y/N on the patients’ Kardex following an email reminder and a verbal prom

NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam
NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam
Question 1
Which of the following medications are approved by the FDA for treating generalized anxiety disorder in children ages 7–17?

A.
Sertraline

B.
Quetiapine

C.
Duloxetine

D.
Clomipramine

 
Question 2
Which of the following is true about social skills training with teens?

A.
Social skills training is used to teach social problem solving.

B.
Social skills training is more potent in a one-to-one setting.

C.
Social skills training is more potent in a group setting due to the peer influences.

D.
A and C

 
Question 3
The clinician asks an adolescent “Have you felt persistently sad or gloomy for more than a year?” to assess for which of the following common diagnostic possibilities?
 

A.
Bipolar disorder

B.
Substance use disorder

C.
Major depressive disorder

D.
Persistent depressive disorder

BUY EXAM HERE
Question 4
Examples of atypical features in a patient with Major Depressive Episode include which of the following?

A.
Overeating and oversleeping

B.
Loss of appetite

C.
Insomnia

D.
Sleep walking

 
NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam Question 5
The ARNP working with a 5-year-old child in a busy pediatric practice is seeking to use Level 1 and Level 2 cross-cutting symptoms measures. Which of the following is true in this situation?

A.
These easy-to-use screens can be filled out prior to coming in for a formal evaluation to expedite assessment of this child

B.
These Level 1 and Level 2 assessments can help the practitioner identify the presenting problem for this child.

C.
Systematic use of the Level 1 and Level 2 cross cutting assessments will provide measurable outcomes for this child.

D.
There is no Level 1 and Level 2 cross-cutting assessments for use with a 5-year-old.

 
Question 6
The principle that competent mental health care and a full array of services should be available for all children, adolescents, and their families address which of the following domains in the American Academy of Child and Adolescent Psychiatry Code of Ethics?

A.
Justice

B.
Fidelity

C.
Autonomy

D.
Nonmaleficence

 
Question 7
Which of the following is inconsistent with what is known about prolonged sleep deprivation?

A.
Prolonged sleep deprivation leads to death.
NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

B.
Prolonged sleep deprivation leads to severe physical impairment.

C.
Prolonged sleep deprivation leads to severe cognitive impairment.

D.
Prolonged sleep deprivation while annoying and frustrating is not life threatening.

 
 
Question 8
Developmental impairments and disruptive behavior problems are predominant issues during which of the following age ranges:

A.
Ages 0–5

B.
Ages 6–12

C.
Ages 13–18

D.
Ages 18+

 
 
 
Question 9
A 15-year-old girl presents with symptoms that include restrictive eating and food avoidance, with a desire to avoid obesity, which persists despite negative consequences. This presentation is consistent with which of the following diagnoses?

A.
Bulimia nervosa

B.
Anorexia nervosa

C.
Encopresis

D.
Autism spectrum disorder

 
Question 10
Strategies that enhance therapeutic engagement include which of the following?

A.
Engage the child/adolescent in a manner to encourage them feeling noticed, heard, and appreciated.

B.
Make sure that the parent/caregiver is always in the room.

C.
Start off with targeted diagnostic questions to save time.

D.
Always take the child/adolescent’s side if there is disagreement with caregiver.

 
 
 
Question 11
According the American Academy of Child and Adolescent Psychiatry (AACP) Code of Ethics, the provider is obligated when providing care to which of the following individuals? NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

A.
The child or adolescent

B.
The child/adolescent’s guardian(s)

C.
Only the guardian(s) for children under 7

D.
A and B

 
 
 
Question 12
During the evaluation of a patient with a history of Bipolar I Disorder, who is manic, the patient states that she is actually the Queen of England and quite wealthy. This is an example of which of the following?

A.
Mood-congruent manic delusion

B.
Mood-incongruent manic delusion

C.
Mood-congruent manic hallucination

D.
Mood-incongruent manic hallucination

 
 
Question 13
Which of the following is NOT true about symptomatology of anorexia nervosa?

A.
Most aberrant behaviors directed toward losing weight occurs in secret.

B.
All patients have an intense fear of gaining weight and becoming obese.

C.
Most patients with anorexia nervosa will have no difficulty eating with their family in public places.

D.
Fear of gaining weight and becoming obese frequently contributes to the individual’s lack of interest in and resistance to therapy/treatment. NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

 
Question 14
Biofeedback, deep breathing, mindfulness, and progressive muscle relaxation are strategies that are typically used in which of the following therapies?

A.
Relaxation therapy

B.
Social skills training

C.
Motivational Interviewing

D.
Applied behavioral analysis

 
Question 15
Principles to be considered when using a rating scale to assess for mood and anxiety disorders include which of the following?

A.
Choose a rating scale with fair diagnostic reliability.

B.
A longer rating scale will provide better diagnostic specificity.

C.
Use a broad-based rating scale to investigate a particular problem.

D.
Select scales that are research validated for age, condition, and (ideally) culture.

 
 
Question 16
Ethical standards set forth by the APA are which of the following?

A.
They are guidelines for psychologists.

B.
They are enforceable rules for psychologists.

C.
They are an exhaustive list of professional standards.

D.
They are standards that apply to professional and private conduct of psychologists.

 
 
Question 17
Which of the following is NOT consistent with what is known about socioeconomic and cultural factors related to mood disorders?

A.
No correlation has been found between socioeconomic status and major depressive disorder.

B.
A higher-than-average incidence of Bipolar I disorder is found among the upper socioeconomic groups.

C.
Bipolar I disorder is more common among persons who graduated from college.
NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

D.
The prevalence of mood disorder does not differ among races.

 
 
Question 18
A variant of Bipolar I disorder characterized by episodes of major depression and hypomania is known as which of the following?

A.
Bipolar II Disorder

B.
Dysthymic Disorder

C.
Cyclothymic Disorder

D.
Bipolar I Disorder, hypomanic type

 
Question 19
Which of the following would be an initial screening question for a child with sleep problems?

A.
Do worries keep you awake?

B.
What is your routine before going to bed?

C.
Do you startle easily or get frequent nightmares?

D.
Do you feel tense, restless or worried most of the time?

 
Question 20
When assessing a child who has presented with concerns of being anxious and worried, the provider asks the child “Do you get sudden surges of fear that make your body feel shaky or your heart race?” to screen for which of the following common diagnostic possibilities?

A.
Obsessive -compulsive disorder

B.
Posttraumatic stress disorder

C.
Panic disorder

D.
Separation anxiety disorder

 
 
 
Question 21
Which of the following is important to realize when treating a child with an anxiety disorder?

A.
Anxiety disorders are commonly diagnosed in families.

B.
Repeated exposures to feared situations will always help the child to unlearn the fear response.

C.
Parents should encourage avoidance of feared situations as this will help the fear dissipate.

D.
SSRI’s are the MOST effective treatment in relieving symptoms of anxiety.
NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

 
 
 
 
Question 22
Which of the following is true regarding the cultural formulation interview with a child and caregiver?

A.
Asking about a child and caregiver’s cultural understanding is an efficient way to build a therapeutic alliance.

B.
While cultural understanding is important, it is important not to personalize the diagnosis.

C.
While obtaining cultural information is important, it may increase bias and thus decrease accuracy of the assessment.

D.
Engaging in a discussion about culture, while interesting and engaging, is a distraction from the problem that brought the child and caregiver to the provider.

Question 23
Major depressive disorder, eating disorders, and substance use disorders predominate at which of the following ages?

A.
Ages 0–5

B.
Ages 6–12

C.
Ages 13–18

D.
Ages 18+

 
Question 24
A distinct period of an abnormally and persistently elevated, expansive or irritable mood lasting at least a week or requiring hospitalization is consistent with which of the following?

A.
A manic episode

B.
A hypomanic episode

C.
Cyclothymia

D.
Bipolar II Disorder

 
 
Question 98
The average time from the start of child mental health symptoms until a young person enters mental health treatment is which of the following? NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

A.
4–6 weeks

B.
3–6 months

C.
1–2 years

D.
8–10 years

 
 
Question 99
Which of the following should first be considered when assessing a child with sleep problems?

A.
Poor sleep habits

B.
Insomnia disorder

C.
Major depressive disorder

D.
Generalized anxiety disorder

 
 
 
Question 100
Which of the following is the most common eating disorder?

A.
Bulimia nervosa

B.
Anorexia nervosa

C.
Binge eating disorder

D.
Night eating syndrome

NRNP 6665: PMHNP Care Across the Lifespan I Midterm Exam

Digital Clinical Experience Orientation Tina Jones

Digital Clinical Experience Orientation Tina Jones
Digital Clinical Experience Orientation Tina Jones
Transcript

Started: Jan 17, 2023 | Total Time: 12 min

All Lines (16)Interview Questions (1)Statements (1)Exam Actions (14)

Hello my name is xx and I’m here to interview and examine you

Greet

01/17/23 12:54 AM MDT

Hey.

Treating high cholesterol helps lower your risk of stroke

Educate

01/17/23 12:55 AM MDT

Treating high cholesterol help lower your risk of stroke (No matching questions found.)

Question

01/17/23 12:55 AM MDT

Thanks for telling me.

 Examined left eye.

Exam Action

01/17/23 12:58 AM MDT

 Examined right eye.

Exam Action

07/17/22 12:58 AM MDT

 Examined right eye. Digital Clinical Experience Orientation Tina Jones

Exam Action

07/17/22 12:58 AM MDT

 Percussed posterior left upper chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior right upper chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior right middle chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior left middle chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior left lower chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior right lower chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior right lower chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior right lower chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior left lower chest wall

Exam Action

07/17/22 12:59 AM MDT

 Percussed posterior left lower chest wall

Exam Action

07/17/22 12:59 AM MDT

 CompletedOrientation

Exam Action

07/17/22 1:02 AM MDT

Objective Data Collection: 2 of 2 (100%)

 Correct
 Partially correct

 Incorrect
 Missed

 Inspected pupils
1 of 1 point

Observations With Penlight (1/1 point)

 No visible abnormal findings (PERRL)
 Unequal
 Irregular
 Miosis
 Mydriasis
 Non-reactive to light
Digital Clinical Experience Orientation Tina Jones

 Percussed chest wall
1 of 1 point

Observations (1/2 point)

 All areas resonant
 Some areas dull, some resonant

Location (1/2 point)

 No areas of dullness
 Dullness, anterior right upper lobe
 Dullness, anterior right lower lobe
 Dullness, anterior left upper lobe
 Dullness, anterior left lower lobe
 Dullness, posterior right upper lobe
 Dullness, posterior right lower lobe
 Dullness, posterior left upper lobe
 Dullness, posterior left lower lobe

Multiple Choice QuestionActivity Time: 0 min

Select the right answer from the available choices.
 Correct: We are here to support you as you develop your clinical reasoning and therapeutic communication skills. If at any time you have questions or concerns, please contact us! There is a direct link to our Help Desk in the upper right hand corner of your screen.

Wrong Answer
Right Answer (Correct Response)
Wrong Answer
Wrong Answer

Open Text QuestionActivity Time: 0 min

Please describe what you look forward to most in your upcoming activities within the DCE.

Student Response: Improving my assessment skills.

Model Note: There are many opportunities to learn and practice your clinical skills within the DCE, and we hope you are looking forward to all of them! Digital Clinical Experience Orientation Tina Jones

CAHIIM Essay

CAHIIM Essay
CAHIIM Essay
Assignment Objectives:

Meet CAHIIM Curriculum requirement for Associate Degree

Domain VI. Leadership
Subdomain VI.K. Enterprise Information Management
Section 1. Apply knowledge of database architecture and design
Competencies: Data dictionary, interoperability

Meet CAHIIM Curriculum requirement for Associate Degree

Domain I.  Data Content Structure and Standards
Subdomain I.C. Data Governance
Section 1. Apply policies and procedures to ensure the accuracy and integrity of health data
Competencies: Data Integrity concepts and standards

Meet CAHIIM Curriculum requirement for Bachelor Degree

Domain III. Informatics, Analytics and Data Use
Subdomain III.H. Information Integrity and Data Quality
Section: 5. Model policy initiatives that influence data integrity
Competencies: Characteristics of data integrity

Meet CAHIIMA Curriculum requirement for Bachelor Degree

Domain I.  Data Content Structure and Standards
Subdomain I.C. Data Governance
Section 2. Construct and maintain the standardization of data dictionaries to meet the needs of the enterprise
Competencies: Data sources

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Assignment Purpose:
HIM Professionals will frequently work with data dictionaries. This assignment will build an understanding of data dictionary development and maintenance and the importance of data integrity.
Assignment Description:
Step One: Review the sample data dictionary below. There are a number of blank fields in the table. Your first task is to fill in all of the blank fields,
Field Name
Field Type
Field Size
Definition
Acceptable Values
Patient_ID (primary key)
Number
8
Unique patient number   automatically generated
0-9
Gender
Character
1
Gender of the patient
M = Male
F = Female
U = Unknown
PT_LN
Alphanumeric
50
Patient’s legal surname
A-Z
PT_FN
Alphanumeric
50
Patient’s legal first   name
A-Z
PT_DOB
0-9
8
Patient’s date of birth
MM-DD-YYYY
PT_Race
Alphanumeric
25
Patient’s declared race
American Indian
Alaskan Native
Asian
African American
White
PayerType
Alphanumeric
25
Patient’s primary source   of payment
BC/BS
CHAMPUS
Medicaid
Medicare
Self-Pay
Other
InsuranceID
City
State
Zip
Country
VisitDate
Step Two: Write a justification discussing why each field was necessary and why the value you used was appropriate. (NOTE: Address every blank that you filled in)
Step Three: Next discuss the characteristics of data integrity. CAHIIM Essay.

Best Psychology Thesis Topics for College Students

Best Psychology Thesis Topics for College Students
What would be the best idea for a psychology thesis topic? Coming up with a paper idea is more challenging than research and writing. It is a requirement nonetheless for you to write a thesis to graduate. Striking a balance between your academics and personal life can be frustrating. Fortunately, there are many places where you can find inspiration.
Finding a topic is the most crucial step while writing any paper. It is essential while writing a psychology thesis. Psychology is a broad topic and requires you to settle for a topic you are conversant with. This will allow you to cover the thesis topic without being overwhelmed easily.
In a general class, you may be required to select a topic within the broad psychology reach. In other cases, you may be required to base your thesis on a specific subject. It is essential to consider the set guidelines before you begin searching for a psychology thesis topic.
You should conduct research and data analysis before deciding on a topic. This is why it is better to settle for a narrow topic to allow you to focus on the subject but not so narrow that you won’t find sources of information to write about. It becomes easier to analyze a topic with proper details.
How to choose a suitable psychology thesis topic
You can choose a topic from any social branch in psychology. Alternatively, you can opt to select a topic related to mental illness or disorder. The complexity of the topic requires in-depth research and analytical study. You should cover all aspects of the topic.
Choosing a good topic is very important when writing a psychology thesis. An interesting topic will draw the attention of your professor. This will, together with a well-written thesis, guarantee acceptance of your idea.  
Researching and studying various psychology thesis topics for your paper is also very important. Once you have selected the topic, the other step is to write your paper. For example, you can choose social psychology topics for your thesis. You can focus on how persuasion can be used to influence behavior.
Other topics in the same branch you can choose from are

Social control and cults
Attitudes
Prejudice and discrimination
Non-verbal communication
Leadership
Attraction and romance
Persuasion, propaganda, and marketing

Psychology thesis papers present a severe undertaking by psychology students during their academic studies. You may feel anxious about writing and also be conflicted on how to choose a suitable psychology thesis topic. Selecting a topic that interests you and one that offers enough information for you to write about is not easy. Below, we try to provide a wide variety of choices of topics and general guidelines for writing good topics for clinical psychology undergraduate thesis.
Psychology thesis paper purpose
A psychology thesis paper aims to inform the reader about new ideas, theories, or experiments on the human mind and behavior. It presents the latest development in psychology by providing facts supported by data and any other hard evidence.
Further, a thesis presents the research you have done throughout your course. Its writing follows in-depth research, usually limited to academic articles only. It analyzes data, assembles evidence, and efficiently delivers it to the reader.
If there is an experimental component, the paper might require an understanding of the methods used. They may include statistical procedures, survey sampling techniques, effect size, etc.
The purpose of papers on specific psychology topics is to demonstrate students’ deep knowledge in the field, testing originality and efficiency through finding reliable evidence and efficient written communication.
Writing tips for psychology thesis paper
Writing a good psychology thesis paper relies on various factors

Choosing a catchy topic

Select a topic that will draw the reader’s attention. It’s undeniably true that some topics are more interesting and others are boring if you can choose one, even better! Otherwise, there is no need to worry. There are ways you can make less attractive topics more gripping by narrowing down the topic to a group of subjects that will be more interesting.

Write an outline

A guide with a clear hypothesis will ensure your paper flows

Offer relevant ideas

Ideas define your content. They will keep the reader interested. Make sure to raise intriguing and shocking questions. Propose and argue your points for the current paradigm shift. Explore different ideas by checking out relevant literature and other sources. Include other sources in online psychology journals. Before narrowing down to a single idea, gather and evaluate facts

Carry out quality research

Site reliable sources and adequately reference them. Avoid plagiarism and convey your messages appropriately. Watch out for journal impact factors or other citation metrics. Ensure that you have carried out in-depth research on your topic for the quality delivery of your argument.

Write edifyingly

Every detail is important. Good introduction and proper conclusion, use of professional terms, precision, proper paper structure, correct language, etc., follow the laid guidelines and ensure your workflows. All these makeup for a winning paper.

Cite all your sources

Use proper citations for all your references to credit the original authors. Include in-text citations and make a reference list at the end of your paper.
How to choose a suitable psychology thesis topic
While looking for psychology thesis topics, several strategies would assist.

Think of an idea

Considering you have been studying for a while by the time you are doing your thesis, research it for better phrasing. If the idea is justifiable, it is likely that It has been researched in the past. You will therefore find academic links and articles on the topic. Alternatively, you may find related or better ideas. This is among the best method for identifying an original and interesting idea.

Identify other large topics

They should be close to the area that interests you. you should be able to get more information by skimming through these. This strategy ensures that you have a broad selection of psychology thesis topics rather than limiting yourself to a few ideas.

Find general articles

Research about your subfield and read through You are likely to find more interesting topics that can be explored in detail.

Narrow down to a specific area

If you have more than one topic and are unable to decide, try exploring more on each to assess the abundance and quality of information available for each topic. Unless you intend to have someone write the thesis for you, you have to perform the research yourself.

Focus more on what will be covered ahead

This will enable you to develop a more exciting and informative psychology thesis topic.
Topics for psychology thesis papers
To name but a few, psychology has different disciplines such as social, experimental, educational, cognitive, forensic, and developmental psychology.

How do you ensure you make the right choice for your thesis paper?
How do you ensure that your thesis topic is exciting and captivating?
How do you ensure that your topic is unique?
How do you ensure that your topic adds value to the community?

Below is a variety of psychology thesis topics list for all academic levels. Read on to explore helpful insights and tips for picking the best topic. Select any topic and start writing your thesis.
Topics for thesis in psychology for undergraduates
Selecting psychology thesis topics is difficult but choosing the right one makes writing easier. Deciding on what to write is very important as it will set precedence for the rest of the paper. Take time to figure out the area you want to concentrate on. Consider all options and make sure you choose something you are passionate about. Picking a topic, you are interested in will no doubt keep you motivated.
 If you are struggling to develop an interesting topic about psychology for a thesis, the ideas below will help you draft a compelling paper.

What are the effects of bullying on children?
The social identity of Tajfel and Turner
Relationship between molarity and law
Similarities and differences in midlife crisis in both men and women
Health benefits of socializing
Effects of postpartum depression on children
The difference in brain functioning in men and women
Causes and effects of sleep paralysis
Symptoms, causes, and treatment of dementia
Social factors that cause panic attacks
Can PTSD cause Alzheimer’s?

Psychology thesis topics for college students
Every student can find a topic for their thesis, given the diversity of psychology. If you ever feel overwhelmed by ideas for your psychology senior thesis topics, remember many good papers available. It is easy to find and an easily researchable topic for your thesis. Stay positive as it is easy to write a custom thesis paper.

How to quit bad behavior?
Gender roles in modern society
What causes schizophrenia?
Symptoms and treatment of ADHD
Importance of sports psychology
The health effects of a bad relationship
Mental and emotional health effects of abortion on women.
Homelessness and mental health
Psychological effects of hate crime
Religion is social psychology

Social psychology topics for thesis
Social psychology is hard but interesting since it entails topics concerning our daily lives. Here is a list of social psychology topics

Gender roles in modern society
Experimental social psychology
Psychological effects of miscarriage on couples
Effects of racism
Socials issues on culture
What is social depression?
What is homophobia?
How does peer pressure affect teenagers?
Causes of gender discrimination
How does violence affect children and their development?

Clinical psychology thesis topics
While clinical psychology is complicated, it is an interesting branch as it addresses behavioral and mental issues faced by individuals across a lifespan. From types of therapies to childhood disorders, students are conflicted on how to choose a suitable psychology thesis topic. Good topics for a clinical psychology undergraduate thesis are available for everyone.

How can psychology be used to control chronic pain?
How to treat insomnia?
Psychological disorders and their clinical treatments
Childhood trauma and its effects on adulthood
Effects of anxiety disorders on one’s daily life
Role of emotional support for treating patients with addiction
Innovative approaches to treating phobias
Factors that contribute to post-traumatic disorders
Causes and treatment of social anxiety
Causes of eating disorders in adolescents

Experimental psychology thesis topics
An experimental method requires you to design your own psychology experiments. This science branch is the most engaging study of the human brain. The results however are useful in improving the understanding of certain human behaviors.
Most of these experiments can be performed at home or school. Finding a good idea for your experimental psychology topic can be difficult. The following are some questions you could answer as part of your thesis.

Does color affect mood?

Can the color of a room or clothes or even exam paper have any psychological impact on your mood?

Can types of music elicit different psychological responses?

Heart rates from different participants may show differences or similarities

Can individual music preference tell about a person’s personality?

Past research indicate that people who prefer certain music style exhibit similar personality traits.

Does social media cause addiction?
Does color affect appetite?
Does smell affect taste?
Does conformity influence behavior?

This experiment investigates the impact of pressure on individual behavior

What is hindsight bias and can it be prevented?
Can facial symmetry cause attraction?

Are individuals with perfectly symmetrical faces rated as more beautiful than those with asymmetrical faces?

Does sex influence short-term memory?

Test whether males or females are better at remembering specific information
Developmental psychology thesis topics
You might have wondered which events in your childhood have shaped you into the person you are today. That is what developmental psychology is about. It is a topic that helps create a better understanding of the family roles in one’s development.
Developmental psychology is one of the most popular topics in psychology and it is very fascinating. It is quite a broad subject that includes anything from prenatal development to health in the final stages of life. The following are some topics that might inspire you.
Developmental psychology topics in Children

How does bullying affect a child?
Are students who are bullied likely to have worse grades than their non-bullied peers?
Does teaching a child sign language hinder or help the language acquisition process?
Does parenting style have any impact on a child’s level of physical activity?
What affects a child’s food choice?
Does birth order define procrastinating?
Are first-borns less likely to procrastinate than last-born?
Permissive and authoritative parenting
Are children raised by uninvolved parents less active than those raised by authoritative parents?

Developmental psychology topics in older adults

Do short-term memory limits change with age?

How does the limit compare to the ages of 15,25, and 45?

Do mental games help elderly adults keep their cognitive skills?
How does behavior change with age?
Does high self-efficacy translate to better memory compared to low self-efficacy?

Cognitive psychology thesis
It is fascinating how the human mind works. Cognitive psychology aims at understanding more about how we think, learn, and remember. This science further aims to understand how we perceive events and make decisions.
If you have an assignment on cognitive psychology, explore perceptive issues and the application of individual decision-making behaviors and patterns. Below is an extensive list of cognitive psychology thesis topics to choose from.

Explore cognitive process shifts in individuals over a period of time and explain the reason for it
Reasoning process

What is the comparative reasoning between children and adults?

Children with reading disabilities

Provide qualitative study depicting traces and trends in two different generations

Why do some people age prematurely while others stay young?
Differentiate between make-believe from reality
Does talking to oneself and self-counseling affect memory?
Habit formation versus habit maintenance. Which of the two phenomena is stronger?
How to measure critical thinking
How do improve memory and concentration?
How does cognition relate to perception?

Health psychology thesis topics
This field of psychology also referred to as medical psychology focuses on psychology and biology influencing health and general wellness. This is a diverse field that is worth exploring if you are studying to be a health professional.
Health psychology ideas
Consider the following ideas if you are looking for thesis topics for your paper. These can be inspirations for your experiment or a class project. Ensure that the topic of interest is as per the specific assignment. Choose a topic that will offer a variety of sources.
Family health ideas

How has public awareness of infant safety changed?
How has it influenced occurrences of CIDS? Has the number of “crib death” declined?
Why do some parents ignore these safety measures?
Childhood approach to immunization

Why do some parents choose not to have their children immunized? How is public health impacted by such choices? What can be done by health professionals to increase the likelihood of children being immunized?

What factors contribute to teen suicide? Are suicide prevention programs effective?
What are the emotional, social, and psychological impacts of caregiving?

Public health topics

What help can be offered to people after a disaster?
Are there better long-term strategies that can yield better results?
What factors contribute to PTSD among veterans?
What mental health interventions are most effective in treating this disorder?
How can stress management help patients who suffer from chronic pain?
How effective are the methods used in comparison to other pharmacological approaches?
Compare and contrast the different approaches to the cessation of smoking.
Look at the different safety equipment
Is there any public safety program you would devise to encourage the use of products such as seat belts and helmets?

Eating and exercise behaviors

What are the psychological strategies that assist people to stick to a diet and exercise program? Is there a strategy that is more effective than others?
Is the media depiction of ideal bodies influence disorders such as bulimia and anorexia? What is the link if any of the pictures are shown and the eating disorders?

Forensic psychology thesis
The field of forensic psychology encompasses diverse approaches to psychology. Each major psychological subdivision has attributes to legal issues research.

Cognitive psychology is used in eyewitness testimonies
Developmental psychology is used in children’s testimonies
Social psychology is used to determine jury behavior
Clinical psychology is used in the assessment of competence
Biological psychology is used while performing a polygraph test
Industrial psychology is used in cases of sexual harassment in the workplace

The below topics represent areas that are of critical importance in today’s society. Check them out if you want your thesis to be impressive and unique.

Early signs of serial killers
Juvenile offenders and corporal punishment
Antisocial personalities disorders
Domestic violence against men
Has society neglected cases of domestic violence against men?
Psychopathy in criminal behaviors
Psychological evaluation in a court trial
Effectiveness of rehabilitation in the criminal justice system
How does a role in law enforcement impact an individual’s private life?
Could the actions of a serial killer have been prevented with a more stable upbringing?
Are there ways to minimize the risks of offenders ending up in the penal system?

Criminal psychology
Understanding criminal psychology can help prevent crime. This field is both interesting and valuable. Below are some criminal psychology thesis topics available for your college assignment.

Competence to stand trial
Prejudice in jury selection
Prison system and rehabilitation
Incarceration and education
Mental illness and the death penalty
Socio-economic status and criminal behavior
Dissociative disorders
Antisocial personality disorder
Effects of social media on copycat crimes
Causes and effects of the mass shooting

Industrial organization psychology thesis topics
This is the scientific study of human behavior in organizations and workplaces. The knowledge acquired through the study of individual, group, and organizational behavior is used to improve workplace problems. The following sources will help you narrow down on the specific topic you wish to concentrate on.

The effects of globalization in workplaces

How do factors such as the internet, social media, and improved travel capabilities fuel the rapidly enveloping globe compared to past demographic constraints?

Workplace stress and coping mechanisms

What are the ways that people deal with workplace stress? Do gender, age, and race affect these coping mechanisms?

Positive job outcomes and work-family balance

What marks a perfect point at which a balance can be struck between work and family?

Privacy and information in organizations

Does an employing organization have the right to know about the personal details of their employee? What validates this point or is it an infringement on personal privacy?

The novice manager and growth toward efficacy

How does one grow as a manager and does that growth have any correlation with success and failure?
Sports psychology thesis topics
You will probably find out that the majority love sports. The hobby is more interesting since the human brain is related to one’s physical activity. As a result, sports psychology is an interesting science branch to write about.

What are the most effective training programs for successful athletes?
What tactics can athletes use to avoid fatigue?
What are the main physical differences between other athletes and gymnasts?
Challenges faced by coaches
Why is team chemistry more important than individual talent?
How do control emotions in sports?
What are the attributes of a good coach?
The evolution of sports psychology
How do deal with stress in sports?
Currents trends in sports psychology

Topics for master’s thesis in cultural psychology
Cultural psychologist aims to understand the behaviors, values, beliefs, and symbols of different cultural groups. This is an interesting field as it offers an insight into diversity. Below are tailored cultural psychology topics guaranteed to give you first-class in your assignment. 

Examine various coping mechanisms of being culturally different
What are the benefits of cultural studies in promoting brands internationally?
What are the impacts of feminism on promoting women’s equality?
Culture conservation in isolated communities
How does religion influence culture?
How does particular language influence culture?
What is the correlation between sex and attitude as tools of culture?

Positive psychology thesis topics
Traditionally, psychology is focused on mental illness or other psychological problems and how to treat them. Positive psychology examines how to be happier and live fulfilled lives. While research suggests that happiness is genetically influenced, people can be happier by developing optimism. Some of the major topics of interest in positive psychology include

Mindfulness
Optimism
Happiness
Positive thinking
Hope
Resilience
Character strength
Virtues

Further, major findings in happiness psychology claim that

People are generally happy
Social relationships and character strengths can combat disappointment and setbacks
Money doesn’t guarantee happiness but it makes individuals happier when spent it is on them

What to consider before choosing a topic

Understand the established rules for the assignment
Check the official guidelines
Consult for any clarifications
If you are conducting an experiment, present your idea to your instructor to gain permission to proceed

Bottom line
Though a psychology paper is based on what you think of the topic, you can get more insight from past research journals and studies. Make sure you include credible sources and back your claims with genuine proof. Hopefully, the above topics and guidelines will help you in choosing and deciding on a psychology thesis topic for your paper.

Systems Development Life Cycle Discussion Essays

Systems Development Life Cycle Discussion Essays

Systems Development Life Cycle Discussion Essays
By Day 3 of Week 9

Post a description of what you believe to be the consequences of a healthcare organization not involving nurses in each stage of the SDLC when purchasing and implementing a new health information technology system. Provide specific examples of potential issues at each stage of the SDLC and explain how the inclusion of nurses may help address these issues. Then, explain whether you had any input in the selection and planning of new health information technology systems in your nursing practice or healthcare organization and explain potential impacts of being included or not in the decision-making process. Be specific and provide examples Systems Development Life Cycle Discussion Essays.

Main post
The Inclusion of Nurses in the Systems Development Life Cycle

The process of system development life cycle usually takes into account for major steps that helps in defining its success; they are analysis, design, development and implementation. If I was part of this system development process firstly I would include two more phases in the overall process, they would be testing process before implementation and maintenance process after implementation. This would help in ensuring that the system that has been developed is completely safe and thoroughly tested before its implementation, as it will bring down the risk factors related to system development and its usage by a huge margin. Further as a nurse I can also contribute to the system development life cycle process by providing inputs from the daily experiences in handling patient on a regular basis. This knowledge input would ensure a practical understanding that would help in improving the overall system development life cycle, further providing flexibility to the structure of SDLC as nurses are continuous contact line between patient and hospital and between changing duty of attendant for patient. This would allow everyone in the process to stay updated with any change related SDLC Systems Development Life Cycle Discussion Essays.
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However in case of absence of participation from nurses in the process of system development life cycle, it can result in development of major gap, as practical knowledge input, testing, implementation and maintenance process will be thoroughly affected, since the contribution of the nurses are major in these segments. This in turn will impact the overall structure along with lack of knowledge input from nurses in SDLC it can also impact the design, which is basic source to successful functioning of SDLC, since nurses are the primary source of contact.
 
References
McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning. Chapter 9, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” (pp. 175–187)
Agency for Healthcare Research and Quality. (n.d.a). Health IT evaluation toolkit and evaluation measures quick reference guide. Retrieved September 27, 2018, from https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/health-it-evaluation-toolkit-and-evaluation-measures-quick-reference
Agency for Healthcare Research and Quality. (n.d.b). Workflow assessment for health IT toolkit. Retrieved September 27, 2018, from https://healthit.ahrq.gov/health-it-tools-and-resources/evaluation-resources/workflow-assessment-health-it-toolkit Systems Development Life Cycle Discussion Essays
sample 2
  Health care organizations across the country and world are choosing to implement electronic medical records (EMR) into their practice. “ In 2008, The New England Journal of Medicine reported that 82% of EHR users report improved clinical decision-making, 92% report improvement in communication with other providers and their patients and 82% of users report a reduction in medication errors”(Palabindala et al., 2016, p. 1). The choice to move away from pen and paper to a more organized system is based on governmental guidelines and the necessity to keep pace with the demands of safety and the best interest of our patients.  Without system-wide input from all end-users, the implementation and results of unilateral decisions could be devastating.
           Many organizations realize the importance of EMRs but some don’t understand the consequences of input from nurses during the Systems Development Life Cycle (SDLC). “ Fifty percent of information system projects fail because of a lack of staff acceptance and willingness to use the system.’ A crucial step in the design, implementation, and reception of an EMR is for administrators and project managers to assess the attitudes of all staff within the organization. (“Nursing Leaders Serving as a Foundation for the Electronic Medical Record,” 2012, p. 111). Starting with the planning phase the nurse’s input could shed light on what specific functions are necessary to have and gain buy-in from staff at the beginning Systems Development Life Cycle Discussion Essays.  I have never been in the planning stage but have seen nursing administration joining project teams to add input.  On an administrative level, the analyst phase is a crucial piece to know.  Working with the informatics team to understand what systems interact with each other is key.  If one system doesn’t have the correct interface scheduling won’t be able to talk with registration.  In wound care our EMR system is separate from the hospital EMR system and without recognition and nursing input data wouldn’t manually flow through. The design and implementation phases are the two most crucial aspects nurses need to be involved with.  As nurses make up the majority of end-users in the hospital, their comfort, usability, and comfort with the EMR are critical in its success. “Sociotechnical theory suggests that EHR systems cannot be designed or implemented successfully without thoughtful consideration of the “fit” of the technology with the people providing care and the existing context of care delivery, including the work environment”(Kutney-Lee et al., 2019, p. 131). Without our input on how the design looks, feels, and operates will lead to dissatisfaction and poor adoption.
          I am currently in the process of converting a paper system to an EMR system in one of my centers in NY.  This center has decided to choose a wound care-specific EMR that I was able to help re-tool to make the system function better.  What I enjoy about the system I am using is that it is easy to adjust to fit the needs of the staff and that the nurse’s input matters.  We went live on conversion last week and in real-time were able to make changes to help flow and output better.  We were able to redesign the product list to match the centers.  We were able to re-organize workflow in the system and build workflows specific for users.  The nurses requested the ability to fax from the program and we enabled that capability for them.  The ability for me and my team to get input from the staff and make changes based on their unique center has lead to what I believe is a more positive transition and hopefully better long-term adoption to it Systems Development Life Cycle Discussion Essays.
                                                                                                                              References
Kutney-Lee, A., Sloane, D., Bowles, K., Burns, L., & Aiken, L. (2019). Electronic health record adoption and nurse reports of usability and quality of care: The role of work environment. Applied Clinical Informatics, 10(01), 129–139. https://doi.org/10.1055/s-0039-1678551
Nursing leaders serving as a foundation for the electronic medical record. (2012). Journal of Trauma Nursing, 19(2), 115–116. https://doi.org/10.1097/jtn.0b013e31825de6cb
Palabindala, V., Pamarthy, A., & Jonnalagadda, N. (2016). Adoption of electronic health records and barriers. Journal of Community Hospital Internal Medicine Perspectives, 6(5), 32643. https://doi.org/10.3402/jchimp.v6.32643
sample 3
Week 9 Discussion
One of the major consequences of not involving nurses when purchasing and in SDLC purchasing and implantation can have adverse effects. Nurses’ area the front line, and when deciding on implementing or purchasing a program, nurses should be consulted, along with providers. The program should be user friendly long with supportive soft wear to where the nurse is accurately able to chart on each patient. “Nurses are well qualified to assume this responsibility. They are intimately aware of the failings of paper records and spend far too much of their own time on clinical documentation – time that could be better spent on providing care to patients. And, as key staff involved in patient intake and information management efforts, they also know that well-designed IT systems are essential to support their own workflows as well as those of other care providers.” (Rein, A., 2017) I know from personal experience that when we went live with the new EHR, it was noted that there were several “bands” with duplicate charting. This led to increased charting, and les time to assessing and spending time with patients Systems Development Life Cycle Discussion Essays.
Potential issues could be “EHR implementation can mess up the workflow in a practice entirely if it is not customized to fit its purpose properly.” (Kressly, S., 2021) Messing up the workflow for nurses and providers could potentially not only cause harm to the patient but will cause the nurse to work twice as hard. This can lead to decreased nurse satisfaction.
I did not have a say in the design of the EHR that we implemented 3 years ago, but I was part of the training. I was a trained as a super user and was working the day we went live. The EHR that the hospital that I currently work for chose Cerner. While over the last 3 years there has been updates and changes, there are still several areas that we are duplicating charting, the notes system is not user friendly, and over all the program is mediocre. While I know this sounds harsh, it is better than the Meditech that we had previously. The pros to Cerner are that the program “offers strategic advisory services, performance improvement, revenue cycle management, practice management, community care management, wellness and scorecards and registries.” (Cerner Review) Overall, I am not disappointed in the system, I just wish they would have tried to include more nurses, not only from ED, but from OR, PACU, Radiology, Cath Lab, and floor nurses.   The pros to Cerner are that the program offers strategic advisory services, performance improvement, revenue cycle management, practice management, community care management, wellness and scorecards and registries Systems Development Life Cycle Discussion Essays.
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Rein, A. (2017, March 17). Early and often: Engaging nurses in health it. RWJF. https://www.rwjf.org/en/blog/2011/12/early-and-often-engaging-nurses-in-health-it.html.
 
Kressly, S. (2021, April 16). 6 common challenges in EHR IMPLEMENTATION. Office Practicum. https://www.officepracticum.com/blog/6-common-challenges-in-ehr-implementation.
https://ehrguide.org/ehr-reviews/cerner-reviews/ Systems Development Life Cycle Discussion Essays

NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making

NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making
NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making
Policy-making is a key factor of having order in health care professions. There are a few ways that RNs and APRNs can contribute to policy-making. The first opportunity that exists is nursing associations or organizations. When nurses join these organizations, they analyze problems to create resolutions in nursing. According to Koehn, two “ordinary problem” policy issues are analyzed, with the examination of how nurses, individually and organizationally, collaborated and advocated to address these issues by triggering local, state, and national action by stakeholders (2020). There are various professional organizations for RNs and APRNs. Many professional nursing organizations have an explicit commitment to advancing health policy and have established a presence on social media platforms; yet, little is known about what policy topics professional nursing organizations choose to disseminate (Waddell,2019). According to Waddell, the American Nurses Association and the American Academy of Nursing are two organizations that often represent the voice of nurses in policy discussions (2019). Professional organizations warrant that any policy that is implemented is effective and that it has the best interest for nurses. The second opportunity is through administrations in workplaces. The RNs and APRNs are professionals who have the opportunities to sit on boards in facilities where policies are reviewed. According to Rasheed et. al, educational institutions and nurse leaders should adequately prepare nurses for policy-making, and nurses should participate in policy-making at the organization, system, and national levels (2020).Through their workplace, RNs and APRNs have a chance to influence a policy review by having the first-hand experience on if the policy is effective in their places of work NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making. 
The professional organizations and associations may endure challenges when it comes to exposure and getting information out. Many people nowadays receive information thru social media platforms. According to Waddell, organization leaders and members should consider how social media content could enhance nurses’ policy participation and advance the dialogue about health and well‐being in the context of high‐stakes healthcare debates (2019). The opportunity of the workplace has its challenges as well. In most facilities, administrators are the prominent people in policy-making. According to Rasheed et. al, the extent of involvement was inadequate, and nurses mainly worked as policy implementers rather than as policy developers (2020). This statement signifies the limitations nurses may have in policy-making in certain facilities.
The two strategies that lead to better communication of the existence of these opportunities are proper training and self-sufficiency. According to Rasheed et. al, nursing institutions and regulatory bodies should prepare and encourage nurses to work as policymakers rather than implementers and advocate for the rightful place of nurses at policy-making forums (2020). With effective training for the nurses, they can better understand their roles and carry out the policies appropriately. Also, leaders of an organization determine whether the nurses will have a chance to review a given policy. Training and good leadership are key elements of a solid, knowledgeable nursing team NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making.
References
Koehn, K. (2020). Triggers for nursing policy action: Getting to the critical point to solving “ordinary problems” in nursing. Nursing Forum, 55(1), 11–15. https://doi-org.ezp.waldenulibrary.org/10.1111/nuf.12376
 
Rasheed, S. P., Younas, A., & Mehdi, F. (2020). Challenges, extent of involvement, and the impact of nurses’ involvement in politics and policy making in in last two decades: An integrative review. Journal of Nursing Scholarship, 52(4), 446. https://doi-org.ezp.waldenulibrary.org/10.1111/jnu.12567
 
Waddell, A. (2019). Nursing organizations’ health policy content on facebook and twitter preceding the 2016 United States presidential election. Journal of Advanced Nursing (John Wiley & Sons, Inc.), 75(1), 119–128. https.//doi-org.ezp.waldenulibrary.org/10.1111/jan.13826
response
Thank you for your post. I agree with you that joining professional organizations and sitting on boards enables nurses to help in policy making. According to Woodward et al. (2016), nurses possess many qualities that are easily transferrable to the political side. They are great communicators and advocates for their patients. Nurses have valuable expertise when drafting policies that protect and promote public health (Woodward et al., 2016). The nurse has direct contact with patients and understand the needs of the patient and the community. The three factors that influence the nurses participation in politics are political education in school, a personal interest in a topic, and membership in professional organizations (Woodward et al., 2016).  
You had also briefly mentioned the use of social media platform. According to Roland (2017), using multimedia presentations on social media is a cost-effective way to promote health policy. There are millions of people that use social media on a daily basis and health messages could be easily disseminated. Some of the drawbacks of using social media can be the reliability of the information and it may act as a deterrent for a patient to seek care (Roland, 2017). I honestly believe that social media could be better used to educate the public about health. 
Roland, D. (2017). Social media, health policy, and knowledge translation. Journal of the American College of Radiology, 15(1), 149-152. https://doi.org/10.1016/j.jacr.2017.09.009 
Woodward, B., Smart, D., & Benavides-Vaello, S. (2016). Modifiable factors that support political participation by nurses. Journal of Professional Nursing, 32(1), 54-61. https://doi-org.ezp.waldenulibrary.org/10.1016/j.profnurs.2015.06.005 NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making
Discussion 2: The Role of the RN/APRN in Policy-Making
Word cloud generators have become popular tools for meetings and team-building events. Groups or teams are asked to use these applications to input words they feel best describe their team or their role. A “word cloud” is generated by the application that makes prominent the most-used terms, offering an image of the common thinking among participants of that role.

What types of words would you use to build a nursing word cloud? Empathetic, organized, hard-working, or advocate would all certainly apply. Would you add policy-maker to your list? Do you think it would be a very prominent component of the word cloud?
Nursing has become one of the largest professions in the world, and as such, nurses have the potential to influence policy and politics on a global scale. When nurses influence the politics that improve the delivery of healthcare, they are ultimately advocating for their patients. Hence, policy-making has become an increasingly popular term among nurses as they recognize a moral and professional obligation to be engaged in healthcare legislation.
To Prepare:

Revisit the Congress.gov website provided in the Resources and consider the role of RNs and APRNs in policy-making.
Reflect on potential opportunities that may exist for RNs and APRNs to participate in the policy-making process.

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By Day 3 of Week 8

Post an explanation of at least two opportunities that exist for RNs and APRNs to actively participate in policy-making. Explain some of the challenges that these opportunities may present and describe how you might overcome these challenges. Finally, recommend two strategies you might make to better advocate for or communicate the existence of these opportunities to participate in policy-making. Be specific and provide examples.

By Day 6 of Week 8

Respond to at least two of your colleagues’* posts by suggesting additional opportunities or recommendations for overcoming the challenges described by your colleagues.
One of the most apparent, and possibly one of the easier methods for registered nurses (RN) and advanced practice registered nurses (APRN) to become active in policymaking is by joining nursing organizations. These organizations range from local or regional organizations to national organizations. Within these organizations are often members who work within the legislative process. “These organizations often have lobbyists that bring nursing issues to Capitol Hill” (American Nurses Association, 2016). These lobbyists can also act as an aid for nurses or advanced practice registered nurses to get their foot in the door with legislators to present the concerns they would like to address.
A second opportunity for registered nurses and advanced practice registered nurses to participate in the policy-making process is to write to legislators. As discussed earlier in the semester, this is most effective if the nurse does research prior to and voiced their concerns to policymakers who have similar views on the concern (Laureate Education, 2018).
Challenges that inhibit nurses and APRNs include a lack of understanding in regard to the policymaking process. This may include lacking a full understanding of the relevant knowledge of the specific legislator the nurse is working with (Shariff, 2014). A strategy to overcome this barrier to policymaking would be for the RN or APRN to work with other members of their organizations who have previously done this. A second strategy is for the RN or APRN should also familiarize themselves with the legislators they plan to approach in order to invoke change. As discussed previously in the semester, nurses will be more successful in making changes if they have something to offer the legislator. The nurse or advanced practice registered nurse should find a way they can help the legislator while also pushing for change on the specific issue at hand (Laureate Education, 2018).
References
American Nurses Association. (2016, September 22). The nursing profession’s potential impact on policy and politics. https://www.myamericannurse.com/nursing-professions-potential-impact-policy-politics/
Laureate Education (Producer). (2018). The Policy Process [Video file]. Baltimore, MD: Author.
Shariff, N. (2014, July 10). Factors that act as facilitators and barriers to nurse leaders’ participation in health policy development. National Institutes of Health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4105513/

response
Nurses are known to implement policies and rather not be part of the formulation process, not because they are not good advocates but because they lack the awareness. I do agree with you; one of the barriers nurses face is political awareness. Nurses have the skills and courage; they advocate and fight for their patients and families (Anders, 2020). However, to get political confidence, there must be an effort made in the workplace to encourage nurses to participate in the policy-making process. Healthcare professionals need to have expert knowledge, communication skills, active listening, negotiation, and group processes to function in the pollical arena (Milstead & Short, 2019). Nurses are the largest profession in healthcare, and collaborating with other healthcare professionals will speak louder as there is power in numbers NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making.
 
References
Anders, R. L. (2020). Engaging nurses in health policy in the era of Covid-19. Nursing Forum, 56(1), 89-94.
https://doi.org/10.1111/nuf.12514
Milstead, J. A., & Short, N.M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones Bartlett Learning NURS 6050 Discussion 2: The Role of the RN/APRN in Policy-Making.

APEA Ortho

APEA Ortho
APEA Ortho.
Question:
A tool for assessing risk factors for osteoporotic fractures is the:
 
DEXA.FRAX.  CorrectBRCA1.HAARM.  Incorrect
 
Explanation:
The FRAX calculator generates fracture risk based on age, body mass index, parental fracture history, use of glucocorticoids, presence of rheumatoid arthritis or secondary osteoporosis, and tobacco and alcohol use. It has been validated for black, Hispanic, and Asian women in the USA and has calculators that are country and continent specific. Duel energy x-ray absorptiometry, DEXA, is the optimal standard for measuring bone density. APEA Ortho. BRAC1 is a gene that can mutate and increase the risk of breast cancer. HAARM is the melanoma risk model.
Question:
Anserine bursitis arises from:
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excessive running.  Correctexcessive kneeling.  Incorrectarthritis.trauma
 
Explanation:
Anserine bursitis arises from excessive running, valgus knee deformity, fibromyalgias, and osteoarthritis. Prepatellar bursitis (“housemaid’s knee”) arises from excessive kneeling. A popliteal or “baker’s” cyst arises from distention of the gastrocnemius semimembranous bursa from underlying arthritis or trauma. APEA Ortho.
Question:
When examining the knee, which of the following symptoms could be indicative of a positive Adduction (Varus) Stress Test?
 
Pain in the lateral joint line  CorrectPain in the medial joint line  IncorrectPain in the anterior joint lineA click along the medial joint line.
 
Explanation:
The Adduction (or Varus) Stress Test is a maneuver that evaluates the function of the lateral collateral ligament. To perform this test, the knee is held in 30 degrees of flexion. With one hand on the medial side of the knee and one hand on the ankle, an adduction force is gently applied. If pain is noted in the lateral joint line, this could be indicative of a lateral collateral ligament tear. When tenderness extends more to the proximal or distal joint line, the collateral ligament may be the cause of pain instead of the meniscus APEA Ortho.
Question:
When assessing the knee, the examiner instructs the patient to straighten his knee. This motion would assess knee:
 
flexion.extension.  Correctinternal rotation.external rotation.
 
Explanation:
Having the patient straighten his leg assesses extension of the knee. The examiner instructs the patient to bend his knee. APEA Ortho. This maneuver assesses knee flexion. Internal rotation of the knee could be elicited by having the patient swing his lower leg toward the midline while sitting. Instructing the patient to swing his leg away from his midline while sitting assesses external rotation of the knee.
Question:
When performing an examination of a tender left finger on an adult, the surrounding tissue reveals warmth, edema, and redness. This finding could be suggestive of:
 
carcinoma.muscular atrophy. synovitis.  Incorrectgouty arthritis.  Correct
 
Explanation:
Redness, warmth, and edema over a tender joint suggest septic or gouty arthritis infection, or possibly rheumatoid arthritis.
Question:
An example of a fibrous joint would be the:
 
vertebral bodies of the spine.skull.   Correctshoulder.  Incorrectpubic symphysis of the pelvis.
 
Explanation:
The skull is an example of the fibrous joint. Examples of synovial joints include the shoulder, knee, hip, wrist, distal radioulnar, elbow, and carpals. Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of cartilaginous joints APEA Ortho.
Question:
To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the:
 
lateral joint line of the knee.on either side of the patella.upper edge of the tibial plateau.  Correcttop of the patella.
 
Explanation:
To palpate the medial meniscus, slightly internally rotate the tibia and palpate the medial soft tissue along the upper edge of the tibial plateau. The lateral meniscus is palpated on the lateral joint line by placing the patient’s knee in slight flexion. To palpate the tibiofemoral joint, face the patient’s knee and place the thumbs in the soft-tissue depressions on either side of the patellar tendon.
Question:
A patient complains of a sharp burning pain in the neck and right arm with associated paresthesias and weakness. These symptoms may be associated with:
 
mechanical neck pain.mechanical neck pain with whiplash.cervical radiculopathy.  Correctcervical myelopathy.
 
Explanation:
With cervical radiculopathy, nerve root compression is the etiology. Symptoms may include sharp burning or tingling pain in the neck and one arm with associated paresthesias. Mechanical neck pain is described as aching pain in the cervical paraspinal muscles and ligaments with associated muscle spasm and stiffness and tightness in the upper back and shoulder, lasting up to 6 weeks. In patients with mechanical neck pain with whiplash, the paracervical pain and stiffness begins the day after injury and may be accompanied by occipital headaches, dizziness, and malaise. In cervical myelopathy, cervical cord compression, the neck pain is associated with bilateral weakness and paresthesias in both upper and lower extremities.
Question:
A patient complains of lateral hip pain while pointing near the trochanter. This type of pain could be suggestive of:
 
sciatica.  Incorrectradicular pain.polyarticular arthritis.bursitis.  Correct
 
Explanation:
Lateral hip pain near the greater trochanter suggests trochanteric bursitis. Sciatica symptoms usually include a shooting pain below the knee, commonly in the lateral leg or posterior calf and accompanied by low back pain. Radicular pain refers to pain that radiates along the dermatome of a nerve due to inflammation or irritation of a nerve root, as with sciatica pain. Polyarticular arthritis refers to arthritis involving several joints.
Question:
The muscle of the scapulohumeral group that crosses the glenohumeral joint posteriorly and inserts on the greater tubercle is known as the:
 
infraspinatus muscle.  Correctpectoralis major. subscapularis muscle.  Incorrectsupraspinatus muscle.
 
Explanation:
One of the muscles of the scapulohumeral group that crosses the glenohumeral joint posteriorly and inserts on the greater tubercle is the infraspinatus muscle. The other one is the teres minor muscle. The pectoralis major muscle is situated on the anterior chest. The muscle that runs above the glenohumeral joint and inserts on the greater tubercle is known as the supraspinatus. The subscapularis muscle originates on the anterior surface of the scapula and crosses the joint anteriorly and inserts on the lesser tubercle.
Question:
Inspection of the hip begins with careful observation of a patient’s gait. A patient’s foot moves forward without bearing weight. This is known as the: APEA Ortho.
 
swing phase of gait.  Correctstance phase of gait.push off phase of gait.heel strike phase of gait.
 
Explanation:
Inspection of the hip begins with careful observation of a patient’s gait. There are 2 phases of gait: stance and swing. The swing phase occurs when the foot moves forward and does not bear weight. The stance phase occurs when the foot is on the ground bearing weight.
Question:
The axioscapular group of muscles:
 
pulls the shoulder backward.  Correctrotates the shoulder laterally.produce internal rotation of the shoulder.  Incorrectdraws the shoulder blade forward.
 
Explanation:
The axioscapular group pulls the shoulder backward and rotates the scapula. The scapulohumeral group of muscles rotates the shoulder laterally, including the rotator cuff, and depresses and rotates the head of the humerus. The axiohumeral group produces internal rotation of the shoulder. The serratus anterior draws the shoulder blade forward.
Question:
When assessing the knee, the examiner instructs the patient to sit and swing his lower leg toward midline. This motion assesses knee:
 
flexion.extension.internal rotation.  Correctexternal rotation.
 
Explanation:
Internal rotation of the knee is elicited by having the patient swing his lower leg toward the midline while sitting. Instructing the patient to bend his knee assesses knee flexion. Having the patient straighten his leg assesses extension of the knee. APEA Ortho. Instructing the patient to swing his leg away from his midline while sitting would be a maneuver to assess external rotation of the knee.
Question:
When performing a musculoskeletal examination, the nurse practitioner instructs the patient to move his arm in front of his body. This motion of the shoulder girdle would be an example of:
 
adduction.  Incorrectabduction.flexion.  Correctextension.
 
Explanation:
When performing a musculoskeletal examination, the nurse practitioner instructs the patient to move his arm in front of his body. This motion of the shoulder girdle would be an example of flexion. Extension occurs when the patient moves his arm behind himself. Abduction occurs when the patient moves his arm away from the body laterally and overhead. Adduction occurs when the patient moves his arm across his body.
Question:
Static stabilizers of the shoulder are referred to as those structures that are:
 
muscular structures of the shoulder girdle.capable of movement. bony structures of the shoulder girdle.  Correctresponsible for stabilizing the humeral head in the glenoid cavity.  Incorrect
 
Explanation:
Static stabilizers are incapable of movement and include the bony structures of the shoulder girdle, the labrum, the articular capsule, and the glenohumeral ligaments that add to joint stability. Dynamic stabilizers are capable of movement and include the SITS muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis). These muscles move the humerus and compress and stabilize the humeral head within the glenoid cavity.
Question:
To test the thumb for abduction, ask the patient to:
 
move his thumb across his palm and touch the base of the fifth finger.  Incorrectmove his thumb from the base of the fifth finger and then as far away from the palm as possible.touch the thumb to each of the other fingertips. place the fingers and thumbs in the neutral position with the palm up and then move the thumb anteriorly away from the palm.  Correct
 
Explanation:
Placing the fingers and thumbs in the neutral position with the palm up and moving the thumb anteriorly away from the palm assesses abduction. To test the thumb for flexion, ask the patient to move his thumb to touch the base of the fifth finger. To test extension, ask the patient to move his thumb from the base of the fifth finger, across the palm, and then as far away from the palm as possible. APEA Ortho. Touching the thumb to each of the other fingers tests opposition. Moving the thumb back to its neutral position assesses adduction.
Question:
Passive flexion, valgus stress, and internal rotation of the lower leg, evaluates the:
 
medial meniscus.lateral meniscus.  Correctlateral collateral ligament (LCL).  Incorrectposterior cruciate ligament (PCL).
 
Explanation:
Passive flexion, valgus stress, and internal rotation of the lower leg, evaluates the lateral meniscus.
Question:
The nurse practitioner instructs the patient to lie supine, bend his knee, and turn his lower leg and foot away from the midline. This maneuver would assess hip:
 
abductionextension.external rotation.  Incorrectinternal rotation.  Correct
 
Explanation:
To assess for hip internal rotation, the patient would lie supine, bend his knee, and turn his lower leg and foot away from the midline. To assess hip abduction, the patient would lie supine and move his lower leg away from the midline. To assess hip extension, the patient would lie face up, bend his knees, place feet flat on the table, and lift his buttocks off the table. To assess for external rotation of the hip, the patient would lie supine, bend his knee, and turn the lower leg and foot toward the midline. APEA Ortho.
Question:
Children with Legg-Calve Perthes disease should:
 
maintain a diet high in protein, vitamins and minerals.sleep on a firm mattress to prevent contractures.   Incorrectavoid weight bearing on the affected extremity.  Correctbe allowed to play basketball.
 
Explanation:
Legg–Calvé–Perthes disease is a childhood hip disorder initiated by a disruption of blood flow to the head of the femur. Due to the lack of blood flow, the bone dies (osteonecrosis or avascular necrosis) and stops growing. Over time, healing occurs by new blood vessels infiltrating the dead bone and removing the necrotic bone which leads to a loss of bone mass and a weakening of the femoral head. APEA Ortho. The bone loss leads to some degree of collapse and deformity of the femoral head and sometimes secondary changes to the shape of the hip socket. The goals of treatment are to decrease pain, reduce the loss of hip motion, and prevent or minimize permanent femoral head deformity so that the risk of developing a severe degenerative arthritis as an adult can be reduced. Diet and sleeping on a firm mattress do not alter the course of the disease. However, avoiding high impact sports such as basketball during treatment is essential since increased weight on the hip will cause further damage.
Question:
The convex medial end of the clavicle that articulates with the concave hollow in the upper sternum is referred to as the:
 
glenohumeral joint.sternoclavicular joint.  Correctacromioclavicular joint.manubrium joint.  Incorrect
 
Explanation:
The convex medial end of the clavicle articulates with the concave hollow in the upper sternum to form the sternoclavicular joint. The glenohumeral joint is where the head of the humerus articulates with the shallow glenoid fossa of the scapula. This joint is deeply situated and not normally palpable. The acromioclavicular joint lies at the lateral end of the clavicle and articulates with the acromion process of the scapula. There is no manubrium joint; it is the broad upper part of the sternum.
Question:
When assessing a patient with complaints consistent with carpal tunnel syndrome, which one of the following symptoms is unlikely?
 
Dropping objectsInability to twist lids off jarsTingling of the first three digits of the handNumbness of the last two digits of the hand  Correct
 
Explanation:
For complaints of dropping objects, inability to twist lids off jars, aching at the wrist or even the forearm, and numbness of the first three digits, consider carpal tunnel syndrome.
Question:
When evaluating a patient who complains of thumb pain, the nurse practitioner would test thumb movement by instructing the patient to place his thumb in the palm and then move the wrist toward the midline in ulnar deviation. This maneuver is commonly known as:
 
de Quervain’s test.Finkelstein’s test.  CorrectTinel’s test.Phalen’s test.
 
Explanation:
When evaluating a patient who complains of thumb pain, the nurse practitioner would test thumb movement by instructing the patient to place his thumb in his palm and then move the wrist toward the midline in ulnar deviation. This maneuver is commonly known as Finkelstein’s test. Tinel’s test assesses for median nerve compression. The examiner would tap lightly over the median nerve of the carpal tunnel. To test Phalen’s sign, the patient would hold his wrists in flexion for 60 seconds while pressing the backs of his hands together to form right angles APEA Ortho.
Question:
Olecranon bursitis may be caused by all of the following except:
 
gout.trauma.frozen shoulder.  Correctosteoarthritis.
 
Explanation:
Olecranon bursitis refers to swelling and inflammation of the olecranon bursa and may result from trauma, gout, or arthritis.
Question:
Women who wear high-heeled shoes with narrow toe boxes are at risk of developing all of the following forefoot abnormalities except:
 
hallux valgus.metatarsalgia.Achilles tendinitis.  CorrectMorton’s neuroma.  Incorrect
 
Explanation:
Women who wear high-heeled shoes with narrow toe boxes are at risk of developing hallux valgus, metatarsalgia, and Morton’s neuroma. Achilles tendinitis more commonly occurs in runners and affects the posterior foot as opposed to the forefoot.
Question:
Upon examination of the foot and ankle, the nurse practitioner notes point tenderness over the posterior aspects of the right malleolus. Additionally, the patient is unable to bear weight after 4 steps. This finding is most consistent with:
 
Achilles tendinitis.  Incorrectan ankle fracture.   Correcta ligamentous injury.rheumatoid arthritis.
 
Explanation:
Point tenderness over the posterior aspects of the right malleolus with an inability to bear weight after 4 steps could be consistent with an ankle fracture. Rheumatoid nodules and tenderness may be associated with Achilles tendinitis. Localized tenderness on examination of the ankle joint could be suggestive of arthritis, infection of the ankle, or ligamentous injury. Tenderness on compression of the foot is an early sign of rheumatoid arthritis.
Question:
The small intrinsic muscles are located:
 
at the anterior surface of the vertebrae. on either side of the midline of the vertebrae.  Incorrectbetween the vertebrae.  Correctin front of the cervical vertebrae.
 
Explanation:
The small intrinsic muscles are located between the vertebrae. Prevertebral muscles run in front of the cervical vertebrae, and they contract generally to flex the neck and bow the head. The paravertebral muscles are located on both sides of the vertebrae and extend downward to the entire spine. Muscles that attach to the anterior surface of the vertebrae include the psoas muscles and the muscles of the abdominal wall. APEA Ortho.
Question:
The nurse practitioner instructs the patient look upward at the ceiling. This maneuver assesses cervical:
 
flexion.extension.  Correctrotation.lateral bending.
 
Explanation:
Assessing neck extension occurs by asking the patient to look upward at the ceiling. Bringing the chin to the chest assesses flexion of the cervical spine. Looking over one shoulder and then the other assesses rotation of the neck. Asking the patient to bring his ear to his shoulder assesses lateral bending of the cervical spine.
Question:
Upon examination of the left shoulder, the patient complains of a dull, aching pain when attempting active or passive range of motion and localized tenderness with external rotation. These symptoms could be suggestive of:
 
a complete rotator cuff tear.adhesive capsulitis.  Correctrotator cuff tendinitis.  Incorrectcalcific tendinitis.
 
Explanation:
Adhesive capsulitis, or frozen shoulder, refers to fibrosis of the glenohumeral joint capsule resulting in a dull aching pain in the shoulder. It progresses to restriction of active and passive range of motion and tenderness with external rotation. With complete rotator cuff tears, active abduction and forward flexion at the glenohumeral joint are severely impaired. A characteristic shrug of the shoulder is noted with a positive arm drop on the affected side. Reports of sharp “catches” of pain, grating, and weakness in the shoulder when lifting the arm overhead are symptoms suggestive of rotator cuff tendinitis or impingement syndrome. Calcific tendinitis involves the supraspinatus tendon and is associated with deposition of calcium salts. This results in disabling attacks of shoulder pain severely limiting motions due to the pain.
Question:
The area at the posterior aspect of the spine lateral to the sacroiliac joint is known as the:
 
posterior superior iliac spine.  Correctischial tuberosity.superior ramus of pubis.pubic symphysis.
 
Explanation:
The posterior superior aspect of the spine lateral to the sacroiliac joint is known as the posterior superior iliac spine. The ischial tuberosity is a large swelling posteriorly on the superior ramus of the ischium. It marks the lateral boundary of the pelvic outlet and bares most of the weight when sitting. The superior ramus of pubis are the pubic bones that help form the obturator foramen. The pubic symphysis is a cartilage-like articulation between the pubic bones.
Question:
Which nerve in the arm runs posteriorly in the ulnar groove between the medial epicondyle and the olecranon process?
 
Median nerveUlnar nerve  CorrectRadial nerveBrachial plexus
 
Explanation:
The ulnar nerve runs posteriorly in the ulnar groove between the medial epicondyle and the olecranon process. The median nerve is located on the ventral forearm and is just medial to the brachial artery in the antecubital fossa. APEA Ortho. The radial nerve originates in the axilla and travels down the arm in a shallow depression (radial groove) on the surface of the humerus. The brachial plexus runs from the spine through the neck, the axilla, and into the arm.
Question:
When examining the knee, the presence of a palpable fluid wave with the returning fluid wave into the suprapatellar pouch is noted. This positive sign for effusion of the knee is known as the:
 
balloon sign.  Correctbulge sign.  Incorrectballoting sign.McMurray’s sign.
 
Explanation:
A positive balloon sign for effusion in the knee is the presence of a palpable fluid wave with a returning fluid wave into suprapatellar pouch. When examining the knee, a fluid wave on the medial side between the patella and the femur is noted. This positive sign for effusion is known as the bulge sign. Balloting of the patella is tested by compressing the suprapatellar pouch and pushing the patella sharply against the femur. If fluid returns to the suprapatellar pouch, then an effusion of the knee is diagnosed. McMurray’s test checks for tears in the medial meniscus.
Question:
Dynamic stabilizers of the shoulder are referred to as those structures that are:
 
incapable of movement.capable of movement.   Correctbony structures of the shoulder girdle.  Incorrectresponsible for joint stability.
 
Explanation:
Dynamic stabilizers are capable of movement and include the SITS muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis). These muscles move the humerus and compress and stabilize the humeral head within the glenoid cavity. Static stabilizers are incapable of movement and include the bony structures of the shoulder girdle, the labrum, the articular capsule, and the glenohumeral ligaments that add to joint stability.
Question:
A structural channel beneath the palmar surface of the wrist and proximal hand is known as the:
 
median nerve plexus.carpal tunnel.  Correctcarpal sheath.flexor retinaculum.
 
Explanation:
A structural channel beneath the palmar surface of the wrist and proximal hand is known as the carpal tunnel. The carpal sheath covers the tendons. The flexor retinaculum is the transverse ligament that holds the sheath in place. APEA Ortho.
Question:
When describing muscle strength, the term paraplegia means:
 
impaired strength.absence of strength.paralysis of all four extremities.paralysis of the legs.  Correct
 
Explanation:
Paraplegia means paralysis of the legs. Impaired strength is called weakness, or paresis. Absence of strength is called paralysis, or plegia. Quadriplegia means inability to move or paralysis of all four limbs.
Question:
A patient reports sharp “catches” of pain, grating, and weakness in the right shoulder when lifting the arm overhead. These symptoms could be suggestive of:
 
a complete rotator cuff tear.adhesive capsulitis.rotator cuff tendinitis.  Correctcalcific tendinitis.
 
Explanation:
Reports of sharp “catches” of pain, grating, and weakness in the shoulder when lifting the arm overhead are symptoms suggestive of rotator cuff tendinitis or impingement syndrome. With complete rotator cuff tears, active abduction and forward flexion at the glenohumeral joint are severely impaired. A characteristic shrug of the shoulder is noted with a positive arm drop on the affected side. Adhesive capsulitis, or frozen shoulder, refers to fibrosis of the glenohumeral joint capsule resulting in a dull aching pain in the shoulder. APEA Ortho. It progresses to restriction of active and passive range of motion. Calcific tendinitis involves the supraspinatus tendon and is associated with deposition of calcium salts. This results in disabling attacks of shoulder pain severely limiting motions due to the pain.
Question:
The structure that encloses the spinal cord is known as the:
 
articular process.spinous process.articular facets.vertebral foramen.  Correct
 
Explanation:
The vertebral foramen encloses the spinal cord. The structure that projects from the spinal column posteriorly in the midline is referred to as the spinous process. The articular processes are located on each side of the vertebra at the junction of the pedicles and the laminae, also referred to as the articular facets.
Question:
When examining the patient for wrist adduction, the nurse practitioner instructs the patient with his palms down to:
 
point his fingers toward the ceiling. move his fingers toward the midline.   Correctmove his fingers away from the midline.point his fingers toward the floor.   Incorrect
 
Explanation:
Adduction occurs by moving fingers toward the midline. When examining the patient for wrist flexion, the nurse practitioner instructs the patient to position his palms down and to point his fingers toward the floor. Extension occurs with pointing fingers toward the ceiling. Abduction occurs by having the patient bring his fingers away from the midline.
Question:
An example of a cartilaginous joint would be the:
 
vertebral bodies of the spine.  Correctskull. shoulder.knee.
 
Explanation:
Vertebral bodies of the spine and the pubic symphysis of the pelvis are examples of cartilaginous joints. Examples of synovial joints include the shoulder, knee, hip, wrist, distal radioulnar, elbow, and carpals. The skull is an example of the fibrous joint.
Question:
When grading muscle strength, a five would indicate:
 
no muscular contraction detected.barely detectable trace of contraction.active movement of the body part with gravity eliminated.active movement against full resistance without fatigue APEA Ortho.  Correct
 
Explanation:
A grade of five for muscle strength would indicate active movement against full resistance without fatigue. Zero muscular strength would indicate no muscular contraction was noted on exam. A grade of one indicates a barely detectable trace of contraction noted on exam. For active movement of the body part with gravity eliminated, a grade of two would be noted.
Question:
With the patient in the dorsal decubitus position, have him slowly extend the knee while maintaining the varus stress and external rotation. If a snap on the medial joint line is palpated, this may indicate a positive test for a:
 
lateral collateral ligament (LCL) tear.medial collateral ligament (MCL) tear.posterior cruciate ligament (PCL) tear.medial meniscal tear.  Correct
 
Explanation:
With the patient in the dorsal decubitus position, have him slowly extend the knee while maintaining the varus stress and external rotation. If a snap on the medial joint line is palpated, this may indicate a medial meniscal tear or a positive McMurray test. The Adduction (Varus) Stress Test evaluates the function of the lateral collateral ligament, while the Abduction (Valgus) Stress Test evaluates the medial collateral ligament APEA Ortho. To test the posterior cruciate ligament, the posterior drawer sign would be assessed.
Question:
When examining the elbow for range of motion, the nurse practitioner instructs the patient to bend his elbow. This motion is an example of:
 
extension.flexion.  Correctsupination.pronation.
 
Explanation:
Instructing the patient to bend his elbow is an example of flexion. Extension occurs with straightening the elbow. Turning the palms upward demonstrate supination. Turning the palms downward demonstrates pronation.
Question:
The nurse practitioner instructs the patient to move his ear to his shoulder. This maneuver assesses:
 
cervical flexion.cervical extension.rotation.lateral bending.  Correct
 
Explanation:
Looking over one shoulder and then the other would be assessing rotation of the neck and having the patient bring his ear to his shoulder would be assessing lateral bending of the neck. Assessing neck extension would be having the patient look upward at the ceiling. Bringing the chin to the chest would be assessing flexion of the neck.
Question:
The nurse practitioner instructs the patient to move his extended fingers so that each touches its nearest finger. This motion assesses the fingers and thumbs for:
 
adduction.  Correctabduction.flexion.  Incorrectextension.
 
Explanation:
Instructing the patient to make a fist with the left hand and to place his left thumb on top of the distal fingers assesses flexion. Extension occurs when the patient is able to completely move the fingers away from the palm and fingers are most distal from the palm. Asking the patient to move the fingers as far apart from each other as possible demonstrates abduction. The fingers must be kept in the same plane. The ability to move the fingers so that each digit touches the finger next to it assesses adduction. The fingers must be kept in the same plane.
Question:
The nurse practitioner would tap lightly over the median nerve in the carpal tunnel to assess:
 
Finkelstein’s test.Tinel’s test.  CorrectPhalen’s test.  Incorrectthumb abduction.
 
Explanation:
The examiner taps lightly over the median nerve in the carpal tunnel to assess Tinel’s sign. A positive Tinel’s test may indicate carpal tunnel syndrome. Asking the patient to point his thumb upward while the examiner applies downward resistance tests thumb abduction. To test thumb movement, instruct the patient to grasp his thumb against his palm and then move his wrist toward the midline in ulnar deviation. This maneuver is commonly known as Finkelstein’s test. To test Phalen’s sign, the patient would hold his wrists in flexion for 60 seconds while pressing the backs of his hands together to form right angles.
Question:
Which one of the following conditions can plantar fasciitis be associated?
 
Achilles tendinitisAn ankle fracture A ligamentous injuryRheumatoid arthritis  Correct
 
Explanation:
Focal heel tenderness on palpation of the plantar fascia suggests plantar fasciitis. This condition can be seen in prolonged standing or heel-strike exercise and also in rheumatoid arthritis, and gout.
Question:
A patient complains of shooting pains below the knee radiating into the lateral leg and calf. This type of low back pain is referred to as:
 
radicular low back pain.  Correctmechanical low back pain.lumbar spinal stenosis.pseudoclaudication pain.  Incorrect
 
Explanation:
Radicular low back pain, or sciatica, presents with shooting pains below the knee, into the lateral leg or posterior calf. It may be accompanied by paresthesias and/or weakness in the affected leg. Mechanical low back pain often arises from muscle and ligament injuries (~70%) or age-related intervertebral disc or facet disease. Common symptoms include aching pain in the lumbosacral area that radiates to the upper leg. APEA Ortho. Common risk factors include heavy lifting, poor conditioning, and obesity. Lumbar spinal stenosis or “pseudoclaudication” refers to pain in the back or legs with walking that improves with rest, lumbar flexion, or both.
Question:
Where the head of the humerus articulates with the shallow glenoid fossa of the scapula is known as the:
 
glenohumeral joint.  Correctsternoclavicular joint.acromioclavicular joint.  Incorrectmanubrium joint.
 
Explanation:
The glenohumeral joint is where the head of the humerus articulates with the shallow glenoid fossa of the scapula. This joint is deeply situated and not normally palpable. The acromioclavicular joint lies at the lateral end of the clavicle and articulates with the acromion process of the scapula. The convex medial end of the clavicle articulates with the concave hollow in the upper sternum to form the sternoclavicular joint. There is no manubrium joint; it is the broad upper part of the sternum.
Question:
Which of the following symptoms would be suggestive of lumbar spinal stenosis?
 
Calf wastingThigh pain after 30 seconds of lumbar extension  CorrectAbsent ankle jerkLoss of normal lumbar lordosis
 
Explanation:
Lumbar spinal stenosis arises from hypertrophic degenerative disease of one or more vertebral facets and thickening of the ligamentum flavum, causing narrowing of the spinal canal. Symptoms include posture flexed forward, lower extremity weakness, hyporeflexia, and thigh pain after 30 seconds of lumbar extension. Calf wasting and absent ankle jerk are typically noted in patients with sciatica or disc disease. Loss of the normal lumbar lordosis

NURS 6053 Assignment: Developing Organizational Policies and Practices

NURS 6053 Assignment: Developing Organizational Policies and Practices
NURS 6053 Assignment: Developing Organizational Policies and Practices
The healthcare issue or stressor identified earlier is nursing staff shortage in the healthcare organization. As can be surmised, this issue has far-reaching implications on the quality of care that a health institution can offer (Antwi & Bowblis, 2018). This fact derives from the simple fact that nurses are the one with direct contact to patients and therefore form the face of the organization’s service product. This paper, therefore, takes a look at this healthcare stressor in terms of competing organizational interest that impact it such as nurses’ need for better pay and a conducive working environment,  and the patients’ need to be offered the best quality care possible by nurses who are committed to…
Assignment: Developing Organizational Policies and Practices
Competing needs arise within any organization as employees seek to meet their targets and leaders seek to meet company goals NURS 6053 Assignment: Developing Organizational Policies and Practices. As a leader, successful management of these goals requires establishing priorities and allocating resources accordingly.
Within a healthcare setting, the needs of the workforce, resources, and patients are often in conflict. Mandatory overtime, implementation of staffing ratios, use of unlicensed assisting personnel, and employer reductions of education benefits are examples of practices that might lead to conflicting needs in practice.
Leaders can contribute to both the problem and the solution through policies, action, and inaction. In this Assignment, you will further develop the white paper you began work on in Module 1 by addressing competing needs within your organization.
To Prepare:

Review the national healthcare issue/stressor you examined in your Assignment for Module 1, and review the analysis of the healthcare issue/stressor you selected.
Identify and review two evidence-based scholarly resources that focus on proposed policies/practices to apply to your selected healthcare issue/stressor. NURS 6053 Assignment: Developing Organizational Policies and Practices
Reflect on the feedback you received from your colleagues on your Discussion post regarding competing needs.

The Assignment (4-5 pages):
Developing Organizational Policies and Practices
Add a section to the paper you submitted in Module 1. The new section should address the following:

Identify and describe at least two competing needs impacting your selected healthcare issue/stressor.
Describe a relevant policy or practice in your organization that may influence your selected healthcare issue/stressor.
Critique the policy for ethical considerations and explain the policy’s strengths and challenges in promoting ethics.
Recommend one or more policy or practice changes designed to balance the competing needs of resources, workers, and patients, while addressing any ethical shortcomings of the existing policies. Be specific and provide examples. NURS 6053 Assignment: Developing Organizational Policies and Practices
Cite evidence that informs the healthcare issue/stressor and/or the policies and provide two scholarly resources in support of your policy or practice recommendations.

 
Nurse Shortage as a Healthcare Issue or Stressor in an Organizational Setting: Competing Needs, Policy Implications, and Ethical Considerations
The healthcare issue or stressor identified earlier is nursing staff shortage in the healthcare organization. As can be surmised, this issue has far-reaching implications on the quality of care that a health institution can offer (Antwi & Bowblis, 2018). This fact derives from the simple fact that nurses are the one with direct contact to patients and therefore form the face of the organization’s service product. This paper therefore takes a look at this healthcare stressor in terms of competing organizational interest that impact it such as nurses’ need for better pay and a conducive working environment,  and the patients’ need to be offered the best quality care possible by nurses who are committed to their job.
In the above context, therefore, the two competing needs in the organization that directly influence this healthcare stressor (nurse shortage) are:

A need by the nurses in the organization to fulfil their financial obligations, take care of their families, and live a comfortable life. This competing need comes against the organization’s owners’ need to get a substantial return on investment (ROI) on their business.
The need by the patients to get only the best in healthcare and nursing services, since they pay for the same and are also entitled to quality healthcare. This is a direct competing need to that one of the nurses above. As the nurses feel that they are not remunerated well enough for their efforts, the patients will be seeing the demotivated nurses as professionals who are not loyal to their calling and who are not following their professional standards of practice. NURS 6053 Assignment: Developing Organizational Policies and Practices

A Relevant Policy Influencing Nurse Shortage as a Healthcare Stressor
One of the organizational policies in my facility that directly influences nursing shortage is the policy of hiring only short-term contractual employees. The contractual agreement between each employee and the organization does not exceed five years. After this, if an employee wishes to continue working for the organization they have to renew their contract. There are no permanent employees in the organization who have full benefits that come with the status. This is a policy that was put in the organization’s strategic plan as a way to save on costs and spend less on human resource. The thinking was that a long-serving employee is more likely to ask for better pay than a new recruit who is fresh from college. Unfortunately, this policy only makes the experienced nurses feel that they are neither valued by the organization nor appreciated. As a result, whenever they get better offers of job security elsewhere, they do not hesitate to tender their resignations. Nurse shortage is therefore a perennial problem at the institution because of this policy (Perry et al., 2018; Cheng et al., 2016).
The policy has thus affected not only the effectiveness of healthcare service delivery, but also its quality. The ratio of nurses to patients in every given shift is one of the parameters with which quality of nursing care is assessed (Rubin, 2015). When there is a perennial shortage of nurses, there is a perennial non-compliance with the professional standards of nursing practice that outline the amount of work that a nurse can comfortably handle. With passage of time, the remaining nurses become overworked and soon start experiencing burnout. What ensues is a vicious cycle of resignations and a drop in the quality of nursing care in the organization (Wise, 2018). NURS 6053 Assignment: Developing Organizational Policies and Practices
Ethical Critique of the Above Policy
The bioethical principles of beneficence, nonmaleficence, and justice require that all patients be handled in such a way that only good is done to them, no harm is brought to them, and fairness is exercised. With a policy that encourages and facilitates nurses to leave the organization for better employers, none of these ethical principles is respected. The low nurse numbers means that clinical tasks cannot be completed correctly and in a timely manner. Patients might thus miss their medication timings, especially those on insulin who may then even go into life-threatening metabolic crises. This is clearly a violation of beneficence and nonmaleficence. Because the patients are also denied the chance to have enough nurses to take good care of them, no justice is done to them and fairness becomes non-existent.
The only strength of the policy above in promoting ethics would be that a new employee is always eager to follow rules, regulations, and standards of practice than those that have stayed for longer. They will not take short-cuts in delivering care and will be compassionate towards the patients because they know that their work ethic is being observed. Because of this, the patients get the best care by default and benefit from this situation and this policy. The weakness, however, is that the policy actually harms the patients in the long run by way of chronic low quality nursing care. Apart from that, it also harms the nurses in that they are overworked without commensurate remuneration. This affects them physically, emotionally, and psychologically such that they may even get a mental breakdown necessitating admission to hospital NURS 6053 Assignment: Developing Organizational Policies and Practices. This is unethical and immoral as the needs of nurses are also important as indispensable members of the healthcare team.
Recommendations of Changes to Practice and Policy
It goes without saying that the biggest policy change that is needed in this organization to turn around the issue of nurse shortage is the recruitment and retention policy. The organization’s top management needs to meet and make immediate policy changes to the effect that nurses who have currently worked for the organization for more than three years are going to be taken as permanent employees with additional benefits. For those who are yet to finish two years, they can be given the opportunity to convert their contract to permanent employee status after the two years. This is to cushion the organization from the financial implications of the new policy. With a promise to review their remuneration in the next fiscal year, the new permanent employees can be given other immediate incentives such as on-the-job upskilling opportunities. This is where, for instance, new healthcare technological product companies are invited to train nurses who will use the said technology.
To ease the acute shortage in the short term, however, temporary nurses working elsewhere can be hired when they are available on locum tenens basis (Thy et al., 2018). This will ensure that services continue normally or near normally as the organization streamlines its human resource policy. Locum is an effective stop-gap measure that has been used elsewhere to plug staff shortages. NURS 6053 Assignment: Developing Organizational Policies and Practices
Conclusion
Nurse shortage is a very serious healthcare stressor that, if not addressed promptly, may bring the operations of a healthcare institution to a grinding halt. This is because the state regulatory authorities such as the nursing boards may not allow for such an eventuality that endangers the safety of patients. Strategies for tackling the issue include a change in the organization’s bad policies and an implementation of new progressive ones. Ethical considerations must also always be taken into account when these policies are reviewed. NURS 6053 Assignment: Developing Organizational Policies and Practices
 
References
Antwi, Y.A. & Bowblis, J.R. (2018). The impact of nurse turnover on quality of care and mortality in nursing homes: Evidence from the great recession. American Journal of Health Economics, 4(2), 131–163. https://doi.org/10.17848/wp15-249
Cheng, C., Bartram, T., Karimi, L., & Leggat, S. (2016). Transformational leadership and social identity as predictors of team climate, perceived quality of care, burnout and turnover intention among nurses. Personnel Review, 45(6), 1200–1216. Doi:10.1108/pr-05-2015-0118 NURS 6053 Assignment: Developing Organizational Policies and Practices
Perry, S.J., Richter, J.P. & Beauvais, B. (2018). The effects of nursing satisfaction and turnover cognitions on patient attitudes and outcomes: A three-level multisource study. Health Services Research. Doi: 10.1111/1475-6773.12997
Rubin, R. (2015). Bill takes aim at national shortage of nurses. JAMA, 313(18), 1787. doi:10.1001/jama.2015.3747
Wise, J. (2018). Hospital suspends chemotherapy because of nurse shortage. British Medical Journal, 363(k4687).  Doi: 10.1136/bmj.k4687
Thy, M., Bardon, J. & Carbonne, H. (2018). Evaluation of locum tenens activity by young anaesthesiologists and intensivists: A national survey. Anaesthesia, Critical Care & Pain Medication, https://doi.org/10.1016/j.accpm.2018.04.005  NURS 6053 Assignment: Developing Organizational Policies and Practices

NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat

NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat
NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat
Case Study 2: Focused Thyroid Exam
Patient Information:
Initials: C.M
Age: 32 years
Sex: F
Race: African American
S.
CC: “I am feeling tired and my hair is falling out.”
HPI: C.M is a 32-year-old African American female patient presenting with chief complaints of feeling tired and her hair falling out. She first noticed her hair falling out from her scalp 12 weeks ago, which occurred in patches when brushing her hair. The symptom of fatigue started after hair loss, about eight weeks ago. C.M. also mentions that she has gained weight, about 30 pounds, in the past year, even though she has experienced a significant decrease in appetite. She states that fatigue occurs when performing light tasks, climbing stairs, and when walking short distances. Her hair falls out when shampooing or brushing. Fatigue is exacerbated by activity and relieved by rest, while any friction on the scalp triggers hair fall. She reports trying to use hair treatments to stop the hair fall out, but they have had no impact NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat.
Current Medications: Vitamin C supplements, 1 tablet per day, long-term use.
Allergies: No known food or drug allergies.
PMHx: Immunization is up-to-date. Last Tetanus- 16 months ago. No history of chronic illnesses.  Had an Incision & Drainage in 2012 due to Abscess on the left thigh.

Social Hx: C.M is a paralegal working in a law firm. She lives in Baltimore, Maryland, with her husband and daughter aged seven years. Her hobbies include writing articles, reading novels, and skiing. She admits taking alcohol, vodka 3-4 glasses on weekends, but denies smoking or using illicit drugs. Her physical exercise routine includes taking brisk walks for about 20 minutes when going to work and swimming on weekends. She sleeps for approximately 7 hours a day and takes three balanced meals. C.M. reports attending annual well-exams, putting on safety belts while driving, and having smoke detectors.
Family Hx: The maternal grandmother has colorectal cancer, diagnosed at the age of 57 years. The paternal grandfather had renal failure. Mother had breast cancer that was successfully treated four years. Siblings are alive and well.  Her daughter has eczema.
ROS:
GENERAL:  Reports weight gain, and fatigue with low energy levels. Denies chills, malaise, or fever.
HEENT: Head: Reports hair loss. Denies headache. Eyes:  Denies visual changes, or excessive lacrimation. Ears: Denies hearing loss, ear discharge, or tinnitus. Nose: Denies sneezing, congestion, runny nose, or epistaxis. Throat: Denies sore throat.
SKIN: Denies skin color changes, rashes, lesions, or itching.
CARDIOVASCULAR:  Reports fatigue on exertion.  Denies chest pain, pressure, or discomfort. No edema, SOB, or palpitations.
RESPIRATORY:  Denies cough, sputum production, or shortness of breath.
GASTROINTESTINAL:  Reports decreased appetite. Denies nausea, vomiting, abdominal discomfort, bowel changes, or blood in the stool NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat.
GENITOURINARY:  Denies pelvic pain, abnormal vaginal discharge, painful urination, urinary frequency/urgency, or blood in the urine. Last menstrual period, 06/18/2020.
NEUROLOGICAL:  Denies headache, syncope, dizziness, muscle weakness, tingling sensations in the extremities, or loss of smell/taste sensation.
MUSCULOSKELETAL:  Denies muscle pain, limitations in movement, joint pain, or stiffness.
HEMATOLOGIC:  No history anemia, easy bleeding or bruising, or blood transfusion.
LYMPHATICS:  No history of inflamed lymph nodes or splenectomy.
PSYCHIATRIC:  Reports sleeping disturbances. Denies history of mental disorders and the presence of suicidal ideations.
ENDOCRINOLOGIC:  Reports cold intolerance. Denies excessive thirst or hunger, increased sweating, or increased urine production.
ALLERGIES:  No history of allergies.
O.
Physical exam:
Vital signs: BP- 110/68, PR- 68, RR- 20, Temp-97.3 F
Ht. – 5’4, Wt. – 167 pounds
HEENT: Head: Normocephalic and atraumatic. Hair black with patches of hair loss. Coarse and straw-like hair. Eyes: Sclera is white; PERRLA. Ears: T.M.s intact. Sinuses: Non-palpable. Nose: Nasal septum well-aligned. Throat: Tonsillar glands non-inflamed.
Neck: Lymph nodes non-palpable; Trachea is midline. On palpation, the Thyroid gland is nodular.
Respiratory: Rhythmic and smooth respirations. Lungs clear on auscultation bilaterally.
Cardiovascular: Capillary refill- 2 secs. No neck vein distensions or edema. RRR and S1and S2 present. No gallop sounds of systolic murmurs.
Integumentary: Skin is dry. No hypo/hyperpigmentation, skin rashes, or lesions.
Diagnostic results:
Complete Blood Count- To establish the Hemoglobin and hematocrit level, red blood cell count, and white blood cell count. Low hemoglobin, hematocrit, and red blood cell count may cause fatigue and cold intolerance (Turner, Parsi & Badireddy, 2020).  The white blood cell count will establish the presence of infection.
Thyroid-stimulating hormone (TSH) Test. A TSH test will establish TSH levels. An increase in TSH is associated with Hypothyroidism, while a decrease in TSH is usually present in hyperthyroidism (Chaker, Bianco, Jonklaas & Peeters, 2017).
A.
Differential Diagnoses
Hypothyroidism
Hypothyroidism is an endocrine condition that results from low levels of thyroid hormone (Chaker et al., 2017). It develops when the thyroid gland is not able to produce adequate amounts of thyroid hormone. Symptoms common in Hypothyroidism include dry skin, hair loss, voice changes, fatigue, constipation, cold intolerance, muscle cramps, sleep disturbances, menstrual cycle abnormalities, weight gain, and galactorrhea (Chaker et al., 2017). Physical findings that may be present in Hypothyroidism include Enlarged thyroid gland, weight gain, slowness of speech and movements, dry skin, coarse and brittle hair, pallor and jaundice (Chaker et al., 2017). Other physical findings include dull facial expressions, bradycardia, pericardial effusion, and prolonged ankle reflex relaxation time.
Hypothyroidism is the priority diagnosis based on pertinent positive findings of weight gain, hair loss, fatigue, cold intolerance, sleeping difficulties, dry skin, and coarse straw-like hair NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat.
The Assignment
Use the Episodic/Focused SOAP Template and create an episodic/focused note about the patient in the case study to which you were assigned using the episodic/focused note template provided in the Week 5 resources. Provide evidence from the literature to support diagnostic tests that would be appropriate for each case. List five different possible conditions for the patient’s differential diagnosis and justify why you selected each.
Anemia
Anemia refers to the reduction in the proportion of the red blood cells (Turner, Parsi & Badireddy, 2020). Symptoms of Anemia include weakness, tiredness, cold intolerance, lethargy, restless legs, shortness of breath on exertion, chest pain, reduced exercise tolerance, and Pica (Turner, Parsi & Badireddy, 2020). Physical findings common in Anemia include cool skin, tachypnea, hypotension, conjunctiva pallor, glossitis, tachycardia, and a systolic murmur.
Anemia is a likely diagnosis based on a positive history of fatigue, tiredness, and cold intolerance. However, there are no findings of Anemia symptoms such as pallor, shortness of breath, systolic murmur, or tachypnea, which rules out Anemia as the priority diagnosis.
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Non-toxic Goiter
Goiter is defined as the enlargement of the thyroid gland. Non-toxic goiter is characterized by thyroid gland enlargement with no disturbance in the thyroid function (Alkabban & Patel, 2020). The enlargement may be diffuse or localized growth. The goiter can compress the upper trachea, laryngeal nerves, and esophagus (Alkabban & Patel, 2020). This results in symptoms such as dysphagia, shortness of breath, and voice hoarseness caused by mechanical compression of laryngeal nerves. Physical examination findings include central neck swelling that is either smooth or nodular, and the mass moves with swallowing (Alkabban & Patel, 2020). The goiter can deviate the trachea or extend retrosternal.
Non-toxic goiter is a likely diagnosis based on positive findings of the palpable nodular thyroid gland. However, the patient has no other findings of non-toxic goiter, making it an unlikely diagnosis NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat.
Hashimoto’s Thyroiditis
Thyroiditis is described as an inflammation of the thyroid gland (Pyzik et al., 2015). It results in either unusually high or low levels of thyroid hormones in the blood. Hashimoto’s Thyroiditis occurs due to the immune system attacking the thyroid gland, making it inflamed and damaged (Pyzik et al., 2015). As the thyroid gland is destroyed over time, it becomes unable to produce enough thyroid hormone. Hashimoto’s Thyroiditis causes symptoms of an underactive thyroid gland such as tiredness, weight gain, and dry skin (Pyzik et al., 2015). Specific symptoms of Hashimoto thyroiditis include perceiving fullness in the throat, painless thyroid enlargement, fatigue, sore throat, and temporary neck pain (Pyzik et al., 2015). On physical exam, a firm, rubbery thyroid gland is usually palpated.
Hashimoto’s Thyroiditis is a differential diagnosis based on pertinent positive findings of fatigue, weight gain, dry skin, and a palpable nodular thyroid gland. However, the patient dies not present with specific symptoms of Hashimoto’s Thyroiditis, which makes it an unlikely diagnosis.
Addison Disease
Addison disease is characterized by primary adrenal insufficiency. It is caused by bilateral adrenal cortex destruction resulting in decreased production of adrenocortical hormones, including aldosterone, cortisol, and androgens (Bornstein et al., 2016). Symptoms of Addison include fatigue, weight loss, generalized weakness, dizziness, anorexia, nausea, vomiting, abdominal pain, tachycardia, and postural hypotension (Bornstein et al., 2016). Diffuse hyperpigmentation of the skin and mucous membranes often occurs in sun-exposed areas as well as decreased body hair (Bornstein et al., 2016). Other physical findings include dehydration and refractory hypotension.
Pertinent positive findings of Addison disease include fatigue, decreased appetite, and hair loss. Nonetheless, the patient has weight gain, which rules our Addison as the primary diagnosis NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat.

References
Alkabban, F. M., & Patel, B. C. (2020). Non-toxic Goiter. In StatPearls [Internet]. StatPearls Publishing.
Bornstein, S. R., Allolio, B., Arlt, W., Barthel, A., Don-Wauchope, A., Hammer, G. D., Husebye, E. S., Merke, D. P., Murad, M. H., Stratakis, C. A., & Torpy, D. J. (2016). Diagnosis and Treatment of Primary Adrenal Insufficiency: An Endocrine Society Clinical Practice Guideline. The Journal of clinical endocrinology and metabolism, 101(2), 364–389. https://doi.org/10.1210/jc.2015-1710
Chaker, L., Bianco, A. C., Jonklaas, J., & Peeters, R. P. (2017). Hypothyroidism. Lancet (London, England), 390(10101), 1550–1562. https://doi.org/10.1016/S0140-6736 (17)30703-1
Pyzik, A., Grywalska, E., Matyjaszek-Matuszek, B., & Roliński, J. (2015). Immune disorders in Hashimoto’s thyroiditis: what do we know so far? Journal of immunology research, 2015, 979167. https://doi.org/10.1155/2015/979167
Turner, J., Parsi, M., & Badireddy, M. (2020). Anemia. In StatPearls [Internet]. StatPearls Publishing NURS 6512 Episodic/ Focused SOAP note Case Study Assignment: Assessing the Head, Eyes, Ears, Nose, and Throat.

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