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USE THE PDSA CYCLE TO ADDRESS THE ISSUE OF PRESSURE ULCERS.,USE THE PDSA CYCLE TO ADDRESS THE ISSUE OF PRESSURE ULCERS.

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USE THE PDSA CYCLE TO ADDRESS THE ISSUE OF PRESSURE ULCERS.

Case

Frustrated with ongoing complaints from family members, Reba Sanders, the administrator of 100-bed Lakeview Skilled Care and Rehabilitation Facility, replaced the director of nursing (DON) after she had been on the job for less than 2 years. At the exit conference with Reba, the DON had remarked, “I don’t think pressure ulcers have been a problem in this facility the way it is made out to be by some families. Some patients develop the ulcers at the hospital before they come here; we try our best to take care of them, and I have explained to the families what we are doing. I think firing me is unfair, but it is your decision.” Before the new DON, James Osterwal, was hired for the job, Reba had mentioned to him that looking into the pressure ulcer problem would be his first priority. Reba arranged for James to attend meetings of the local chapter of a national quality improvement organization for nursing homes. Based on some of the information presented at the meetings, James quickly settled on making pressure ulcer elimination as his primary goal. James was quite familiar with the PDSA quality improvement cycle. He discussed it with the charge nurses, decided how data would be collected, and started a campaign asking all nursing staff to adopt the motto: “We will eliminate pressure ulcers at Lakeview.” The associates liked the motto because it gave them a specific goal to work toward. At James’ request, Reba approved hiring an RN nurse coordinator to float between the three shifts. The charge nurses asked their nursing assistants to report to them right away all cases of skin breakdown. James trained the nurses in best practice protocols to treat pressure ulcers. After 4 months, data showed little to no improvement in the prevalence (total number of cases) of pressure ulcers at Lakeview. Both Reba and James could not understand why.

Questions
1.  Based on what you have learned to this point in the course, evaluate the quality improvement program as it pertains to pressure ulcers at Lakeview. Provide a specific outline of weaknesses in the overall approach.

2.  Use the PDSA cycle to address the issue of pressure ulcers. Be specific. For example, how should data be collected? How would you go about identifying root causes of the problem? What interventions would you implement? What roles should the various personnel and the administrator have?

What is neurogenesis and where does it occur in the brain?

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Biology homework help

Continue your investigation of the effects of stress on brain function and behavior. Read more about the hippocampus, amygdala, and prefrontal cortex in these articles:

“How to Prevent Stress from Shrinking Your Brain,” in Psychology Today

“Stress Effects on Structure and Function of Hippocampus,” by the Rockefeller University

Answer the following questions in paragraph format to write an essay about the findings reported by these articles:

Introduction Paragraph:

First, do some research on how the amygdala, hippocampus, and prefrontal cortex communicate and result in normal behavioral response. You will begin your reading on the amygdala by following this link. After reading this section, click on several other structures in the brain at the end of the page to read about the interactions between these three regions. Briefly describe this pathway and the behavior that results from the interaction of these regions using the format and requirements outlined below.

Body Paragraph 1

Summarize the effects of glucocorticoids on the hippocampus and prefrontal cortex reported in the article How to Prevent Stress from Shrinking Your Brain.

Body Paragraphs 2 and 3

What effect on hippocampal cells have stress hormones had in recent studies described by Stress Effects on Structure and Function of Hippocampus? What effect have they had on the amygdala in studies? What are the implications of these effects? HINT: What are the functions of the regions and how might they be affected by changes in their structure?

Body Paragraph 4

What is neurogenesis and where does it occur in the brain? What effect on the regeneration of hippocampal cells is reported in this article? What is the mechanism?

Conclusion Paragraph 1

Summarize the effects of cortisol on this pathway by describing how PTSD can result from perpetuated cortisol release and how this can result in depression by activating and/or reinforcing depression pathways.

Conclusion Paragraph 2

Describe the methods proposed to counteract the negative effects of chronic stress in How to Prevent Stress from Shrinking Your Brain.

SLP Assignment Expectations

For this assignment, write an essay using the outline above. You are provided with many scholarly references to complete this assignment. Include a References section that lists these and any additional sources you used (refer to the Background page). For any additional research you are required to do to complete your assignment, please use scholarly references such as a peer-reviewed journal article or a government-sponsored or university-sponsored website. As you read through your sources, take notes from your sources and then write your paper in your own words, describing what you have learned from your research. Direct quotes should be limited and must be designated by quotation marks. Paraphrased ideas must give credit to the original author, for example (Murray, 2014). Direct copying from “homework help” websites will not receive credit.

An Ethical Dilemma in Nursing Homes

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An Ethical Dilemma in Nursing Homes

  • This week’s readings identify a number of broad based ethical dilemmas found in nursing homes. Choose one from the following list and write a 2-3 page paper that explains the dilemma. Include in your writing how you would approach the decision making process to resolve issues within the dilemma you chose.

 

  • Nursing Home Placement
  • Autonomy and Informed Consent
  • Making a Determination of Incapacity
  • Compliance & Everyday Interventions
  • Rehabilitation
  • Unreasonable Demands
  • RestraintsSupport your statements with evidence from the Required Studies and your research. Cite and reference your sources in APA style.

Ethics and the Law: Child Abuse Residential Course Assessment and Treatment.View the film and write a four-page paper discussing the presenting issues relevant to child abuse, including some discussion of presenting symptoms

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Ethics and the Law: Child Abuse Residential Course Assessment and Treatment.View the film and write a four-page paper discussing the presenting issues relevant to child abuse, including some discussion of presenting symptoms

Order Description

This Boy’s Life (1993)
View the film and write a four-page paper discussing the presenting issues relevant to child abuse, including some discussion of presenting symptoms, family dynamics, the role of outside institutions/agencies, the role of individuals outside the family who have an impact on the abused child’s life, and the role of resiliency and healing in the filmA. Content – Major elements of course content included as applicable. These might include assessment, intervention, treatment, cultural context, ethical and legal responsibilities, as well as your lived experiences relating to this topic.
?? Assessment 6 points
?? Intervention 6 points
?? Treatment 6 points
?? Cultural context 6 points
?? Law and ethics 6 points
?? Your lived experiences 6 points
Subtotal Possible Points: 36/_____
B. Organization – The introduction clearly provides background on the topic and previews major points; structure is clear, logical, and flows smoothly; narration and text support the central theme; conclusion follows logically from the body of the paper
Subtotal Possible Points: 10/_____
C. Synthesis and application – Student should demonstrate an understanding of how to move from course content to application in clinical practice.
Subtotal Possible Points: 10/_____
D. Writing Style – Papers must be typed, double-spaced, utilizing Pacifica/APA style guidelines and referencing format. Citations and reference page included.
?? Formatting (margins, title page, page numbers) 1
?? Citations in text 1
?? Reference page 1
?? Grammar and spelling 1
Subtotal Possible Points: 1

total 4/____

about this class :
Course Description
The objective of this course is to present a comprehensive overview of the ethics and laws regarding child abuse assessment, reporting responsibilities, and interventions pertaining to clinical practice. This course integrates an understanding of various cultures and the social and psychological implications of socioeconomic status as well as the principles of mental health recovery-oriented care and methods of service delivery in recovery-oriented practice environments.Students will:
1. Distinguish the definitions and manifestations of child abuse, including: neglect, emotional, physical, and sexual abuse.
2. Demonstrate competency in the skills necessary to identify and assess child abuse through acquiring knowledge of: physical and behavioral indicators, parental attitudes or behaviors, and multicultural differences.
3. Develop and demonstrate familiarity with immediate interventions, treatment strategies, treatment plans, and adjunctive services available to victims and families.
PACIFICA GRADUATE INSTITUTE M.A. Counseling Psychology Program
2
CP 525 Ethics and the Law: Child Abuse Residential Course Assessment and Treatment
Winter 2015 – M.A. C I, L I, D I, and W I Tracks 1.0 quarter units/10 quarter hours
4. Integrate an understanding of family systems, cultural diversity, and the psychosocial implications of socio-economic status in the treatment of child abuse.
5. Integrate an understanding of the principles of mental health recovery-oriented care and methods of service delivery in recovery-oriented practice environments.
6. Identify the legal responsibilities of the therapist according to the Child Abuse and Neglect Reporting Act, the law under which all issues regarding child abuse are addressed within legislation. [A number of Penal Codes address who needs to report and the guidelines for reporting specifically California Penal Code Sections 11164-11174.3. The Welfare and Institutions codes relevant for child abuse are WIC 300 subsections (a) through (j). The Welfare and Institutions Codes specify different kinds of child abuse. (physical, sexual, abandonment, etc.).
7. Determine the array of potential therapist issues such as countertransference and vicarious traumatization and how they might impact the therapeutic work.

 

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A patient experiencing immotile cilia syndrome should be frequently assessed by the nurse for which priority complication?

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A patient experiencing immotile cilia syndrome should be frequently assessed by the nurse for which priority complication?

Answers:

A. Epistaxis resulting from loss of cilia in the nasal passageway

B. Sterility caused by inability of the sperm to swim downstream

C. Bronchiectasis due to interferences with clearance of inhaled bacteria along the respiratory tract

D. Inability to hear soft sounds related to kinocilium on the hair cells in the inner ear

What is meant by sensory impairment, why is this a falls risk?

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What is meant by sensory impairment, why is this a falls risk?

ASSESSMENT B1 Short Answer Question

Questions/Tasks
1) What is meant by sensory impairment, why is this a falls risk?
2) How does incontinence affect risks for falls?
3) What is meant by gait? What are gait assistance devices?
4) How does moisture increase risks of pressure sores?
5) Why do we need an assessment tool for measuring pressure areas?
6) What information will you be required to provide for the patient and ensure is
documented in the case notes or treatment orders.
7) Define the term micturition?
8) What is CO?
9) Define what orthopnoea, dyspnoea and paroxysmal nocturnal dyspnoea?
10) What is the difference between oedema and pitting oedema?
11) What is a pleural effusion?
12) What is a pneumothorax and the clinical manifestations for this condition?
13) Define what a CT is and its purpose as a diagnostic tool
14) Dignity is what and why is this important to maintain when caring for an individual?
15) Provide a definition of what Maslow’s hierarchy of need is and why is this important to nursing?
16) What does MRI stand for?
17) What is a cerebral aneurysm?
18) What is a stroke and its clinical manifestations?
19) Provide and explanation of what a clipping an aneurysm is?
20) Provide an explanation of what a CABVG is and why this is performed?
21) Why when you have a L) sided hemisphere stroke is the R) side effected?
22) Discuss the underlying pathophysiology of asthma and its signs and symptoms
23) How is asthma managed
24) What is dopamine and where is it produced
25) What is a Thalotomy?
26) Identify the difference between the following –
L1 paraplegic
T6 paraplegic
C6 quadriplegic
C4 quadriplegic
27) What is a tonic clonic seizure and how is this managed?
28) What is a cholinergic drug and what are they used for?
29) Define what Picks disease is?
30) What is phlebitis and what causes this?
31) What are corticosteroids and what are they used for. Provide three examples of the
drugs used.
32) What is a barium enema and why is this test performed?
33) Provide an brief explanation of what a a referral is and why would these be arranged for a client
34) What effects would being diagnosed with uterine cancer have on a woman amd what would you do to support this client
35) In relation to the ANMC competencies what elements best reflect ensuring that we continually update our knowledge and have the interests of the client the forefront
when providing care?

SUGGESTED RESOURCES
Koutoukidis G , Stainton K and Hughson J 2013 Tabbner’s Nursing Care Theory and Practice 6th Ed., Elsevier, Australia
National Competency Standards for Enrolled Nurses
http://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/CodesGuidelines.aspx
Thibodeau G, Patton K 2014 The Human Body in Health and Disease 6th Edition, Elsevier, Canada

Category: Essay Writing

 

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Compare the literary description of the holocaust in Elie Wiesel’s Night with the cinematic portrayal of similar events in Steven Spielberg’s Schindler’s List. Be sure to cite specific passages from the text that support your interpretation with (last name of author, date, p. ).

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Compare the literary description of the holocaust in Elie Wiesel’s Night with the cinematic portrayal of similar events in Steven Spielberg’s Schindler’s List.
Be sure to cite specific passages from the text that support your interpretation with (last name of author, date, p. ).

Discussion: Compare the literary description of the holocaust in Elie Wiesel’s Night with the cinematic portrayal of similar events in Steven Spielberg’s Schindler’s List. Is literature or cinema more powerful in depicting the holocaust? Why? Cite specific scenes from the film and specific lines from the reading to support your claims. How do you think filmmaker Claude Lanzmann would answer this question? Why? What do you think Lanzmann would say about Wiesel’s book? Once you have a clear understanding of the issues about holocaust remembrance, you may want to apply the same reasoning to history in general. Is the holocaust unique in its ethics of remembrance, or does the same reasoning apply to all history? Is literature or cinema a more appropriate tool for depicting historical narratives?

Discussion for Week 4. Initial post of 350-400 words due Thursday, day 3, and at least three responses that will comprise another 400 words to total 800 words. That means each response to a peer needs to be a minimum of a paragraph to meet this requirement. You must post on four different days, which is a post a day. In your initial post, thread it as a response to my post. In addition, use textual evidence with proper citations whether from the textbook, articles, or novels.

 

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Why do hormones only affect certain cells in your body?

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Draw a flow diagram to show how hormones work. Refer to Cyclic AMP in your answer. Why do hormones only affect certain cells in your body? Refer to the structure of the cell membrane in your answer.

On an outline of a human body draw on and label the major glands of the endocrine system:

a) Pituitary gland

b) Hypothalamus

c) Thyroid and parathyroid gland

d) Pancreas

e) Adrenal medulla

f) Adrenal cortex

g) Gonads and placenta

h) Pineal

i) Gastrointestinal tract

You may wish to use a key system.

Explain elements that contribute to mental health.

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Nursing homework help

Case Study, Mohr

CHAPTER 1, Introduction to Psychiatric–Mental Health Nursing In completing the case study, students will be addressing the following learning objectives: Explain elements that contribute to mental health.

Review trends, problems, and goals related to the delivery of mental health care and treatment of mental illness.

1. Karen is a 25-year-old white woman who lives alone in an apartment with her dog. Karen has been divorced for 2 years and is taking Prozac prescribed by her psychiatrist for depression.  Karen and her boyfriend had been discussing marriage until he told her that he wanted to end their relationship.  Karen became even more depressed and could not work for a week.  Karen returned to work, refusing to discuss her issues with family, friends, or coworkers. She did, however, make an appointment to see a psychiatric nurse practitioner.  Karen told the nurse that she was making some changes in her life.  Karen said that she and a girlfriend were joining a gym program for workouts and a social group for young men and women.  Karen stated that she realizes that her former boyfriend had not been committed to her, and she anticipates meeting and dating other young men from the adult social group.  Karen also said that she thinks that the gym exercise will be beneficial to her mentally and physically.

Learning Objectives: 1, 4)

  • How will the psychiatric nurse assess if Karen has made progress toward self-realization?
  • Identify strengths that Karen has for progress in personal growth.

Karen has been seeking treatment for her depression. Analyze the factors that might contribute to Karen’s reluctance to discuss her depression with others.

Case Study, Mohr:  CHAPTER 2, Neuroscience: Biology and Behavior

In completing the case study, students will be addressing the following learning objectives:

Discuss neuroplasticity and how this concept relates to mental health and mental illness.

Briefly explain the importance of interaction between genes and environment, the role of endophenotypes, and the stress-diathesis model of psychiatric illness.

Assess your personal wellness and develop a plan to prevent personal and professional stress and burnout.

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Assess your personal wellness and develop a plan to prevent personal and professional stress and burnout.

In this assignment, you will assess your personal wellness and develop a plan to prevent personal and professional stress and burnout. The personal wellness plan should outline how you will practice physical, cognitive, emotional, and spiritual self-care throughout your duration in the clinical mental health counseling (CMHC) program and beyond. Personal counseling may be one part of a wellness plan. This program focuses on personal and professional growth and at times, you may recognize (or faculty may point out) the need for personal growth as you move through the program.

Click here to download the Self-Care Assessment Worksheet.

Tasks:

Evaluate your results of the Self-Care Assessment Worksheet.
Develop a personal wellness plan based on the results of your self-care assessment. Your plan should discuss the area in which you consider yourself most healthy and describe how you will improve your level of wellness in two areas.

 

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