NR 500 Week 6: Systems-Structure and Function

Nurse informatics possess diverse skills and expertise that spread across a wide range of sub-specialties. Nurse informatics skills are essential in systems development and implementation, clinical...

NRS-493 Capstone Change Project Resources Solved Assessment Description

The implementation of the capstone change project in the nursing home will require a host of resources; both human and material resources that include financial. The intervention is about implement...

How the Project and Objectives Advocate for Autonomy and Social Justice for Individuals and Diverse Populations

NRS-493 Capstone Change Project Resources Solved Assessment Description

Topic 1 DQ 1: Society for Human Resource Management The Role of HR in Developing HR-Mindedness

What two elements do you believe play the most significant role in sustaining change and why? Topic 8 DQ 1

What two elements do you believe play the most significant role in sustaining change and why?

Topic 8 DQ 1

What formal and informal onboarding or assimilation processes exist in your organization or an organization with which you are familiar? Topic 4 DQ 2

Part 5 The patient was discharged to her home, but 3 months after discharge was admitted to hospice service. She is no longer able to swallow her tablets and requires them to be crushed. The hospice nurse requests your advice on an equivalent regimen using transdermal fentanyl and oxycodone for breakthrough pain. Pain Assessment: 8 out of 10 Current Meds: Metoprolol succinate ER 50 mg daily; rivaroxaban 20 mg daily; levothyroxine 150 mcg daily; polyethylene glycol 3350 17 g daily; lisinopril 2.5 mg daily; amiodarone 200 mg daily; diclofenac transdermal gel 1% to neck and left shoulder four times daily; morphine sulfate ER 30 mg twice daily; mirtazapine 15 mg at bedtime. • What additional recommendations would you have at this time regarding pain management? • Are there any other therapeutic issues that should be addressed?

My experience with hospice services is that it is considered to be comfort measures. Converting her current dose of morphine ER 30mg BID would yield a Fentanyl 25mcg patch Q3 days. For breakthrough...

Part 4 The patient has been at the skilled nursing facility for 2 weeks and is making progress toward rehabilitation goals; however, during a follow-up appointment to her surgeon, she learned that she has metastatic ovarian cancer. She states that she has not been sleeping well and has lost 7 lb (3.2 kg) since admission. She also states that she hates waiting for her pain pills and requests something longer acting. Pain Assessment: 8 out of 10 Current Meds: Metoprolol succinate ER 50 mg daily; rivaroxaban 20 mg daily; levothyroxine 150 mcg daily; polyethylene glycol 3350 17 g daily; lisinopril 2.5 mg daily; amiodarone 200 mg daily; sertraline 50 mg daily; diclofenac transdermal gel 1% to neck and left shoulder four times daily; hydrocodone/acetaminophen 10/325 mg every 4 hours as needed for pain (uses 6 doses per day). • What additional recommendations would you have at this time regarding pain management? • Are there any other therapeutic issues that should be addressed? _____________

Part 4 Her pain is not being adequately controlled with the hydrocodone and now she has a new diagnosis of metastatic ovarian cancer and sleep disturbances. I would not recommend a sedative-hypnoti...

Current Meds: Metoprolol succinate ER 50 mg daily; rivaroxaban 20 mg daily; levothyroxine 150 mcg daily; polyethylene glycol 3350 17 g daily; lisinopril 2.5 mg daily; amiodarone 200 mg daily; sertraline 50 mg daily, hydrocodone/acetaminophen 10/325 mg every 6 hours as needed for pain. Pain Assessment: Patient reports pain of 7 out of 10; worse with movement. She complains of pain "everywhere, but my shoulder is really bothering me.". Physical therapy notes indicate patient is unable to complete therapy goals due to complaints of pain in her shoulder. • Based on this information, what would you recommend to optimize pain control? • Prescribers play a critical role in prescription drug misuse and abuse prevention. What steps can be taken to identify signs of dependence and abuse and what education can you provide to the patient regarding the negative effects of medication misuse?

Part 3 This patient is complaining of shoulder pain after surgery. This would indicate to me that she had a laparoscopic procedure. The most common issues with laparoscopic surgeries are referred p...

Part 2 Following surgery, she was placed on morphine patient-controlled analgesia (PCA). She has been using 27 mg of morphine/24 hours with adequate pain control; however, she has developed redness and itching on her neck that is believed to be due to the morphine. Current Meds: Morphine PCA; metoprolol succinate ER 50 mg daily; rivaroxaban 20 mg daily; levothyroxine 150 mcg daily; polyethylene glycol 3350 17 g daily; lisinopril 2.5 mg daily; amiodarone 200 mg daily; sertraline 50 mg daily. She will be discharged to a skilled nursing facility for rehabilitation therapy. You would like to convert her to a combination preparation of hydrocodone / APAP. • What dosing regimen would you suggest? • Recommend a monitoring plan for this patient. • How would you assess pain response? • The patient is concerned about the redness and itching that he developed while on morphine. Would you document this as an allergic reaction? • What other interventions or education may be necessary at this time?

Part 2 After the surgery she was placed on a patient-controlled analgesia (PCA) pump because there were most likely concerns of swallowing issues which could lead to aspiration, especially in the e...

Part 1 HPI: A 72-year-old woman with a tumor of the right fallopian tube is to undergo surgery to remove the tumor. PMH: Hypothyroidism for 40 years; hypertension for 20 years; atrial fibrillation for 5 years; depression for 2 years. FH: Mother had osteoporosis; father had diabetes SH: Lives with husband; has four grown children Meds: Metoprolol succinate ER 50 mg daily; rivaroxaban 20 mg daily; levothyroxine 150 mcg daily; polyethylene glycol 3350 17 g daily; lisinopril 2.5 mg daily; amiodarone 200 mg daily; sertraline 50 mg daily Pain Assessment: Patient rates pain as 4 on a scale of 0 to 10 • Based on the type of injury, what type of pain is this patient likely to experience? • What type of pain management regimen would you recommend in the postoperative period? Explain your answer.

Opioid Case Discussion Part 1 Currently this 72-year-old woman is having pain rated as a 4 on a scale from 0 to 10. Her current medication list does not include any pain medications. “The Ame...

Part 1: HPI: A 78-year-old man who is to undergo a left above the knee amputation due to a limb abscess Based on the type of injury, what type of pain is this patient likely to experience?

JM is a 42 year old female who was referred for management of insomnia. She reports that she is unable to sleep at all during the week (difficulty going to sleep and staying asleep) and sleeps all day on Sunday. She currently takes temazepam (Restoril) 30 mg HS (recently increased from 15mg). She also experiences depression due to an abusive relationship with her boyfriend as well as her current lack of employment. She reports poor sleep hygiene (reads and watches TV in bed), drinks 6-8 cups of coffee throughout the day and does not pay attention to how late she eats or exercises. What non-pharmacological and pharmacological therapies would you recommend for JM?

JM is a 42 year old female who was referred for management of insomnia. She reports that she is unable to sleep at all during the week (difficulty going to sleep and staying asleep) and sleeps all ...

KT is a 24 year old female completing her studies. While home for spring break, she presents to her primary care physician because she has been worried about her academic, professional, and personal future since class restarted in late August. She is constantly worried about passing all of her exams and that she is going to be the only one of her friends that graduates school without a ring on her finger. How would you help her assuming she meets the criteria for GAD? WD is a 49-year-old male who suffered a myocardial infarction one week ago. Upon discharge, it was noted that WD appeared depressed. At a follow-up visit with his physician a week later, WD met criteria for a diagnosis of major depressive disorder. His past medical history includes: treatment refractory hypertension, diabetes mellitus (type II), and severe uncontrolled narrow angle glaucoma How would you help him assuming he meets the criteria for MDD?

LW is a 32 year old female patient who comes to your medical clinic for primary care. She has been on hormonal contraceptives for years, although she’s just been married and has stopped her pills in hopes of becoming pregnant. Her PMHx includes obesity, HTN (diagnosed 3 years ago), familial hypercholesterolemia, and PCOS. Her current medications are as follows: Metformin 2000 mg PO daily, Lisinopril 10 mg PO daily, rosuvastatin 5 mg PO daily, and a multivitamin. GD is an 82-year-old patient is taking 2 mg of terazosin for BPH every morning. He comes in complaining of dizziness, generalized muscle weakness and persistent lower urinary tract symptoms (LUTS). How should you advise these patients and manage their medications? What was the process you went through to assess the current medications and to recommend an updated regimen?

LW is a 32 year old female patient who comes to your medical clinic for primary care.  She has been on hormonal contraceptives for years, although she’s just been married and has stopped...

SubmitThere are hundreds of opioid conversion calculators available online, though they are not all of good quality. I would like to direct you to one of the opioid conversion calculators that I find to be most useful and evidence based. Locatehttp://opioidcalculator.practicalpainmanagement.com/and evaluate the following case using the calculator as necessary. Discuss your approach to the overall case and results of your calculation.  A 79 year old white male is taking hydrocodone/APAP 10/325 for lower back pain (pt diagnosed with degenerative disc disease several months ago). The physician had written a prescription forVicodin® 10/325 1 or 2 tablets Q4-6h prn pain with a quantity of 120. Her expectation was that this would last the patient for one month. The patient is now requesting refills about every 10-14 days. He states he has been taking 2 tabs Q4h (12 tablets per day) because "the pain is so bad I just can't stand it!". He also tells the provider he is "constipated so bad it s

There are hundreds of opioid conversion calculators available online, though they are not all of good quality. I would like to direct you to one of the opioid conversion calculators that I find to ...

Essay on Growth Marketing Plan for a High-Growth Alternative Protein Startup Quorn (Business and Entrepreneurship)

Introduction

This exposition will give a complete Internet and Social Media Marketing Plan for a mycoprotein-based meat substitute, Quorn. The arrangement would distinguish the objective ...

Essay on Impacts of Online Shopping on the Clothes Retailers in the UK

Online shopping in United Kingdom, has been increasing gradually since the 19th century. Due to the shopping formats of consumers, the clothes retailers in America, have been forced by technol...

Research on Effect of Gambling on the Premier League and Its Viewers

Abstract

The British Premier League and Championship form the world’s most well-attended soccer leagues, that are accompanied by different experiences such as gam...