Category: Nursing

Nursing Process and Nursing care plan

Nursing Process and Nursing care plan
Nursing Process and Nursing care plan

Nursing Process and Nursing care plan

Order Instructions:

Tips for Success
The M6A3: Application of the Nursing Process Paper counts as 30% of your grade for this course.
We suggest that you develop and outline and use the following time-line as your guide for completing your paper:

Week 1: Review the requirements for the paper.
Week 2: Begin developing an outline for your paper.
Week 3: You should have your outline completed.
Week 4: You should be using your outline to write your paper.
Week 5: Continue work on your paper.
Week 6: Finalize your paper and submit by the end of the week.

linked item M6A3: Application of the Nursing Process Paper
Using APA format, the information from this course, and your assigned readings write a six (6) to ten (10) page paper (excludes cover and reference page) addressing the application of the nursing process to a patient care scenario. Use these directions and the scoring rubric as you develop the paper. Outlines and abstracts are NOT required with this paper. Do not include the scenario in the paper
A minimum of three (3) current professional references must be provided excluding a nursing diagnosis book. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used. Do not use abbreviations…write out everything.
The paper consists of three (3) parts:

The meaning and use of the nursing process in making good nursing judgments that effect patient care
The development of a plan of care using the nursing process for a specific patient situation
The preparation stage for a teaching plan to prevent a recurrence of a similar situation

The following sheet will assist you when composing the plan of care for the paper: Overview of the Nursing Process.
Part 1 (3-4 pages)

Review the required readings about the nursing process. In your own words, define each step of the process and provide an example for each step.
In the implementation step, what is meant by direct and indirect care as described by the Nursing Intervention Classification (NIC) project?
Discuss the three (3) types of nursing interventions (nurse-initiated, dependent, and interdependent) that applies to the patient care situation. Provide an example of each (refer to your textbook).
Explain how the nursing process provides the basis for the registered nurse to make a nursing judgment that results in safe patient care with good outcomes.
Discuss how the registered nurse evaluates the overall use of the nursing process. Identify three (3) variables that may influence the ability to achieve the desired outcomes for the patient.
How is the plan of care modified when the outcomes are not met?
How does the RN use the nursing process to make decisions about the priority of care?

Part 2 (3 pages)
Patient scenario
A 78-year-old man is living in an assisted living facility. He is able to walk very short distances and uses a wheelchair to transport himself to the communal dining room. He administers his own medications independently and bathes himself. Over the last year he prefers to remain in the wheelchair even when in his room. He has a history of CHF, hypertension, hyperlipidemia and lower extremity weakness. He is able to state his current medications include metoprolol (Lopressor) 50 mg once daily by mouth, furosemide (Lasix) 20 mg once daily by mouth, Quinapril (Acupril) 20 mg once daily by mouth, atorvastatin (Lipitor) 20 mg once daily by mouth. During a routine examination, his physician noted a pressure ulcer over the ischium on the right buttocks. The wound is oval about 10mm x 8 mm, with red and yellow areas in the middle and black areas on some surrounding tissue. It has a foul odor. The patient had been padding the area so “it doesn’t get my pants wet”. The physician arranged for him to be admitted to the hospital in order for intravenous antibiotic therapy and wound care to be initiated. After being admitted to the hospital his medications are: metoprolol (Lopressor )50 mg orally every 12 hours, furosemide (Lasix ) 40mg once daily by mouth, quinapril HCl (Accupril) 40 mg once daily by mouth, cefazolin (Ancef)1.5 Grams in 50 mL 0.9 % Normal Saline intravenously three times a day. The result of the wound culture identified Methicilin-resistant staphylococcus aureus. After a surgical debridement of the black tissue a SilvaSorb® (antimicrobial gel) dressing was ordered daily.
Develop a Plan of Nursing Care for this patient that includes all steps of the nursing process:

One (1) actual NANDA-I nursing diagnosis statement addressing the priority problem the patient is experiencing. You need to provide the entire nursing diagnosis statement. For example: Acute pain, related to tissue trauma, as evidenced by patient rating pain at 7 on the 0-10 verbal pain scale. Provide a rationale, with evidence, why this nursing diagnosis is the priority for this patient.
What is the assessment data that supports the use of this nursing diagnosis? These are the assessments you will collect to determine if the patient has this nursing diagnosis. For example: Will assess the patient’s pain using the 0-10 verbal pain scale.
One (1) expected outcome (realistic, measureable and contains a time frame). that addresses the diagnosis and meets the criteria for an expected patient outcome. Discuss whether the outcome is a cognitive, psychomotor, affective or physiologic outcome. Discuss why the time frame selected for the evaluative criteria was selected. Use evidence as the basis for the time frame and criteria. You need to be specific to this particular patient. For example: Patient will rate pain at 3 on the 0-10 verbal pain scale. Of course, you would also need to answer the rest of the items in this section.
Four (4) nursing interventions that includes at least one (1) nurse-initiated, one (1) dependent, one (1) interdependent intervention. Label your interventions as above. Provide a rationale for each intervention that is evidence-based. Lastly, your interventions must be able to move the patient toward the achievement of the outcome. Select interventions, you as the RN can perform, that could reduce the pain and provide the rationale as to why; be sure they are evidence-based. For example: Teach patient guided imagery to distract attention and reduce tension.

Part 3 (1-2 pages)
To assist the patient in preventing a recurrence of a similar incident once he returns to the assisted living environment, the RN needs to develop a teaching plan. Use the nursing process to consider the information the RN would need prior to development of the plan. Respond to the following and be able to support your answers. You will not be developing a teaching-learning plan but demonstrating using the teaching-learning process to prepare for an individualized plan.

How does the RN decide the format of the teaching plan, i.e., written, verbal, or other?
How does the RN know which information needs to be included?
When does the RN determine how and when to evaluate the teaching-learning process?

Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format.

SAMPLE ANSWER

Nursing Process and Nursing care plan

Part 1: Nursing Process

Nursing process is the key factor that facilitates the nurses in delivering quality patient centered care. Nursing is defined as the science and art concerned with protecting and promoting peoples psychological, physical, psychological and cultural aspects. The science is based on a big theoretical framework whereas its art is depicted on the caring capacities and skills of each nurse. The concept of nursing process was established to defined to guide the nurses when making decisions on  care  provision and it involves five major steps namely; a) Assessment, b) diagnosis, c) planning/identification of outcome, d) implementation, and e) evaluation (Bruylands Et al., 2013).

Assessment is the first step of nursing process and involves gathering of information and data concerning a particular event. The nurses are encouraged to perform holistic care assessment of both patient healthcare history and physical examination so as to determine the specific healthcare demands of a patient. The data gathered is sorted, organized and documented for future references. Nursing diagnosis is the second step in nursing process; which involves analysis of the assessment and data gathered. Diagnosis process is conducted with the aim of establishing the patient’s specific healthcare needs.  It involves identifying the actual problem including disease clinical manifestation. It also includes identification of risks factors and ways to improve patient’s outcome (Liu, 2013).

Planning step entails all activities geared towards   development of priorities, objectives and the identification of the desired outcomes. It involves identification of specific nursing interventions as documented by action plan. Nursing action plan is effective if it is guided by Maslow’s hierarchy of needs and the Betty Neuman’s system theory. The implementation process involves putting the action plan into action to achieve the desired outcome set for each patient. The patient continued to receive treatment and quality care until their healthcare condition is achieved. The last step is evaluation and it involves assessing of the outcomes to see if it is congruent with the action plan. If the outcomes are negative, the interventions are modified appropriately (Fleming, 2014).

According to Nursing Interventions Classifications (NIC), direct nursing interventions refer to nursing interventions which involve direct interaction with the client/patient. For example, medication therapy being provided to person with congestive heart failure.  Indirect nursing interventions include strategies that are implemented to improve patient’s health but the client is indirectly involved. This includes issues such as introduction of hourly rounding’s in hospital to reduce the number of hospital falls. Nursing interventions are classified into three broad categories including; a) dependent, b) interdependent, and c) independent intervention.  Interdependent intervention involves nursing actions that are implemented through partnership and teamwork. It involves intensive consultations across the healthcare provider before any intervention is implemented. These includes actions such recommend surgery to patients with hyperthyroidism.  This will only be done if all other therapy implemented has failed, and it involves a lot of consultation between the healthcare providers before the decision is made. The dependent interventions involve strategies that are recommended by higher health care authorities to the nurses. These include actions such as terminating patient’s medication due to reactions. The   independent intervention includes all actions that can be implemented by the nurse without any consent from the authority.  These involve all practices permitted by nurse practitioner scope of practice (Kehrel, 2015).

The nursing process guides the registered nurse in taking patients medical history while still remaining culturally competent.  Nursing process requires the nurses to identify the healthcare problem, identify the etiology analyze the risk factors. Using the data generated form these process, the nurse can design patient focused action plan.  The process also guides the identified intervention implementation in an orderly and structured manner.  The outcomes expected are goal oriented and focused in providing care to the patient (Lu Et al., 2015). The process requires documentation in each step and well communicated whenever it is necessary. The nurse interventions are then evaluated to check if they match the expected patient outcome. The evaluation process requires joint effort between the   healthcare providers; and where the outcomes are not achieved, it may require a little bit of brainstorming to identify the gap and to establish the variables that need to be re-evaluated. Some of the variables  that can be re-evaluated include  the data gathering/ assessment to check if the information was collected thoroughly or there was some information that  were overlooked. The second variables include diagnosis to check if risk factors were adequately explored (Vaillant-Roussel Et al., 2014).

In some cases, the etiology can be wrong or inadequately explored.  In some cases, the expected outcomes and interventions developed could be unrealistic or unreasonably unmanageable.  If the outcomes are not met, the nursing process begins all over again from the assessment, diagnosis and action plan to implementation. This time, the nurse can involve other peers so that they can contribute to the healthcare dilemma and hopefully identify the relevant ideologies in establishing the best intervention. The best intervention is the evidence based one. The nurses need to make thorough research to identify the best practice which must be agreed by all the health care providers and the stake holders involved. This way, the nursing processes helps the registered nurse by helping then identify and define the problem, gather the healthcare information relevant to the matter and to generate the best possible conclusions (Svavarsdottir Et al., 2014).

Part 2: Nursing care plan

Assessment

George King lives in a residential care facility. His movement is restricted and mainly depends on wheel chair. He can manage the daily living activities such as bathing and dining. He likes living in isolation. He has history of Cardiac Heart Failure disease, hyperlipidemia, and hypertension and lower extremity weakness. He is under the following medication. His previous  medication  including  Lopressor 50 mg, Atorvastatin  20 mg, Furosemide 20 mg and Quinapril 20 mg.

He is currently on Metoprolol 50 mg; Quinapril 40 mg, Furosemide 40 mg which are administered orally and cefazolin 1.5 g diluted in 50 mL 0.9% normal saline which is administered thrice a day. Recent routine medical checkup reported a pressure ulcer on his right side of the buttock.  The ulcer is estimated to be around 10 mm by 8 mm. It is red in color with yellow sports all over it. The ulcer produces foul odor.

Physical examination

Height: 5’8”; Weight: 56 kg; Temperature: 36.60C; Pulse: 90 BPM; Respiration: 22/Minute; Bp: 160/7 80 mm Hg: Skin is most but pale; the pupils dilated; the neurovascular system, muscular system and gastrointestinal system are intact. The patient complains of memory loss.

 Nursing diagnosis

  • Manage the pressure ulcer
  • Pain relieve
  • Patient education

Pathophysiology

The pressure ulcer is on the patient’s right side of the buttock.  The ulcer is estimated to be around 10 mm by 8 mm. It is red in color with yellow sports all over it. The ulcer produces foul odor.

Outcome expectation

The main objective is to relieve the discomfort associated with the pressure ulcer. The patient has to verbalize reduction of pain by 80%. The patient must be taught on ways to ensure that the pressure ulcer does not progress and to prevent occurrences of the pressure ulcer in the future.

Nursing interventions

  1. Establish the main reason why the patient prefers to use the movement aid rather than walking. This will facilitate identifying strategies to ensure that the patient does not remain sitting most part of his life
  2. Record the patients agility to record and monitor the patient pattern of movement so as to determine alternative walking aids that can be used other  than the wheel chair
  3. Nurse will conduct evidence based practice that can be applied to reduce progression of the disease and to relieve as well as cure the pressure ulcer nursing interdisciplinary approach.
  4. Educate the patient on behavioral modification such as mild exercises that can be done routinely to ensure that the patient does not remain seated most part of his life

Rationale and evaluation

  1. The patient verbalizes pain relief. There is little discomfort. The main reason the pressure ulcer occurred was the prolonged sitting in one position. The patient verbalizes the understanding of the disease pathophysiology
  2. The routine monitoring and increased exercise relieved the patient pressure ulcer. The patient was also advised to use roho cushion seats to reduce the  pressure on the wound
  3. The teaching program was objective and realistic. The RN is considering to teach other patients on strategies to reduce the pressure ulcer

 Part 3: Patient teaching plan

Working in partnership between the patient and the healthcare provider is important because it makes it possible to establish an all-inclusive relationship between these two parties. The man aim of partnership is to improve the quality of care. Communication is a key factor in teaching the patient on the best self-care management.   Patient education program is important because it enables patient understand their health conditions thereby improving their self-esteem.  The registered nurse is responsible for the development of a teaching plan; and during the process, the nurse should put several factors into consideration. To decide the format of teaching, the nurse must be close with the patient so as to identify their specific care needs that needs to be addressed through education (Fleming, 2014).

The main objective for patient education is to empower the patient, and once the teaching process initiates, it should not cease until the registered nurse is sure that the patient can take great care of themselves.  The patients’ health care demand can be assessed through physical examination and through consultation of medical history so that the nurse can identify the specific patients’ healthcare requirements. Based on the patient’s assessment report, three approaches can be used to teach the   patient. Cognitive approach involves using the patient cognitive function. The affective teaching involves applying of social cultural values and beliefs to make the patient trust the registered nurse education. This is particularly important when dealing with patient who belief in traditional and cultural values. Psychomotor involves physical teaching to the patient. Additionally, the nurse should   use the best format based on the patient age, education back ground and cognitive function to strategize if he/she will use verbal, written or audiovisual approach (Bruylands Et al., 2013).

Using the best approach, the nurse can identify the best intervention for each need. This includes identification of long term and short term objectives. Other close persons that interact with the patient can also join in the teaching process so that they can accord the patient the support he/she needs. For the mentally challenged person, the psychomotor teaching approach is the best. For the elderly, the registered nurse is advised to use audiovisual approach because it makes it better for the patient to understand. The young and those whose cognitive function is in good condition   can be taught using cognitive approach and both verbal and written format. The registered nurse should always check for feedback to evaluate if the patients completely understand the education completely. During the assessment, the nurse should assess weakness and strengths. This will enable the nurse to address the weakness better. Assessment can be conducted through questionnaires and observations. The report made can be used to enhance the patient teaching plan even more. In some cases, the objectives may not be realized because they are too complicated or unmanageable. In this context, the registered nurse should begin the whole process again, and where necessary integrate the peers so that they can contribute to strategies to help the patient self-manage their care (Svavarsdottir Et al., 2014).

   References

Bruylands, M., Paans, W., Hediger, H., & Müller-Staub, M. (2013). Effects on the Quality of the Nursing Care Process Through an Educational Program and the Use of Electronic Nursing Documentation. International Journal Of Nursing Knowledge, n/a-n/a. doi:10.1111/j.2047-3095.2013.01248.x

Fleming, J. (2014). A Future for Adult Educators in Patient Education. Adult Learning, 25(4), 166-168. doi:10.1177/1045159514546217

Kehrel, U. (2015). The acceptance of process innovations in drug supply – An empirical analysis of patient-individualized blister packaging in stationary nursing facilities. International Journal Of Healthcare Management, 8(1), 58-63. https://www.doi:10.1179/2047971914y.0000000085

Liu, J. (2013). Exploring nursing assistants’ roles in the process of pain management for cognitively impaired nursing home residents: a qualitative study. J Adv Nurs, 70(5), 1065-1077. doi:10.1111/jan.12259

Lu, C., Tang, S., Lei, Y., Zhang, M., Lin, W., Ding, S., & Wang, P. (2015). Community-based interventions in hypertensive patients: a comparison of three health education strategies. BMC Public Health, 15(1). doi:10.1186/s12889-015-1401-6

Svavarsdottir, E., Sigurdardottir, A., Konradsdottir, E., Stefansdottir, A., Sveinbjarnardottir, E., & Ketilsdottir, A. et al. (2014). The Process of Translating Family Nursing Knowledge Into Clinical Practice. Journal Of Nursing Scholarship, 47(1), 5-15. doi:10.1111/jnu.12108

Vaillant-Roussel, H., Laporte, C., Pereira, B., Tanguy, G., Cassagnes, J., & Ruivard, M. et al. (2014). Patient education in chronic heart failure in primary care (ETIC) and its impact on patient quality of life: design of a cluster randomised trial. BMC Family Practice, 15(1). doi:10.1186/s12875-014-0208-3

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Cultural competency in health and social care & nursing care  

Cultural competency in health and social care & nursing care
Cultural competency in health and social care & nursing care

Cultural competency in health and social care & nursing care

Order Instructions:

This is a 7 pages paper
Tips for Success
The M6A3: Cultural Competence: Registered Professional Nurse Responsibility Paper counts as 30% of your grade for this course.
We suggest that you develop and outline and use the following time-line as your guide for completing your paper:

Week 1: Review the requirements for the paper.
Week 2: Begin developing an outline for your paper.
Week 3: You should have your outline completed.
Week 4: You should be using your outline to write your paper.
Week 5: Continue work on your paper.
Week 6: Finalize your paper and submit by the end of the week.

Information on how to use the Excelsior College Library to help you research and write your paper is available through the Library Help for AD Nursing Courses page.
Information on using an outline and writing a scholarly paper is available through the Excelsior College Online Writing Lab (OWL).
If you have questions, reach out to your instructor via My Messages.
linked item M6A3: Cultural Competence: Registered Professional Nurse Responsibility Paper
Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that examines culturally sensitive nursing care. The paper consists of two (2) parts and must be submitted by the close of week six (6).
A minimum of three (3) current professional references must be provided. Current references include professional publications and valid websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.

Part 1 – Introduction
Address the following:

  • Using your own words, define culturally competent nursing care. Support the definition with a professional literature citation.
  • Identify four (4) guidelines the registered professional nurse may use to enhance the ability to provide culturally competent nursing care. Provide one example the culturally competent nurse applies to each of the four (4) selected guidelines. At least one example must address care of patient(s) not occurring in an acute care hospital.
  • Describe how the registered professional nurse evaluates if the patient’s cultural needs have been met.
  • Describe whether cultural practices must be accommodated in all aspects of health care. Provide a specific example and rationale to support your response.

Part 2- Demonstrating Culturally Competent Nursing Care
Address the following:

  • Select one of the following cultures:
    Asian
    Native American
    Hispanic
  • Select four (4) cultural features, associated with the selected cultures that influence the provision of nursing care for patients with chronic illness and at the end of their lives. Describe how the four (4) cultural features influence the provision of care to the patients.
  • Provide two (2) nursing interventions that demonstrate nursing care, which reflect the respect for the dignity and uniqueness of those cultural features for patients experiencing chronic illness and at the end of their lives.

Compose your work using a word processor (or other software as appropriate) and save it frequently to your computer. Use a 12 font size, double space your work and use APA format for citations, references, and overall format.

SAMPLE ANSWER

Part A:  Cultural competency in health and social care

The reforms in health care industry are focusing on ways to embrace diversity in providing care. Cultural differences affect patient’s perceptions about sickness, their assessment and disease outcome. With the advancement in technology, it has become easy for people to move from place to place making countries to be ethnically diverse than the nursing forces.  Thus, the nurses work with the patients from various cultural backgrounds. Therefore, the health care facility must provide a culturally competent healthcare environment.  Cultural refers to the way of life of a population including shared values, skills and languages (McClimens, Brewster & Lewis, 2014). It is the aspect of the society which defines person’s character due to the conscious and unconscious beliefs that have been installed in them. In this context, cultural competency refers to the ability to deliver quality care which is congruent with people’s social background and cultural expectations. A culturally competent organization is one that demonstrates that their organizations integrate awareness of the community health related cultural beliefs and how they impact the disease prevalence and the mortality rates. The healthcare settings must be established in a manner that acknowledges the value of culture and the repercussions if the health care providers fail to respect the diversity (Legha Et al., 2014).

Four essential elements are necessary in ensuring that the institutions are culturally diverse including a) valuing cultural diversity; b) valuing the cultural dynamics that makes the community interact effectively; c) adapting and reflecting to the understanding of the existing cultural diversity and d) possessing institutionalized cultural knowledge.  From all levels, the nurse must reflect on the diversity on the population the healthcare facility serves. This will facilitate the nurses to push better for care for the underprivileged and the underserved populations.  Valuing the diversity in the community it facilitates their understandings of the community perceptions about health. Everybody in the society or a nurse interacts with has a cultural identity which in one way impact their perception about culture. Importantly, the nurse must understand that culture is not static. It evolves over and over again with time (Dudas, 2012).

A client from developing country was admitted in one of the healthcare facility in this country. The person migrated into this country as an asylum seeker and all her life, she has believed and worshipped in one religion in the country of origin. Fortunately, on migration, the patient found other members in this country and fellowshipped together.  Whenever a person is admitted in hospital, there must be a ritual that has to be performed so as to scare away the evil spirits. The ceremony involves chanting, burning of the incense stick and produces some smoke. When the nurse in charge was requested, she was in a dilemma because she had never experienced these cultural rituals in public places before (Mareno & Hart, 2014). However, understanding the value  of cultural competence she discussed the matter with the senior  management  who evaluated the impact of disturbances  to the other clients  due to noise from chanting, risks for fire as the  burning of the things was being done  and the effects of smoke to patients from these  processes. The administration provided a separate room for the ritual. They even went ahead in incorporating the cultural concepts in their medication process. The patient was requested to chant prayers three times while facing west before taking the medication. Within a week, the patient condition had improved due to the increased cooperation with the medical providers (Norton & Marks-Maran, 2014).

From the case scenario, valuing the cultural components in the community will help the nurse reduce reactions and prejudices which could impact the patient-nurse relations. As a matter of fact, nurse culture is influenced by professional values as are slightly influenced by nurses’ beliefs.  Valuing cultural diversity is an important guideline because it the nurses responsibility to assess the patient’s needs and expectations as established by the patient cultural values.  For instance, some community beliefs that giving birth to disabled children is a curse; and is often associated with evil spirits. In such a case, it is more likely that the infant’s mother could feel distressed and confused. The nurse must listen to the patient to understand her concerns; and it is their responsibility to ensure that the mother overcomes the fear. These impacts the whole society as the woman could be bold to speak out for her child, empowering other women who are under similar circumstances (Legha Et al., 2014).

Additionally, the ability to recognize the cultural dynamics within the society is important. This is because it acts as a guide on how the community uses the dynamics to make sure that they live in harmony and that their health is protected or promoted. The cultural dynamics and potential interactions among the community increase the probability for stereotyping and misjudging. For instance, a nurse can associate certain ailments with cultural practices which seem unhygienic. In other cases, the nurse can discuss topics which are identified as bad omen to the society such as discussing issues of unborn child.  In this case, the nurse must listen to the patient’s description of their health conditions, the reason the patient thinks the disease is manifesting its symptoms and their perception on treatment (Norton & Marks-Maran, 2014).

Adapting and reflecting to the understanding of the existing cultural diversity is the third guideline that facilitates the nurses provide culturally competent care.  Every patient has a set values and beliefs that affect the way they view life and how they react to the world.  The best way to ensure that the nurse provides culturally competent care is through self-reflection on the values and barriers that could underscore his/her strategy to provide quality care to the patient. It is important for a nurse to reassess their interventions to various situations so as to identify issues that hinder or introduce cultural biasness; and where necessary seek assistance from other peers to establish the best intervention for a particular objective (Diaz, Clarke & Gatua, 2015).

Possessing institutionalized cultural knowledge is very vital in all sectors of health care systems. Nursing profession has cultural values too. These values include truthfulness, empathy, caring respect to patient preferences and promotion of health and autonomy. This nurse culture determines how a nurse interacts with the clients. For instance, a nurse who values patient empowerment and autonomy meets a patient whose cultural values does not allow them to make healthcare decisions for themselves, but the decision making process integrates the entire extended family could be in a dilemma, especially if the decision involves a  health care therapy that must be performed quickly to save the patient’s life. Therefore, the nurses must be empowered adequately so that they can make the right decision when faced by an ethical dilemma.  If the concept of cultural competency is ignored in medical schools, there will be increased mortalities, disease burden nurse burn out and increased turnover rates; especially in underprivileged societies in this nation (McClimens, Brewster & Lewis, 2014).

Part B: Culturally competent nursing care                                                   

The cultural belief is that illness is caused by ghosts, a punishment for not following taboos or loss of equilibrium between the body and the environment. The sick will often be stoic and quiet because the culture demands so. The sick person is more likely to request alternative therapy. The nurse must devise strategies that will integrate the patient culture when providing care. The culture does demands that terminal illness must not be discussed directly to the patient or in open discussion because it may hasten death events. The Native American like many other cultures emphasizes on cooperation and mutual aid.  In this context, the patient’s relatives will be mostly involved in decision making processes. The head of the family is the spokesperson of the person who is ill; and in most cases it is this person that will be used to communicate the family decisions.  Therefore, the nurse should consider integrating the community and the family in patient education. However, it is important for the nurse to observe the professional values including autonomy and independence (Hodge & Limb, 2010).

The most important issues in Native American culture are the spiritual; healing and that vary considerably from one tribe to another. The community is stratified into ranks, and member of each rank can be differentiated from the type of dress they wear. The dresses also indicate person rank in the society. Everything worn has a symbolic meaning on either prayer or healing. In this context, the healthcare must be vigilant when removing any clothes or ornament from the patient. If patient is not conscious to make decision if the cloth or the ornaments have to be removed, the items must be put very close to the patient and should be replaced back as soon as the medical operation is done. Some practices that are congruent with the health is burning sage, therefore, the nurse can spray sage as it is considered as a method of purification (McClimens, Brewster & Lewis, 2014).

The Native American culture has set standards for means and modes of communication. The person with higher authority is respected. Religious people are accorded the highest respect and must be addressed with respect.  Respect is shown by avoiding eye contact, keeping distance and having as little body contact as possible. In fact, the nurse should avoid hand shake. When the patient is speaking, he/she should not be disrupted as it is perceived as sign of disrespect.  In most cases, the client could make long pauses which are considered as a means of conversation, which implies that the patient is not in agreement with whatever the nurse is suggesting.  Speaking loudly to Native American indicates aggression, and it must be avoided. Where there is need to make an imperative command, the nurse must be emphatic and direct. If there is more healthcare recommendation or requests to be made, the nurse must give succinct explanation why the recommended process is important in a personable and polite way (Hodge & Limb, 2011).

Cultural assessment is one of the nursing interventions that is important in ensuring that quality healthcare is provides. This involves asking open-ended questions to the patient if he/she is conscious or a family member. This will improve the relationships between the nurse and the patient; making the patient becomes more cooperative. There are several cultural competence health assessment programs online which can be used to perform the process.  However, it would even be more appropriately if the health care facility designs their own tailor made cultural assessment program, one that fits the diverse people in the community. The nurse must also perform transcultural studies to understand the geographic region and values, beliefs and of the community living in the neighborhoods (Hodge & Limb, 2010).

Communication barriers are other challenges that enhance health disparities. Effective communication between the patient and the nurse facilitates better partnership. The patient is able to express about how he/she feels and his/her perceptions about the disease. The nurse can interact with the patient’s thought process which in turn facilitates the designing and implementation of the action plan. Health citizens will require establishing of a culture that embraces cultural competencies and reduces misunderstandings.  This way, the patients get empowered on ways to self-manage their health condition to meet their health care demands and   to improve the quality of life.  Effective communication between the patient and the nurse implies that the patient will be well informed and can be integrated in decision making processes. This in turn will facilitate provision of quality care, increase patient self-esteem and autonomy and improve their quality of life (Norton & Marks-Maran, 2014).

References

Diaz, C., Clarke, P., & Gatua, M. (2015). Cultural Competence in Rural Nursing Education: Are We There Yet?. Nursing Education Perspectives, 36(1), 22-26. doi:10.5480/12-1066.1

Dudas, K. (2012). CULTURAL COMPETENCE: An Evolutionary Concept Analysis. Nursing Education Perspectives, 33(5), 317-321. doi:10.5480/1536-5026-33.5.317

Hodge, D., & Limb, G. (2010). Native Americans and Brief Spiritual Assessment: Examining and Operationalizing the Joint Commission’s Assessment Framework. Social Work, 55(4), 297-307. doi:10.1093/sw/55.4.297

Hodge, D., & Limb, G. (2011). Spiritual Assessment and Native Americans: Establishing the Social Validity of a Complementary Set of Assessment Tools. Social Work, 56(3), 213-223. doi:10.1093/sw/56.3.213

Legha, R., Raleigh-Cohn, A., Fickenscher, A., & Novins, D. (2014). Challenges to providing quality substance abuse treatment services for American Indian and Alaska native communities: perspectives of staff from 18 treatment centers. BMC Psychiatry, 14(1), 181. doi:10.1186/1471-244x-14-181

Mareno, N., & Hart, P. (2014). Cultural Competency Among Nurses with Undergraduate and Graduate Degrees: Implications for Nursing Education. Nursing Education Perspectives, 35(2), 83-88. doi:10.5480/12-834.1

McClimens, A., Brewster, J., & Lewis, R. (2014). Recognising and respecting patients’ cultural diversity. Nursing Standard, 28(28), 45-52. doi:10.7748/ns2014.03.28.28.45.e8148

Norton, D., & Marks-Maran, D. (2014). Developing cultural sensitivity and awareness in nursing overseas. Nursing Standard, 28(44), 39-43. https://www.doi:10.7748/ns.28.44.39.e8417

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Business communication in nursing emails

Business communication in nursing emails
Business communication in nursing emails

Business communication in nursing emails

Order Instructions:

business communication but the class is nursing

Acting as supervisor for a company of your choice, draft two examples of formal company e-mails to employees.

The first email will be good-news message delivering information that your employees will likely view as positive.
The second email will be a bad-news email delivering information that your employees will likely view as negative.
Each email will be approximately two-three concise, professionally-written paragraphs in an appropriate tone. Post both emails in the same document.

SAMPLE ANSWER

Business communication in nursing emails

Bad Email

Dear employees,

Our company’s turnover rate for the last financial year is reported to be unexpectedly low. Consequently, the company is experiencing financial downside and this call for a contingency plan to reduce the operation costs. For this reason, the management has agreed to reduce the number of employees.

We have strived to the best of our abilities to avoid this approach but there is no other alternative to stabilize the financial crisis. We regret to inform you that we have to terminate some positions held by new employees, interns and freshers.

We are sincerely grateful for your diligence and commitment towards achieving the company goal. We assure you that this move is only a temporary measure and when the situation stabilizes, we may consider hiring you back. The company will give you some bonus as a measure of our gratitude.

Yours Sincerely,

HR

Good Email

Dear employees,

Kindly accept our warmest gratitude for your hard work and marvelous contributions to the organization. We value the much time and energy dedicated towards achieving the organization goals and mission. It is a great pleasure to know that we can always account on you as we strive to climb even higher.

The company management was delighted to learn that our company was voted among the best performing company in the world. We understand that this was not easy, and that it is your willingness strives above and beyond.

For this reason, the management has decided that every employee shall have a pay raise of 13% of their current salary. The employees will also have increase in major allowances including house allowance, medical allowance and transport.

Yours Sincerely,

HR

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Care plan for the chronically ill; Cancer

Care plan for the chronically ill
   Care plan for the chronically ill

Care plan for the chronically ill

Order Instructions:

Utilizing the information you have gathered over the weeks regarding the specific illness group you identified, this week, you will create a holistic plan of care for your chronic illness group.

Create the plan in a 3- to 4-page Microsoft Word document written in APA style format. Include the following in your plan:
•Start the paper with a brief introduction describing the chronically ill group you selected and provide rationale for selecting this illness and the participants. Clearly identify the purpose of the paper.
•Divide the report in two parts. In Part I, include a compilation of the assignments from Week 1 to Week 4. Identify how each week’s assignments help you to create a well-managed care plan.

•In Part II, include the care plan for your chronic illness group organized under the following headings:

  • Nursing Diagnoses
  • Assessment Data (objective and subjective)
  • Interview Results
  • Desired Outcomes
  • Evaluation Criteria
  • Actions and Interventions
  • Evaluation of Patient Outcomes

Include a reference page to provide reference for all citations.
•Include strategies for the family or caregiver in the care plan and provide your rationale on how they will work.

Support your responses with examples.

Cite any sources in APA format.

SAMPLE ANSWER

The chronically ill group chosen for this project is the cancer patients. The reason why cancer was chosen is because it is one of the leading killers in the world at an estimated eight million deaths per year. Globally, estimated populations of fourteen million people are usually diagnosed with cancer every year. (IHartmann, Loprinzi & Mayo Clinic, 2012, pg 5). Below is a report whose main aim is to create a plan of care for the cancer patients.

The assignments from the previous weeks played a major role in helping in the development of the care plan. The first assignment which was on the identification of the illness helped in the grasping of what the illness is all about that is in terms of the signs and symptoms. The second assignment was on the impact of the disease. This helped in showing how the disease can affect an individual and this provides perfect grounds of planning how to deal with such individuals. The third assignment which was on support need analysis of cancer patients helped in the drafting of an efficient nursing action and intervention. The fourth assignment  was on resources available for the people suffering from cancer. This was  crucial and helpful in the drafting of assessment data to be used in diagnoses since for the assessment data to be collected, these resources must be available to aid in the process of collecting the data.

 CARE PLAN

Nursing diagnoses

A common sign diagnosed among most of the patients is usually fatigue. (Weis & Horneber, 2014, pg 20)

Assessment Data

A number of tests are usually carried out  and these tests are as follows.

Firstly, there is the endoscopy test is done  to determine whether there are any abnormalities and this is done through the direct visualization of the internal body organs and cavities

Secondly, there is the carrying out of scans such as magnetic resonance imaging and this is done so as to identify metastasis and other diagnostic purposes

Thirdly, there is the biopsy test which may be taken from organs such as the bone marrow and the skin and the main function of this is to diagnose and delineate the treatment.

Fourthly, there is the using of screening chemistry tests such as electrolytes.

Fifthly, there is the counting of blood cells with the platelets and differential and this may be used to detect anemia, change in the blood cells or an increase in the number of platelets.

Sixthly, there is the conducting of chest x-rays to screen for possible diseases of the lung which can easily interfere with breathing.

Lastly, an interview is also conducted between the patient and the nurse.

Interview results

After the interview, some data is collected and this data is the result of the fatigue

  • The accumulation of cellular waste materials
  • Difficulty of sleeping and resting
  • Anemia, which causes tissue hypoxia.
  • Nausea and anxiety.
  • Disinterest in surroundings.

Desired outcome

The most desired outcome is to minimize the fatigue and enable the cancer patients to take part in desired activities at their maximum level of ability

Evaluation criteria

This is the criterion that was used in determining that the data collected is as a result of the fatigue and it is as follows;

The diagnosis of cancer and the chemotherapy treatments brings about overwhelming emotional demands which can easily bring about the fatigue.

The continuous and active growth of tumor combined with an increase in the amount of certain cytotoxins raises the metabolic rate which means that there is an increased use of energy in the body.

The medications used to control the pain have side effects which bring about the fatigue hence bringing about the nausea and anxiety.

The accumulation of cellular waste materials occurs as a result of the rapid breaking down of the normal and cancerous cells by cytotoxic drugs.

Difficulty of sleeping and resting occurs as a result of fear, anxiety and discomfort which come with the diagnosis of the disease.

The tissue hypoxia is as a result of anemia. The anemia is most likely caused by malnutrition and the suppression of bone marrow which is usually induced by the chemotherapy treatment. (Noogle, 2012, pg 420)

Actions and interventions

Once the fatigue has been diagnosed certain actions should be taken by the nurse and these are as follows;

Firstly, the symptoms and signs of fatigue should be assessed for and be determined whether or not they are present.

Secondly, the patients should be informed that the fatigue is as a result of the disease itself and the chemotherapy treatment

Thirdly, the patient should be aided to identify the pattern of fatigue and this is aimed at avoiding performing some activities during the greatest time of fatigue

Fourthly, there should be the Implementation of actions to minimize fatigue. Such actions include promoting a nutritional status that is adequate, administering anemia treatment as prescribed, facilitating the psychological adjustment of the patient to the diagnosis of the disease and the side effects of its treatment and also gradually increasing the patient’s activity as tolerated.

Lastly, if the signs and symptoms of fatigue continue to worsen, an appropriate health care provider should be consulted

Evaluation and intervention

Once the actions have been followed, the following will be used to assess whether the goals of the care plan have been reached

Firstly, the patients will be able to perform their usual activities of daily living as they used to perform before the illness.

Secondly, the patients will have an increase in the interest of their surroundings. Their level of concentration will also improve.

Thirdly, the patients will able to notice the feeling of their body experiencing an increase in the level of energy unlike before when they were experiencing the fatigue.

Strategies for the family/caregiver

The following actions from the caregiver or family of the patient are quite important since they aid in the quick recovery from the fatigue.

The family or care giver of such a cancer patient should give moral support to the cancer patient especially when the patient seems to be withdrawn from the surrounding environment.

It is also important for the family/caregiver of the patient ensures that the patient takes all the medication prescribed by the health professional.

At times a health professional might suggest for the patient to perform actions such exercises. The family/caregiver should ensure that the patient performs all this actions

The family/caregiver should have the contacts of the health professionals which is important in case of any emergency.

In conclusion, a care plan is effective in dealing with a diagnosis since it acts as an aid to a nurse in helping to determining and dealing with a certain diagnosis.

References

Hartmann, L. C., Loprinzi, C. L., & Mayo Clinic. (2012). The Mayo Clinic breast cancer book. Intercourse, PA: Good Books.

Weis, J,. & Horneber, M. (2014). Cancer related fatigue

Noogle, C. A. (2012). Neuropsychology of cancer and oncology. New York: Springer Pub.

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The State of the Nursing Profession

The State of the Nursing Profession
The State of the Nursing Profession

The State of the Nursing Profession

Order Instructions:

assignment “Key Questions”
Capstone Project
Key Questions

Directions: Submit a minimum of 2-3 pages APA format with a minimum of 3 references

Answer the following questions about your profession:

  • Where are we?
  • Where do we need and want to be?
  • What is the best way to get there?
  • How do we evaluate our progress?

SAMPLE ANSWER

The State of the Nursing Profession

As it has always been, the nursing profession is highly competitive. There is a growing need for more nurse practitioners day-in-day-out. The growing global population requires more nursing personnel to provide service to them. Hospitals are also being established all over the world creating job opportunities for nurses. The issue of insufficiency of health care services has been a concern in most countries. As most of these countries advance economically, they are able to improve the sector by the construction of hospitals of different categories to ensure that the basic need is accessed by all citizens. The need to equip the hospitals with health care professionals especially nurse practitioners and doctors has been prioritized by most present governments. Generally, the profession is at a good condition and there are unlimited job opportunities for nurses. Unlike several other professions, nursing allows graduates to practice in different environments all over the world, offering them a wide range of market. However, as De Milt, Fitzpatrick and McNulty noted, some practitioners experience discomforts in their job, just as they do experience satisfactions. Particularly, a good population of the practitioners is dissatisfied with the lack of collegiality in the profession, insignificance of intra-practice partnerships as well as the questionable growth of the profession, (DE MILT, FITZPATRICK, & McNULTY, 2011, pg. 87).As a result of such occurrences; some nurses consider the working environment unfavorable.

Nurses need to gain confidence with their profession. Though nurses are still needed in abundance, securing employment has been a challenge to some of them. National Students Nurses Association (NSNA) noted that new graduates in nursing face unemployment due to flooding of the registered nurses field by old experienced nurses (NSNA, 2012, Pg. 38). It is the wish of every nurse to get employed. It would be a disappointment, if after undergoing the intensive training in nursing, one would still have to take a long while to secure a job.Usually, most firms require experienced nurses, which is probably right for them. The question now comes in: how and where should the new nurses earn experience if they are not employed in the first place?

NSNA advised on the ways that would enable fresh young nurses overcome unemployment. New nurses are advised to first enroll as Certified Nursing Assistants (CAN) as a means of introducing themselves into the field where they would concurrently gain experience (NSNA, 2012, Pg. 58). While new nurses are not discouraged, they are advised that experience is crucial considering the nature of the profession. It is therefore an important thing to seek for them to become competitive. Nursing graduates are also advised to advance their education while still working as CNAs. Those with diplomas and associate degrees are advised to pursue RN (Registered Nurse), while those with RN are advised to pursue masters programs (NSNA, 2012, Pg. 38).

To improve the working environment for nurses, American Nurses Association (ANA) offered a guideline that constituted of six mechanisms. The six were ability to communicate in a skilled manner, team work orientation in service provision, making of sound and effective decisions, adequacy of staff, mutual recognition among nurses and pursuit of an authentic leadership style (ANA , 2010, Pg. 14).

Progress Evaluation

Achievements in nursing would be translated in the satisfaction seen among members of the profession. The more the unaddressed challenges are, the high the likelihood of nurses to feel insecure. The ease with which nursing graduates get employed is also likely to relate directly with achievements of the entire profession. If proposed methods to improve the status of the profession are implemented, a spirit of collegiality would be felt in the interactions among nurses. Generally, progress would be evaluated by the extent to which confidence in the profession is maintained.

Bibliography

ANA. (2010). Nursing: Scope and Standards of Practice. Maryland, MD: Silver Spring

DE MILT, D. G., FITZPATRICK, J. J., &McNULTY, R. (2011).Nurse Practitioners’ Job Satisfaction and Intent to Leave Current Positions, the Nursing Profession, and the Nurse Practitioner Role as a Direct Care Provider. NCBI, 23(1):42-50. doi: 10.1111/j.1745-7599.2010.00570.x.

NSNA.(2012). Realities of the Current Job Market. Retrieved May 8, 2015 from http://www.nsna.org/Portals/0/Skins/NSNA/pdf/RealitiesOfTheCurrentJobMarket.pdf

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Nurses Utilization of Strategic Planning in New Millennium

Nurses Utilization of Strategic Planning in New Millennium Order Instructions: Directions: Submit a minimum of 2-3 pages APA format with a minimum of 3 references

Nurses Utilization of Strategic Planning in New Millennium
Nurses Utilization of Strategic Planning in New Millennium

What ways can nursing utilize Strategic Planning in the new millennium?

Nurses Utilization of Strategic Planning in New Millennium Sample Answer

How Nurses can utilize Strategic Planning in the New Millennium. Proper planning allows nurses to offer quality services to their clients. Just like in any other profession, planning is necessary in ensuring that an organization runs smoothly. Laying out strategies helps the stakeholders to anticipate different situations, therefore, putting them at a good position in the handling of varied circumstances. Planning also protects an organization from external influence such as competition. Political influence as illustrated by Patricia and Morana could for instance have detrimental consequences on nurses if they do not anticipate it. A good strategy for nurses should ensure that they anticipate challenges in their work. Such a strategy should also provide means by which challenges are to be addressed.

Challenges likely to be faced by nurses in a health care facility include shortage of staff to handle clients, and insufficiency of resources. To handle the issue of shortage of staff, a previous plan could for instance giveguidelines on the way the available nursing staff should organize itselfto avoid inconveniencing other patties. For the case of insufficient resources, a good plan could offer alternatives such as where and how to solicit for funding. Unlike in a situation where no plans are laid, either of the above illustrated issues could be handled in time, and with optimal efficiency.

In their plan, nurses should clearly outline their objectives and confine them within specific timelines. Patricia and Morana(2009) wrote that a strategic plan should be flexible to allow modifications with time.  Nurses should ensure that their strategic plan sails with time to avoid future obstructions. As they carry out their duties, the nurses should be guided by the outlined objectives to minimize unnecessary diversion of attention from their goals. The plan should also allow the nurses to work toward a common goal by being acceptable by the whole personnel, (Patricia, & Morana, 2009, pg.29). The plan should bring together the entire workforce in the addressing issues that may arise in the future. By giving guidelines on what should be done, a well stipulated strategic plan would minimize incidences of misunderstanding among nurses, and in turn promote their unity.

During the formulation of the plan, nurses should prioritize on their welfare as well as that of other patties in their environment. For instance, the nurses could ensure that the plan leads to the well-being of patients. It should also offer good ways of interacting with other health care staff, including doctors, pharmacists, record keepers and subordinate staff.

By implementation of their strategic plan, nurses should attain good results with minimal strain. For the future success of an organization, its current situation should be controllable. A strategic plan could allow nurses to check their progress by directly comparing their achievements to the expectations earlier stated in the plan. Fox wrote that planning enables assessment of progress and allows for constant evaluation of an organization’s achievements (Karen, 2012, Pg. 243)

Criticism should be encouraged to ensure that the nurses strictly adhere to their plan. There should also be channels through which constructive criticism is offered so that any reluctance of the members in the execution of the plan is noted, positively discouraged and corrected.

A good plan promotes unity by creating the impression that the welfare of the entire organization is prioritized. Personal gains in a plan should only be felt after the success of the organization at large. Planning, importantly, ensures timely addressing of arising issues that may hinder the success of the nurses. In addition, the plan would see to a healthy interaction between seniors and their juniors.

To conclude, a strategic plan guides the nursing community to their future. The more comprehensive a plan is the higher are the chances of the nurses’ success.

Nurses Utilization of Strategic Planning in New Millennium References

Karen, D. (2012, May). Strategy as Solution: Developing a Nursing Strategic Plan. Lippincott Williams & Wilkins, 42(5), 242-243

Patricia, L., &Morana, C. (2009, March). Nursing Strategy: What’s your Plan? Nursing Center, 40(3), 25-29

 

Nurses Performance and Role in Multidisciplinary Team

Nurses Performance and Role in Multidisciplinary Team Nurses Performance and role Within the Multidisciplinary Team contemporary nurse’s role within the multidisciplinary team and how does the nurse perform those roles within the team Order Instructions: ESSAY:What are a contemporary nurse’s role within the multidisciplinary team and how does the nurse perform those roles within the team? Give some examples.

Nurses Performance and Role in Multidisciplinary Team
Nurses Performance and Role in Multidisciplinary Team

Resources:10 current & relevant that are less than 5 yrs.old text & journal Format: APA double space with Introduction,Body and Conclusion.

Nurses Performance and Role in Multidisciplinary Team Sample Answer

Contemporary Roles of a Nurse within a Multidisciplinary Team

Introduction

Nurses are essential health care personnel in the contemporary society. Their roles dominate the health care sector in more than ways. Nurses work with other health care providers in order to fully serve patients. In the dissemination of health care services, most hospitals divide their personnel into departments that constitute specialties from different fields. Usually, nurses and other health professionals may undertake post-graduate courses to increase specialty in their respective fields. Grouping of health workers with related knowledge but from different perspectives guarantees high-quality medication to patients. The grouping results into a number of team each addressing cases within the areas of specialty. By so doing, the otherwise bulky and complicated activities in the health sector are simplified. Specialization and job division ensure that the personnel are not overworked and at the same time, allow the different personnel to develop experience in relevant matters. The concept of grouping professionals with related specialty but from different basics results in what is termed as multidisciplinary teams. A team that addresses conditions of a certain type is usually different from others. If a hospital establishes the team spirit within its workforce better results are likely to be attained with less straining. Just like other health care professionals, nurses advance their education to increase their specialty. As such, nurses join their counterparts from other fields and together as a team they provide care to the patients.For example, a nurse who pursues midwifery associates with professionals in the field of gynecology. On the other hand, a nurse who pursues psychiatric would join a team that deals with mental health care. In particular, a team dealing with mental health would comprise of psychiatrists, psychiatrist nurses, clinical psychologists and psychiatric social workers (PATIDAR, 2013, INTRODUCTION SECTION). All such personnel are related though each of them approaches the matter from a perspective different from the others’.Issues in this paper focus on the nurse’s contribution to such a team.

Contemporary Roles of a Nurse within a Multidisciplinary Team

American Nurses Association (ANA) noted that nurses are mainly involved with primary care for patients (2012). For instance, they are the ones most trusted to offer first aid to patients, especially the victims of accidents and crime. Usually, after doing what is expected of them, nurses should them allow professions of other relevant fields to do their part. In a multidisciplinary context, each professional is entrusted with a particular service to the patient. For instance, nurses are believed to the most appropriate professionals to offer first aid services. Regarding their training, professionals on a team are expected to account for what is relevant to their field. Data shows that nurses in the US are the most health care providers that offer primary care to patients (NAYLOR & KURTZMAN, 2010, Pg. 893). The data correlates with expectations.

Nurses conduct close monitoring of in-patients and offer valuable information to other health professionals. In this way, nurses link patients to doctors and other clinicians therefore, enhancing the provision of quality services. Nurses for instance could observe the feeding, talking, breathing and other activities of a patient and communicate the same to doctors. Nurses usually pay attention to observable improvements or deteriorations that a patient may depict. By performing this role, nurses facilitate the provision of improved care to the most important concern in the health sector; the patient. A nurse could for instance reports to the doctor that a patient, seems to be affected by a certain medication and by heeding to the advice, the doctor responds by prescribing an alternative drug. The ultimate healing of the patient therefore depended on the nurse at least for a time.

Nurses also provide extensive education to their patients (JENNINGS, 2015, Pg. 78). In most cases, nurses interact more with patients than does any other health care provider professionals. The direct interaction place nurses in a good position for extending advice to patients. They may even offer education that could be important, though unrelated to the patient’s present condition. For instance, nurses would talk with women in their wards about benefits of breastfeeding their babies while in the contextit is not the babies that are sick but the women.

Nurses also have a role to play by making policies pertaining to the health sector. The health sector is a dynamic sector that is influenced by many external players. Being at the central position in the health sector, nurses have plenty of information that would be useful in the formulation of laws and policies concerning health matters (WAYNE, 2012, Pg. 18). For instance, in the case of first aid provision, nurses could offer information that would help improve services to victims of accidents and crimes. A nurse could cite the critical conditions of the patients they receive to push that victims be given advanced care regardless of whether their medication is funded or not. Murphy noted that nurses are competent enough to influence changes in the health sector (In WAYNE, 2012, Pg. 56).This shows that nurses play a vital role in policy making.

Nurses are also viewed as innovators who should contribute to advanced health care provision (HASSMILLER, 2010, Pg. 173). Due to their wide exposure to different health conditions, nurses can work with other health care providers to develop solutions to medical problems. Nurses are placed in a position where they can easily identify arising issues in the health care. For instance, nurses may observe the best environments for patients with a particular medical condition, and use the knowledge in solving medical issues. If nurses offer their best into research, many developments in the management of different health conditions would be made.

In addition, nurses together with other health professionals should suggest and develop education policies that would equip health care students with the best skills to handle current issues in their field. The working experience the nurses’ gain should place them into a position where they can contribute to the betterment of the health sector by ensuring that newly graduated nurses possess the best skills required to handle matters in the field. By offering this, nurses would have responsibly and selflessly served the public.

Nurses also have the responsibility to protect the rights of their patients. Since most patients are ignorant of the particulars of services offered to them, nurses have a great responsibility of ensuring that they do not exploit the patients. All duties undertaken by the nurses should see to it that while satisfying their interests, nurses do not tend toward evil implications for the patients. People who make good nurses are compassionate and possess willingness to help others.

Nurses Performance and Role in Multidisciplinary Team Conclusion

Nurses have a great role in the creation of the team-work environment with other health care providers. As Hassmiller wrote, nurses should generously contribute in all matters pertaining to health care provision. Nurses as Hassmiller further advised should promote the spirit of teamwork when working with professionals from other fields by first understanding and appreciating the role of other professionals. For multidisciplinary teams to succeed, members should have a common goal, embrace each other and avoid creating tension among them (JANE, LESLEY, JOANNE, BRONWYN, & KATHLEEN, 2010, 61).Hospitals with multidisciplinary teams performs better than those without (O’ LEARY, SEHGAL, TERRELL, & WILLIAMS, 2011, Pg. 48)

Nurses Performance and Role in Multidisciplinary Team References

AMERICAN NURSES UNION.(2012). CareCoordination and Registered Nurses’ Essential Role. Retrieved May 4, 2015 from http://nursingworld.org/MainMenuCategories/Policy-Advocacy/Positions-and-Resolutions/ANAPositionStatements/Position-Statements-Alphabetically/Care-Coordination-and-Registered-Nurses-Essential-Role.html

HASSMILLER, S. (2010).Nursing Role in Health Care Reform.HealthCom Media, 5(9), n.p

JANE, C., LESLEY, W., JOANNE, C., BRONWYN, W., & KATHLEEN, H. (2010). Multidisciplinary Teams Caring for People with Chronic Conditions: Experiences of Community Nurses and other Allied Health Professionals. A journal for Australian Nursing Profession, 36(1/2), 61-70

JENNINGS, L. (2015). Roles and Functions of the Nurse. Retrieved May 4, 2015 from http://study.com/academy/lesson/roles-and-functions-of-the-nurse.html

NAYLOR, M. D., & KURTZMAN, E. T. (2010).The role of Nurse Practitioners in Reinventing Primary Care. Health Affairs, 29(5), 893-899. doi: 10.1377/hlthaff.2010.0440

NHS CAREERS.UK.(n.d.).Nursing. Retrieved May 4, 2015 from http://www.nhscareers.nhs.uk/explore-by-career/nursing/

NYBERG, K. (2011). Teamwork and Collaboration Lead to Better Medical Care in Hospital Setting. Yale School of Medicine. Retrieved May 4, 2015 from http://yalemedicine.yale.edu/autumn2011/news/chronicle/109165/

O’LEARY, K. J., SEHGAL, N. L., TERRELL, G., & WILLIAMS, M. V.( 2011). Interdisciplinary Teamworks in Hospitals: A Review and Practical Recommendations for Improvement. PubMed.gov, 7(1), 48-54 doi:  10.1002/jhm.970. Epub 2011 Oct 31

PATIDAR, J. V. (2013). Multidisciplinary Mental Health Team.LinkedIn Corporation, retrieved May 4, 2015 from http://www.slideshare.net/drjayeshpatidar/multidisciplinary-mental-health-team

WAYNE, K. (2012). The Nurses Role in Health Care Reform at the State Level.American Journal of Nursing, 112(3), 8.doi: 10.1097/01.NAJ.0000412628.02033.27

 

Assessments and nursing interventions for Post Anaesthetic Care Unit (PACU)

Assessments and nursing interventions for Post Anaesthetic Care Unit
Assessments and nursing interventions for Post Anaesthetic Care Unit

Assessments and nursing interventions for Post Anaesthetic Care Unit (PACU)

Order Instructions:

Hello writer sir, how are you today

Thank you very much for helping me to complete this assignment.

• Please see the detail instruction for Assessment task, video reflections and rubric marking guide.
• I attached Video link with assessment task paper. There are 5 questions to give the answers.
• I need at least 15-20 genuine references with APA referencing style between years 2008 to 2015.
• I attached unit outline for your kind information to know what they looking in to the assessment and you can find some useful references.
• I am in Australia so please try to use Australian or New Zealand based study or article to support the papers please ( if you can)
• If you need any other information please feel free to email to me ASAP

SAMPLE ANSWER

Assessments and nursing interventions for Post Anaesthetic Care Unit (PACU)

  1. Identify the assessments performed. Were these assessments adequately prioritized?

The post-operative care must be adequately planned to make the client’s recovery process fast.   After the patient identification is positive, the second step is physical assessment (Parekh Et al.,2013). This includes recording patient Heart Rate, respiration rate, temperature SpO2, and Blood pressure. Other processes include examining patient’s oxygen requirements, Urine output, IV fluids, Blood loss, Analgesia, surgical wound assessment and presence of drains. The RR, HR, SpO2 should be done continuously until the patient is ready for transfer to inpatient ward (Barnes Et al., 2013).

From the video, the assessments performed were prioritized. Once the nurse received and formally identified the patient from operating room, she performed full body assessments, starting with the airway, to ensure that it is patent. Oxygen is a very important aspect of the body metabolic functions; its deficiency leads to serious complications or even death. An artificial airway must remain in place until the patient can breathe easily (Milby Et al., 2014).

The nurse monitored the oxygen saturation levels via pulse oximetry. If the difficulty in coughing is prolonged, the nurse is supposed to suction the accumulated secretions. The patient in the video seemed to have small in difficulty in breathing. In this case, it is also important to encourage the patient to take deep breath and cough every 2 hours as this will help boost oxygen saturation levels in the lungs (Price Et al., 2011). The patient lung’s was auscultated.

In terms of the circulatory system, the nurse assessed the patient any indication of internal or even external bleeding and there was none. She did this assessing the patient’s skin color and condition. The patient ECG readings were closely monitored. The patient indicated that she was hypothermic; therefore, the nurse provided a heated blanket (Bittner, Eikermann & Schmidt, 2012).

The patient positioning is also very important during PACU (Demirel Et al., 2014). The nurse positioned the patient with head flat. Evidence based practice indicates that this positioning prevents hypotension (Price Et al., 2011). For unconscious and/ or unresponsive patients, they should be positioned on their side to reduce risk of aspiration (Tighe Et al., 2014). For patients with abdominal incision, they should be repositioned every two hours (Seglenieks, Painter & Ludbrook, 2014).

If the patient is fully responsive, the head should be raised slightly so that the respiratory expansion is facilitated (Shah Et al., 2014). Most patients present with a reaction to anesthesia such nausea and vomiting (Simpson & Moonesinghe, 2013).   For such clients, antiemetic drugs should be administered. It is also important for the nurse to assess the patient sensations and movement in the extremities (Tighe Et al., 2014).

The nurse also assessed the patient’s bladder for distention and the catheters in situ for patency. The patient’s frequency in urination, the urine color, odor and the amount of urine were also assessed. The Nurse checked the surgical wound to check for signs of excessive drainage. The surgical wound did not indicate any complication. Pain assessment was scored at 7/10. For this high pain scores, the nurse was required to administer pain medication (Harrop-Griffiths, Et al., 2013).

All the assessments procedures were within the normal range. Once the patient is ready for transfer, other investigations should be conducted including biochemistry analysis of the patient’s complications, the secondary symptoms associated with the surgical process.  This way, the patient educational demands will be addressed adequately on the nutritional requirement and the job/mobility restrictions (Madenski, 2014).

 

  1. How effective was the communication between the two nurses? Did it promote teamwork?

Effective communication in nursing is important because it increases opportunities to interact with one another. Effective communication between the two nurses facilitates quick and informed decision making with minimal chances for medical errors (Lunn Et al., 2012).  Communication between the nurses can face some hurdles such as perceived loss of autonomy, clashing perceptions and trust issues. However, the two healthcare providers had an open attitude, trust and some mutual respect for each other. Consequently, the process was conducted with utmost professionalism and increased satisfaction; thus promoting teamwork (Haenke, 2013).

  1. How effective was the communication between the nurses and the patient?

Engaging in communication is also portrayed in the way the nurses engage the patient in communication during the assessment (Law Et al., 2011). This ensures that the patient is informed and can be integrated in the decision making process (Haenke, 2013).  Additionally, through communication, the healthcare providers understood the patient demands thereby ensuring that the patient received individualized care.  This nurse-patient interaction indicated nurses’ extent of courtesy, sincerity and kindness (Lunn Et al., 2012).

  1. Identify the post -op orders. Were all of these discussed?

The Post-op orders were well communicated both verbally and in written form.  For instance, the clinical handover highlighted issues that were important throughout the intraoperative period. These included issues such as patient’s body temperature, which recorded low, and the inability of the patient to do a deep breathe and cough, among others. The patient pre-surgery conditions were also explained in detail to the PACU nurse to ensure that the PACU nurses had a baseline for comparison (Christensen Et al., 2013).

  1. Based on literature, are there any recommendations to improve for future practice?

Post-operative patients are normally taken to the post anesthesia unit (PACU) in order to monitor their recovery from anesthesia (Price Et al., 2011). During this time, the nurses conduct relevant assessments and provide medication as necessary, in order to relieve pain, or to avoid further complications (Lovestrand, Phipps & Lovestrand, 2013). Postoperative processes are associated with many complications resulting from immobility, a compromised respiratory system and thrombophlebitis (Milby Et al., 2014). The patient is also at risk of suffering from anemia due to excess blood loss resulting in reduced circulating blood volume. Tissue perfusion also commonly referred to as Hypovolemia may occur due to reduced circulating blood volume (Demirel Et al., 2014).

The evidence-based practice acknowledges the importance of evaluating patient recovery system from anesthesia using Aldrete scoring system (Yip Et al., 2014).  Each of the vital body organ must exhibit stability and these includes circulatory system, oxygen saturation, consciousness and activity. The patient is ready for discharge from PACU if the Aldrete score is 8 out of 10. The patient must also exhibit stability in most of the vital signs (Ganter Et al., 2014). Additionally, there should be no bleeding and the reflexes must have returned to normal including swallowing, cough and gags. The surgery wound should be minimal to moderate and the urine output must be at least 30mL/ hr (Yazicioglu, Akkaya & Kulacoglu, 2013).

Other recommendations provided by evidence-based practice are provision of discharge education of the patient. This includes education relating to medications, in terms of the dosage, purpose of dosage and possible adverse effects. Dietary guidelines should be provided as well as all activity restrictions.  The patient should also be advised wound treatment instructions and how to use assistive devices (Ganter Et al., 2014). This involves care givers roles implying that they must be integrated in the process. Future studies should look into staff beliefs and attitudes on patient relative’s visitations in the PACU; and how this impacts patient satisfaction and during the recovery process.

References

Barnes, C., Stowelt, KM., Bulger, T., Langton, E., & Pollock, N. (2015),Safe duration of postoperative monitoring for malignant hyperthermia patients administered non-triggering anaesthesia: an update). (2015, February 22). Medical Devices & Surgical Technology Week, 157. Retrieved from http://go.galegroup.com.ezproxy2.acu.edu.au/ps/i.do?id=GALE%7CA406363429&v=2.1&u=acuni&it=r&p=AONE&sw=w&asid=07227708e60596f007e8f97b391b611a.

Bittner, E., George, E., Eikermann, M. and Schmidt, U. (2012). Evaluation of the association between quality of handover and length of stay in the post anaesthesia care unit: a pilot study. Anaesthesia, 67(5), pp.548-549.

Christensen, R., Voepel-Lewis, T., Lewis, I.,  Ramachandran, S., & Malviya, S. (2013). Pediatric cardiopulmonary arrest in the postanesthesia care unit: analysis of data from the American Heart Association Get With The Guidelines®-Resuscitation registry. Pediatric Anesthesia 23: 517–523

Demirel, I.,  Et al., (2014) Comparison of patient-controlled analgesia versus continuous infusion of tramadol in post-cesarean section pain management. J. Obstet. Gynaecol. Res. Vol. 40, No. 2: 392–398

Ganter, M.T., Et al (2014).  The length of stay in the post anaesthesia care unit correlates with pain intensity , nausea and vomiting on arrival. Perioperative medicime 3:10

Haenke, R. (2013). Letter to the Editors: Post-Anesthesia Care Unit and Six Sigma Process. HERD: Health Environments Research & Design Journal, 7(1), pp.126-128.

Harrop-Griffiths.,  W.,  Hosie, H., Kilvington, B., MacMahon, M., Smedley P. & Verma, R. (2013). Immediate post anaesthesia recovery 2013 Association of Anaesthetists of Great Britain and Ireland. Anaesthesia 2013, 68,

Law, C.J., Sleigh, J.W., Barnard, J.P.M., & MacCOLL., J.N. (2011). The association between intraoperative electro-encephalogram-based measures and pain severity in the post-anaesthesia care unit. Anaesth Intensive Care 2011; 39: 875-880

Lovestrand, D., Phipps, S., & Lovestrand, S. (2013). Posttraumatic stress disorder and anesthesia emergence. AANA journal 81:3; 199-205

Lunn, T.H., Kristensen, B.B., Gaarn-Larsen, L., Husted, H., & Kehlet, H. (2012). Post-anaesthesia care unit stay after total hip and kneearthroplasty under spinal anaesthesia. Acta  Anaesthesiol  Scand 2012;56: 1139–1145

Madenski, A.D. (2014). Improving nurses pain management in the post anesthesia care unit. Retrieved from http://scholarworks.umass.edu/cgi/viewcontent.cgi?article=1034&context=nursing_dnp_capstone

Milby, A., Bohmer, A., Gerbershagen, M.U., Joppich, R., Wappler, F. (2014). Quality of post-operative patient handover in the post anesthesia care unit: a prospective analysis. Acta Anaesthe siol Scand 58: 192-197

Parekh, J., Roll, G.R., Feng, S., Niemann , U., & Hirose, R. (2013). Peri-operative hyperglycemia is associated with delayed graft function in deceased donor renal transplantation. Clin Transplant 2013: 27: E424–E430 DOI: 10.1111/ctr.12174

Price, C., Golden, B., Harrington, M., Konekwo, R., Wasil, E., Herring, W. (2011). Reducing Boarding in a Post-Anesthesia Care Unit. Production & operations management 20:3;431-441

Seglenieks,R., Painter, T.W.,  & Ludbrook, G.L. (2014). Predicting patients at risk of early postoperative adverse  events. Anaesth Intensive Care 2014; 42: 649-656

Shah, P., Dongre, V., Patil, V., Pandya, S., Mungantiwar, A., & Choulwar, A. (2014). Correspondence: Comparison of post-operative ICU sedation between dexmedetomidine and propofol. Indian Journal of Critical Care Medicine May 2014 Vol 18 Issue 5 291-298

Simpson, J., & Moonesinghe, R.S. (2013). Introduction to post-anaesthetic care unit. Peri-operative medicine 2:5;

Tighe, P.J., Harle, C.A.,  Boezaart, A,P., Aytug, H., & Fillingim, R. (2014).  Acute pain & Periopeartive pain section. Of Rough Starts and Smooth Finishes: Correlations Between Post-Anesthesia Care Unit and Postoperative Days 1–5 Pain Scores. Pain medicine 15: 306-315

Yazicioglu, D., Akkaya, T. and Kulacoglu, H. (2013). Addition of lidocaine to bupivacaine for spinal anaesthesia compared with bupivacaine spinal anaesthesia and local infiltration anaesthesia. Acta Anaesthesiologica Scandinavica, 57(10), pp.1313-1320.

Yip, P.C., Hannam, J.A., Cameron, J.D., &  Campbells, D. (2010). Incidence of residual neuromuscular blockade in a post anaesthetic care unit. Anaesthesia & intensive care 38; 91-95

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Nursing Assignment Paper Available Now

Nursing Assignment Paper
Nursing Assignment Paper

Nursing Assignment Paper

Nursing Assignment Paper

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Part 1

What factors should a nurse consider when assessing a patient’s or patient’s family needs for supportive care? Name one major barrier you encountered in your assessment and discuss how it could be resolved.

Part 2

Search the South University Online Library for caregiver role strain. What is the most important factor that causes caregiver role strain? What can be done to prevent it?

at least 1 citation for each part

SAMPLE ANSWER

Part 1: Demographic as well as economic changes have become prevalent in our ever-growing multicultural world. The long-standing disparities especially in the healthcare field have challenged health care providers to take into account cultural diversity as a priority during care delivery. It is therefore of importance of care providers to recognize that care delivery goes beyond cultural beliefs and values. Some other factors that affect supportive care apart from culture include gender, age, religion, language, socio-economic status, geographical location, and occupation status.

One of the barriers encountered I encountered when providing supportive care was managing scarce resources. Mostly, health care institutions have an under-supply of various health professionals (Kabene, 2011, Pg. 129). This shortage has risen as a barrier to effective care coordination that has adversely affected the quality of healthcare delivery. This is because the shortage has placed pressure on the practising healthcare officials who have been forced to take care of large volumes of patients. The increasing number of patients has limited the support and care of health officials to their patients.

I believe this problem can be solved efficiently by employing more nurses and increasing the number of students who enrol as nurses.  Health care institutions can also ask for more intern students who will help relieve the burden on other nurses.

Part 2: For me, an increase in responsibility that results in burnout is one of the leading factors that cause caregiver role strain. For health official to solve this problem, they need to sit down and come up with a list of all their personal needs in order to fulfil them and avoid them from feeling deprived (Wilkinson & Treas, 2011, Pg. 229).  They should also eat a proper diet and get enough rest.

References

Wilkinson, J. M., & Treas, L. S. (2011). Fundamentals of nursing. Philadelphia: F.A. Davis Co.

Kabene, S. M. (2011). Human resources in healthcare, health informatics and healthcare systems. Hershey, PA: Medical Information Science Reference.

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Non-Small Cell Lung Cancer Assignment

Non-Small Cell Lung Cancer
     Non-Small Cell Lung Cancer

Non-Small Cell Lung Cancer

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its the same essay you advertised dated 8 April 2014(symptom management case study)my case study is about a patient newly diagnosed non small cell lung ca .contact me on my email if need clarification,its more reliable,supported relevant evidence should be no more than 5 years.

SAMPLE ANSWER

The case study is about a 72-year old female patient (Jane) that has been diagnosed with non-small cell lung cancer (NSCLC). The woman has three adult children that don live with her. Unfortunately her husband passed away and she has no one to take care of her. It is for this reason that Jane needs nursing care.

Non-Small Cell Lung Cancer

Most of the patients that have been diagnosed with this illness have smoked in sometime in their past or are smoking. However, some of the other factors that result in the development of NSCLC include; radon (a radioactive gas commonly found in rocks and soil), air pollution, radiation therapy to the chest, asbestos, and HIV/AIDS (Kitchens, Kessler & Konkle, 2013, Pg. 89).  It is also hereditary.

Symptoms of NSCLC

Mostly, lung cancer cells do not cause symptoms until they have spread many organs. However, symptoms have been detected in NSCLC. Patients with NSCLC have the following symptoms;

  • A persistent cough that keeps worsening
  • Pain in the chest. The pain gets worse when the patients breathe deeply, cough or laugh (Giaccone, 2012, Pg. 37).
  • Hoarseness
  • LOSE weight as well as appetite.
  • Cough up rust-colored sputum or blood
  • Have short breath
  • Fatigue
  • Have recurrent infections of bronchitis and pneumonia
  • Wheezing

NSCLC begins severe and spreads to other body organs. At this stage, the patients experience pain the bone, neurologic changes such as headaches, numbness of the arms, problems in balancing, and dizziness (Leary, 2011, Pg. 45). When NSCLC affects the liver, the patients’ skin becomes yellow (jaundice). When NSCLC affects the lymph nodes and the skin, lumps start developing on the body surface. Most of these conditions are likely to be caused by other conditions apart from NSCLC.

Consequences of the Symptoms to the Patient and the Family

When serious disease or disability strikes a person, the whole family is affected by the illness process as well as the entire health care experience. In the case study, Jane’s illness disrupts her whole family. Her illness has made her sons change their lifestyle and take on some role functions of Jane, which in turn has affected their normal role functioning. For instance, the eldest son, who is also a father of two, has been forced to take leaves to console his mum. His sons have also been forced to arrange for their parents care.

Jane’s illness has also caused additional strain due to economic problems and interruptions. NSCLC requires expensive therapy procedures and costly medications too. However, on a positive note, Jane’s illness has brought her family close together. She has had the opportunity to re-unite with her sons who have been busy all through. The sons have been forced to adjust their priorities and forgo some plans to just take care of their ailing mum. They also live in fear of their mum passing on.

To Jane NSCLC has caused her to undergo immense suffering. She feels a lot of pain that causes deep sorrow. She has lost her weight and has no appetite; she even sometimes regrets and feels as if she is a nuisance to her sons by making them visit her every now and then to confirm how she is fairing. NSCLC is a life-threatening disease; its symptoms have trouble Jane to a point that she feels that she should just rest in peace instead of going through intense suffering. This has led to Jane being assigned counseling officers to encourage her and let her know that there are some patients that were in the same condition that she is in but have then recovered and resumed their normal duties.

Goals of Care

Every person and every illness is peculiar. After patients such as Jane have been diagnosed with NSCLC, nursing care is aimed at;

  • Relieving pain and other NSCLC associated symptoms
  • Addressing patients’ spiritual as well as emotional concerns of the patient and their families.
  • Coordination of care
  • Improving the patients’ quality of life during their illness.

For instance, a palliative care nurse has been assigned to Jane. The nurse prescribes medications and other therapies to help treat Jane’s pain, shortness of breath, constipation, and other symptoms. Jane also has a social worker who has been charged with the responsibility of acting as Jane’s advocate on her behalf and family. She also has a chaplain who offers her spiritual support and aids her in exploring her values and beliefs. The care is also aimed at updating Jane’s family on her progress and necessary medical information.

Nursing Care Plan for NSCLC Patients

Nursing care for patients suffering from lung cancer deals with comprehensive supportive care and educating patients on how to reduce the complications they are experiencing with an aim of speeding recovery from radiation, surgery, and chemotherapy (Almeida  & Barry,  2011, Pg.67). The following are nursing’s care plans for patients with lung cancer;

(I)Impaired Gaseous Exchange

Impaired gas exchange is associated with a change in the supply of oxygen and a decreased oxygen carrying capacity of the blood. Patients present with cyanosis, restlessness, dysnea, and hypercapnia (Kumar & Eng, 2014, Pg. 26). Nursing care plan is provided to the patients with these symptoms with an aim of improving ventilation and sufficient oxygenation of body tissues. The care plan also targets freeing symptoms of respiratory.

Nursing Interventions

-To achieve the above patient outcomes, nurses should examine respiratory rate, depth, and ease of respirations. They should also monitor accessory muscles, variations in the color of the mucous membrane, pursed-lip breathing, and cyanosis (Lam & Cavallari, 2013, Pg. 73). Patients may have an increased respiration as a result of pain or as a compensatory mechanism that is triggered in order to accommodate the loss of lung tissue.

-Nurses should also auscultate the patient’s lungs to examine movement of air or abnormal breath sounds.

-Restlessness and variation in mentation or consciousness should also be investigated. This procedure may demonstrate high levels of hypoxia and mediastinal shift complications that could be accompanied with tachycardia (Newman, 2010, Pg. 851).

– Evaluation of the patients’ response to an activity. Nurses should allow patients to have rest periods and reduces activities to promote patient tolerance. Surgery and increased consumption of oxygen can lead to dysnea. However, patients should participate in early mobilization to aid in preventing pulmonary complications as well as obtain efficiency in their circulatory and respiratory systems.

– Finally, nurses should monitor and record ABGs and levels of hemoglobin (In Matzo, & In Sherman, 2015, Pg. 143). Low partial oxygen concentration and high carbon dioxide may necessitate the need for ventilator support.

(ii)Impaired Airway Clearance

Can be linked to restricted chest movement, fatigue, and increased secretion of mucous in the airway. Patients present with dysnea, abnormal sounds of breath, and ineffective cough (Kumar & Eng, 2014, Pg. 243). Nurses provided care that is aimed at clearing these abnormal sounds and decreasing secretions.

Some of the interventions that are involved include;

  • Observing the amount and appearance of sputum and other aspirated secretions. Initially, increased amounts of watery, colorless or blood streaked secretions are normal (Davey, 2012, Pg. 67). However, such secretions should decrease as the patient progresses with recovery.
  • Patients should be encouraged to have oral fluid intake of approximately 2500mL/day within tolerance of the cardiac activity. This is because adequate hydration helps in keeping secretions loose and also promotes expectoration.
  • Clinicians administered bronchodilators, analgesics, and expectorants. This will aid in improving airflow, increase production of mucous, liquefy, and reduce viscosity of secretions.

(III)Acute Pain

The pain may be due to surgical incision, disruption of nerves, and tissue trauma. Chest tubes and invasion of NSCLC into the pleura may also be a cause of pain (In Palmer, In Brown & In Hobson, 2013, Pg. 56). Clinicians will learn that patients are experiencing pain when the patients have verbal discomfort, guard the area that is affected, are restless or have changes in blood pressure and respiratory rate.

Nursing Care Interventions

-Care providers should evaluate the patients’ verbal and non-verbal pain cues whereby discrepancy between non-verbal and verbal cues would indicate the degree of pain.

– They should encourage measures that minimize pain such as changing the patient’s position, supporting them with pillows, and back rubbing patients.

Barriers of NSCLC Symptom Management

Poly-pharmacy

Studies have shown that cancer is associated with 13% increase in medical use (Jeremić, 2011, Pg. 92). Some of the factors that result in poly-pharmacy include age-related physiologic changes and multiple chronic conditions. When cancer patients take multiple drugs, adverse drug reactions take place. This poses as one of the biggest threat in management of cancer patients.

Frailty among older patients who might have experienced loss of organ function and general decline of overall health is also a barrier in management. Frail patients require careful considerations of appropriate non-pharmacologic and pharmacologic approaches.

To aid in tackling some of these barriers care providers may use non-pharmacologic practices such as acupuncture, Tai Chi, yoga or acupressure which have been reported to have tremendous positive effect in cancer survivors (Ellis, Calne & Watson, 2011, Pg. 231).

References

Giaccone, G. (2012). Systemic treatment of non-small cell lung cancer. Oxford: Oxford University Press.

Kitchens, C. S., Kessler, C. M., & Konkle, B. A. (2013). Consultative hemostasis and thrombosis. Philadelphia, PA: Elsevier/Saunders.

Ellis, H., Calne, R., & Watson, C. (2011). Lecture Notes: General Surgery. New York, NY: John Wiley & Sons.

Perry, M. C., Doll, D. C., & Freter, C. E. (2012). Chemotherapy source book. Philadelphia: Wolters Kluwer/Lippincott Williams & Wilkins.

In Palmer, K. T., In Brown, I., & In Hobson, J. (2013). Fitness for work: The medical aspects.

Jeremić, B. (2011). Advances in radiation oncology in lung cancer. Berlin: Springer.

Rohde, G., & Subotic, D. (2013). Complex Pleuropulmonary Infections: European Respiratory Monograph 61. Sheffield: European Respiratory Society.

Sinclair, A. J., Morley, J. E., & Vellas, B. (2012). Pathy’s Principles and Practice of Geriatric Medicine. New York, NY: John Wiley & Sons.

Taktak, A. F. G., & Fisher, A. C. (2012). Outcome prediction in cancer. Amsterdam: Elsevier.

Davey, P. (2012). Medicine at a Glance. New York, NY: John Wiley & Sons.

In Matzo, M., & In Sherman, D. W. (2015). Palliative care nursing: Quality care to the end of life.

Kumar, D., & Eng, C. (2014). Genomic Medicine: Principles and Practice. Oxford: Oxford University Press.

Lam, Y.-W. F., & Cavallari, L. H. (2013). Pharmacogenomics: Challenges and Opportunities in Therapeutic Implementation. Burlington: Elsevier Science.

Roth, J. A., Cox, J. D., & Hong, W. K. (2011). Lung Cancer. New York, NY: John Wiley & Sons.

Small cell lung cancer: New insights for the healthcare professional (2011 edition). (2012). S.l.: Scholarly Editions.

Newman, W. G. (2010). Pharmacogenetics: Making cancer treatment safer and more effective. Dordrecht: Springer.

Almeida, C., & Barry, S. (2011). Cancer: Basic Science and Clinical Aspects. New York, NY: John Wiley & Sons.

Pass, H. I., Pass, H. I., & International Association for the Study of Lung Cancer. (2010). Principles and practice of lung cancer: The official reference text of the IASLC. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.  http://www.academia.edu/11476728/Principles_and_Practice_of_Lung_Cancer

Leary, A. (2011). Lung cancer: A multidisciplinary approach. Chichester, West Sussex, UK: Wiley-Blackwell.

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