The Patient Protection and Affordable Care Act of 2010 otherwise known as Obama Care has been the center of debate among the government, policymakers, politicians, and health care providers over the past decade. For much of the last 4 years, the government has tried to repeal and replace Obama Care; however, they were unsuccessful in their attempts. There are currently modifications made to the initial Act. As a middle manager in the Health Care Industry, what type of attitude is most essential during this volatile period of change? Discuss your reasons?

r. J.S. is a 66-year-old man who just arrived on the medical surgical unit following an appendectomy. He is complaining of pain. You are the nurse assigned to care for Mr. J.S.

1. What critical assessment data do you need to identify and collect?

2. Formulate a nursing diagnosis based on your assessment data.

3. Describe two nursing interventions to assist the patient.

4. What criteria would you use to evaluate the effectiveness of the nursing interventions?

Write about the following

1. Because clients have rights, healthcare professionals have responsibilities to tell the truth, respect confidentiality, function as an advocate, and accept accountability for providing proper health care. How do these attributes impact community mental health professionals ?

2. How are the methods to measure accountability in community mental health defined?

3. Is the right to health care a basic human right?

4. Explain how the negative right to be free to enjoy good health led to the positive right to obtain certain services or community mental health safeguards.

5. Explain the differences and similarities in the terms "Right to health" and "Right to healthcare."

6. Does "Society have an ethical obligation to ensure equitable access to health care for all?

A 62 year-old inmate is admitted to the hospital from prison with a complain of chest pain. The patient is being worked up for possible myocardial infarction and admitted to the cardiac unit. Because the patient is an inmate, while he is in the hospital a prison guard will be posted outside of the patient’s room and he patient will be hand cuffed to the bed rail. During the initial assessment, the admission nurse finds the patient to be withdrawn. The nurse discovers the patient has a past medical history significant for abuse of multiple substances. . the patient describes how the addictive behaviours led to his incarceration and estrangement from his family. The patient expresses to the nurse interest in meeting with a chaplain while in the hospital.

• QUESTION

Describes examples of the how a nurse can provide care to this patient as guided by each of the 10 caritas processes.

Describe and provide an example of the law relating to dignity of risk in the workplace

1. CASE STUDY

A 62 year-old inmate is admitted to the hospital from prison with a complain of chest pain. The patient is being worked up for possible myocardial infarction and admitted to the cardiac unit. Because the patient is an inmate, while he is in the hospital a prison guard will be posted outside of the patient’s room and he patient will be hand cuffed to the bed rail. During the initial assessment, the admission nurse finds the patient to be withdrawn. The nurse discovers the patient has a past medical history significant for abuse of multiple substances. . the patient describes how the addictive behaviours led to his incarceration and estrangement from his family. The patient expresses to the nurse interest in meeting with a chaplain while in the hospital.

• QUESTION

Describes examples of the how a nurse can provide care to this patient as guided by each of the 10 caritas processes.

Ms. Aaliyah Abimbola; a 56-year old female who emigrated from Africa 20 years ago. Ms. Abimbola is a single parent with three female children, ages 14, 17, and 18. You are working on the respiratory ward and have been allocated to Ms. Abimbola who has been admitted with an exacerbation of COPD. Ms. Abimbola presented to A&E via ambulance at 8 AM after experiencing acute shortness of breath while preparing breakfast this morning.

Based on the information provided in this case study, you are required to discuss your initial assessment of Ms. Abimbola using Steps 1 and 2 the Levett-Jones’ (2018) Clinical Reasoning Cycle (CRC) before interpreting the information (Step 3 CRC) you have been given to identifying 3 nursing care priorities (Step 4 CRC) for Ms. Abimbola.

You are the RN on a morning shift on the respiratory ward of a large inner-city hospital. At 10:30 AM you receive a patient from the Emergency Department.

This is the hand-over you receive.

Your initial assessment findings on the ward for Ms Abimbola are as follows:

Medications

Metoprolol 100mg daily, Aspirin 100mg daily, Atorvastatin 20mg mane, Glibenclamide (Daonil) 5mg orally daily before breakfast, Salbutamol sulphate (Ventolin) 100mcg inhaler as required for symptom relief (1-2 puffs as required), Fluticasone propionate/salmeterol xinafoate (Seretide) 50/25 inhaler (2 puffs BD)

Current vital observations:

BP 142/96mmHg

HR 96bpm

RR 24 bpm

SpO2 93% on RA

T 36.7C

Health assessment findings:

Height 158cm, Weight 93kg,

Total cholesterol level - 5.2mmol/L

Fasting BGL - 9.6mmol/L

Inspiratory and expiratory wheeze. speaking in short phrases taking 2-3 breaths between each phrase before continuing to speak.

Alert and orientated to time, place, and person.

Further information you gather from her medical history and as part of her admission questions:

Ms Aaliyah Abimbola is a 56 year old female who emigrated from Africa 20 years ago. Ms Abimbola is a single parent with three female children (ages 14, 17 and 18) living in the inner-west of Melbourne.

Ms Abimbola went to her local health care clinic 2 weeks ago complaining of increasing shortness of breath and lack of energy. She says she was given some breathing medication (inhalers) by the doctor and told to take it easy for a few days. She has been struggling to get from the ground floor living area to the upstairs bedrooms without resting half-way to catch her breath. She says sometimes the medication helps her catch her breath but she still has to rest half way even with the medication.

Ms Abimbola has been working at the local flour mill since she arrived in Melbourne from Africa 20 years ago. She has never smoked but says the dust at the flour mill often makes her cough. Her job for the first 3 years was filling bags with flour until that process became fully automated. She then got promoted to running one of the flour grinding machines. 2 years later she got another promotion to shift supervisor in the milling and packaging section. She says her clothes were always covered in white dust at the end of every shift. "I used to look like a ghost at the end on my shift. We all did!" The flour mill made it mandatory to wear a mask and other protective equipment when you're working in the factory about eight years ago. However, Ms Abimbola has been working in the office for the last 6 years and no-one wears protective equipment in the office as it's not necessary. She says there's always a fine layer of dust on the paperwork in the office because the 'flour just gets everywhere no matter how often you clean or how careful you are."

Ms Abimbola is currently averaging 50 hours/week which means she needs to work on most weekends. Since the Covid 19 lockdown the factory has increased production to 24 hours a day 7 days a week. That means the office is also extremely busy. Ms Abimbola has always accepted any overtime on offer to help pay the rent for their house and cover the school fees for the Catholic school her children attend. She is adamant that she wants them to get a good education so they can make the most of the opportunities she never had in Africa. She has always been socially active within her Church community, but due to her increased working hours this has restricted her ability to attend mass and contribute to her community. She states that she needs to “prioritise any free time I have so I can spend it with the kids, especially my oldest who is doing VCE this year”. She has two close friends at church who help with looking after her children when she has to work late or on weekends.

Ms Abimbola states that she tries to exercise when she has time and walks to the train station every day to get to work. It used to take 8 minutes each way but lately it takes at least 20 minutes including rest stops to catch her breath. She also does a lot of walking at the flour mill taking paperwork to the production supervisors and picking up reports for processing. However, she has had to ask one of the younger staff to get the reports and deliver the orders more and more over the last year or so as she get's too short of breath when she walks too far too quickly.

Ms Abimbola has not spoken to her husband since she and the children left him 6 years ago. She says he used to work at the flour mill but was sacked for being drunk at work eight years ago. He had a hard time finding work so drank heavily and became violent. She took the children and left him after he hit the middle child for spilling his coffee. She doesn't know where he lives and has had no contact with him for over 4 years.

Family history

Her father died from a stroke in 2005.

Based on the information provided in this case study, you are required to discuss your initial assessment of Ms Abimbola using Steps 1 and 2 the Levett-Jones’ (2018) Clinical Reasoning Cycle (CRC) before interpreting the information (Step 3 CRC) you have been given to identify 3 nursing care priorities (Step 4 CRC) for Ms Abimbola.

The key components of Assessment 1 are to:

• Discuss the key elements of Step 1 of the CRC and why it is important by:
  • developing and presenting a concept map of Ms. Abimbola and her situation
  • Including evidence to support the content of your concept map

OULD YOU PLEASE PREPARE GOOD CONCEPT MAP FOR ABOVE QUESTION A/C TO CASE STUDY.

THANK YOU

What is the importance of interdisciplinary collaboration in the management of chronic and complex healthcare

A 42-year old female presents with a complaint of a papule on her left forearm for the past 2 months that “looks funny”. Denies itching, scaling, drainage, or other complaints.

Discuss what questions you would ask the patient, what physical exam elements you would include, and what further testing you would want to have performed, In SOAP format, list Pertinent positive and negative information, differential and working diagnosis, treatment plan, including Pharmacotherapy with complementary and OTC therapy, diagnostics (labs and testing), health education and lifestyle changes, age-appropriate preventive care, and follow-up to this visit.

What is a Professional Nurse?

Explain in about 450 words

You will develop a nursing care plan for a person with a nutritional concern. choose a patient condition type

High Cholesterol

Ethnic specific Hispanic

Age specific: children,

Geographic specific: urban, rural

Write up One priority nursing diagnosis.

Subjective data:  

Objective data:  

Measurable Goal:  

nursing interventions

Evaluation:  

#of intervention

Rationale

citation

1. Patient is on a ventilator; explain how you would fix the following ABG:

7.25

69

70

24

-2.3

2) What does compliance have to do with the lungs?

3)What does the static compliance formula use that dynamic compliance does not?

A 28-year-old mother gave birth to a 2.8 kg female by cesarean section at 36 weeks’ gestation. Apgar scores were 6 at 1 minute and 9 at 5 minutes. The baby developed tachypnea with a respiratory rate of 93 breaths per minute soon after birth and had moderate work of breathing with mild nasal flaring and retractions. The patient was placed on 1 L/min of oxygen by nasal cannula and was transferred to the neonatal intensive care unit. The assessment revealed: heart rate 158 beats per minute; respiratory rate 80 breaths per minute; blood pressure 65/45 mm Hg. The infant was well perfused and breath sounds were clear to auscultation. The remainder of the assessment was unremarkable. A chest radiograph was obtained which revealed normal lung expansion, fluid in the horizontal fissures and increased pulmonary vascularity. Differential diagnosis of transient tachypnea of the newborn was made. Over the next 24 hours the infant’s respi- ratory status worsened. Supplemental oxygen by high-flow nasal cannula was initiated at an FiO2 of 40% to maintain oxygen saturations >92%. By day 3 the patient’s status improved, a high-flow nasal cannula therapy was ordered. Within 6 hours the infant did not require any additional oxygen support. Vital signs were as follows: heart rate 145 beats per minute; respiratory rate 50 breaths per minute; blood pressure 60/40 mm Hg; and oxygen saturation >95% on room air. There were no further complications with respiratory function, and the patient was discharge to go home.

1. How soon does TTN present after birth?

Angela, a coder, was informed that an encounter she coded was denied by an insurance company
because medical necessity was not met. The patient was admitted with right knee pain, for which the
provider ordered a right knee x‐ray. However, the patient started having chest pain while waiting for the
results of the right knee x‐ray. The provider quickly took vitals and ordered a chest x‐ray with an EKG to
rule out a heart attack. Both were negative. Angela coded the right knee pain, right knee x‐ray, chest xray,
and EKG, but the claim was submitted to the payer without the chest pain code.

1. Why was the claim denied?

2. What should Angela have done to ensure this claim would be paid?

Consider technology and the strides we have made throughout the world and the products that have been developed. Technology has enabled us to see our doctor over video chat (telemedicine) from the comfort of our home; you are also able to print out and investigate blood tests, x-rays, MRI's, etc. Information is valuable and can help to make better decisions about our health.

What are the pros and cons of using video-chat and technology for medical care?

How might the increased use of technology affect the patient-provider relationship?