Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients.

It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.

Evaluate the Health History and Medical Information for Mr. C., presented below.

Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.

Health History and Medical Information

Health History

Mr. C., a 32-year-old single male, is seeking the information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

  1. Height: 68 inches; weight 134.5 kg
  2. BP: 172/98, HR 88, RR 26
  3. 3+ pitting edema bilateral feet and ankles
  4. Fasting blood glucose: 146 mg/dL
  5. Total cholesterol: 250 mg/dL
  6. Triglycerides: 312 mg/dL
  7. HDL: 30 mg/dL
  8. Serum creatinine 1.8 mg/dL
  9. BUN 32 mg/dl

Critical Thinking Essay 

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

  1. Describe the clinical manifestations present in Mr. C.
  2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
  3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems that can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
  4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
  5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for the prevention of future events, health restoration, and avoidance of deterioration of renal status.
  6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

Describe treatment strategies and interventions for the individual in both cases case.

Intervening with individuals experiencing symptoms of disorders relating to mood can be challenging. It is especially important to be able to identify the symptoms of the correct disorder so that you can work with the individual in the appropriate manner. This assignment will help you to differentiate between different disorders related to mood, and become familiar with intervention techniques.

Describe treatment strategies and interventions for the individual in both cases case.

Scenario1

Bob graduated high school a few years ago with all his friends and then got a job at a local grocery store which according to his parents he was successfully employed at for a year and a half. Bob parents report that all of sudden Bob started behaviors of being late, missing work, staying in his room all day, sleeping a lot more and not even wanting to go hang out with his friends. After several months of these behaviors Bob ended up losing his job and his parents became very worried about him but Bob insisted that he was fine and just wanted to be left alone.

After a few weeks of his parents worrying, it was like Bob became a whole new person who was motivated to get looking for another job, helped his parents out more around the house and stayed out often driving around town and hanging out with his friends. Bob was having fun, he started drinking more, meeting random girls at clubs and getting into fights. One night Bob was hanging out with his friends, Bob started accusing his best friend of stealing his money and began pushing him around. Bob’s friend insisted that he did not take his money which made Bob angry and Bob picked up a vase nearby and smashed it over his friends head. Bob went to jail and an assessment was done concluding that Bob has bi-polar disorder.

Scenario 2

Joe is a thirty four male who is in prison for burglary charges, reckless driving, unlawful use of a deadly weapon, and public nuisance. Joe received these charges when he drove his car into a gun shop window, grabbed a gun and then ran out into the middle of the street stopping traffic where he fell to his knees holding the gun to his throat until the officers arrived and stopped him from pulling the trigger. Joe reports that he did those things because he missed his wife and kid and felt like he did not want to go on without them. Joe reported that his wife left him for another man and that he felt his temper and drinking may have been the cause.

Joe reported that his wife and he were very happy at one time until Joe started to spend more time at work then at home and being in the same routine of work and then home began giving him headaches. Joe and his wife would fight all the time because all Joe wanted to do when he was home was sleep and would not make time for family activities. Joe noticed that he started to be irritated by all the things that his wife did, often found himself angered by her and would end up just wanting to escape. Joe suffers from having depression disorder.

What are the advantages and disadvantages of PPACA that was passed in 2010?

The discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered.

For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned.

Start reviewing and responding to the postings of your classmates as early in the week as possible. Respond to at least two of your classmates. Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion. Complete your participation for this assignment by the end of the week.

Currently, in the United States, an individual is not required to purchase a health insurance plan. However, according to Section 1501 of the PPACA, beginning in 2014, “Individuals will be required to maintain minimum essential coverage beginning in 2014. Failure to maintain coverage will result in a penalty of $95 in 2014, $350 in 2015, $750 in 2016 and indexed thereafter.”

Currently, employers are not required to provide health insurance coverage to their employees. However, in 2014, the employers’ responsibility in health insurance coverage will change, according to the PPACA. This is the latest update in a long line of US health care reform efforts.

Using South University Online Library or the Internet, search on the topic of latest health care reforms. On the basis of your research and your understanding of the topic, answer the following questions:

  • Track the progress of health care reform efforts in the US history starting with the early 1900s detailing the role of Presidents’ attempting to pass health care reform.
  • Give your views on the AALL’s efforts to pass National Health Reform.
  • What are the issues of culture, politics, and special interests in the United States that have made health care reform difficult to achieve?
  • Of these three issues, which issue do you find to be the most difficult to overcome? Why?
  • What is path dependency? What has this been an issue in health reform? How can the power of inertia be overcome?
  • What are the advantages and disadvantages of PPACA that was passed in 2010?

Compare and contrast the three major government health insurances. Include eligibility, administrative jurisdiction, and method of financing.

The government provides health insurance to low-income individuals, the elderly, and the disabled. These individuals cannot afford private health insurance and would be uninsured if government insurance did not exist. Medicaid and Medicare are entitlement programs, while SCHIP is a block grant program.

On the basis of your knowledge on Medicaid, Medicare and SCHIP, write a 3- to 4-page essay in a Microsoft Word document on these government insurance programs. Your essay should include answers to the following questions:

  • Compare and contrast the three major government health insurances. Include eligibility, administrative jurisdiction, and method of financing.
  • Compare the Medicaid program in the state you reside in with a Medicaid program in another state. Should Medicaid programs be uniform throughout the United States? Explain why or why not.
  • Compare the structure and eligibility rules for SCHIP in your state and SCHIP in another state. Do you think that SCHIP should be uniform throughout the United States? Why or why not?
  • Describe entitlement and block grant programs. How are these two programs different?
  • Should all government health insurances be entitlement programs or should they all be block grant programs? Why?

In healthcare workers (P), how does handwashing according to WHO guidelines (I) affect the incidence of hospital- acquired infections (O) ?

PICOT Question to use: In healthcare workers (P), how does handwashing according to WHO guidelines (I) affect the incidence of hospital- acquired infections (O) ?

The (C) and (T) are optional- you really don’t need them for your question

To complete this Assessment:

Reflect on your current healthcare organization and think about potential opportunities for evidence-based change.

Identify a clinical issue of interest that can form the basis of an evidence-based change.

Develop a PICOT question to address this issue.

Using the keywords from the PICOT question, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles at the systematic-reviews level.

Create a PowerPoint presentation by addressing the following in 8–14 slides:

Briefly describe your healthcare organization, including its culture and readiness for change.

Describe the current problem or opportunity for change. Include in this description the circumstances surrounding the need for change, the scope of the issue, the stakeholders involved, and the risks associated with change implementation in general.

Propose an evidence-based idea for a change in practice using an evidence-based practice approach to decision-making. Note that you may find further research needs to be conducted if sufficient evidence is not discovered.

Be sure to include a description of the PICOT question that you developed for your search, and which databases you consulted.

Describe your plan for knowledge transfer of this change, including knowledge creation, dissemination, and organizational adoption and implementation.

Describe the measurable outcomes that you hope to achieve with the implementation of this evidence-based change.

Based on your readings of the Silva article, is there a correlation between depression and violent crime?

Based on your readings of the Silva article, is there a correlation between depression and violent crime? Do the findings from these studies confirm or contradict earlier findings? What are the limitations of the study? What if any changes should be made to the treatment of depression based on these findings?

Review the best practices of criminal investigators presented throughout the course and develop a list of positive traits to follow and negative traits to avoid that will lead to successful prosecutions of accused offenders.

 The presentation of the case to a jury is the responsibility of the prosecutor. However, case development is often left to the devices of the criminal investigator. Review the best practices of criminal investigators presented throughout the course and develop a list of positive traits to follow and negative traits to avoid that will lead to successful prosecutions of accused offenders.

Describe the format of the meeting that you attended and provide details about the atmosphere or experience of being in the meeting.

Locate an open recovery or support group in your local community. Please note this should be a non-clinical meeting. Attend one of the group’s meeting. The group can be for any type of substance or process addiction. It must be  a peer-led support group to help with the recovery from any addictive disorder. Ensure that the meeting is considered “open” prior to attending it.

Important Note:  The group must be attended in person. It is not appropriate to take notes while in the meeting, so please refrain and just take notes for yourself immediately after the meeting.

Write a two-part paper that summarizes your experience at the meeting. Be sure to include important concepts presented in the meeting while maintaining the privacy of all group participants. Include the following in your paper:

Part 1: Attending the Meeting

  • Attend a recovery support group meeting (include the name, time, and place of the meeting)
  • Describe the format of the meeting that you attended and provide details about the atmosphere or experience of being in the meeting.
  • Describe each of the following: Closed meeting, open meeting, steps, sponsor, and home group. Please note: These terms are specific to AA and NA.

Part 2: Individual Recovery Methods

  • Based on your observations during the meeting, identify the impact of a substance use disorder on an individual’s life problems based on the meeting attended.
  • List two examples of Participant Recovery Goals and the benefits of entering into the maintenance stage of recovery with these goals as identified in research.
  • Identify two specific actions a counselor can take during the therapy session and related follow-up that can help someone with a substance use disorder be successful.
  • List one specific example of how a counselor can help a client overcome self-defeating behaviors.
  • Include at least three scholarly resources in your paper.

Determine the impact of the company’s mission, vision, and primary stakeholders on its overall success as a competitive employer in the industry.

Research the company on its own website, the public filings on the Securities and Exchange Commission EDGAR database, the University’s online databases, the Nexis Uni database, and any other sources you can find. The annual report will often provide insights that can help address some of these questions.

You will do a 15-minute presentation to the Board of Directors of the corporation. Develop an eight- to twelve-slide PowerPoint presentation with speaker notes or record a video based upon Assignments 1 through 3. You may choose to compare your chosen corporation to a major competitor with whom you would like to work. You will make recommendations to the Board of Directors based upon your analysis and decision on why the corporation remains or is not a good fit for you.

Determine the impact of the company’s mission, vision, and primary stakeholders on its overall success as a competitive employer in the industry.

  • Create a SWOT analysis for the company to determine its major strengths, weaknesses, opportunities, and threats.
  • Based on the SWOT analysis, outline a strategy for the company to capitalize on its strengths and opportunities, and minimize its weaknesses and threats.
  • Discuss the various levels and types of strategies the firm may use to maximize its competitiveness and profitability.
  • Outline a communications plan the company could use to make the strategies you recommend above known to all stakeholders.
  • Assess efforts by this corporation to be a responsible (ethical) corporate citizen and determine the impact these efforts (or lack thereof) have on the company’s bottom line. Provide specific examples to support your response.
  • Develop an executive-level PowerPoint presentation with speaker notes and appropriate graphics or professional video.