Category: Nursing

  • Assessing the Problem: Leadership, Collaboration, Communicat…

    In a 5-7 page written assessment, define the patient, family, or population health problem that will be the focus of your capstone project. Assess the problem from a leadership, collaboration, communication, change management, and policy perspective. Plan to spend approximately two direct practicum hours meeting with a patient, family, or group of your choice to explore the problem and, if desired, consulting with subject matter and industry experts.
  • Anatomy and Physiology and music appreciation

    150 words each 1. Research and share a bone related disorder/disease. Include specifics regarding the target cells affected and available treatments. 2. The rise of purely instrumental music during the late Baroque period illustrates that the structural elements of Baroque music became developed enough so that they alone could create a viable musical statement without the need for text or voices. What does instrumental music use in place of text to create a sense of meaning? Include the reading and listening examples in your response.
  • Emerging Technologies Paper

    Follow these guidelines when completing each component of the assignment. Contact your course faculty if you have questions.

    General Instructions

    Visit the

    .

    1. Select an article or white paper published on the HIMSS Healthcare IT News homepage within the past 6 months related to artificial intelligence or precision medicine. News articles and editorials may be used to find an example of an emerging technology and must be appropriately cited. News articles are typically editorials and blogs, which do not meet the standards for acceptable scholarly sources. Please review the
    2. .
    3. Download the
    4. . Use of the template is required. If the template is not used, a 10% deduction will be applied. See the rubric. Save the template and include your name in the file name.
    5. Write 1000 1500 words (excluding title and reference pages).
    6. Use APA in-text citations and complete references to support your writing.
    7. Follow APA current edition rules for grammar, spelling, word usage, and punctuation consistent with formal, scholarly writing.
    8. Abide by Chamberlain University’s academic integrity policy.

    Include the following sections (detailed criteria listed below and in the grading rubric):

    1. Article Selection
    2. Select an article or white paper published on the HIMSS Healthcare IT News homepage within the past 6 months related to artificial intelligence or precision medicine.
    3. Article Summary
    4. Provide a clear summary of the article.
    5. Identify and define the emerging technology described in the article.
    6. Provide an in-text citation from one scholarly source to support your writing.
    7. Example of Technology
    8. Describe your intended area of practice.
    9. Provide an example of how the emerging technology could be used in your future area of nursing practice.
    10. Provide an in-text citation from one scholarly source to support your writing.
    11. Ethical, Legal, and Safety Issues
    12. Describe at least one legal issue related to the emerging technology.
    13. Describe at least one ethical concern related to the emerging technology.
    14. Describe at least one client safety concern related to the emerging technology.
    15. Provide an in-text citation from one scholarly source to support your writing.
    16. Mitigating Strategies
    17. Describe a mitigating strategy for the identified legal issue related to the emerging technology.
    18. Describe a mitigating strategy for the identified ethical concern related to the emerging technology.
    19. Describe a mitigating strategy for the identified client safety concern related to the emerging technology.
    20. Provide an in-text citation from one scholarly source to support your writing.
    21. Reflection
    22. Identify whether you support the use of the technology in healthcare.
    23. Provide a rationale for why or why not.
    24. Reflect on how the knowledge will improve your effectiveness as an advanced practice nurse.

    Submitting Work to Turnitin

    This assignment will be uploaded automatically to Turnitin upon submission to verify this is your original work. The directions to submit your assignment are:

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    4. Click Submit Assignment.
    5. Your Turnitin report will be visible in the Assignment Details or Grades section of your course.
  • STAFFING PLAN

    Staffing Plan Assignment – 2026

    Develop a Staffing Plan for a New Department of Service

    This week, you will develop a Staffing Plan Outline for a new service or department you will be starting. It might be a new nursing unit within the hospital that you plan to open or a new service line. you will continue this project by developing a Business Plan for this same department or service.

    Provide a detailed description of the staffing plan and how you arrived at your projections.

    Include the following in the plan:

    Introduction (self)

    Description of your new service or department

    Literature Review (Evidence-Based Practice)

    Impact on Nursing Care- how will this new service benefit nursing care and place the needs of the patient as the center of nursing care?

    Staffing Plan for the new department and how you arrived at this plan. Identify and include staffing projections for the new department, listed by number and type of staff.

    Financial Considerations for Staffing Plan- how much will each of the staff members receive as compensation? How does this fit into your overall cost projections for your new service? Remember to include the costs required for training new staff members.

    Ethical Considerations

    Conclusion/Summary (Evaluation)

    Utilize peer-reviewed literature as references for your projections in APA format.

    Ideas for a new service:

    Open a new nursing unit within a hospital.

    Area of work: Urban Hospital treating substance use disorders.

    Reference: Financial management for Nurse managers and executives. Finkler & Mose.

  • Proposed population-based intervention for low income in Har…

    Proposed population-based intervention for low income in Harris County, Texas

    Introduction

    Despite advancements in both medical technology and service delivery within the

    U.S., many communities continue to have difficulty accessing healthcare services. For

    individuals who live below the poverty line, financial burdens, lack of transportation, and

    limited access to primary care often lead to delayed treatments and the development of

    preventable health conditions. These barriers can be seen on a community level, where there

    are numerous factors relating to the social environment that impact the overall health

    outcomes of individuals. Nurses involved with population health and community-based

    practice must understand how social determinants impact access to care for those they serve.

    This paper will explore low-income adults residing within the region of Harris County, Texas,

    with an emphasis placed upon identifying limited access to healthcare as a significant social

    determinant affecting overall health status. The goal of this paper is to assess the needs of the

    surrounding communities while providing evidence-based recommendations for an

    intervention to increase access to healthcare services.

    Description of Location and Subpopulation

    Harris County, Texas, contains an estimated population of approximately 5,009,302

    individuals. Approximately 50.4% of individuals living in Harris County identify as female,

    whereas approximately 49.6% of individuals living in Harris County identify as male. These

    numbers suggest that Harris County has a balanced ratio of males to females. (U.S. Census

    Bureau, 2024). The racial/ethnic breakdown of Harris County consists of approximately

    43.0% Hispanic/Latino, 19.2% Black/African American, 36.4% White/Caucasian, 7.4%

    Asian, and a smaller percentage of individuals identified as the other racial categories. The

    above statistics demonstrate that there is a large amount of racial/ethnic diversity within

    Harris County (U.S Census Bureau, 2023). For the purpose of this assessment, low-incomeadults are defined as individuals 18-64 living at or below 200% of the federal poverty level

    (U.S Census Bureau, 2020).

    The socioeconomic condition in Harris County demonstrates that about 16% to 18%

    of Harris County’s population falls below the federal poverty threshold; this is much higher

    amongst people of the Hispanic and Black ethnicities and those making under $25,000 yearly

    (U.S. Census Bureau, 2023). Therefore, such socioeconomic challenges also create barriers

    for these individuals, and combined with their overall lack of access to preventative health

    services, will create barriers for healthy living today and in the future. The median income for

    households in the county is around $63,022. In regard to education in Harris County, many of

    those with lower educational attainment tend to show socioeconomic vulnerabilities. For

    example, 23.7% of adults have a high school diploma or lower, which relates directly to

    having lower health literacy, decreased work opportunities, and long-term health outcomes

    (Texas Community Health News, 2024).

    Crime and safety are major worries; approximately one-third of people living there

    said they are victims of either being targeted because of their ethnicity/race, sex/gender, or

    another form of discrimination that affects them mentally (e.g., by being treated differently).

    Domestic violence was reported by over half of those victims (Rice University report titled:

    “Crime and Victimization in Harris County: An Assessment”, 2024). In 2024, the Crime

    Stoppers of Houston managed to provide solutions to 362 felony cases, 18 of which were

    homicides, and 60 cases were burglary, robbery, and theft (with low-income communities

    being disproportionately exposed to these crimes) (Crime Stoppers of Houston, 2024). The

    crimes involving property are still concentrated in the economically disadvantaged areas.

    There are additional issues associated with living in these areas (i.e., challenges to healthy

    living due to the local community environment), food insecurity affects approximately thirty-

    nine percent of Harris County households, more than double the national rate of 14% (KinderInstitute for Urban Research, 2025) and some demographic groups, especially

    racially/ethnically disadvantaged households, have a higher prevalence of these challenges

    (i.e., food insecurity). Many poor neighborhoods today not only face food shortages because

    they do not have enough grocery stores to meet their needs, but they are classified as food

    deserts, which means they have high use of convenience stores or places selling fast food as

    their primary source of food. This contributes to increased risk for obesity and poor nutrition

    (Kinder Institute for Urban Research, 2025).

    The low-income neighborhoods in Harris County have a critical lack of access to

    nutritious food. Food insecurity reaches about 39 percent of households in the county, or

    almost three times the national rate of 13.5 percent (USDA Economic Research Service,

    2025; Kinder Institute for Urban Research, 2025). A large number of poorer neighborhoods

    can be considered food deserts in which the residents are forced to go a long way to get to

    full-service grocery stores and fill their staple food diets with convenience stores and fast-

    food outlets. One of the health outcome indicators that illustrates health inequities in Harris

    County is obesity. Approximately 47.7% of adults ages 45-64 in Harris County are

    considered obese, and adults who earn less than $25,000 a year are almost twice as likely to

    be obese as adults who earn a higher income. (Understanding Houston, 2023). Cases of

    health discrepancies are evident among the low-income adults in Harris County. Individuals

    with lower incomes than 25,000/year have diabetes rates of about 18%, a high prevalence of

    hypertension (more than 38%), and obesity rates (more than 52%), which are significantly

    above the county-wide statistics (Harris County Public Health, 2025; Understanding Houston,

    2023). These collective indicators demonstrate that low-income adults (especially those

    earning less than $25,000) in Harris County are faced with several social and structural

    barriers that adversely affect their access to healthcare, their economic stability, and their

    overall health outcomes.Disparities exist between low-income adults in Harris County in terms of the health

    and nutrition indicators described above. Approximately 14% of adults aged 18-64 years have

    diabetes; over 32% of adults aged 18-64 years have hypertension; nearly 48% of adults aged

    45-64 are considered obese. The prevalence of these health conditions is substantially higher

    among adults with a gross income of $25,000. As a result, access to preventive and primary

    healthcare services is restricted due to both distance and cost of accessing healthcare services

    (Understanding Houston, 2023; County Health Rankings & Roadmaps, 2023).

    Subpopulation Impact of Limited Access to Healthcare

    Biggest Contributor to Morbidity and Mortality

    The leading cause of preventable morbidity in low-income adults in Harris County is

    limited access to healthcare, where patients who do not have health insurance go to the

    emergency room at almost double the frequency of those with health insurance, and also have

    substantially less access to preventative and chronic disease management services. (Harris

    Health System Community Health Needs Assessment, 2023). In Harris County, residents who

    are low-income encounter many obstacles to getting the basic health care services they need,

    which are causing higher levels of illness and death in this area. Some examples of these

    complicated factors impacting those who suffer from chronic illnesses are their lack of

    insurance and the unavailability of primary care physicians in Harris County. Diabetes is

    present in approximately 14% of the adults living in Harris County. In comparison,

    hypertension affects more than 32% of adults, and the proportions of both of these chronic

    conditions are much higher among adults living at or below 200% of the federal poverty level

    (County Health Rankings & Roadmaps, 2023). Therefore, individuals who have these chronic

    illnesses may not have sufficient medical care to help prevent the occurrence of

    complications from these diseases that could have been prevented. This data shows that

    having limited access to basic healthcare services within Harris County can create too manyemergency room visits that could have been prevented with proper medical attention. In

    addition, it can make it harder for people with chronic illnesses to get the care they need,

    which can lead to an early death and/or affect their overall quality of life in the long run

    (Texas DSHS, 2023; CDC, 2023).

    In Harris County, cardiovascular disease and diabetes are the two leading causes of

    premature death for those 40 years and older who fall below the poverty line. According to

    local mortality reports, heart disease is to blame for about 22% of all county deaths, while

    around the same rate of deaths due to complications of diabetes occurs compared to Texas

    and national death rates (Texas DSHS, 2023; CDC, 2023). The combination of delayed

    diagnosis and a disjointed healthcare system (poor access to treatment) increases the chance

    of developing more advanced stages of an illness when diagnosed, thereby increasing the

    potential for being hospitalized and dying prematurely. State and national mortality data

    indicate that preventable and treatable conditions are much higher among the uninsured than

    those with insurance, and continue to evidence a greater relative mortality burden among

    people below the poverty line (CDC, 2023).

    Controversial Community Health Concern

    One currently very hotly debated area of community health in Harris County concerns

    the inappropriate use of the emergency department for health-related problems that do not

    require an emergency response. Multiple reports by both public health officials and the health

    care system provide documentation that supports this concern (Harris Health System

    Community Health Needs Assessment, 2023; Crime Stoppers of Houston, 2024). On average,

    during the year preceding the COVID-19 pandemic, adults in Harris County who did not

    have health insurance utilized the emergency department at nearly double the rate of those

    with health insurance (Harris Health System Community Health Needs Assessment, 2023).

    The result of the overuse of emergency departments is an overall increase in the number ofpatients seen within the emergency department, resulting in longer wait times for treatment

    and strain on hospital resources to accommodate the high number of patients, particularly due

    to the lack of availability of affordable primary care services for individuals without health

    insurance. Because of these issues, there are growing concerns regarding health equity and

    the long-term viability of the health care systemin both local and statewide communities

    due to the continued inappropriate utilization of the emergency department.

    Community Health Concerns

    Individuals in the community have expressed having difficulty obtaining timely care,

    long waiting periods for appointments, and limited help in navigating the health care system,

    such as making appointments and understanding benefits (Kinder Institute for Urban

    Research, 2025). Similar access issues have been identified in low-income families in other

    areas where poverty and social justice issues prevent people from receiving adequate health

    care (Tiruneh et al., 2024). Individuals experiencing diabetes complications and hypertension

    are commonly hospitalised, and their hospitalisations could often be prevented. The increased

    quality of life and financial burden to both the individual and the health care system are

    decreased when people cannot access adequate care (Harris County Public Health, 2025). In

    addition to financial burdens, inadequate access to care contributes to decreased productivity

    and higher levels of stress. An improvement in access will improve both the individual and

    the system.

    Emergency Room Visits and Hospital Admissions

    Members of this subpopulation utilize emergency care as a primary service for

    hospital admissions or emergency room visits for conditions that can be treated with

    outpatient care (e.g., uncontrolled diabetes, hypertensive crises, asthma exacerbations,

    infections) as well as for complications resulting from either delayed diagnosis or treatment

    (e.g., preventable hospitalizations for chronic health problems), with these numbers beinglarger among low-income individuals compared to those with higher incomes (Harris Health

    System Community Health Needs Assessment, 2023; Texas DSHS, 2023). Data collected at

    the state level validate the claim that low-income individuals in Texas have limited access to

    outpatient care and that lack of outpatient care (i.e., regular healthcare visits) contributes to

    increased usage of emergency rooms and hospitalization. Costs associated with emergency

    room visits and hospitalizations place additional burdens on both the patient and provider,

    and essentially lead to overcrowding within hospitals.

    Impact on Quality of life

    Those residents of Harris County who lack regular access to healthcare endure an

    inferior quality of life as a result of their inability to manage conditions that (commonly) lead

    to chronic illness, as well as the burden of financial strain and/or being unable to take

    preventive measures. In the county, almost forty percent of low-income families report food

    insecurity, which has been shown to have strong negative associations with worse health

    outcomes, more overall stress, and a lower functional status (The Kinder Institute for Urban

    Research, 2025; USDA Economic Research Service, 2025). Chronic illness management

    barriers, coupled with the added financial anxiety associated with accessing medical care,

    result in decreased capacity of these individuals to hold jobs and perform engagements with

    health-promoting activities, thus continuing the cycle of poor health and social and economic

    disadvantage within a community.

    Social Determinant of Health: Limited Access to Healthcare

    The lack of access to healthcare is a key social determinant of poor health for adults

    living on low incomes in Harris County, as high costs, limited insurance coverage, and not

    having enough primary care providers lead to delays in accessing health services. Because of

    the lack of regular primary care, people will often put off seeking care, resulting in an

    increase in the severity of their health problem(s). This has been shown by numerous researchstudies that looked at the relationship between social needs and health care service utilisation.

    Due to the lack of access to primary care, many people end up in an emergency room for

    conditions that are preventable if they were able to have regular access to a primary care

    doctor and/or other types of providers. Furthermore, untreated chronic conditions can result

    in increased rates of morbidity and mortality within this population. Therefore, addressing

    barriers to access to health care is essential for improving the overall health of populations in

    Harris County.

    The community health issues related to inadequate access to care have been found through

    the repeated use of emergency departments, the prevalence of uncontrolled chronic

    conditions, and the financial burdens of high costs associated with health care.

    Available Community Resources

    Several community resources are available to assist lower-income adults in Harris

    County, Texas. Federally Qualified Health Centres serve individuals without insurance or

    who are under-insured by providing Primary Care Services on a sliding fee scale. Federally

    Qualified Health Centres provide preventive care, chronic disease management, and referral

    to specialty services, resulting in a decrease in avoidable emergency department visits (Fiori

    et al., 2024). Other than Federally Qualified Health Centres, the Harris Health System also

    provides healthcare to low-income county residents through the Financial Assistance and

    Gold Card programs, which enable low-income county residents to have access to Primary

    Care, Speciality Care, and Hospital Services through the Harris Health System, even if they

    do not meet the traditional eligibility criteria for health insurance coverage. Medicaid also

    assists low-income adults by covering essential healthcare services to those who meet the

    eligibility criteria. Collectively, these community and systemic resources provide assistance

    to provide healthcare to lower-income adults; however, there are still gaps in access to

    healthcare.Needed Resources

    The people of Harris County need more assistance to increase their healthcare

    options. These services include increased Care Coordination opportunities to help the people

    who use them find out about their insurance policies and make appointments and referrals to

    other providers (State of the Health System Report 2014). The evidence from community

    health worker programs indicates that People who are supported through navigation services

    can access medical care and coordinate with their healthcare providers (Fiori et al., 2024).

    Providers of medical services in Harris County must offer more flexible hours of service as

    well as develop mobile service opportunities to allow greater access to those individuals with

    non-traditional work hours. The lack of sufficient transportation assistance for residents

    continues to restrict the ability of those individuals to access their medical care. All of the

    items mentioned above are necessary to ensure that residents of Harris County have the

    ability to access medical services to reduce the number of avoidable conditions resulting from

    a lack of access.

    Proposed Evidence-Based Intervention

    To remedy the lack of access to Healthcare faced by low-income adults, the

    development of a Nurse-led Community Health Worker Care Navigation program is being

    initiated. The integrated inclusion of Community Health Workers as part of an overall

    problem-solving model is the most comprehensive method to effectively assess Social Needs,

    while also providing ongoing assistance with Social Needs and care navigation processes to

    their members. The data support the assertion that Community Health Workers positively

    influence success through increased access to community resources and decreased barriers to

    care, with more significant benefits to underrepresented populations (Fiori et al., 2024). The

    Nurse will maintain oversight of the screening process, while also coordinating referrals to

    both medical and Social Services. Community Health Workers will assist the members inrelation to appointment scheduling, insurance registration/ enrollment, and linking members

    to community resources associated with their needs. The Coordinated Community Care

    Model provides both clinical support and support to meet the social requirements for

    members of these communities. By implementing this model, we will begin to address the

    long-standing access issues that many individuals experience when seeking Healthcare.

    Evidence supports this proposed method for applying Social Needs Screening

    processes + Navigation Services together. This is demonstrated by Systematic reviews

    showing that post-program follow-up and coordination ultimately reduce utilisation of

    Emergency Room services while increasing patient engagement through their respective

    Primary Care provider (Yan et al., 2022). By placing services in proximity to Community

    members and supplying personalised assistance, this methodology addresses many of the

    barriers, including Transportation and The Complexity of navigating the Health Care System.

    For instance, monthly visits to communities identified as having the greatest need, by Mobile

    Units supporting Registered Nurses (RNs) and Community Health Workers (CHWs), would

    allow for screening for Social Needs and establishing Referrals for community services.

    These continual interactions would foster consistency in the delivery of Care, leading to long-

    term Health Management. Evidence also exists to demonstrate the Sustainability of such

    interventions, by Successful Integration into the Current Health Systems (Fiori et al., 2024).

    The proposed method aligns Nursing professionals’ roles within Population Health and Care

    Coordination.

    Conclusion

    Harris County’s low-income adults are at a significant disadvantage when it comes to

    accessing healthcare. They encounter barriers to being able to receive care, thus preventing

    them from having a higher quality of life due to their illnesses that could have been

    prevented. The limited access to care for low-income adults is due to financial, structural, andenvironmental barriers; thus, these barriers represent a significant social determinant of

    health. The current resources that exist do provide some assistance, but they do not

    adequately meet the needs of all low-income individuals in Harris County. A nurse-led

    community health worker navigation program would be an evidence-based solution and

    practical strategy to improve access for low-income residents of Harris County and improve

    coordination of care for this underserved population. The nurse-led community health worker

    navigation program would provide a holistic approach to both social and clinical needs,

    thereby reducing health disparities and improving overall population health. Community-

    based strategies, such as this one, require the involvement of nurses to lead and implement

    such programs.References

    CDC. (2023). Chronic disease indicators. Centers for Disease Control and Prevention.

    https://www.cdc.gov/cdi/index.html

    County Health Rankings & Roadmaps. (2023). Harris County, Texas. University of

    Wisconsin Population Health Institute. https://www.countyhealthrankings.org

    Crime Stoppers of Houston. (2024). Annual report 2024. https://crime-stoppers.org/wp-

    content/uploads/2025/09/Annual-Report-FINAL.pdf

    Fiori, K. P., Levano, S., Haughton, J., Whiskey-LaLanne, R., Telzak, A., Hemen Muleta, V.,

    K., Chambers, E. C., & Racine, A. (2024). Advancing social care integration in health

    systems with community health workers: an implementation evaluation based in the

    Bronx, New York. BMC Primary Care, 25(1). https://doi.org/10.1186/s12875-024-

    02376-7

    Harris County Public Health. (2025). Community health assessment.

    https://publichealth.harriscountytx.gov/Divisions-Offices/Offices/Office-of-

    Planning-Innovation/CHA-CHIP/Community-Health-Assessment

    Harris Health System. (2023). Community health needs assessment 2023.

    https://www.harrishealth.org/about-us/community-health-needs-assessment

    Kinder Institute for Urban Research. (2025). Food insecurity in Harris County. Rice

    University. https://kinder.rice.edu

    Misganaw Guadie Tiruneh, Eneyew Talie… [Content truncated to 3000 words]

  • NURS 211L – Intermediate MedSurg, Complete the Clinical judg…

    Hello. I’m gonna be as detailed as possible because this assignment requires a lot of details. To start off, the PDF that I uploaded is just an example my teacher gave us. I cannot use any information whatsoever from that PDF. It is only for me to understand the assignment’s formatting. The docx I uploaded is what I need you to fill out with all the information I’ll give you plsease. I also uploaded two screenshots of the rubric. Everything needs to be in APA format, with in-text citations and references. Please follow the rubric and again there’s another example. let me know if you have questions CJP Info:

    Room: 2156
    Patient Initials: A.G.M
    Admission Date: 2/1/26
    Code Status: Full Code
    Allergies: Codeine, Gabapentin, Influenza vaccine
    Advanced Directive: None


    Chief Complaint

    Shortness of breath and wheezing.


    History of Present Illness (HPI)

    A.G.M is a 79-year-old male admitted on 2/1/26 with severe sepsis, acute hypoxic respiratory failure, and multifocal pneumonia. He presented with shortness of breath and wheezing. Chest X-ray confirmed multifocal pneumonia. Bronchoscopy showed concern for interstitial lung disease. He was started on IV antibiotics, steroids, and oxygen therapy. He is currently improving and being weaned off oxygen.


    Admitting Diagnosis & Pathophysiology

    Severe Sepsis: A life-threatening organ dysfunction caused by a dysregulated response to infection. In this patient, pneumonia triggered systemic inflammation, leading to elevated WBC and respiratory compromise.

    Acute Hypoxic Respiratory Failure: Occurs when the lungs cannot adequately oxygenate the blood. Pneumonia causes inflammation and fluid in the alveoli, impairing oxygen exchange.

    Multifocal Pneumonia: Infection in multiple areas of the lungs causing inflammation, impaired gas exchange, and increased WBC count.


    Past Medical History & Pathophysiology

    Hypertension: Chronic elevated blood pressure increasing cardiovascular strain.
    Hypothyroidism: Decreased thyroid hormone production affecting metabolism.
    Hyponatremia: History of low sodium levels, increasing risk for electrolyte imbalance.
    Type 2 Diabetes Mellitus: Insulin resistance leading to hyperglycemia.

    No past surgical history.


    Social History

    Speaks Spanish and understands English.
    Hard of hearing.
    Family support from wife and daughter.

    Height: 175.3 cm
    Weight: 72.1 kg
    Diet: Carbohydrate-consistent diet.


    Physical Assessment

    Neuro: A/O x4, follows commands, calm and cooperative. PERRLA. Muscle strength 5/5 all extremities.

    Cardiac: No murmurs. Radial and pedal pulses 2+. No edema.

    Respiratory: On 2L NC at 98% SpO. Lungs clear bilaterally. Being weaned to room air. RT following.

    GI: Continent. Abdomen soft, non-distended. Last BM 2/6. Normal bowel sounds.

    GU: Continent. Urine clear yellow. Hourly output 500 mL.

    Musculoskeletal: Ambulates independently. Pain 2/10 generalized. PT/OT consult.

    Skin: Warm, dry, intact. No wounds.

    IV: Left IV present.


    Diagnostics

    Chest X-ray: Multifocal pneumonia.
    Bronchoscopy: Concern for interstitial lung disease.


    Lab Values

    WBC 15.06 (High) Indicates active infection (pneumonia/sepsis).
    HGB 10.4 (Low) Mild anemia.
    HCT 29.6 (Low).
    Platelets 378 Normal/high normal.
    Na 135 Low-normal; history of hyponatremia.
    K 3.3 (Low) Risk for cardiac dysrhythmias.
    Ca 8.3 (Low).
    Glucose 341 Hyperglycemia; insulin administered.
    BUN 19 Normal.
    Cr 0.80 Normal kidney function.
    Lactate 8.3 (Low/normal per facility range).


    Medications (Relevant to This Patient)

    Cefepime (IV BID) Antibiotic
    Purpose: Treat bacterial pneumonia and sepsis.
    MOA: Inhibits bacterial cell wall synthesis.
    Nursing: Monitor WBC, signs of infection improvement.

    Insulin (4 units given)
    Purpose: Lower blood glucose of 341.
    MOA: Promotes glucose uptake into cells.
    Nursing: Monitor glucose levels AC/HS.

    Steroids
    Purpose: Reduce lung inflammation.
    Side effect: Can increase blood glucose.

    Bronchodilators
    Purpose: Improve airway clearance and reduce wheezing.

    Carbohydrate-consistent diet
    Purpose: Maintain stable glucose control.


    PRIORITY PROBLEMS

    Priority Problem #1

    Infection r/t bacterial pneumonia AEB WBC 15.06 and multifocal pneumonia.

    Goal: Patient will show decreasing WBC and stable vital signs during hospitalization.

    Interventions:
    Monitor WBC trends
    Administer antibiotics BID
    Monitor temperature and respiratory status
    Encourage pulmonary hygiene

    Evaluation: Infection improving; no progression of sepsis.


    Priority Problem #2

    Imbalanced Blood Glucose r/t Type 2 DM and steroid therapy AEB glucose 341.

    Goal: Patient will maintain glucose within ordered range.

    Interventions:
    Monitor glucose AC/HS
    Administer insulin per sliding scale
    Maintain carb-consistent diet
    Monitor for hyper/hypoglycemia

    Evaluation: Glucose controlled with insulin therapy.


    Priority Problem #3

    Risk for Electrolyte Imbalance r/t history of hyponatremia and current Na 135.

    Goal: Patient will maintain sodium within normal range.

    Interventions:
    Monitor sodium levels
    Monitor mental status
    Monitor fluid balance

    Evaluation: Sodium remains stable; no neurological changes.


    Plan of Care

    Continue antibiotics, steroids, breathing treatments, diabetes management, and oxygen weaning. PT/OT consult for mobility. Plan for discharge to rehab unit (RU) once stable.

    1. Acetaminophen (Tylenol)

    Class: Non-opioid analgesic, antipyretic
    Indication: Mild pain, fever
    Dose/Route/Frequency: 650 mg PO every 4 hours PRN
    Contraindications: Severe liver disease
    Nursing Considerations: Monitor liver function, assess pain/temperature
    Side Effects: Nausea, hepatotoxicity (overdose)
    Teaching: Do not exceed 4,000 mg/day; avoid alcohol


    2. Budesonide (Pulmicort)

    Class: Corticosteroid
    Indication: Reduce airway inflammation
    Dose/Route/Frequency: 0.25 mg inhalation BID
    Contraindications: Acute bronchospasm
    Nursing Considerations: Rinse mouth after use; monitor for thrush
    Side Effects: Oral candidiasis, hoarseness
    Teaching: Not for acute attack; rinse mouth after use


    3. Hydralazine (Apresoline)

    Class: Vasodilator, antihypertensive
    Indication: Hypertension
    Dose/Route/Frequency: 50 mg PO TID
    Contraindications: Hypotension, CAD
    Nursing Considerations: Hold if SBP < 100; monitor BP
    Side Effects: Tachycardia, dizziness
    Teaching: Change positions slowly


    4. Insulin Lispro (Humalog)

    Class: Rapid-acting insulin
    Indication: Type 2 DM, hyperglycemia
    Dose/Route/Frequency: Sliding scale subcutaneous before meals
    Contraindications: Hypoglycemia
    Nursing Considerations: Check glucose before giving
    Side Effects: Hypoglycemia
    Teaching: Eat within 15 minutes of injection


    5. Tamsulosin (Flomax)

    Class: Alpha-1 blocker
    Indication: BPH
    Dose/Route/Frequency: 0.4 mg PO nightly
    Contraindications: Hypotension
    Nursing Considerations: Monitor dizziness
    Side Effects: Orthostatic hypotension
    Teaching: Take 30 min after same meal daily


    6. Vitamin B Complex

    Class: Vitamin supplement
    Indication: Prevent deficiency
    Dose/Route/Frequency: 1 tablet PO daily
    Contraindications: Hypersensitivity
    Nursing Considerations: May cause mild GI upset
    Side Effects: Bright yellow urine
    Teaching: Take with food


    7. Cefepime (Maxipime)

    Class: 4th-generation cephalosporin antibiotic
    Indication: Bacterial pneumonia/sepsis
    Dose/Route/Frequency: IV BID (per order)
    Contraindications: Cephalosporin allergy
    Nursing Considerations: Monitor WBC, monitor for allergic reaction
    Side Effects: Diarrhea, rash
    Teaching: Complete full antibiotic course


    8. Steroids (Prednisone or Methylprednisolone)

    Class: Corticosteroid
    Indication: Reduce lung inflammation
    Dose/Route/Frequency: Per provider order
    Contraindications: Systemic fungal infections
    Nursing Considerations: Monitor blood glucose (can increase levels)
    Side Effects: Hyperglycemia, immunosuppression
    Teaching: Do not stop abruptly; monitor blood sugar

    Requirements: stated

  • I need help writing in Tenecteplase using an article given i…

    i need a 50 slides powerpoint on this article.i need to do a one hour presentation of the article. Be thorough: include disease context, mechanism, trial data, safety, dosing, and comparison to existing therapies. If the scope is narrow, provide a clear rationale for the choice. Suggested Structure for Presentation Introduction disease state & unmet need Mechanism of Action (MOA) molecular target & pathway Clinical Evidence trial phase, design, primary outcomes Safety & SideEffect Profile Dosing & Administration any weightbased or special considerations Comparison with Existing Therapies guidelines, benefitrisk, advantages Future Directions ongoing studies, potential new indications Key Takeaways concise conclusion Prior work: identified a dosing gap based on patient weight; provided clinical evidence supporting weightbased dosing. Presentation Outline Template (Suggested) Title Slide topic, presenter, date Clinical Background prevalence, unmet need Mechanism of Action molecular target, pathway (illustrations optional) Clinical Evidence trial design, phase, primary outcomes, key data points Safety Profile common adverse events, contraindications Dosing & Administration standard regimen, special considerations (e.g., weightbased) Comparison to Existing Therapies guideline recommendations, benefitrisk assessment Future Directions ongoing trials, potential new indications Key Takeaways bulletpoint summary Suitable for a presentation on dose optimization and clinical implementation. i willneed speaker notes

    Use important pictures from the article.

    Requirements: very detailed

  • Discussion post

    Business Plans

    A business plan is a detailed plan of a proposed program, project, or service that includes information used to assess the financial feasibility of the project. Business Plans are widely used in healthcare for making a case for undertaking a new project. A business plan should begin with identifying the problem. Other important steps in planning a new program and developing a business plan include understanding which organizational goals the program will promote, a market analysis, a financial analysis, a timeline, a feasibility statement, and an executive summary. How the project aligns with the mission and values of the organization is also important. Timelines can easily be tracked using a Gantt chart.

    Weekly Discussion Question:

    Think of a new service or new project that could be developed in your area of work (or use the idea you developed for the Staffing Plan Project). Describe the following components used in developing a business plan, along with their purpose, needed for the new service that you will develop.

    For this discussion, please provide only a general description of each component below.

    1. Identification of the problem

    2. Define the product

    3. Conduct a Market Analysis: Include 4 Ps of marketing

    4. Financial plan or analysis: Budget estimate

    5. Develop a detailed operations plan or timeline (use of a Gantt Chart)

    6. Break-even analysis

    7. Cash flow analysis

    8. Conclusion

    9. Elevator Speech- describe this concept and the benefits of using this approach.

    Area of work: Urban hospital treating substance use disorders.

    Reference: Financial management for nurse managers and executives ( Finkler & Mose)

  • Epidemiology

    Discussion – Epidemiology

    Discussion Prompts:

    • Demonstrate application of principles of epidemiology, including use of data tracking systems (CO 4)
    • Provide one example from your current or past nursing practice and consider how the principles of epidemiology were applied to enhance care (CO 4)
    • Be sure to cite and reference the course materials (see PDF attachments) + any other sources within the last 5 years

    Attached Files (PDF/DOCX): covid19webcastfinal1588860928600.pdf, NUR 4252 Epidemiological Applications Module 3.pdf

    Note: Content extraction from these files is restricted, please review them manually.

  • concept mapss

    rewrite the bullet points part only thanks. make the map creative