COMMENT VANE

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 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 120-150 WORDS

 

What nursing interventions are appropriate for Mrs. J. at the time of her admission?

 

Patient is admitted with decompensated heart failure, with signs and symptoms of pulmonary edema from the poor output of the heart, arrhythmias specifically atrial fibrillation with rapid ventricular response (RVR). The nurses interventions at the time of admission should be a full assessment, blood work to check for electrolyte imbalance, infection, and etc, EKG and continuous tele monitoring to assess if the atrial fibrillation converts to sinus (paroxismal) or if she remains in a-fib (chronic), patient must be started on oxygen via nasal cannula, and she must be started on the medications stat. After being started on Lasix, nursing interventions should include monitoring for intake and output, safety is another intervention since the patient’s BP is low and she is in a-fib, she may experience dizziness and fall, therefore BP must be monitored and safety measures placed for patient. Patient should be positioned in high fowler’s to help with the breathing. 

 

What is the rationale for the administration of each of the following medications?

 

IV furosemide (Lasix)- This is a loop diuretic used to prevent or treat fluid retension in patients with heart failure, liver disease, and renal failure. In this case, the patient has crackles in the lungs, is complaining of shortness of breath, has edema and distended jugular veins, low blood pressure, and coughing, all signs of heart failure and pulmonary congestion secondary to left sided heart failure. 

Enalapril (Vasotec)-This is a ACE inhibitor (Angiotensin Converting Enzyme) which is used to treat hypertension and heart failure. It allows the ventricles to pump blood out of the heart. 

Metoprolol (Lopressor)-This is a beta blocker used for hypertension, heart failure, coronary artery disease, and arrhythmias. IN this case, the Metoprolol can help with the patient’s heart failure by allowing the heart to relax and lower the heart rate. Metoprolol is a vasodilator, it relaxes the blood vessels of the heart. Since the patient is in heart failure and afib, his heart is working harder to pump blood and its overworking the heart and weakening it, therefore Metoprolol is used to treat this. 

IV morphine sulphate (Morphine)-This is an opiate given to patients with angina and heart failure due to its effects on the sympathetic nervous system. The reduction of the sympathetic stimulation reduces heart rate, cardiac work, and myocardial oxygen consumption. In this scenario, the Morphine will be helpful in reducing the pateint’s anxiety, pain, heart rate, and will allow the heart to relax. 

 

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

 

 

Coronary artery disease (CAD)- The buildup of plaque/cholesterol in the arteries of the heart can diminsh blood flow to the heart and cause angina or heart attack if it is completely occluded. CAD can also cause HTN and in turn heart failure. CAD can be managed by controlling blood pressure, weight control, diabetes, hyperlipidemia, exercising, and if smoker, tobacco cessation. These will lower the chances of developing CAD. If patient is diagnosed with CAD, then they must be managed with blood thinners, statins, beta blockers, and ACE inhibitors. They should be counceled on low sodium diet, low fat/calorie diet, and exercise therapy. Sometimes, cardiac rehab is helpful for those with chornic angina and CAD. Making sure the patient is compliant with meds and their diabetes, cholesterol, and blood pressure are controlled will help prevent heart failure. 

 

Hypertrohic cardiomyopathy-Blood vessels in the heart that are damaged from drug use of ETOH use cause cause heart failure. The weakned heart muscle can result in HF. These patients must be monitored for arrhythmias because patients with dilated cardiomypathy commonly have ventricular arrhythmias and low EF and have SCD or syncope. Often, they will require an ICD implant to prevent SCD (Nguyen, V., 2017). To prevent heart failure, patients wiht CMP need medications to help strenthen the heart muscle or avoid worsening of CMP. These medications include ACE inhibitors, ARB’s, beta blockers, diuretics, nitrates, and more. Referring to cardiac rehab is important for these patients as well. 

 

Hypertension-The high pressure in the heart vessels causes the heart to overwork and eventually weaken causing heart failure. Patient education about low sodium diet, exercise, and medication compliance to control BP. Patients must be educated that if their BP is uncontrolled on meds, they need to seek medical attention. 

 

Myocardial Infarction-Heart attack results in diminished or no blood flow to the heart muscle, causing the muscle to “die” and makes it harder for the heart to pump blood (American Heart Association, 2017). Similar to CAD interventions, patients with MI require long term medical therapy. MI can result in ischemic cardiomyopathy and in turn heart failure. Patients with ICMP also require a ICD implant if the EF does not improve with meds. These patients need constant monitoring of blood pressure and more MI’s or coronary blockages. Paitents with previous MI’s or CAD need annual stress test to evaluate their EF and check for cardiac ischemia. If indicated, a left heart catheterization and PCI should be perfomed before another MI hits them leading to HF. 

 

 

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

 

Polypharmacy, or taking too many medications at the same time can have complications specially in the elderly population because they have poor mediation regimen, may be forgetful which can result in underdosing or overdosing of medications, may be taking herbal supplements at home that can interact with medications and cause adverse reactions (Woodruff, 2010). 

Nurses can help avoid this problem. 

1.Patient education about each medication, what it is taken for, what side effects to expect, what to avoid with this medication

2.Organize their pills. Give them a written copy of all of their meds and organize them into the time they should be taken and how many should be taken. For example, the paper can be divided into three parts (morning, lunch, night). Under each part, the names of the medications can be written so they know exactly what to take and when to take them and will prevent them from taking everything at the same time.

3. Teach them how to take their meds. For example, with food, with water, oral route, or injected. 

4.Discard old, expired, or discontinued medications. Keep all meds together in one place. 

 

References

 

American Heart Association. Causes of Heart Failure. 2017. Retrieved from 

http://www.heart.org/HEARTORG/Conditions/HeartFailure/CausesAndRisksForHeartFailure/Causes-of-Heart-Failure_UCM_477643_Article.jsp#.WZTzVcdlnL8

 

Nguyen, V. (2017). Dilated Cardiomyopathy Treatment and Management. Retrieved from emedicine.medscape.com

 

Woodruff, K. (2010). Preventing Polypharmacy in Older Adults. Retrieved from https://www.americannursetoday.com/preventing-polypharmacy-in-older-adults/

 

 

 

COMMENT EVE

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I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

The link between nurse education and patient outcomes was confirmed in 2011, when Aiken published a study in Medical Care that found that a 10 percent increase in the proportion of BSN-prepared nurses reduced the risk of death by 5 percent. In 2013, Aiken co-authored a study in Health Affairs that found that hospitals that hired more BSN-prepared nurses between 1999 and 2006 experienced greater declines in mortality than hospitals that did not add more BSN-prepared nurses. Patients in hospitals in which 60% of nurses had bachelor’s degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor’s degrees and nurses cared for an average of eight patients (Building the Case for More Highly Educated Nurses, 2017). There have been numerous studies that correlate higher education with better patient safety outcomes. However, studies like these do not account for other variables such as the number of patients each nurse had as mentioned above. In my personal experience, I have worked with many ADN prepared nurses and some LVNs that are outstanding nurses. The first code blue that I ever participated in was ran by an ADN nurse. She had many years of experience and it was amazing to watch her in action. She was calm and knew exactly what to do and how to lead the rest of the team. I believe that experience can in some way make up for lack of school education. However, I feel that even a nurse with years of experience must be willing to evolve with the health care system. Nursing is constantly changing due to evidence based practices and BSN nurses may have a better understanding of how to apply that to every day practice.

Building the Case for More Highly Educated Nurses. (2017, May 16). Retrieved September 17, 2017, from http://www.rwjf.org/en/library/articles-and-news/2014/04/building-the-case-for-more-highly-educated-nurses.html

 

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Tunesha Chambliss 

 

3 posts

 

Re:Topic 2 DQ 1

 

Emotional intelligence is the intersection of thinking and emotion. Skill building and training in positive thinking and a focus on positive emotions assist nurses to better listen, encourage, motivate, and create connections (Huber, 2014). Having self awareness simply means that you understand you. You have an awareness of what makes you tick as well as what makes your heart sing or sink.  When you know your strengths and weaknesses as a person, you can then start to understand why you feel the way you do and what makes you feel the way you feel. When you can learn to understand your own emotions, as well as how to control them, you can identify their impact to you and those in your team (Candy, 2016).  

 

I have a personal example of this from a current situation that I am facing on my job in which I am the program manager. In the last two months I have had two of my staff to move from our area.  Recently, one of the two Nurses I have left has decided to transfer to another clinic to “work less days”. She is fully aware that this will only leave our program with one nurse other than myself. This nurse shared this information to me openly in front other team members (Charge nurse, Social worker, dietician, secretary). It was so quiet you could hear a pin drop. I politely said ok, I want you to do what is going to make you happy and work for your family. Now the other team members didn’t take this news so calmly. What I have learned through the years from trial and error is that as the Leader I cannot allow my feelings to control my behavior. Deep down inside I wanted to scream because it takes 6 months for a new nurse to take call and train patients and I’m in school. To this day my staff are still not aware of how I really feel about the situation. As the leader of our program I could not afford to display the heart drop in my heart that I felt deep down inside because I didn’t want to envoke uneccessary anxiety on them. Surprisingly they have come to privately stating how surprised they were that  I was able to remain so calm after hearing that another nurse was leaving. Of course after hearing that I could only say “Thank you Lord” because that is an area that I have really had to seek God’s help with. 

 

 

 

Candy, L (2016). Emotional Intelligence Theory: Highlighting and Developing Leadership Skills. Retrieved 7/4/2017 from http://www.educational-business-articles.com/emotional-intelligence-theory/

 

Huber, D (2014). Leadership & Nursing Care Management, 5th Edition. Retrieved 7/4/2017 from https://pageburstls.elsevier.com/#/books/9781455740710/cfi/0!/4/2/2@0:51.6

 

 

 

 

 

P5

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

Katy Morris  

 

 

Mucormycosis is a rare infection caused by organisms that belong to a group of fungi (CDC, 2013). These fungi are typically found in the soil and in association with decaying organic matter, such as leaves, compost piles or rotten wood (CDC, 2013). The infection is more common among people with weakened immune systems, but it can occur, rarely, in people who are otherwise healthy (CDC, 2013). In the pulmonary or sinus form of infection, exposure occurs by inhaling fungal spores from the environment (CDC, 2013). Lung infection, or pulmonary mucormycosis, is pneumonia that gets worse quickly and may spread to the chest cavity, heart, and brain (CDC, 2013). Medical/nursing interventions that would be helpful in treating the patient include antifungal medications to slow or halt fungal spread (The New York Times, 2017). Amphotericin B, initially intravenous, is the usual drug of choice for antifungal treatment (The New York Times, 2017). In addition, placing the patient on supplemental oxygen would be helpful due to the patient having pneumonia and that causes it to be difficult to breathe. Laboratory values that are considered abnormal include the patients HCO3, PO4, fasting glucose, WBC, lymphocytes, pH, PaO2, PaCO2. Patients HCO3 is 29 and the normal value is 22-28. Patients PO4 is 2.9 and the normal value is 3.0-4.5. Patients fasting glucose is 138 and the normal value is less than 100. Patients WBC count is 15.2 and the normal value is 3,500-10,500. Patients lymphocytes are 10% and the normal value is 20-40%. Patients pH is 7.50 and the normal value is 7.35-7.45. Patients PaO2 is 59 and normal value is 75-100. Patients PaCO2 is 25 and normal value is 38-42. The abnormal ABG information means that the patient is in partially compensated respiratory alkalosis (McAuley, 2017). The patient has increased WBC count due to infection of the pneumonia. Patients lymphocytes are decreased due to an infection. The increased fasting blood glucose levels means that the patient is more susceptible to infection, in this case making the patient susceptible to pneumonia. Medications that are likely to be prescribed by the physician could be Amphotericin B-an antifungal medication to slow or halt fungal spread, Insulin due to an increased blood glucose level, and Prednisone to help with inflammation and improve breathing. Treatments likely to be prescribed by the physician could be Nebulizer breathing treatments to help improve breathing, supplemental O2 to improve breathing and increase oxygen saturation, and IV fluids to help ensure the patient is hydrated because if the patient becomes dehydrated more issues could arise.

 

P2

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Karan Kortlander 

 

1 posts

 

Re:Topic 1 DQ 1

 

The nursing shortage is not stopping.  Registered nurses are near the top of the list when it comes to employment growth (BLS 2012 Table 8 – RNs are #4). Additionally:

 

  • Over the past decade, the average age of employed RNs has increased by nearly two years, from 42.7 years in 2000 to 44.6 years in 2010.
  • America is seeing vast increases in the number of people over 65. This age group has many medical and health needs, and will put a strain on our health system.
  • Recent reforms in healthcare will give millions of people access to the healthcare system. More nurses and health professionals are needed in response.

 

These factors, combined with an anticipated strengthening of the economy, will create a renewed critical shortage for nurses.

 

According to the Nursing World, while nursing shortage affords opportunity, there are negative effects to the nursing shortage.  Nurses often need to work long hours under stressful conditions, which can result in fatigue, injury, and job dissatisfaction. Nurses suffering in these environments are more prone to making mistakes and medical errors. Patient quality can suffer. For these reasons, and more, ANA is dedicated to improving the workplace safety for nurses around the nation. 

 

Nursing Shortage Legislation and Strategies ANA lobbies both houses of congress, as well as the federal agencies, on policies and legislation to bolster the number of RNs and nurse faculty. 

 

 

 

Retrieved from http://www.nursingworld.org/nursingshortage

 

 

 

 

 

COMMENT KAREN

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I NEED A POSITIVE COMMENT BASED IThe Patient Protection and Affordable Care Act (PPACA) was signed into law in 2010; it has and will continue to have a dynamic impact upon the nursing profession. The PPACA has introduced many provisions applicable to nursing, but this discussion will focus on education and nurse-managed health clinics.
          The Institute of Medicine (IOM) recognizes that healthcare has become increasingly complex, intensive, and technical, and that nurses are given greater responsibilities. Consequently, it is imperative that nurses achieve advanced levels of training and education. In response to this need, the PPACA has increased the loan amount for nurses education to $17,000 and has also expanded the funding allotted to graduate nursing students for clinical education. It should be noted that although the cost of education has risen dramatically, the federal loan amounts have not been changed for over a decade. The government has authorized $338 million to develop programs that include advanced education grants for nurses. Furthermore, the Health Resources and Service Administration (HRSA) provides support programs for RNs who are pursuing careers as Advanced Practice Nurses.
          In the US today, we are currently experiencing a physician shortage problem (Stokowski, 2010); very often patients must wait over one month to see a specialist. On the contrary, Nurse Practitioner (NP) candidates and programs are increasing. The good news is that the PPACA is not only granting funds for NP training, but also for nurse-managed health clinics.  In 2014, HRSA estimated that nearly 60 million persons had limited access to healthcare. In 2013, Health Affairs published the results of a study conducted by the RAND Corporation; the committee recommended that nurse-managed care centers could relieve the current pressures experienced by the primary care staff.
          Because of the recommended provisions, educational opportunities for nurses will be less costly and burdensome. For example, at the hospital where I am employed, the tuition reimbursement amount has risen. Nurses will be more likely to pursue advanced degrees, and when they do achieve their goals, facilities will be available where they can practice advanced skills.
 
American Nurses Association, (2014). Health care reform. Retrieved from
          www.nursingworld.org
Health care reform law begins to have effect on nursing (2011). Retrieved from
          http://www.rwif.org/en/library
Hertel, R. (2011). Health care reform & issues in nursing. Matters.(2011).
Stokowski, L. (2010). Healthcare reform and nurses: challenges and opportunities.
          Retrieved from http://www.medscape.com
National Nursing Centers Consortium. Nurse-managed health clinics.N THIS ARGUMENT..BETWEEN 100-120 WORDS

The Patient Protection and Affordable Care Act (PPACA) was signed into law in 2010; it has and will continue to have a dynamic impact upon the nursing profession. The PPACA has introduced many provisions applicable to nursing, but this discussion will focus on education and nurse-managed health clinics.

          The Institute of Medicine (IOM) recognizes that healthcare has become increasingly complex, intensive, and technical, and that nurses are given greater responsibilities. Consequently, it is imperative that nurses achieve advanced levels of training and education. In response to this need, the PPACA has increased the loan amount for nurses education to $17,000 and has also expanded the funding allotted to graduate nursing students for clinical education. It should be noted that although the cost of education has risen dramatically, the federal loan amounts have not been changed for over a decade. The government has authorized $338 million to develop programs that include advanced education grants for nurses. Furthermore, the Health Resources and Service Administration (HRSA) provides support programs for RNs who are pursuing careers as Advanced Practice Nurses.

          In the US today, we are currently experiencing a physician shortage problem (Stokowski, 2010); very often patients must wait over one month to see a specialist. On the contrary, Nurse Practitioner (NP) candidates and programs are increasing. The good news is that the PPACA is not only granting funds for NP training, but also for nurse-managed health clinics.  In 2014, HRSA estimated that nearly 60 million persons had limited access to healthcare. In 2013, Health Affairs published the results of a study conducted by the RAND Corporation; the committee recommended that nurse-managed care centers could relieve the current pressures experienced by the primary care staff.

          Because of the recommended provisions, educational opportunities for nurses will be less costly and burdensome. For example, at the hospital where I am employed, the tuition reimbursement amount has risen. Nurses will be more likely to pursue advanced degrees, and when they do achieve their goals, facilities will be available where they can practice advanced skills.

 

American Nurses Association, (2014). Health care reform. Retrieved from

          www.nursingworld.org

Health care reform law begins to have effect on nursing (2011). Retrieved from

          http://www.rwif.org/en/library

Hertel, R. (2011). Health care reform & issues in nursing. Matters.(2011).

Stokowski, L. (2010). Healthcare reform and nurses: challenges and opportunities.

          Retrieved from http://www.medscape.com

National Nursing Centers Consortium. Nurse-managed health clinics.

COMMENT KAREN

/in /by

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS

Current statistics show that at present, there are 1,048 Associate Degree Nursing (ADN) colleges and 696 Baccalaureate Degree Nursing (BSN) institutions in the United States (Cherry & Jacob, 2017). Recent studies show that a correlation exists between patient safety outcomes and whether a nurse has an ADN or BSN. Linda Aiken, PhD, RN, who is associated with the Robert Wood Johnson Foundation (RWFJ), believes that hospitals who employ more BSN-prepared nurses have better patient outcomes and lower mortality rates (RWJF, 2014).

          In 2003, Aikens reported on studies done in Pennsylvania hospitals showing a 5% decrease in patient deaths at hospitals that staffed a 10% increase in BSN-prepared nurses (RWJF, 2014). Challengers of Aikens note that these studies raise further questions (Sentinel Watch, 2014). For example, what were the actual causes of death of these patients, and were they related to the action of an ADN nurse? Could there be other factors or causal relationships that affected patient care in these circumstances?

          In defense of Aikens, the Sentinel (2014) states that no one is calling ADN nurses “bad nurses”. In fact, errors, infections, and adverse events are often due to process and system problems. Aikens maintains that by promoting evidence-based practice and leadership, the BSN curriculum will better prepare nurses to correct problems and implement solutions.

          I agree that it is advantageous for nurses to expand their knowledge by obtaining a BSN degree, but I do not feel that deaths and adverse outcomes are the result if ADNs care, or lack of. Many other factors need to be considered. For example, poor staffing, long shifts, poor communication, fatigue, documentation errors, etc. affect everyone no matter what type of degree they hold. I have been at the hospital where I am currently employed for almost 20 years and have seen no evidence that the care given by ADNs is substandard to the care given by BSN-prepared nurses.

References

Cherry, B. & Jacob, S. (2017).Contemporary nursing, issues, trends, & management. St. Louis: Elsevier

Robert Wood Johnson Foundation. (2014).  Building the case for more highly

          educated nurses. Retrieved from http://www.rwjf.org/en/library/articles

The Sentinel Watch. (2014). How does your nursing degree affect patient

          mortality rates? Retrieved from http://www.american sentinel.edu 

Statics help

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Please use the data, StatCrunch, and your knowledge of statistics to answer the questions below.. Download the provided CDC data into StatCrunch (located at the bottom of these directions). You will utilize this data in weeks 3 and 8 for your Healthcare Applications Assignment. 

Part I

  1. Calculate the correlation coefficient between each of the independent variables and the variable—diabetes. What does this value tell us about the relationship between each of the independent variables and diabetes?
  2. Run a regression using diabetes as the dependent variable and smoking as the independent variable.
    • Is there a statistically significant relationship between poverty rates and diabetes? (Use the T-stat or P-value.) Explain.
    • Write out the regression line calculated using the data.
    • Interpret b1 (the slope coefficient).
    • Suppose a state raises the tobacco tax and the rate of smoking in the state falls from 21% to 18%. What would the decrease be in the rate of diabetes based on the regression results?

Part II

Suppose you work for a local hospital. Your manager requests that you use the CDC data on diabetes and smoking, obesity rate, physical activity, and poverty rate to present a compelling argument to the board regarding the importance of creating state initiatives to reduce diabetes rates. You must present statistical data in a written report to the board. Write an APA formatted paper, double spaced, 2-4 pages in length, with a cover page and references page addressing the following:

  • Include a minimum of four types of statistical tests to make your case. Examples include hypothesis tests, confidence intervals, correlations, regressions, etc. You may use statistical tests that you have completed in weeks 3 and 8 or develop your own.
  • Include a minimum of three graphs with your report. Examples include scatter plots, histograms, regression lines, box-plots, etc. You may use graphs that you have completed in weeks 3 and 8 or develop your own.
  • Write an essay using these statistics and graphs to make a convincing argument for the need to create an initiative to reduce the rate of diabetes.  In your essay, explain the relationship between diabetes and obesity, smoking, physical activity, and poverty rates utilizing statistical data, tests, and graphs. Be sure to explain your results and how these results show there is a need to create an initiative to reduce the diabetes rates. 

p6

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Ashley Pittman 

 

1 posts

 

Re:Topic 1 Mandatory Discussion Question

 

Ms G. presents to the ED with cellulitis of the LLL.  She reports no improvement since applying heat for several days.  Miss G. also reports increased pain and has developed chills suggesting that she has a fever.  Assessment findings show an open wound on her LLL with drainage present and swelling of >3 cm in comparison to her RLL.  She has a temperature of 102.2 F and wound cultures are positive for Staph aureus.  Lab values show an elevated WBC with > 10% bands and 80% L shift in neutrophils.

 

My recommendation would be IVF, Abx, A1C, CMP, complete set of VS, head to toe assessment, CBG ac/hs (insulin if needed).  Miss G. would also benefit from evaluation by OT and PT as well as meeting with a Diabetic Educator.  Social work would also be beneficial as she lives alone and may have greater needs than we are aware of.  Imaging of the LLL can tell us if she is experiencing DVT or if there is damage beyond what we can see. 

 

It is essential that we treat the existing infection so that she can return to baseline, and it is equally important that we assess her knowledge of Diabetes as uncontrolled diabetes can have a serious impact on wound healing. 

 

Muscle groups that are likely to be affected by Miss G.’s infection include gastrocnemius, soleus, extensor hallucis longus, extensor digitorum longus, fibularis longus, vastus medialis, rectus femoris, and extensor hallucis brevis (ARC Resource Center, nd).

 

The data presented paints a picture of where Miss G may need assistance and/or education.  She needs to be evaluated on her understanding of Diabetes and management of the disease.  Many complications come from diabetes including delayed wound healing.  She will need labs drawn over the course of her stay to evaluate the effectiveness of the abx.  An A1C will tell us if Miss G manages her Diabetes well over time.  Evaluation by PT and OT are important for safe discharge home as she lives alone and was not able to perform ADLs independently upon admission.  She will need to follow up with her PCP after discharge to have the wound on her leg looked at. 

 

As mentioned above, delayed wound healing can be caused by diabetes and also poor nutrition. Miss G may also suffer from depression as she is managing a chronic condition and living alone; depression has also been linked to delayed wound healing. 

 

“The moment a person with diabetes suffers a break in the skin of their foot, they become at danger for amputation. Most commonly, patients have neuropathy, which could be causative. When coupled with an impaired ability to fight infection, these patients become largely unable to mount an adequate inflammatory response. Thus, the DFU that may look like a healing wound becomes a portal for infection that can lead to sepsis and require limb amputation” (Journal of Investigation, 2007).

 

 

 

 

 

comment stephanie

/in /by

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT.BETWEEN 100-120WORDS

Discuss how two of the provisions related to nursing outlined by the ANA have impacted, or will impact, your current practice of nursing.

In regards to the Advanced Practice Registered Nurses (APRNs) provision, where they are proven providers of high quality and cost effective primary care (Health Care, 2010). This provision has and will continue to impact my current practice of nursing by having APRN available within the hospital or a phone call away to collaborate and assist with getting the necessary treatments needed for a patient. In surgery, our main cardiovascular surgeon, has a APRN that rounds on all his patients, initially sees consults in the hospital that are called into him, and then relays the status of the patient to him, and if surgery is needed, she makes sure the appropriate orders are placed, which in turn helps us in surgery immensely. She is available if we have questions regarding one of the patients or we see a particular test isn’t done, she can check on it or verify it. Having a dedicated and capable APRN in this case, allows for the surgeon to be able to devote more of his time with surgery and other duties necessary and relieves some of the burden from him, which in the long run, benefits the patient.

The second provision outlined by the ANA, which will impact my current practice, is the nurse education, practice, and retention provision. The section 5309, added 2 new grant programs specifically aimed at nurse retention. The first grant program would award grants to accredited nursing schools or health facilities to promote career advancement among nurses (Health Care, 2010). And the second grant program would award nursing schools and health facilities for exhibiting enhanced collaboration and communication among nurses and other health care professionals (Health Care, 2010). I think this provision would impact my nursing practice by first encouraging career advancement among nurses provides nurses with a goal or a commitment and gives them purpose. I think up until now in my practice I felt that I really had no purpose, with incentives to promote nurses and make them a vital part of the health care team provides worth to the health facility’s staff, therefore they strive to be the best they can be. I think this also contributes to nurse retention, as well, which in the long run helps with staffing and also helps the hospital to save money. And secondly, by encouraging enhanced collaboration and communication among nurses and other health care professions helps to provide quality continuum of care to patients and supports a team-approach to patient care, and a valued member of the health profession.  

Reference:

Health Care Reform, Key Provisions Related to Nursing. (2010). Retrieved September 11, 2017, from http://www.rnaction.org/site/DocServer/KeyProvisions_Nursing-PublicLaw.pdf?docID=1241&verID=1

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