Nursing

Common Illnesses and the Use of CAM
Common Illnesses and the Use of CAM
The Course Outcome covered this week is CO1.
CO1: Identify theories, concepts, and beliefs related to transcultural nursing. (PO1)
We encounter patients after they have explored various avenues of self-help. At times, these avenues involve the use of complementary and alternative medicine (CAM). Our readings this week are very helpful.
Select a common (or not so common) illness or condition that affects a specific ethnic group.
Identify two (2) CAM therapies that patients are likely to try before seeking (or in addition to) allopathic, osteopathic, or ayurvedic medical intervention for the illness or condition.
Discuss the effectiveness of each therapy you identified.
Note: Do not discuss an illness or condition about which a classmate has already posted. The diversity will lead to a more robust discussion. There are many examples you may discuss, including sickle-cell disease in African Americans, constipation in the elderly people, or the use of Reiki for mental and emotional healing by Japanese people. Think of others from your practice settings or prelicensure experiences.
bjectives. The purpose of our study was to determine the prevalence of complementary and alternative medicine (CAM) use and its clinical and psycho-social correlates, including perceived satisfaction with care and cultural health beliefs.
Methods. A cross-sectional study was carried out in public sector primary care clinics in Singapore using a random sample of 488 adult patients with chronic diseases. The measures were CAM use, satisfaction with care and traditional health beliefs.
Results. The 1 year prevalence of CAM use was 22.7%. In univariate analyses, factors associated with CAM use included: middle age, arthritis, musculoskeletal disorders and stroke, multiple conditions, poor perceived health, family use of CAM, recommendation by close social contacts, strong adherence to traditional health beliefs and perceived satisfaction with care. Patients who were dissatisfied/very dissatisfied with the cost of treatment [odds ratio (OR) = 1.79, 95% confidence interval (CI) 1.15–2.82] and waiting time (OR = 1.96, 95% CI 1.20–3.19) were more likely to use CAM. Patients who were very satisfied with the benefit from treatment were much less likely to use CAM (OR = 0.49, 95% CI 0.29–0.83). Satisfaction with doctor–patient interaction was not associated with CAM use. Being ‘very satisfied’ on overall care satisfaction was significantly associated with much less CAM use (OR = 0.30, 95% CI 0.14–0.68). Multivariate analyses confirmed that CAM use was significantly and independently predicted by the ‘chronic disease triad’ (arthritis/musculoskeletal disorders/stroke) (OR = 4.08, 95% CI 2.45–6.83), overall satisfaction with care (OR = 0.32, 95% CI 0.14–0.74) and strong adherence to traditional health beliefs (OR = 1.88, 95% CI 1.07–3.31).
Conclusion. CAM use in Asian patients is prevalent and associated with the ‘chronic disease triad’ (of arthritis, musculoskeletal disorders and stroke), satisfaction with care and cultural beliefs. In particular, CAM use is not associated with the quality of doctor–patient interaction.
510 × 475

Capella FP5004 Assessment 1
Assignment: Capella FP5004 Assessment 1
Draft a proposal of 4–5 pages for the development of an interprofessional team to address a problem in delivering safe, high-quality health care.
Read each portion of the assessment carefully and see if the suggested resources can help you complete it.
Effective interprofessional collaboration is an essential strategy for health care leaders in delivering safe, high-quality health care and reducing costs. The ability to establish effective professional relationships among internal and external resources is the foundation of collaboration (Lawson, 2004).
This assessment provides an opportunity to consider the practical value and implementation of a collaborative strategy in your professional practice or area of interest.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Explain the concepts, principles, and characteristics of effective health care leadership.
Analyze the factors contributing to a problematic health care issue.
Competency 2: Explain the role of health care leaders in facilitating interprofessional collaboration.
Explain the need for interprofessional collaboration to improve the quality and safety of health care in specific instances.
Assess the effectiveness of a particular leadership approach in building and maintaining interprofessional collaborative relationships.
Develop a collaborative plan for improving the quality and safety of health care in specific instances.
Determine the leader’s role in implementing collaborative health care improvement projects.
Competency 4: Determine the influence of the practitioner-scholar role on professional practice and leadership development. Assignment: Capella FP5004 Assessment 1
Determine how the practitioner-scholar model might be applied in resolving a particular health care issue.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Develop a strategy for communicating the progress of interprofessional teams to organizational leaders.
Write coherently to support a central idea, using correct grammar, mechanics, and APA formatting.
Assignment: Capella FP5004 Assessment 1:Reference
Lawson, H. (2004). The logic of collaboration in education and the human services. Journal of Interprofessional Care, 18(3), 225–237.
Preparation
Health care leaders often find that resolving a problem in delivering safe, high-quality health care requires the combined effort of a number of agencies, departments, and individuals.
For this assessment, identify a quality-related situation or problem relevant to your professional practice or area of interest that requires the collaborative effort of several departments and individuals to resolve. You will assume the role of team leader and draft a proposal for the organization’s executive leadership that outlines why this interprofessional team is necessary, who should take part in the collaboration, how the team will function, and how progress will be reported.
A project proposal should identify the situation or problem, identify the causes or contributing factors, present a plan of action, provide details about the plan, and provide reasons why the plan should be undertaken.
Note: Remember, you can submit all or a portion of your draft to Smarthinking for feedback before you submit the final version of your proposal for this assessment. However, be mindful of the turnaround time for receiving feedback if you plan on using this free service.
Proposal Requirements: Assignment: Capella FP5004 Assessment 1
Write a proposal for assembling an interprofessional team. As you begin drafting your proposal, consider your goal and the needs of the leaders whose decisions will be based on the information you provide.
Note: The requirements outlined below correspond to the grading criteria in the Interprofessional Collaboration scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed. You are provided an example proposal that illustrates what proficient-level work for this assessment looks like.
Proposal Format and APA Style
Use the simplified Project Proposal Template, linked in the Resources, to draft your proposal. You may organize the content of your proposal in a format used in your organization. An abstract is not required.
Your proposal should be 4–6 double-spaced pages in length, not including the title page and reference page.
Apply correct APA formatting to all in-text citations and references.
Use Times New Roman, 12-point font.
Writing: Assignment: Capella FP5004 Assessment 1
Be concise, but thorough. Your readers need sufficient and accurate information on which to base their decisions, and do not have time to sift through information that is not pertinent.
Express your main points, arguments, and conclusions coherently.
Use correct grammar and mechanics.
Be sure to support your claims, arguments, and conclusions with credible evidence from 3–5 current, scholarly or professional sources.
Proofread your writing.
Plan Content
Analyze the factors that have contributed to the problem. ( Hint: Examine the reasons for ineffective communication, not just the communication itself. Reasons may include staff burnout, workload, staffing shortfalls, attitudes, assumptions, and so on.)
Consider whether certain combinations of factors might be contributing to the problem.
Explain why an interprofessional team is needed to address the problem and achieve expected project outcomes.
Determine who should be on the team. Identify the disciplines or areas team members should come from and any specific job titles prospective team members should hold.
Describe the knowledge and expertise each discipline has to offer in resolving the situation. In addition, consider the level of creativity and problem-solving skills that are needed.
Assess the effectiveness of a particular leadership approach in building and maintaining interprofessional collaborative relationships. Consider how effective that approach is in:
Encouraging participation by all team members.
Engaging reluctant or resistant team members.
Maintaining a respectful platform for members to voice their ideas.
Develop a strategy for communicating progress by the team to executive leadership.
Determine which approach to communicating with leaders will be most effective and efficient.
Determine whether you will have regular meetings and generate status reports.
Develop a collaborative plan for resolving the problem.
Identify the ethical or political issues that are relevant factors in your proposed solution.
Identify the social, cultural, or economic factors that are relevant to your proposed solution.
Explain how you would address the ethical, political, social, cultural, or economic factors you have identified as relevant to your plan.
Describe your role as a leader in implementing the proposed solution.
Determine how the practitioner-scholarmodel might be applied in resolving the problem.
Consider how theory, research, and the published work in the field, in conjunction with your own experience and professional knowledge, might be used to develop strategies to analyze and resolve the problem.
Note: Your instructor may also use the Writing Feedback Tool to provide feedback on your writing. In the tool, click the linked resources for helpful writing information.
Capella FP5004 assessment 2
Write an executive report of 4–5 pages that analyzes the role of diversity in an underperforming community program, unit, or department, and outline a plan for providing ongoing training on cultural awareness, inclusion, and sensitivity to current employees.
Be sure you read all of the requirements for this assessment and review the suggested resources to see if they may be useful in completing the assessment.
This assessment provides an opportunity to determine how you can help advance your professional field by developing a strategy for managing diversity that recognizes the synergy achieved by having a diverse and inclusive workforce.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 1: Explain the concepts, principles, and characteristics of effective health care leadership.
Determine the influence of effective leadership on the development of a diverse and culturally competent workforce.
Competency 3: Analyze standards of professional ethics and the principles of diversity and inclusion as applied by health care leaders in real-world situations.
Outline a plan to recruit, hire, and retain a diverse workforce.
Outline a plan for providing employee training on cultural awareness and sensitivity.
Explain the benefits of a diverse and culturally competent workforce to a health care organization and the community it serves.
Competency 4: Determine the influence of the practitioner-scholar role on professional practice and leadership development.
Explain how the academic and research skills one develops as a practitioner-scholar can be of service in one’s role as a health care leader.
Competency 5: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with applicable organizational, professional, and scholarly standards.
Write coherently to support a central idea, using correct grammar, mechanics, and APA formatting.
Preparation
Use the following case study as the basis of this assessment.
Imagine you are the manager of a new health care facility satellite office or community outreach center located in a diverse neighborhood. The parent organization opened the facility to address the underserved health care needs of the culturally diverse residents who were not using the services offered at the main facility. The first month of operation saw a very high volume of patients, but since then, the numbers have dropped off drastically. Executive leadership wants to understand why this has happened and what you plan to do about it.
After careful examination of all aspects of the facility, and talking with some of the neighborhood residents, you have determined that the residents do not feel comfortable coming to the facility because the staff does not represent the diversity of the neighborhood. Staff members were hired for their skill, but their diversity was not considered. Now, you must report to executive leadership what you have learned and how you intend to manage diversity.
Note: Remember, you can submit all or a portion of your draft to Smarthinking for feedback before you submit the final version of your proposal for this assessment. However, be mindful of the turnaround time for receiving feedback if you plan on using this free service.
Report Requirements
Write an executive report on the need for a diverse, culturally competent staff, including your plans to address that need.
Note: The requirements outlined below correspond to the grading criteria in the Managing Diversity scoring guide. At a minimum, be sure to address each point. In addition, you are encouraged to review the performance level descriptions for each criterion to see how your work will be assessed. You are provided an example report, to illustrate what proficient-level work for this assessment looks like.
Report Format and APA Style
Use the Executive Report Template, linked in the Resources, to draft your report. You may also organize the content of your report in a format used in your organization. An abstract is not required.
Your report should be 4–5 double-spaced pages in length, not including the title page and reference page.
Apply correct APA formatting to all in-text citations and references.
Use Times New Roman, 12-point font.
Writing
As you begin composing your report, consider the purpose of the report, the appropriate tone and style, and the expectations of the executive leaders who will be reading it.
Be clear and concise in your reporting.
Express your main points, arguments, and conclusions coherently.
Use correct grammar and mechanics.
Be sure to support your claims and arguments with credible evidence from 3–5 current, scholarly or professional sources.
Proofread your writing.
Report Content
Outline a plan to recruit, hire, and retain a more diverse workforce. Note: Your outline should be a high-level overview of a plan, not a detailed plan. Other courses in your program will go into human resource practices and diversity in depth. In drafting your plan, consider the following questions:
How does a leader develop a diverse workforce?
Where will you look for more diverse employees? Will you post job ads?
What will the interviewing and hiring process look like? Who will do the interviewing? Who will make the final decisions?
What kind of incentives will you offer diverse employees to retain them? What do you need to know about the culture and values of diverse employees before developing a retention plan?
How will you address issues related to diversity that result in conflict?
Outline a plan for the ongoing training and professional development of existing staff in cultural awareness and sensitivity. Consider how your plan can:
Improve communications and interpersonal skills.
Help overcome bias and resistance to change.
Explain the benefits, to both the organization and the community it serves, of having a diverse and culturally competent workforce.
Explain the relationship between health care organizations and communities.
Explain the role that diversity plays in providing culturally competent care and access for the under-served in a community.
Determine the influence of effective leadership on the development of a diverse and culturally competent workforce.
Explain the importance of cultural competence for leaders in an organization.
Explain how the academic and research skills you develop as a practitioner-scholar can serve you in your role as an effective health care leader.
Explain how those skills might contribute to your credibility and effectiveness as a leader.
Explain how those skills might prepare you to lead a diverse workforce.
Note: Your instructor may also use the Writing Feedback Tool to provide feedback on your writing. In the tool, click the linked resources for helpful writing information.

Singapore Airlines Case Study
Singapore Airlines Case Study
Research a health care organization or a network that spans several states within the U.S. (Example: United Healthcare, Vanguard, Banner Healthcare, etc.).
Harvard Business Review Online and Hoover’s Company Records, found in the GCU Library, are useful sources. You may also find pertinent information on your organization’s webpage.
Review “Singapore Airlines Case Study.”
Prepare a 1,000-1250-word paper that focuses on the organization or network you have selected.
Your essay should assess the readiness of the health care organization or network in addressing the health care needs of citizens in the next decade, and include a strategic plan that addresses issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction. Provide a comparison to the health care organization or network and the Singapore Airlines. Include any cultural issues that may influence the practices listed above.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
Research a health care organization or a network that spans several states within the U.S. (Example: United Healthcare, Vanguard, Banner Healthcare, etc.).
Harvard Business Review Online and Hoover’s Company Records, found in the GCU Library, are useful sources. You may also find pertinent information on your organization’s webpage.
Permalink:
Review “Singapore Airlines Case Study.”
Prepare a 1,000-1250-word paper that focuses on the organization or network you have selected.
Your essay should assess the readiness of the health care organization or network in addressing the health care needs of citizens in the next decade, and include a strategic plan that addresses issues pertaining to network growth, nurse staffing, resource management, and patient satisfaction. Provide a comparison to the health care organization or network and the Singapore Airlines. Include any cultural issues that may influence the practices listed above.
Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Assignment: Patient Diagnosed with Dementia
Assignment: Patient Diagnosed with Dementia
Question 20 (5 points) Question 20 Unsaved
An older resident of a long-term care facility diagnosed with dementia has in the last 48 hours become more confused than usual and while usually requiring help with toileting has been incontinent of urine. The client’s healthcare provider orders a complete blood count and serum electrolytes. When the lab tests are all within normal limits the nurse initially:
Question 20 options:
Attributes the changes in the resident’s functioning to advancing dementia.
Suggests that the resident be placed on broad-spectrum antibiotics to prevent infections.
Speaks with the healthcare provider regarding the changes in the client’s function and the possibility of obtaiing a urine culture.
Changes the plan of care to include bladder training and implement a 24-hour calorie count.
Question 21 (5 points) Question 21 Unsaved
An 81-year-old patient is being discharged from the hospital to home. She is on seven different medications, which are to be taken at four different times during the day. What would be most useful in helping this patient manage her medications? The nurse makes the greatest impact on the safe management of an 81-year-old client’s medication administration when included in discharge education is:
Question 21 options:
The package inserts from all of the medications for the client to read.
A pillbox with compartments for each day and each of the doses.
A written list of all the client’s medications and administration routine.
A suggestion that the client’s daughter administer the medications.
Question 22 (5 points) Question 22 Unsaved
A 78-year-old is admitted to the long-term care facility after a hospitalization for pneumonia. The client has a history of a right cerebrovascular accident and dysphagia. When preparing the room for this patient, what equipment is most important in the care of this patient?
Question 22 options:
A room located within sight of the nursing station
An adjustable height bed that goes low to the floor
A suction machine
Oxygen at bedside
Question 23 (5 points) Question 23 Unsaved
The nurse is managing the care of an older client experiencing the symptoms of heat fatigue. Which intervention will the nurse implement to help resolve the condition? Select all that apply.
Question 23 options:
Helping the client assume a comfortable resting position.
Monitoring the client’s intake of electrolyte replacement fluids.
Withholding the client’s prescribed antidiuretic medication.
Documenting that the client’s skin remains pale, moist and cool.
Keeping the environmental humidity low and temperature cool.
Question 24 (5 points) Question 24 Unsaved
Based on recent studies, which statement regarding touch and touch zones is most accurate?
Question 24 options:
Persons age 66 to 100 are the most often touched.
Newly graduated nurses tend to touch clients less often than do nursing students.
When performing peri-care the nurse is working within the zone of intimacy.
The comfort of touch depends on place, situation, social status, and age.
Question 25 (5 points) Question 25 Unsaved
Based on current demographic data, which statement identifies a predictive trend regarding the health care needs of society?
Question 25 options:
There will be an increasing need for health programs for older males.
More nursing services will be required to serve the needs of the population 85 years of age and older.
Fewer nurses will be needed to care for the older, especially in long-term care facilities.
North Dakota is likely to experience the greatest need for gerontological nurses.
Question 26 (5 points) Question 26 Unsaved
Which intervention to manage wandering in clients in a long-term care facility should be implemented? Select all that apply.
Question 26 options:
Camouflaging doorways.
Close observation to identify the person’s individual patterns.
Engaging the person in social interactions.
Using physical restraints to prevent wandering to maintain safety.
Providing enclosed pathways for walking.
Question 27 (5 points) Question 27 Unsaved
When using the Fulmer SPICES assessment tool the nurse expects to ask:
Question 27 options:
“Do you think that you sleep well?”
“Are you ever incontinent of urine?”
“When was the last time you fell?”
“Who helps you when you can’t do something by yourself?”
Question 28 (5 points) Question 28 Unsaved
A woman is terminally ill. Although it has never been discussed in the family nor stated outright by her physician, she suspects that she will die because of her illness. Upon which concept will the nurse base therapeutic intervention on?
Question 28 options:
Closed awareness.
Suspected awareness.
Mutual pretense.
Mutual pretense.
Question 29 (5 points) Question 29 Unsaved
When an older adult client is diagnosed with restless leg syndrome (RLS), the nurse is confident that client education on the condition’s contributing factors has been effective when the client states:
Question 29 options:
“A warm bath at night instead of in the morning is my new routine.”
“Eating a banana at breakfast assures me the potassium I need.”
“I’ve cut way back on my caffeinated coffee, teas and sodas.”
“I elevate my legs on a pillow so as to improve circulation.”
Question 30 (5 points) Question 30 Unsaved
State Death with Dignity Laws require that the terminally ill client be:
Question 30 options:
Educated regarding treatment alternatives.
Over the age of 55.
Be supported in their decision by immediate family members.
Eligible for federal support services.
Question 31 (5 points) Question 31 Unsaved
Serious and well controlled research studies on aging have been available:
Question 31 options:
Only in the past 50 years
Since the turn of the 20th century
Following the Great Depression
Since the year 2000
Question 32 (5 points) Question 32 Unsaved
Which activity would a couple in the reorientation phase of their retirement engage in?
Question 32 options:
Establishing a new budget that will allow them to travel to see the grandchildren.
Reading magazines devoted to making decisions about retirement plans.
Looking for ways to ‘fill up the days.’
Volunteering at the local animal shelter.
Question 33 (5 points) Question 33 Unsaved
What factor is an important contribution to polypharmacy in older adults?
Question 33 options:
Inadequate communication among medical care providers.
Implementation of Medicare Part D prescription drug benefit.
Use of generic medications.
Increasing popularity of dietary and herbal supplements.
Question 34 (5 points) Question 34 Unsaved
Which is the most likely reason that Type 2 diabetes mellitus is often difficult to diagnose in older adults?
Question 34 options:
Presenting symptoms occur very quickly.
The disease rarely occurs in older adults.
The classic symptoms may not be present in older adults.
There are no recognizable symptoms; it is a “silent killer.”
Question 35 (5 points) Question 35 Unsaved
An older client in a long-term care facility is receiving an annual physical and is ordered laboratory tests that include a complete blood count, serum electrolytes, and thyroid tests. When the client’s son questions why these tests are being ordered by saying, “Dad is 85 and supposed to be sleepy,” the nurse’s response is based on an understanding that:
Question 35 options:
The healthcare provider ordering the tests needs to explain the rationale to the son.
When conducted annually, all of the tests are helpful in promoting maximum health for older adults in the long-term care setting.
The tests are useful, but only if clinically indicated.
The complete blood count and serum electrolytes are useful screening tests, but the usefulness of the thyroid test should be questioned.
Question 36 (5 points) Question 36 Unsaved
Which reaction to the loss of a spouse or long-term partner is a unique example of older adult male bereavement?
Question 36 options:
Withdrawing from friends and family.
Remarrying within months of the loss.
Focusing on ‘doing’ rather than ‘feeling.’
Experiencing moderate to severe depression.
Question 37 (5 points) Question 37 Unsaved
It is imperative that nursing take a leadership role in providing effective health care across the lifespan and in various health care settings. Which intervention will have the greatest impact on achieving positive outcomes concerning that issue?
Assignment: Patient Diagnosed with Dementia

Renal and Genitourinary Disorders
Renal and Genitourinary Disorders
Case Study
A 52 year old woman presented to the clinic for ongoing fatigue and weight loss during the last 6 weeks. She thinks she’s loss at least “10 pounds”. For the past week and a half she’s noted some progressing ‘muscle cramping’ tetany, as well as ‘tingling’ sensation around her mouth and lower extremities. She’s also noted some intermittent colicky abdominal pain. On your exam, you noted a positive Chvostek’s sign. PMH: 20 year history of Crohn’s disease. She also tells you that she is a practicing vegan.
List the primary diagnosis and rational
List at least 3 differential diagnosis with a brief rational
Describe the pertinent history required to rule in or rule out
Describe you physical exam findings or screening tools used
Discuss the treatment plan for the patient in your case study using this format
Prescriptions(s):
Interventions/ lifestyle changes:
Referrals:
Follow up:
Education:
(Minimum 2 references)
Overview of Genitourinary Disorders
What does genitourinary mean?
Genitourinary is a word that refers to the urinary and genital organs.
Urology is the branch of medicine concerned with the urinary tract in both genders and the genital tract of the reproductive system in males.
Nephrology is the branch of medicine concerned with the kidney.
What is the urinary tract?
The urinary tract includes the organ system primarily responsible for cleaning and filtering excess fluid and waste material from the blood. The urinary system is made up of the following:
Kidneys
Ureters
Bladder
Urethra
The kidneys also function as glands that produce hormones necessary for building red blood cells and regulating blood pressure.
What causes problems in the urinary system?
In children, problems of the urinary system include acute and chronic kidney failure, urinary tract infections, obstructions along the urinary tract, and abnormalities present at birth.
Diseases of the kidneys often produce temporary or permanent changes to the small functional structures and vessels inside the kidney. Frequent urinary tract infections can cause scarring to these structures leading to renal (kidney) failure. Some diseases that cause kidney damage include:
Glomerulonephritis
Hemolytic uremic syndrome
Polycystic kidney disease
Hydronephrosis
Urinary tract infections
Disorders of the urinary tract are often related to a blockage that prevents complete emptying of the bladder and often leads to reverse flow of urine. A urinary tract obstruction can cause damage to the urinary tract and kidneys because urine backs-up and pools in various areas along the tract. Pooling of urine in the bladder, ureters, or kidneys can lead to infection, scarring, and long-term kidney failure. Some disorders that cause obstruction of the urinary tract include:
Megaureter
Posterior urethral valves
Ureterocele or ureteral duplication
Vesicoureteral reflux
Neurogenic bladder
Several disorders of the urinary tract only affect males, which are largely related to the male anatomy as well as fetal development. Disorders that affect males may involve the penis, urethra, or testes. Some of the male urogenital disorders include:
Undescended testes or cryptorchidism
Hydrocele
Hypospadias
Inguinal hernia
Micropenis
Testicular torsion
Disorders of the genitourinary system in children are often detected by fetal ultrasound prior to birth. If not detected on fetal ultrasound, often children will develop a urinary tract infection that will prompt your child’s doctor to perform special diagnostic tests that may detect an abnormality. Some diseases of the kidney do not reveal themselves until later in life or after a child has a bacterial infection or an immune disorder.

Clinical Reasoning: Neurological System
Clinical Reasoning: Neurological System
Respond to the following:
Question 1: What other questions would you ask Ms. Barthel? What specific exams would you perform on Ms. Barthel?
Question 2: You believe Ms. Barthel has multiple sclerosis (MS). Discuss what you know about the diagnosis of this disease. What tests and specialist(s) would you recommend her seeing?
Question 3: Describe your concerns about Ms. Barthel’s health and safety. What kinds of health promotion activities would you suggest for Ms. Barthel?
You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.
Submission Instructions
Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”
To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.
Evaluation
This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.
DQ2 Clinical Reasoning: Putting it All Together
Respond to the following:
Question 1: What would you do prior to conducting a comprehensive assessment? What things would you organize and what would be your first priority?
Question 2: What have you learned about health assessment and physical assessment during the course of this semester? What were your “aha” moments?
You are expected to participate in academic conversations with peers and faculty to generate scholarly dialogue. Expectations for participation in the course discussions are described under the Discussion Rubric: Exploration, Spirit of Inquiry, and Engagement (interactions) when relating your experiences, opinions, viewpoints, and ideas supported by evidence.
Submission Instructions
Consult the Discussion Posting Guide for information about writing your discussion posts. It is recommended that you write your post in a document first. Check your work and correct any spelling or grammatical errors. When you are ready to make your initial post, click “Reply.” Then copy/paste the text into the message field, and click “Post Reply.”
To respond to a peer, click “Reply” beneath her or his post and continue as with an initial post.
Evaluation
This discussion will be graded using the discussion board rubric. Please review this rubric, located on the Rubrics page within the Start Here module of the course, prior to beginning your work to ensure your participation meets the criteria in place for this discussion. All discussions combined are worth 15% of your final course grade.

Assignment: Social Work Self Reflection
Assignment: Social Work Self Reflection
Permalink:
Exploring the reasons for wanting to be in social work and examining your motives for choosing a career of helping others is very important. Your background, including childhood experiences, may be instrumental in bringing you into the field of social work. Understanding the possible connection and working to resolve any underlying unresolved issues is essential to becoming an effective social worker. While working with a client, you must strive to be objective, but in the end we are all human with past hurtful experiences that can impact our ability to effectively work with clients. While complete objectivity is impossible and not expected, it is necessary to self-reflect and become aware of when a situation or a certain personality type causes you to react in an unprofessional manner. Understanding potential internal and external barriers you and your client bring to the room will assist you in balancing an appropriate empathetic response with proper objectivity.
For this Discussion, review the Geller & Greenberg (2012) article and the program case study for the Petrakis family, and view the corresponding video. ATTACHED
Assignment: Social Work Self Reflection
Assignment: Social Work Self Reflection
Assignment: Social Work Self Reflection
Post your explanation of the importance of identifying internal and external barriers of the client and social worker. Then describe the barriers experienced by Helen and the social work intern. Finally, suggest ways the intern could overcome these barriers.
Support your posts with specific references to the Learning Resources. Be sure to provide full APA citations for your references.
The Petrakis Family
Helen Petrakis is a 52-year-old heterosexual married female of Greek descent who says that she feels overwhelmed and “blue.” She came to our agency at the suggestion of a close friend who thought Helen would benefit from having a person who could listen. Although she is uncomfortable talking about her life with a stranger, Helen said that she decided to come for therapy because she worries about burdening friends with her troubles. Helen and I have met four times, twice per month, for individual therapy in 50-minute sessions. Helen consistently appears well-groomed. She speaks clearly and in moderate tones and seems to have linear thought progression; her memory seems intact. She claims no history of drug or alcohol abuse, and she does not identify a history of trauma. Helen says that other than chronic back pain from an old injury, which she manages with acetaminophen as needed, she is in good health. Helen has worked full time at a hospital in the billing department since graduating from high school. Her husband, John (60), works full time managing a grocery store and earns the larger portion of the family income. She and John live with their three adult children in a 4-bedroom house. Helen voices a great deal of pride in the children. Alec, 27, is currently unemployed, which Helen attributes to the poor economy. Dmitra, 23, whom Helen describes as smart, beautiful, and hardworking, works as a sales consultant for a local department store. Athina, 18, is an honors student at a local college and earns spending money as a hostess in a family friend’s restaurant; Helen describes her as adorable and reliable. In our first session, I explained to Helen that I was an advanced year intern completing my second field placement at the agency. I told her I worked closely with my field supervisor to provide the best care possible. She said that was fine, congratulated me on advancing my career, and then began talking. I listened for the reasons Helen came to speak with me. I asked Helen about her community, which, she explained, centered on the activities of the Greek Orthodox Church. She and John were married in that church and attend services weekly. She expects that her children will also eventually wed there. Her children, she explained, are religious but do not regularly go to church because they are very busy. She believes that the children are too busy to be expected to help around the house. Helen shops, cooks, and cleans for the family, and John sees to yard care and maintains the family’s cars. When I asked whether the children contributed to the finances of the home, Helen looked shocked and said that John would find it deeply insulting to take money from his children. As Helen described her life, I surmised that the Petrakis family holds strong family bonds within a large and supportive community. Helen is responsible for the care of John’s 81-year-old widowed mother, Magda, who lives in an apartment 30 minutes away. Until recently, Magda was self-sufficient, coming for weekly family dinners and driving herself shopping and to church. But 6 months ago, she fell and broke her hip and was also recently diagnosed with early signs of dementia. Through their church, Helen and John hired a reliable and trusted woman to check in on Magda a couple of days each week. Helen goes to see Magda on the other days, sometimes twice in one day, depending on Magda’s needs. She buys her food, cleans her home, pays her bills, and keeps track of her medications. Helen says she would like to have the helper come in more often, but she cannot afford it. The money to pay for help is coming out of the couple’s vacations savings. Caring for Magda makes Helen feel as if she is failing as a wife and mother because she no longer has time to spend with her husband and children. Helen sounded angry as she described the amount of time she gave toward Magda’s care. She has stopped going shopping and out to eat with friends because she can no longer find the time. Lately, John has expressed displeasure with meals at home, as Helen has been cooking less often and brings home takeout. She sounded defeated when she described an incident in which her son, Alec, expressed disappointment in her because she could not provide him with clean laundry. When she cried in response, he offered to help care for his grandmother. Alec proposed moving in with Magda. Helen wondered if asking Alec to stay with his grandmother might be good for all of them. John and Alec had been arguing lately, and Alec and his grandmother had always been very fond of each other. Helen thought she could offer Alec the money she gave Magda’s helper. I responded that I thought Helen and Alec were using creative problem solving and utilizing their resources well in crafting a plan. I said that Helen seemed to find good solutions within her family and culture. Helen appeared concerned as I said this, and I surmised that she was reluctant to impose on her son because she and her husband ed to value providing for their children’s needs rather than expecting them to contribute resources. Helen ended the session agreeing to consider the solution we discussed to ease the stress of caring for Magda.
In our second session, Helen said that her son again mentioned that he saw how overwhelmed she was and wanted to help care for Magda. While Helen was not sure this was the best idea, she saw how it might be helpful for a short time. Nonetheless, her instincts were still telling her that this could be a bad plan. Helen worried about changing the arrangements as they were and seemed reluctant to step away from her integral role in Magda’s care, despite the pain it was causing her. In this session, I helped Helen begin to explore her feelings and assumptions about her role as a caretaker in the family. Helen did not seem able to identify her expectations of herself as a caretaker. She did, however, resolve her ambivalence about Alec’s offer to care for Magda. By the end of the session, Helen agreed to have Alec live with his grandmother. In our third session, Helen briskly walked into the room and announced that Alec had moved in with Magda and it was a disaster. Since the move, Helen had had to be at the apartment at least once daily to intervene with emergencies. Magda called Helen at work the day after Alec moved in to ask Helen to pick up a refill of her medications at the pharmacy. Helen asked to speak to Alec, and Magda said he had gone out with two friends the night before and had not come home yet. Helen left work immediately and drove to Magda’s home. Helen angrily told me that she assumed that Magda misplaced the medications, but then she began to cry and said that the medications were not misplaced, they were really gone. When she searched the apartment, Helen noticed that the cash box was empty and that Magda’s checkbook was missing two checks. Helen determined that Magda was robbed, but because she did not want to frighten her, she decided not to report the crime. Instead, Helen phoned the pharmacy and explained that her mother-in-law, suffering from dementia, had accidently destroyed her medication and would need refills. She called Magda’s bank and learned that the checks had been cashed. Helen cooked lunch for her motherin-law and ate it with her. When a tired and disheveled Alec arrived back in the apartment, Helen quietly told her son about the robbery and reinforced the importance of remaining in the building with Magda at night. Helen said that the events in Magda’s apartment were repeated 2 days later. By this time in the session Helen was furious. With her face red with rage and her hands shaking, she told me that all this was my fault for suggesting that Alec’s presence in the apartment would benefit the family. Jewelry from Greece, which had been in the family for generations, was now gone. Alec would never be in this trouble if I had not told Helen he should be permitted to live with his grandmother. Helen said she should know better than to talk to a stranger about private matters. Helen cried, and as I sat and listened to her sobs, I was not sure whether to let her cry, give her a tissue, or interrupt her. As the session was nearing the end, Helen quickly told me that Alec has struggled with maintaining sobriety since he was a teen. He is currently on 2 years’ probation for possession and had recently completed a rehabilitation program. Helen said she now realized Alec was stealing from his grandmother to support his drug habit. She could not possibly tell her husband because he would hurt and humiliate Alec, and she would not consider telling the police. Helen’s solution was to remove the valuables and medications from the apartment and to visit twice a day to bring supplies and medicine and check on Alec and Magda. After this session, it was unclear how to proceed with Helen. I asked my field instructor for help. I explained that I had offered support for a possible solution to Helen’s difficulties and stress. In rereading the progress notes in Helen’s chart, I realized I had misinterpreted Helen’s reluctance to ask Alec to move in with his grandmother. I felt terrible about pushing Helen into acting outside of her own instincts. My field instructor reminded me that I had not forced Helen to act as she had and that no one was responsible for the actions of another person. She told me that beginning social workers do make mistakes and that my errors were part of a learning process and were not irreparable. I was reminded that advising Helen, or any client, is ill-advised. My field instructor expressed concern about my ethical and legal obligations to protect Magda. She suggested that I call the county office on aging and adult services to research my duty to report, and to speak to the agency director about my ethical and legal obligations in this case. In our fourth session, Helen apologized for missing a previous appointment with me. She said she awoke the morning of the appointment with tightness in her chest and a feeling that her heart was racing. John drove Helen to the emergency room at the hospital in which she works. By the time Helen got to the hospital, she could not catch her breath and thought she might pass out. The hospital ran tests but found no conclusive organic reason to explain Helen’s symptoms. I asked Helen how she felt now. She said that since her visit to the hospital, she continues to experience shortness of breath, usually in the morning when she is getting ready to begin her day. She said she has trouble staying asleep, waking two to four times each night, and she feels tired during the day. Working is hard because she is more forgetful than she has ever been. Her back is giving her trouble, too. Helen said that she feels like her body is one big tired knot. I suggested that her symptoms could indicate anxiety and she might want to consider seeing a psychiatrist for an evaluation. I told Helen it would make sense, given the pressures in her life, that she felt anxiety. I said that she and I could develop a treatment plan to help her address the anxiety. Helen’s therapy goals include removing Alec from Magda’s apartment and speaking to John about a safe and supported living arrangement for Magda.

Assignment: Explore the National Institute of Nursing Research (NINR)
Explore the National Institute of Nursing Research (NINR) website:www.ninr.nih.gov/ Review their publication Bringing science to life: NINR strategic plan (2011, p. 7) to identify the current priorities for nursing research. Do you agree with the priorities or would you recommend addition or elimination of some of the priorities? What effect do the nursing research priorities have on nursing researchers?
What criteria must be met in order to consider a practice, evidence-based? Provide examples. Explain the role quality plays in evidence-based practice?
Based on the information you’ve learned to this point, write a research proposal that relates to the topics you chose for a previous assignment. Be sure to include the following information in your proposal:
Hypothesis
Theory
Design model
Method
Anticipated results
Potential Dissemination Avenues
The assignment should be between 1500 and 2000 words in length and contain at least two scholarly sources, in addition to the textboook. Assignment: Explore the National Institute of Nursing Research (NINR)
The Division of Extramural Science Programs (DESP) serves NINR’s extramural research community and NINR by overseeing policy and management for grants and contracts to support NINR research and training. DESP also performs other specialized functions for the Institute, such as overseeing a nationwide Research Centers program.
DESP OFFICES
Office of Extramural Programs (OEP)
OEP manages the funding activities of NINR that occur outside of NIH, in research institutions across the country and around the world.
Office of End-of-Life and Palliative Care Research (OEPCR)
OEPCR manages the funding activities of NINR in end-of-life and palliative care research including support of EOLPC activities across the NIH and extramural community.
Office of Extramural Research Administration (OERA)
OERA provides leadership and advice to the Senior Executive for Science Programs on implementing and coordinating extramural research, training and career development grant program operations and policies.

NUR 2488 Module 03 Written Assignment – Cultural Considerations in Mental Health Nursing
Assignment: Cultural Considerations in Mental Health Nursing
Submit an evidence-based practice paper about cultural competency in mental health nursing. An evidence-based practice paper allows you to explore best practice and help improve client outcomes on a psychiatric unit. Your paper should describe how you, as a nurse, will include – or have included – cultural awareness in a client diagnosed with a mental illness. The person you describe could be someone in your clinical setting, someone you have worked with in the past, or a theoretical client.
Remember that culture can also include gender equality, sexual orientation, and other cultures besides race and religion – including cultures unique to one particular family. Your paper should be at least 3 pages (double-spaced, not including the title or reference pages) in APA Format and include:
Assessment: Discuss what you would assess in regard to a client’s culture. For example, are there specific dietary requirements? Are schedule changes necessary to avoid conflicts with religious practices? Who is the spokesperson for the family? What would you assess?
Diagnosis: List any mental health nursing diagnoses this person has or may be at risk for. Include at least one cultural diagnosis.
Planning: What planning needs to be done to ensure the cultural and emotional safety of the client?
Implementation:What are interventions that would ensure the safety of your client in regard to culture? Include at least two interventions. For example, if your client has religious beliefs that affect the ability to take medications, what interventions would you create to ensure the client’s safety? What can you do to make sure the client’s cultural needs are met?
Evaluation:How will you evaluate whether your implementation was effective? Make sure the parameters are objective and measurable.
In your summary, discuss whether any completed interventions were successful. What could be done differently in the future? If the interventions have not yet been carried out, you might discuss some institutional changes that could be made to ensure cultural safety for all clients in that setting.
Your paper should utilize proper APA guidelines and include at least three scholarly sources to support your paper. A scholarly source is a source that has been peer reviewed and has appropriate authors that are credentialed. For more information on APA, please visit the Online Library. Assignment: Cultural Considerations in Mental Health Nursing

Assignment: General Survey/Skin/Nutrition
Assignment: General Survey/Skin/Nutrition
This week’s graded discussion topic relates to the following Course Outcomes (COs)
CO1 Utilize prior knowledge of theories and principles of nursing and related disciplines to explain expected client behaviors, while differentiating between normal findings, variations, and abnormalities (PO 1)
CO3 Utilize effective communication when performing a health assessment (PO 3)
Your home health agency has received an order from a local hospital to evaluate and treat an elderly woman being discharged from its medical surgical unit
Millie Gardner, an 83-year-old female patient, is being discharged home today to the care of her husband Fred (87 years old) following a 9-day hospitalization for pneumonia, dehydration, and failure to thrive She has a history of hypertension (HTN), Type II Diabetes, and cerebral vascular accident (CVA) with left-sided weakness Patient is alert and oriented but does have periods of forgetfulness during the overnight hours Patient has intermittent incontinence of bowel and bladder and requires assistance with all activities of daily living (ADLs)
Medications:
Lopressor
Lisinopril
Plavix
Metformin
Novolin R per sliding scale *NEW*
Multivitamin
Colace
Zithromax *NEW*
Upon arrival you are greeted by Champ, the couple’s rambunctious miniature Doberman pinscher dog Millie is in her wheelchair staring blankly out the window, and Fred is busy in the kitchen preparing the couple’s lunch
Based on the scenario above, please use the general survey process to describe the areas that you would be observing immediately upon entry to the home
What, if any, concerns related to Millie’s skin and nutritional status do you have?
What nursing interventions will you include in the plan of care to address these concerns?
What teaching strategies will you use to educate Millie and Fred on the new medications?
Using the SBAR, please include the information that you will communicate to the physician’s office at the completion of the visit