Clinical Scenarios and Decision Making Assignments

Health Promotion Plan

• Choose a specific health concern or health need as the focus of your hypothetical health promotion plan. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.
  • Bullying.
  • Teen Pregnancy.
  • LGBTQIA + Health.
  • Sudden Infant Death (SID).
  • Immunizations.
  • Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (MUST address all tobacco products).
• Create a scenario as if this project was being completed face-to-face.
• Identify the chosen population and include demographic data (location, lifestyle, age, race, ethnicity, gender, marital status, income, education, employment).
• Describe in detail the characteristics of your chosen hypothetical individual or group for this activity and how they are relevant to this targeted population.
• Discuss why your chosen population is predisposed to this health concern or health need and why they can benefit from a health promotion educational plan.
• Based on the health concern for your hypothetical individual or group, discuss what you would include in the development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or lifestyle behaviors that may have an impact on health as you develop your educational plan in your first assessment. You will take this information into consideration when you develop your educational plan in your fourth assessment.
• Identify their potential learning needs. Collaborate with the individual or group on SMART goals that will be used to evaluate the educational session.
• Identify the individual or group’s current behaviors and outline clear expectations for this educational session and offer suggestions for how the individual or group needs can be met.
• Health promotion goals need to be clear, measurable, and appropriate for this activity. Consider goals that will foster behavior changes and lead to the desired outcomes.

Behavioral Health

Review the literature for sleep guidelines and provide an overview

Explain how neuro activity changes when there is a lack of sleep and how it can impact mental health

Describe hypnotics effect on brain activity and identify common pharmacologic agents

Provide a sleep management plan and how the APRN can monitor it

Nursing Assignment 3

Read the case study below and answer the questions associated with the scenario. Cite references according to APA guidelines.

Scenario

A 41-year-old Hispanic male patient presents at the community walk-in clinic for an ER follow-up. He was seen yesterday for right knee pain after pivoting quickly during a soccer game. He hand carries an MRI report showing he was diagnosed with a full thickness ACL tear. He was discharged with a knee immobilizer, crutches, and ibuprofen for pain. He has a follow-up appointment with ortho in three days. He reports minimal relief with 800 mg ibuprofen qid, rest, ice, and elevation. Current pain level is reported at a 9 out of 10, and you note the patient to be uncomfortable and grimacing in pain.

Case Questions

You have decided to prescribe an opioid analgesic for this patient. What analgesic would you prescribe, and why?
Access your state’s prescribing guidelines. Based on these guidelines, how many days of the opioid would you provide? What resources are available to help you prescribe safely for this patient? Are there any database checks required by your state to help you identify potential issues with drug diversion? Summarize your state’s opioid prescribing guidelines.
What are some additional nonpharmacological comfort measures to recommend for this patient?

Nursing Assignment 4

John is a 32 year old male nurse working in a prison. He is married and has two children at home- one boy at 14 years of age and a girl that just turned ten years of age. A new prisoner to the institution has requested that John be a healthcare surrogate for him because he is 72 years of age and not in good health. John discovers that this prisoner is a pedophile and although no one at work is aware of this, John’s son was molested by the father of a friend of his sons while visiting their home. The son has gone through therapy and they continue to have problems with the son, John is hopeful that his son will improve his mental health.

John feels divided because on one hand he feels obligated to serve as an RN professional and on the other hand he feels very hateful of the pedophile lifestyle that seems to encompass the newly admitted prisoner.

Questions:

1. What kinds of issues ethically is John dealing with?
2. How would you counsel John in his dilemma?
3. Finally, what would be a reasonable approach to this problem that John has professionally and personally?

Nursing Assignment 5

In your initial post, share the following information:

• Introduce the person or organization with whom you communicated to assess the community needs and resources.
• Introduce the community and describe a few of the priority health and wellness issues facing this community.
• What health promotion activities are already in place?
• Find and share one source (website, journal article, etc.) you could use to assist this community to promote health and wellness. Be sure to acknowledge sources in citations and references.
• What is one way you could begin collaborating with this community to support health and wellness? What health promotion strategies might you create?

Nursing Assignment 6

Mary Smith has just reported for duty and is reviewing the patients she will have during the evening shift. One of them, Ida Monroe, is on isolation for an infectious disease. Dr. Jerome comes into the nursing station around 9:00 P.M. after making hospital rounds to see his patients. He tells Mary that he noticed that one of his neighbors, Ida Monroe, is a patient, and he would like to review her medical chart. Mary starts to give him the chart and then realizes that Dr. Jerome is not Ida’s physician. Dr. Jerome says not to worry about that since he has taken care of the rest of Ida’s family for years and is sure that Ida will want him to consult on her case. When Mary hesitates to give him the chart, Dr. Jerome says that he will report her to her nursing supervisor. He walks over to pick up the chart.

Instructions:
1. Read the scenario above and then, answer the following questions:
a. Should Mary give Ida’s medical chart to Dr. Jerome? Why or why not?
b. What should Mary say to Dr. Jerome?
c. What should Mary do if Dr. Jerome continues to insist on seeing Ida’s chart?
d. What ethical principles are involved in this case? What legal regulations are involved in this case?

Nursing Assignment 7

A 56-year old male with a history of ADHD and BPH is complaining of fatigue and feeling overwhelmed. He has worked as a corrections officer in a state penitentiary for 18 years.

How is fatigue psychiatric public health problem? What is burnout? How will it manifest itself in your future patients? What does the literature reveal about work-related stress and mental health? What are possible precipitants and/or antecedents of burnout or fatigue for this patient? You can comment on topics like self-care and what it really means, or explore the phenomenon of burnout and the impact on mental health, relationships, well-being, and social and academic costs.

Please address all these questions and create new questions and present. Use peer reviewed articles .

Ask your own questions. Explore and present.

Nursing Assignment 8

A woman has just been diagnosed with breast cancer. Her doctor tells her that while cancer is a multifactorial disease, she carries the breast cancer susceptibility gene, BRCA1. One of her two identical twin 19-year-old daughters is afraid that she also may have inherited the gene

1. What considerations would you give her daughter who is worried about inheriting the cancer gene?
2. What ethical issues are raised when one identical twin wants to know her genetic susceptibility to a disease and other does not?

Nursing Assignment 9

Select 1 of the Following for Discussion:

1. Living with HIV

   Disclosing one’s HIV+ status is a complex, difficult, and very personal matter, because it entails communication about a potentially life threatening, stigmatized and transmissible illness. Choices people make about this are not only personal but vary across different age groups, in different situations and contexts, with different partners, and may change with time depending on one’s experiences. Disclosure may have lifelong implications since more people are living longer, and often asymptomatically with HIV. Public health messages have traditionally urged disclosure to all sexual and drug-using partners. In reality, some HIV+ persons may choose not to disclose due to fears of rejection or harm, feelings of shame, desires to maintain secrecy, feelings that with safer sex there is no need for disclosure, fatalism, perceived community norms against disclosure, and beliefs that individuals are responsible for protecting themselves.

   In 300-400 words, discuss your position on the following:

   Does an individual have an obligation to disclose his/her HIV status? Explain.

   Does a physician or other health care provider have an obligation to disclose a patient’s HIV status? Explain.

   Do public health concerns trump the individual’s rights to medical confidentiality? Explain.

2. The Blood Donation Restrictions for Men Who Have Sex with Men (MSM)

   There are several restrictions on blood donation in the United States including known HIV status, use of blood thinning medications, or diagnosis of sickle cell disease to name a few. There are also several restrictions related to lifestyle such as a 3-month deferral of blood donation for IV drug users or those with new tattoos and piercings. However, men who have sex with men (MSM) must defer blood donation as well. They are instructed to abstain from sex with other men for three months before they are eligible to donate. The concern with MSM donating blood is that their lifestyle is considered high-risk for HIV transmission. The blood donation ban was originally a lifetime ban, then changed to a 12-month deferral in 2015, and in 2020 was updated to a three-month deferral.

   In 300-400 words, discuss your position on the following:

   How is the MSM blood donation deferral controversial and unethical?

   How can the blood eligibility rules better screen and defer individuals at risk for HIV transmission?

   Does this blood donation deferral continue to contribute to the mistreatment and mistrust many LGBTQ+ individual feel about the United States healthcare system? Why or why not?

Nursing Assignment 10

Research the Patient Health Questionnaire (PHQ-9).

Explain the reliability and validity of the screening tool.

Utilize the tool to describe a mental health case study of a patient (in a clinic setting/or created) with a diagnosis of depression and/or anxiety.

Explore differential diagnoses and a necessary work-up.

Provide a treatment management plan.

Nursing Assignment 11

Discuss your position regarding access to and coverage for health care. Are we obligated to provide access to and coverage for health care for all Americans as an entitlement (a right)? Or should health care be considered a commodity that is subject to the influences of economic, social, and market demand (supply and demand)? Be sure to include the rationale for your position in your discussion.

Strategies for academic portfolios

In the realm of marketing, a successful branding strategy is one of the most important contributors to organizational success. A solid branding strategy can help add visibility and credibility to a company’s products.

Similarly, nurse-scholars can build a personal brand to add visibility and credibility to their work. You can begin building your brand by developing and maintaining an academic portfolio. Such an activity can help share the results of your efforts and contribute to your success. This Discussion asks you to consider and share strategies for building your portfolio.

To Prepare:

Reflect on strategies that you can pursue in developing portfolios or portfolio elements that focus on academic achievements.

Review one or more samples from your own research of resources focused on portfolio development.

Post an explanation of at least two strategies for including academic activities and accomplishments into your professional development goals. Then, explain how those goals may align with the University’s emphasis on social change. Be specific and provide examples.

Nursing Assignment 13

Gastrointestinal Function:

R.H. is a 74-year-old black woman, who presents to the family practice clinic for a scheduled appointment. She complains of feeling bloated and constipated for the past month, some-times going an entire week with only one bowel movement. Until this episode, she has been very regular all of her life, having a bowel movement every day or every other day. She reports straining most of the time and it often takes her 10 minutes at a minimum to initiate a bowel movement. Stools have been extremely hard. She denies pain during straining. A recent colonoscopy was negative for tumors or other lesions. She has not yet taken any medications to provide relief for her constipation. Furthermore, she reports frequent heartburn (3–4 times each week), most often occur-ring soon after retiring to bed. She uses three pillows to keep herself in a more upright position during sleep. On a friend’s advice, she purchased a package of over-the-counter aluminum hydroxide tablets to help relieve the heartburn. She has had some improvement since she began taking the medicine. She reports using naproxen as needed for arthritic pain her hands and knees. She states that her hands and knees are extremely stiff when she rises in the morning. Because her arthritis has been getting worse, she has stopped taking her daily walks and now gets very little exercise.

Case Study Questions

In your own words define constipation and name the risk factors that might lead to develop constipation. List recommendations you would give to a patient who is suffering from constipation. You might use a previous experience you might have.

Based on the clinical manifestations on R.H. case study, name and explain signs and symptoms presented that are compatible with the constipation diagnosis. Complement your list with signs and symptoms not present on the case study.

Sometimes as an associate diagnosis and a complication, patients with constipation could have anemia. Would you consider that possibility based on the information provided on the case study?

Nursing Assignment 14

You have been requested to determine decisional capacity on a patient. Please access the peer-reviewed literature to learn about the topic and to assist you in answering important practice questions. In the future, you may need to access the scientific literate to solve clinical problems. This exercise is meant to assist you in answering practice questions through the use peer-reviewed, scientific literature.

In the discussion board, please assist your peers in answering these or any relevant clinical questions that may arise with regard to capacity?

What is capacity?

What are types of capacity?

How do you determine capacity?

Are there scales or assessment tools and how reliable are they?

Who can determine capacity?

What current theories on capacity?

What are common practice dilemmas associated with determining capacity?

Explore the topic. Please cite two articles that you have found to assist with the questions. Be original. If you come across something valuable, interesting, or relevant, please share.

Nursing Assignment 15

J.R. is a 36-year-old white, middle-class woman who has been sexually active with one partner for the past 2 years. She and her partner have no history of STIs, but her partner has a history of fever blisters. She reports genital pain, genital vesicles and ulcers, and fever and malaise for the last 3 days. Examination reveals adenopathy and vaginal and cervical lesions.

*What drug therapy would you prescribe? Why?

*What are the parameters for monitoring the success of the therapy?

*Discuss specific education for J.R. based on the diagnosis and prescribed therapy.

Nursing Assignment 16

Creation of a health promotion initiative to improve health indicators for “your health problem”. This activity is focusing on your creativity, analysis of facts, organization and leadership qualities. Be concise but comprehensive in your ideas.

MAP-IT stands for:

M Mobilize

A Asses

P Plan

I Implement

T Track

Using MAP-IT framework determine how you may:

1. Mobilize resources and stakeholders to take care of the selected health problem in your community, determining mission and vision of the resulted coalition, defining partners, their roles and meeting plans.
2. Asses the problem, including a realistic long-term goal, how you may collect data to determine your needs and priorities logically organized.
3. Plan objectives and steps to achieve them. Consider opportunities for interventions with broad reach and impact. How may you measure your progress? What is expected to change, by how much, and by when? Choose objectives that are challenging yet realistic.
4. Implement. Create a detailed work plan that includes concrete action steps assigned to specific people with clear deadlines and/or timelines. Share responsibilities across coalition members but consider having a single point of contact to manage the process to ensure that things get done. Check in with coalition members by using the Coalition Self-Assessment to see if your process is running smoothly. Develop a simple communication plan. Use kick-off events, activities, or campus meetings to showcase your coalition’s accomplishments.
5. Track. Plan regular evaluations to measure and track your progress over time. Evaluations can help your coalition determine if your plan has been effective in achieving your goals. Be mindful of limitations of self-reported data, data quality, data validity, and reliability. Partnering with a statistician or researcher at your institution can help you conduct a quality evaluation. You can use these basic formulas to calculate baseline, target, and achieved rates for your selected health outcomes.

Nursing Assignment 17

Topic 1.

Explore the models for Community and Health Promotion mentioned below:

• Ecological models
• The health belief model
• Stages of change model (trans-theoretical model)
• Social cognitive Theory
• Theory of reasoned action/planned behavior

1. After studying those models, select one that you consider could be used as a framework for a health promotion initiative of your interest to improve the indicators of your main health problem. Why is this model suitable as a health promotion framework for your health problem? Discuss your selection including the strengths and potential barriers to implementing a health promotion strategy that you may wish to articulate in your community or group of interest.

Topic 2.
Of the non-selected models to improve the indicators of the chosen health problem debate about one that you believe is not applicable to the potential goal of your health promotion initiative. Explain why you arrived at such a conclusion, including potential barriers and challenges for its articulation.

Nursing Assignment 18

Research the health-illness continuum and its relevance to patient care. In a 750-1,000-word paper, discuss the relevance of the continuum to patient care and present a perspective of your current state of health in relation to the wellness spectrum. Include the following:

1. Examine the health-illness continuum and discuss why this perspective is important to consider in relation to health and the human experience when caring for patients.
2. Explain how understanding the health-illness continuum enables you, as a health care provider, to better promote the value and dignity of individuals or groups and to serve others in ways that promote human flourishing and are consistent with the Christian worldview.
3. Reflect on your overall state of health. Discuss what behaviors support or detract from your health and well-being. Explain where you currently fall on the health-illness continuum.
4. Discuss the options and resources available to you to help you move toward wellness on the health-illness spectrum. Describe how these would assist in moving you toward wellness (managing a chronic disease, recovering from an illness, self-actualization, etc.).

You are required to cite a minimum of three peer-reviewed sources to complete this assignment. Sources must be published within the last 5 years, appropriate for the assignment criteria, and relevant to nursing practice.

Nursing Assignment 19. Writing Narrative Hooks

Write a post that gives 3-5 examples of narrative hooks for the introduction to a study of interest to you for your peers to give you feedback about.

Your feedback to your peers should focus on the following questions:

• “Do the hooks draw the reader in?”
• “Do the hooks create interest in the study?”
• “Are the studies presented at a relatable level to the reader?”

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