1) Minimum 6 full pages(No words)
Part 1: minimum 3 pages (No words)
Part 2: minimum 3 pages(No words)
Submit 1 document per part
2)¨******APA norms (Mandatory)
All paragraphs must be narrative and cited in the text- each paragraphs
Bulleted responses are not accepted
Dont write in the first person
Dont copy and pase the questions.
Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph
3) It will be verified by Turnitin and SafeAssign
4) Minimum 8 references not older than 5 years
Minimum 4 references per part
5) ***************Identify your answer with the numbers, according to the question.
Example:
Q 1. Nursing is XXXXX
Q 2. Health is XXXX
6) You must name the files according to the part you are answering:
Example:
Part 1.doc
Part 2.doc
______________________________________________________________
Part 1:
Case Study:
Malpractice Action Brought by Yolanda Pinellas
Yolanda Pinellas is a 21-year-old female student studying to be a music conductor. She was admitted for chemotherapy. The medication Mitomycin was administered by intravenous infusion through an infusion pump.
During the evening shift the infusion pump began to beep. The RN found that the IV was dislodged and discontinued the infusion, notified the physician and provided care to the infusion site. The patient testified that a nurse came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done. The documentation in the medical record indicates that there was an infiltration to the IV.
Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The patient is alleging that because of this, she is no longer able to perform as a musical conductor.
The risk manager had noted when doing chart reviews over the last 3 months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings, and nights then coming back and working the evening shift. The risk manager also noted a pattern of using float nurses to several units.
Questions:
Using the information from the case study, discuss the following issues from the perspective of the APN Administrator role:
1) What were the standards of care that were violated?
2) Who was responsible for the violations?
In your role:
3) What risk management steps needs to be taken before or after the incident to alleviate the issue?
Part 2:
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 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:
Height: 68 inches; weight 134.5 kg
BP: 172/98, HR 88, RR 26
3 pitting edema bilateral feet and ankles
Fasting blood glucose: 146 mg/dL
Total cholesterol: 250 mg/dL
Triglycerides: 312 mg/dL
HDL: 30 mg/dL
Serum creatinine 1.8 mg/dL
BUN 32 mg/dl
Critical Thinking Essay
1) Describe the clinical manifestations present in Mr. C.
2) Describe the potential health risks for obesity that are of concern for Mr. C.
3) Discuss whether bariatric surgery is an appropriate intervention.
4) Assess each of Mr. C.’s functional health patterns using the information given.
5) Discuss at least five actual or potential problems 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.)
6) Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
7) Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
8) 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.
How to Solve 1) Minimum 6 full pages(No words) Part 1: minimum 3 pages (No words) Part 2: minimum 3 pages(No words) Submit 1 document per part 2)¨******APA norms (Mandatory) All paragraphs must be narrative and ci Nursing Assignment Help
Part 1:
1) The standards of care that were violated in this case are related to patient safety and quality of care. The registered nurse failed to maintain the correct positioning of the patient’s intravenous catheter, resulting in infiltration. The healthcare provider did not address the beeping of the infusion pump in a timely manner or reposition the catheter correctly. The documentation also was inaccurate and insufficient to depict the actual events that occurred.
2) The nurse, healthcare provider, and possibly the healthcare facility may be held culpable for the violations. The nurse failed to meet the accepted standards of care in positioning the catheter correctly, monitoring the infusion pump continuously, and responding to the alarms. The healthcare provider did not supervise the nurse correctly by neglecting to diagnose and treat the infiltration and discontinuing the medication. The healthcare facility may face liability for short staffing and would need to establish appropriate policies to monitor staffing.
3) In my role as an APN administrator, various steps can be taken to alleviate such issues. Risk management is an essential component of the role of a healthcare administrator, which involves establishing policies and procedures that promote patient safety and quality. This includes promoting staff training, reviewing medical records regularly to identify patterns that indicate quality issues, and ensuring adequate staffing levels. After the incident, the facility should conduct root cause analysis and make the necessary changes to prevent recurrence. Re-education of the staff regarding the facility’s policies and procedures, infusion therapy, monitoring infusion pumps, reducing shortcuts to decrease stressors, educating patients on the importance of reporting to administer urgent and registered health providers is crucial.
Part 2:
1) The clinical manifestations present in Mr. C. are obesity-related with complications such as sleep apnea, shortness of breath with activity, swollen ankles, and pruritus due to the edema in his lower extremities.
2) The potential health risks for obesity that are of concern for Mr. C. are hypertension, diabetes, dyslipidemia, and obstructive sleep apnea, which could result in cardiovascular disease, stroke, and other metabolic diseases.
3) Bariatric surgery could be an appropriate intervention in this case. Mr. C.’s BMI is above 40, making him an eligible candidate for bariatric procedures. He has already attempted dietary sodium restriction, which has not resulted in weight loss and poses many cardiovascular risks. Bariatric procedure revision can significantly affect weight, and considering his young age, can eventually enhance his quality of life.
4) Mr. C.’s functional health patterns are affected by the comorbidities of obesity. The patterns identified are sleep-rest, activity-exercise, and nutritional.
5) The actual or potential problems identified from the functional health patterns are inadequate sleep, limited physical activity, poor nutritional habits, obesity sleep apnea, and decreased cardiac function that might cause activity intolerance. Mr. C.’s cardiovascular system could be compromised due to poor nutritional habits and harmful lifestyle. It is necessary to monitor his health perception to facilitate successful lifestyle changes to avoid further health risks.
6) End-stage renal disease (ESRD) occurs when kidney function declines to less than 10% to 15%, resulting in significant waste and fluid retention in the body. The condition is categorized based on the degree of kidney function (glomerular filtration rate, GFR), which ranges from Stage 1-5. Causes of ESRD commonly relate to various illnesses like hypertension, diabetes, or recurrent urinary tract infections that cause chronic kidney disease with progressive renal decline and acute kidney injury that causes a sudden decline in the renal function.
7) Patient education is necessary to prevent future events, restore his health, and avoid future deterioration. Mr. C. can be taught about lifestyle modifications such as exercise, weight reduction, and implementing a healthier diet to promote renal health. He should also be taught about avoiding intake of sodium-rich foods and fluid restriction to manage his hypertension. Mr. C. must be advised to continue his follow-up appointments and medication regimen.
8) Available resources for ESRD patients for non-acute care include maintaining close communications with medical providers, case managers, social workers, rehabilitation therapists, and developmental specialists. The recommended multidisciplinary approach can be beneficial for ESRD patients, including registered dietician, pharmacist, and diabetic educator to support the patient’s best nutrition intake and glycemic control. The patient can visit the patient centered education websites, attend support groups, and communicate with other ESRD patients. Transportation plans may also be necessary for patients who have low vision or mobility issues or in need of wheelchair accessibility. They may also require home health services and personal care, equipment, and assistive devices.
