Category: Nursing

A Comprehensive Soap Note for an STI HPV Infection

A Comprehensive Soap Note for an STI HPV Infection Order Instructions: Purpose: To explain what each section of the SOAP note should include. Remember that Nurse Practitioners treat patients in a holistic manner and your SOAP note should reflect that premise.

 

A Comprehensive Soap Note for an STI HPV Infection
A Comprehensive Soap Note for an STI HPV Infection

SUBJECTIVE DATA: What the patient tells you but organized by you in a logical fashion
Chief Complaint (CC):

 

1. Location
2. Quality
3. Quantity or severity
4. Timing, including onset, duration, and frequency
5. The setting in which it occurs
6. Factors that have aggravated or relieved the symptom
7. Associated manifestations
Medications: list each one by name with dosage and frequency
Allergies: include specific reactions to medications, foods, insects, environmental
Past Medical History (PMH): Illnesses, hospitalizations, risky sexual behaviors. Include childhood illnesses
Past Surgical History (PSH): Dates, indications, and types of operations
OB/GYN History: (if applicable) Obstetric history, menstrual history, methods of contraception and sexual function
Personal/Social History: Tobacco use, Alcohol use, Drug use. Patient’s interests, ADL’s IADL’s if applicable. Exercise, eating habits
Immunizations: Last Tdp, Flu, pneumonia, etc.
Family History: Parents, Grandparents, siblings, children
Review of Systems: Go Head to toe. Cover each system that covers the Chief Complaint, History of Present Illness and History (this includes the systems that address any previous diagnoses). YOU DO NOT NEED TO DO THEM ALL UNLESS YOU ARE DOING a TOTAL H&P. Remember, this is what the patient tells you.
General: any recent weight changes, weakness, fatigue, or fever
Skin: rashes, lumps, sores, itching, dryness, changes, etc.
HEENT:
Neck:
Breasts:
Respiratory:
Cardiovascular:
Gastrointestinal:
Peripheral vascular:
Urinary:
Genital:
Musculoskeletal:
Psychiatric:
Neurological:
Hematologic:
Endocrine:

OBJECTIVE DATA: This is what you see, hear, feel when doing your physical exam. Again, you go head to toe and you only need to examine the systems that are pertinent to the CC, HPI, and History unless you are doing a total H&P. Do not use WNL or normal. You must describe what you see.
Here is where the vital signs go. Include ht and wt and BMI
General: General state of health, posture, motor activity and gait. Dress, grooming, hygiene. Odors of body or breath. Facial expression, manner, affect and reactions to people and things. Level of conscience.
SKIN:
HEENT:
Neck:
Chest/Lungs: ALWAYS INCLUDE IN YOUR PE
Heart/Peripheral Vascular: ALWAYS INCLUDE THE HEART IN YOUR PE
Abdomen:
Genital:
Musculoskeletal:
Neurological:

ASSESSMENT: Need to list your priority diagnosis(es) first. For each priority diagnosis, list at least 3 differential diagnoses. Support your selection with evidence.
Example: Migraine headache (tension headache, cluster headache, brain tumor)
Hypertension (renal disease, stress, renal artery stenosis)
For holistic care you need to include previous diagnoses and indicate whether these are controlled or not controlled and remember to include that in your treatment plan.
What evidence or guidelines did you use to support your diagnoses?
PLAN: Treatment plan. Labs, x-rays, etc. Include both pharmacological and non-pharmacological strategies. Include alternative therapies. When do they need to follow-up? Any referrals? Consultations?
Health Promotion: What does the patient/ family need to do to promote their health? Exercise, healthy diet, safety, etc.
Disease Prevention: For the patient’s age, what needs to be done to detect disease early…fasting lipid profile, mammography, colonoscopy, immunizations, etc.
What evidence did you use to support your treatment plan?
REFLECTION: What did you learn from this experience? What would you do differently? Do you agree with your preceptor based on the evidence? Really think about what you are doing in clinical.

A Comprehensive Soap Note for an STI HPV Infection Sample Answer

 A Comprehensive Soap Note for an STI (HPV Infection)

S: Subjective Information

Chief Complaint (CC): “I have small bumps on my genital area.”

History of Present Illness (HPI): Ms. Z is a 21-year-old white American woman who is a sexual worker present with complaints of the presence of small bumps that developed on her genital area since she began doing her current job six months ago. She describes the bumps her genital area as being flat-topped and darker than her normal skin tone. She also describes her vaginal discharge as foul smelling and occurs during sexual intercourse and complains of an aching pelvis and experiencing some abdominal pains. She further presents with similar bumps on her feet and nails that are causing irritation. The aggravating factor was sexual intercourse with no relieving factor. She has a normal menstrual cycle with no signs of infection or disease had last being on August 20th 2014, and the age of onset was 12 years. She has multiple sexual partners and one regular partner with similar bumps. She uses the birth control pills Drospirenone and Estradiol and never uses a condom. Her Pap test taken three months ago was inconclusive. She has a previous medical admission and surgical history with unknown allergies to medicine and no childhood illness.

Medications: Bath control pills Drospirenone and Estradiol 1 daily tablet PO.

Allergies: Uknown allergies to medications, foods, insects and environment.

Past Medical History (PMH): no history of an STI, admitted for alcohol poisoning for three days in March 2013, admitted for ecstasy overdose in June 2013, admitted for starvation and fed through a tube in January 2014.

Past Surgical History (PSH):  Intentional Termination of Pregnancy
(ITOP) in March 2013.

OB/GYN History:

Obstetric History: GO, TO, AO and LO. Regular menstrual period that is on time and lasts for four days and the contraception method is the birth control pill Drospirenone and Estradiol, and she is extremely sexually active.

Menstrual History: Menarche occurred at 12 years old and her last period was on August 20th 2014, and her period is regular lasting for four days. The results of her last Pap test 3 months ago were unknown.

Contraception Method: Bath control pills Drospirenone and Estradiol 1 daily tablet PO.

Personal/Social History: she is single with no children and is a commercial sex worker at a local club. She takes at least “at least six bottles of alcohol, smokes a packet of cigarettes and occasionally takes ecstasy. She rarely and has a single regular sexual partner and multiple daily and lifetime partners.  She has developed a low self-esteem after the attempted rape that occurred on her 20th birthday, and she ran away from home not reporting the case to the authorities or informing the mother. She never uses a condom despite knowing the risks and has no known hobbies.

Family History: mother whose age is unknown and today she is an alcoholic and living in a shelter for the homeless.”

Review of Systems:

General: Significant changed in appetite, fatigue and weakness with a considerable weight loss.

Gastrointestinal: she experiences abdominal pains.

Genital: She reported a foul smelling vaginal discharge with no itching or burning sensation.

Psychiatric: She admits having developed depression since the attempted rape incidence

O: Objective Information

Vital Signs: BP 96/74, P 76, R 12, T 37.50 C and W 100 lbs.

General: Ms. Z is a 21-year-old woman but appears five years older than her age. She is constantly biting her nails and unsettled displaying anxiety. She looks weak and frail with a bony framework. She is well kempt, but her face seems to be having traces of makeup that was left indicating she did not take a bath. She occasionally smiles with a strong perfume. She is eloquent in English and does not speak much although she was cooperative in answering the questions.

SKIN: Pale with no rushes.

HEENT:  her eyes are sagged with equal round pupils and accommodation. She has normal hair distribution and normal oral mucosa and all the teeth.

Pelvic Exam:  The external genitalia had a triangular escutcheon with multiple flesh-colored lesions (>0.5 cm) in the perineal area. There was no hymen and with a piercing at the clitoris and another just above the rectocele area. There was a thick, foul-smelling yellow discharge with small masses of warts with signs of inflammation. There was right adnexal cervical tenderness and severe cervical motion tenderness. The uterus was large, smooth and mobile.

Neurological:  She is alert, conscious of the time and place, and responds appropriately.

A: Assessment

  1. Human Papillomavirus (HPV) infection. This is a small, double-stranded virus that mostly that affects the epithelial cells of the skin (Ramírez-Fort, Khan, Rady, & Tyring, 2013). This is the most likely condition as it affects the cutaneous epithelium and result into skin warts that are categorized with their epidemiological association with cervical cancer. Infection with low-risk HPV results into benign or low-grade abnormalities of the cervical cell, genital warts, and papillomas of the larynx. The high-risk HPV results into lesions that can turn into a tumor in undetected and untreated. It is passed through skin contact especially during sexual intercourse, but intercourse does not always have to be involved (Ramírez-Fort, Khan, Rady, & Tyring, 2013). The treatments include includes Podofilox 0.5% gel or solution, Imiquimod 5% cream, or Sinecatechins 15% ointment. Therapy that is provider-administered includes cryotherapy with liquid nitrogen or cryoprobe, podophyllin resin 10% – 25% in compound tincture of benzoin, or Trichloroacetic acid (TCA) or bichloroacetic acid (BCA) 80% – 90% (CDC, 2012)
  2. Herpes Simplex Virus (HSV). This virus is part of the alpha herpes virus subfamily of the herpes viruses and is of two types HSV – 1 and HSV – 2 (Karasneh & Shukla, 2011). It is a double-stranded DNA virus forming part of the alpha herpesviridae subfamily of viruses and distinguished using their antigenic differences in their protein envelope (Azwa & Barton, 2009). This is the second likely condition as its spread through sexual intercourse and especially where there is no condom use. The infection results into the development of lesions in the perennial area of the genitals (Azwa & Barton, 2009). This is treated with antiretroviral drugs such as acyclovir, famciclovir, and valacylovir oral or topical drugs. Alternative care is also effective that is dietary supplements, and these are, for example, L-lysine, aloe Vera, eleuthro, and Echinacea (Levitsky et al., 2008).
  3. Yeast Infection. Yeast is fungi that live in small colonies in the vagina, and an infection occurs when the yeast cell colonies increase in the vagina (Kaufmann, 2000). This is the least likely because it is not an acute condition and does not require sexual intercourse to develop. The warts are also not serious as they do not easily spread, and their treatment and side effects are not as serious as in HPV and HSV (Kaufmann, 2000). Treatment is often effective unless the infection is recurrent and often involves maintenance of proper hygiene. Pharmacological treatment involves the use of an antifungal cream, tablets, suppository, or ointment. A single flucunazole oral tablet dose is also effective. Azole medication is effective for long-term treatment and taken for seven to fourteen days (Mayo Clinic, 2014).

P: Plan

Diagnostics:

Pap Test/Pap Smear/Culture (HPV): Also known as a pap smear and investigates abnormal changes in the cervical cells. Cells to be used as samples are removed from the cervix, and they are cultured and observed through a microscope in the presence or absence of genital warts (Coutlée, Rouleau, Ferenczy, & Franco, 2005).

Antigen detection test (HSV): Fresh sore cells are scraped off they are then smeared on a microscope slide to find antigen markers on the cells found on the surface that are infected with the virus (Shulman et al., 2012).

Fungal Smear (Yeast infection): The superficial cells are obtained and cultured to isolate the yeast infection (Elin, Whitis, & Snyder, 2000).

Medication: Podofilox 0.5% gel.

Provider-administered: Cryotherapy with Trichloroacetic acid (TCA) 80% – 90% (CDC, 2012).

Health promotion: She should also continue with a special protein and carbohydrate diet for the next six months, urinate and wipe properly after sexual intercourse, wear panty liners, avoid douching both in general and during treatment. Continue with regular morning run and the ortho tricycle for the next on yea and avoid intercourse with the infected regular partner and reduce sexual activity.

Referral to a counselor would be necessary to provide therapy to deal with the trauma, maintain proper hygiene, and from the attempted rape including the need for a lifestyle change and a nutritionist for proper diet and nutrition.

Return in case of recurrence and persistence of symptoms

Disease Prevention: Regular pap tests

Pharmacological therapy employed the Centre for Disease Control and Prevention guidelines on Genital warts and the Canadian Consensus Guidelines on Human Papillomavirus. The non-pharmacological guidelines were from the American Psychological ACNP and Promotion Dietary Guidelines for Americans.

Reflection

The process of diagnosis and determining the appropriate treatment for patients is rigorous and requires a careful consideration of all symptoms the patient is presenting because certain disease may have similar symptoms. For the diagnostic process, I would place more emphasis on the psychological factors of the patient as they seem to be the underlying factors for the patient’s behaviors that are putting her at risk. I would also inquire of the client can change her job as it is the greatest risk factor. The regular partner should also seek medical intervention. The evidence provided is in line with HPV and its treatment guidelines by the various bodies hence I agree with the instructor.

A Comprehensive Soap Note for an STI HPV Infection References

Azwa, A., & Barton, S. E. (2009). Aspects of Herpes Simplex Virus: A Clinical Review. J Fam Plann Reprod Health Care, 35 (4), 237–242.

CDC. (February 8, 2012). Centers for Disease Control and Prevention. Retrieved September        14, 2014 from Centers for Disease Control and Prevention Web site:                          http://www.cdc.gov/std/treatment/2010/genital-warts.htm

Coutlée, F., Rouleau, D., Ferenczy, A., & Franco, E. (March/Aprl 2005). The Laboratory  Diagnosis of Genital Human Papillomavirus Infections. Can J Infect Dis Med  Microbiol, 83-91.

Elin, R. J., Whitis, J., & Snyder, J. (2000). Infectious Disease Diagnosis From a Peripheral Blood Smear. Laboratory Medicine, 31 (6), 324-328.

Karasneh, G. A., & Shukla, D. (2011). Herpes Simplex Virus Infects most Cell Types In   vitro: Clues to its Success. Virology Journal, 8 (481), 1-11.

Kaufmann, D. A. (2000). The Fungus Link: An Introduction to Fungal Disease Including the Initial Phase Diet (2nd ed., Vol. 1). (B. T. Hunt, ed.) MediaTrition.

Levitsky, J., Duddempudi, A. T., Lakeman, F. D., Whitley, R. J., Luby, J. P., Lee, W. M., et        al. (2008). Detection and Diagnosis of Herpes Simplex Virus Infection in Adults with Acute Liver Failure. Liver Transpl, 14, 1498-1504.

Mayo Clinic. (2014). Mayo Clinic. Imenukuliwa September 17, 2014 kutoka Mayo Clinic  Web site: http://www.mayoclinic.org/diseases-conditions/yeast-infection/basics/treatment/con-20035129

Ramírez-Fort, M. K., Khan, F., Rady, P. L., & Tyring, S. K. (eds.). (2013). Human Papillomavirus: Bench to Bedside. Basel, Switzerland: Karger Medical and Scientific Publishers.

Shulman, S. T., Bisno, A. L., Clegg, H. W., Gerber, M. A., Kaplan, E. L., Lee, G., et al.                (September 9, 2012). Clinical Practice Guideline for the Diagnosis and Management     of Group A Streptococcal Pharyngitis: 2012 Update by the Infectious Diseases  Society of America. Clinical Infectious Diseases , 1-19.

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Sample Interview Questions for Nurses

Sample Interview Questions for Nurses
Sample Interview Questions for Nurses

Sample Interview Questions for Nurses

1. Tell me about yourself.

2. What led to your interest in nursing?

3. Describe a challenging problem you faced on one of your clinical rotations. How did you solve the problem?

4. When you are experiencing a stressful work situation, how do you relax?

5. Give a specific example of a time when you knew you did a good job as a nurse.

6. Have you ever been burned out? When? What did you do about it?

7. How would you respond if asked by the nurse manager to do some of the menial tasks for patients that are normally not your responsibility?

8. How do you relax when faced with stressful work situations?

9. How would you respond if, in a rude and haughty tone, a doctor questioned your work, which you knew to be top-notch and absolutely accurate?

10. Do you think you will be a career nurse or eventually look for another profession? Why?

11. Why did you decide to become a nurse rather than a doctor?

12. Describe a situation in which you found yourself working with someone who was very sensitive and thin-skinned?

13. Can you describe a situation connected with nursing that mad you angry?

14. We have all tried different ways of showing consideration for others. What are some things that you have done in this respect?

15. What are some ways that you feel that nursing can become more professional?

16. If you were told that the nursing field was closed and that you could not become a nurse, what would you do?

17. What types of colleague do you least like to work with every day?

18. What type of nursing tasks do you find most objectionable?

19. Describe a situation connected with nursing that you experienced in the last year that made you angry.

20. How many years do you plan to stay with this hospital?

21. How do you go about making a decision?

22. What is your description of a good nurse?

23. What challenges did you have at your last job that you feel could prepare you for this job?
24. Which shift do would you prefer?
25. What attracts you to work at the VA Hospital?
26. What advice would you give your younger self as a new nurse?
27. What kind of personality characteristics would you like in a preceptor?
28. Are there any questions that you have for me?

SAMPLE ANSWER

Interview Question

  1. Tell me about yourself.My name is Alex Peters. I come from Florida. I am a graduate in Nursing.
    2. What led to your interest in nursing?I developed interest in nursing at a tender age. My father was a doctor and when I visited the hospital he used to work, I developed an interest to be a nurse. I loved the attire the medics wore.
  2. Describe a challenging problem you faced on one of your clinical rotations. How did you solve the problem?
    One of the problems I faced was addressing a complaint from a patient. The patient complained that the medicines prescribes were not the right ones. I solved the problem by engaging the patient. I was apologetic and assured the client that this was not going to happen again. I told her the reasons that might have caused the same and assured her of immediate action for those responsible.4. When you are experiencing a stressful work situation, how do you relax?

I normally, like going at a quiet place just to relax. I also listen to inspiring songs.

5. Give a specific example of a time when you knew you did a good job as a nurse.

The time I knew, I had done a good job as a nurse, was when the hospital management recognized me as the hardworking nurse. I was given a trophy and a certificate for my dedication to my work.

  1. Have you ever been burned out? When? What did you do about it?It was not a burn but rather a suspension. Part of my team members failed to execute their duties leading to the suspension of the entire team. This happened in my first year of employment. I write a letter citing that I was not part of those involved and therefore I was a sacrificial lamb.
  2. How would you respond if asked by the nurse manager to do some of the menial tasks for patients that are normally not your responsibility?I will have to comply and assist because I respect the manager as my leaders as well as I champion the spirit of teamwork.
    8. How do you relax when faced with stressful work situations?I relax by staying in a siren environment listening to music.
  3. How would you respond if, in a rude and haughty tone, a doctor questioned your work, which you knew to be top-notch and absolutely accurate?I will calm down and ask to give him an explanation on the same. I believe he will understand me once I have explained the situation to him.10. Do you think you will be a career nurse or eventually look for another profession? Why?I believe I will be a career nurse because this is my passion. I am focused on this career for the rest of my life
  4. Why did you decide to become a nurse rather than a doctor?I decided to become a nurse because, it was my passion.
    12. Describe a situation in which you found yourself working with someone who was very sensitive and thin-skinned?I have worked with very sensitive and thin-skinned persons on various occasions. For me, I did not find anything-strange working with such people, as I believe that every situation and individuals are unique in their own way and I must execute my responsibility with professionalism.13. Can you describe a situation connected with nursing that made you angry?

    I was made angry by a patient who refused to take her medication as prescribed.

  5. We have all tried different ways of showing consideration for others. What are some things that you have done in this respect?I value and appreciate other people I work with and those I come across. I have done various things to show consideration for others such as standing in for my fellow colleagues at work when they are sick or attending to other issues, I have as well helped to promote healthy living among the elderly in my community

15. What are some ways that you feel that nursing can become more professional?

Nursing can become professional by continuing their education to higher levels and embracing codes of ethics in their practice (Philip & Kalisch, 2003). They also need to be devoted to their duties of impacting positively on the care they render.

16. If you were told that the nursing field was closed and that you could not become a nurse, what would you do?

I do believe that nurses are still required and therefore, opportunities are there. However, in case the field was closed, I would pursue a health related career because I have a strong affinity and passion in the area of healthcare.

  1. What types of colleague do you least like to work with every day?I do not like working with lazy colleagues18. What type of nursing tasks do you find most objectionable?

Diagnosing and prescribing medication

19. Describe a situation connected with nursing that you experienced in the last year that made you angry.

I was made angry by a patient who failed to observe his dosage. This negligence made the health of the patient to deteriorate.

20. How many years do you plan to stay with this hospital?

I want to stay here so long as I add value to the patients and the hospital. My aspiration is to stay here not less than five years.

21. How do you go about making a decision?

I first take time to understand a situation from different perspectives before I make a decision.

22. What is your description of a good nurse?

A good nurse is someone that understands his or her responsibilities of providing care to the patients

  1. What challenges did you have at your last job that you feel could prepare you for this job?

One challenge is dealing with upset/angry client

24. Which shift do would you prefer?

I prefer daytime shift

25. What attracts you to work at the VA Hospital?

The conducive working environment

26. What advice would you give your younger self as a new nurse?

To always aspire to give the best in whatever I do. As a younger new nurse, I need to always be determined to impact positively on nursing profession

  1. What kind of personality characteristics would you like in a preceptor?

Intelligent, respectful, hardworking and creativity

28. Are there any questions that you have for me?

Yes, as a professional and an experienced nurse, what challenges have you encountered and what do you think that nurses can improve to provide quality healthcare?

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How APTA is transforming society

How APTA is transforming society
How APTA is transforming society

How APTA is transforming society by optimizing movement to improve the human experience

Order Instructions:

APTA’s vision for physical therapy is “transforming society by optimizing movement to improve the human experience”. How will you embody this vision as a future physical therapist?

The essay is limited 4500 characters (approximately 1 page) with spaces.

 

SAMPLE ANSWER

How APTA is transforming society

The American Physical Therapy Association (APTA), in 2000, adopted a vision statement for its profession in physical therapy. This vision is ‘transforming society by optimizing movement to improve the human experience’ (Hayhurst, 2014). The Association however has a strategic plan to help its members achieve their vision. As a future physical therapist, I would come up with my own principles that will guide me in achieving this vision. The principles would clearly demonstrate how the society in general would look after the vision of transforming society has been achieved.

Despite the fact that the American physical Therapy Association is adopted a vision for its future physical therapists, it also has a great impact to the society at large. It inspires people in the society to come together as a community to create important systems that may optimize movements and great functions for all people. All people that contribute and participate in the society move from one place to another to gain more experience. It is said to be a means of a most favorable way of living and excellence of life. This applies to any individual that extends beyond health to his or her ability to participate in the society. The society, however, may also involve some complex needs that may result to a poor lifestyle that may further lead to a physical therapy. Examples of these complex needs could be the needs that may eventually result from a sedentary lifestyle. The physical therapy may give way to a reduction of the costs for health cares and at the same time, it may overcome all barriers that may prevent involvement in the society which will further guarantee a good future existence of the society at large (Hayhurst, 2014).

As a future physical therapist, I would evaluate and manage people’s movement in order to encourage a very favorable development, limit activities, make a diagnosis of impairments, restrict participation, and provide intercessions that may prevent or ameliorate limitations in activities and participation. My central point is the movement system with my main reason being to improve the health of the society. This is mainly because the movement system helps one to understand the structure, the functioning and the potential of the human body. This is where I would mainly practice on to encourage and promote the most favorable development. After that identity, I would go ahead and involve myself in dissemination, validation and generation of the evidences that take up payments for the outcomes and the clients’ satisfaction. I would demonstrate too much competence and strive to prevent events that may be unfavorable to the patient. I would ensure I give my best in my client’s intervention, examination, diagnosis and quality outcome measurement. I would strive as much as I can to prevent any possible adverse events that could be related to my patients care.

To solve the health challenges that the society faces, the physical therapy profession must collaborate with other people including the consumers, community organizations, healthcare providers and other disciplines. Thus, apart from giving quality diagnosis, I would ensure I have the value of collaboration to help me achieve the company’s vision. I would ensure services are of value, consumer-centered and coordinated by co-managing, engaging other consultants, and supervising and directing care.  To achieve the best value, I would ensure a safe, client-centered, efficient, effective, and above all, an equitable physical therapy profession. Apart from that, my outcomes would be both meaningful and cost friendly to clients. This profession offers imaginative and practical solutions that enhance the delivery of health services, and at the same time, increases its value to the society. I would then innovate and collaborate with developers, entrepreneurs and engineers to extend and reach beyond my client’s settings.

In this profession, I would ensure I provide my services by responding to the cultural considerations of individuals, their needs and values. Their goals are the central part in which this profession engages. Cultural competence is a necessary skill that would ensure a good practice in providing the therapy services in this profession. I would support all patients in practice, education and in research to ensure I promote necessary changes, take on best practices principles and approaches, and at the same time, ensure that the physical therapy systems are consumer centered (Hayhurst, 2014). Finally as a physical therapist, I would be acquainted with the health imbalances; that is the disparities and the inequities, and work hard towards ameliorating them through inventive models of advocacy, collaboration, service delivery and clear attention to all social determinants of physical condition to consumers and the collaboration with the community entities. I would manage and promote any necessary changes to my clients so as to adopt the best practices ever in my standards and all kinds of approaches.

These guidelines of identity, consumer centricity, collaboration, value, advocacy, quality and innovation show how the society and the physical therapy profession will be, once the vision is achieved. As a future physical therapist, I would do my best to make sure I follow those guidelines for the sake of the society and the profession.

Reference

Hayhurst, C. (2014). A Vision to Transform Society. Physical Therapy, 20-25.

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Legal Malpractice or Negligence Case Fact Pattern

Legal Malpractice or Negligence Case Fact Pattern
Legal Malpractice or Negligence Case Fact Pattern

Legal Malpractice or Negligence Case Fact Pattern

Order Instructions:

Application of Standards of Care and the Nurse Practice Act to Advance Practice Nurses Involved in a Legal Action

Before completing this paper , it is important that the write understand very well the Nurse Practice Act that’s is use in the U.S because it will be discuss base on the fact that it happened hear in the U.S . It is critical to discuss every details that’s mentioned in this case hear and also use case laws and pear review articles to supports the facts.

Describe the case below and discuss the standard of care that the parties will be held to in this case. How will the standards of care and the Nurse Practice Act be applied in a court of law if the case is sued?

Hear below is the case to be use for this paper . let the writer take time to look at it and respond to the above questions according using case laws to support his augments.

Case Study 1: Malpractice Action Brought by Yolanda Pinnelas

People Involved in Case:
Yolanda Pinnelas-patient
Betty DePalma, RN, MS-nursing supervisor
Elizabeth Adelman, RN, recovery room nurse
William Brady, M.D., plastic surgeon
Mary Jones, RN-IV insertion
Carol Price, LPN
Jeffery Chambers, RN-staff nurse
Patricia Peters, PharmD-pharmacy
Diana Smith, RN
Susan Post, JD-Risk Manager
Amy Green-Quality Assurance
Michael Parks, RN, MS, CNS-Education coordinator
SAFE-INFUSE-pump
Brand X infusion pump
Caring Memorial Hospital

Facts:
The patient, Yolanda Pinellas is a 21-year-old female admitted to Caring Memorial Hospital for chemotherapy. Caring Memorial is a hospital in Upstate New York. Yolanda was a student at Ithaca College and studying to be a music conductor.
Yolanda was diagnosed with anal cancer and was to receive Mitomycin for her chemotherapy. Mary Jones, RN inserted the IV on the day shift around 1300, and the patient, Yolanda, was to have Mitomycin administered through the IV. An infusion machine was used for the delivery. The Mitomycin was hung by Jeffrey Chambers, RN and he was assigned to Yolanda. The unit had several very sick patients and was short staffed. Jeffery had worked a double shift the day before and had to double back to cover the evening shift. He was able to go home between shift and had about 6 hours of sleep before returning. The pharmacy was late in delivering the drug so it was not hung until the evening shift. Patricia Peters, PharmD brought the chemotherapy to the unit.

On the evening shift, Carol Price, LPN heard the infusion pump beep several times. She had ignored it as she thought someone else was caring for the patient. Diana Smith, RN was also working the shift and had heard the pump beep several times. She mentioned it to Jeffery. She did not go into the room until about forty-five minutes later. The patient testified that a nurse Updated: June 2014 MN506- Unit 9 Page 3 of 5
came in and pressed some buttons and the pump stopped beeping. She was groggy and not sure who the nurse was or what was done.
Diana Smith responded to the patient’s call bell and found the IV had dislodged for the patient’s vein. There was no evidence that the Mitomycin had gone into the patient’s tissue. Diana immediately stopped the IV, notified the physician, and provided care to the hand. The documentation in the medical record indicates that there was an infiltration to the IV.
The hospital was testing a new IV Infusion pump called SAFE-INFUSE. The supervisory nurse was Betty DePalma, RN. Betty took the pump off the unit. No one made note of the pump’s serial number as there were 6 in the hospital being used. There was also another brand of pumps being used in the hospital. It was called Brand X infusion pump. Betty did not note the name of the pump or serial number. The pump was not isolated or sent to maintenance and eventually the hospital decided not to use SAFE-INFUSE so the loaners were sent back to the company.

Betty and Dr. William Brady are the only ones that carry malpractice insurance. The hospital also has malpractice insurance.
Two weeks after the event, the patient developed necrosis of the hand and required multiple surgical procedures, skin grafting, and reconstruction. She had permanent loss of function and deformity in her third, fourth, and fifth fingers. The Claimant is alleging that, because of this, she is no longer able to perform as a conductor, for which she was studying.
During the procedure for the skin grafting, the plastic surgeon, Dr. William Brady, used a dermatome that resulted in uneven harvesting of tissue and further scarring in the patient’s thigh area where the skin was harvested.

The Risk Manger is Susan Post, J.D. who works in collaboration with the Quality Assurance director Amy Green. Amy had noted when doing chart reviews over the last three months prior to this incident that there were issues of short staffing and that many nurses were working double shifts, evenings and nights then coming back and working the evening shift. She was in the process of collecting data from the different units on this observation. She also noted a pattern of using float nurses to several units. Prior to this incident the clinical nurse specialist, Michael Parks, RN, MS, CNS, was consulting with Susan Post and Amy Green about the status of staff education on this unit and what types of resources and training was needed.

Resources

Hunt, J. A., & Hutchings, M. (2014). Innovative group-facilitated peer and educator assessment of nursing students’ group presentations. Health Science Journal, 8(1), 22–31.

Essentials of Nursing Law and Ethics

Chapter 2: “Regulation of Nursing Practice”

Chapter 4: “Standards of Care”

Chapter 33: “Contracts”

Chapter 48: “Social Media and Online Professionalism”

Chapter 50: “Maternal and Fetal Rights”

SAMPLE ANSWER

Legal Malpractice or Negligence Case Fact Pattern

Introduction

Medical practitioners in their line of duty engage in legal malpractices or even neglect their role in provision of quality services to their patients. Upon performing these malpractices and acts of negligence, a patient can sue the nurse in a court of law (Yonda- Wise, 2014). The nurse can be charged for violating the Nurse Practice Act and negligence of the Standards of Care. The following discussion describes a certain case and how standards of care will be held in this case. The paper also indulges to argue how Standard of Care and Nurse Practice Act can be applied in a court of law if the case is sued.

Description of the Case

The case involves a 21-year-old female, Yolanda Pinnelas, who is admitted for chemotherapy at Caring Memorial Hospital.  Mary Jones inserted the recommended Mitomycin using IV and it was hanged on using an infusion machine. The situation at the hospital was that there were limited staff, and the pharmacy delayed in delivering the drug on time so that it was not hung until evening by Jeffrey. In the evening, Carol Price heard the infusion pump beeping severally and ignored. Diana Smith, still on the shift, heard of the beeping and informed the RN in charge, but did not go into the patient’s room until about forty-five minutes later. The patient was not informed of what had happened. It was reported of Infiltration on the IV after it was stopped. During this time, the hospital was trying a new ‘safe infuse’ device. When putting it into practice, the supervisor, Betty DePalma, did not take note of the name and serial number of the pump. The pump was neither isolated nor maintained and eventually led to its dismissal. After all this malpractices and negligence, Yolanda, develops necrosis of the hand. During harvesting of the skin to remedy the problem, Dr. William Brady caused further scarring of Yolanda’s skin.

Standard of care violated in the case above

The main element of violating standard of care in this case is negligence. In the case above, Patricia Peters neglected his role in providing drug on time (Lilley, Collins, Snyder & Savoca, 2014). Jeffrey in charged did not hang the infusion at the appropriate time (Carol, 2011). Mary Jones was first to hear the beeping of the infusion machine, but did not bother about.  Although Diana smith heard the beeping and informed the RN in charge, he did not go into the room immediately (Masters, 2014). In addition, the RNs did not take the initiative to inform the patient about her treatment process. Betty DePalma depicts some elements of negligence when he could not take note of the name of the devise and its serial number when testing it.

Legal implications of the malpractices and negligence

This scenario will be judged in rhyme with case law of ‘Monk vs. Doctor’s hospital’ where the facility and the physician were found negligent when an application of a surgery resulted in a patient burn (Wojcieszak & Houk, 2006). Another case law that can be applied to the case above is ‘Llyod Noland Hospital vs. Durham’. In this case law, the court ruled that the staff failed to administer a standing order of preoperative antibiotics to a patient (Wojcieszak & Houk, 2006). All the cases relate to Yolanda’s case where negligence of the hospital staff led to her developing necrosis of hand. The implication will be that Yolanda will be compensated while the medical practitioners involved in the negligence will either be suspended, fired, or their licenses revoked.

 Conclusion

In summary, malpractices and negligence in provision of services in hospital can lead to legal implications. RNs stand chances of being sued for the failure to observe and perfect standard of care. This is because the society expects services from them to be ideal. Susan Post is likely to be fired on sleeping on her job. William, Army, and Michael can be sued for complicating the health of Yolanda.

References

.Carol B. Liebman, (2011). Medical Malpractice Mediation: Benefits Gained, Opportunities. Journal for legal and contemporary problems in nursing

Lilley, L. L., Collins, S. R., Snyder, J. S., & Savoca, D. (2014). Pharmacology and the nursing process. St. Louis, Mo: Elsevier/Mosby.

Masters, K. (2014). Role development in professional nursing practice. Burlington, MA: Jones & Bartlett Learning.

Whitehead, D. K., Weiss, S. A., & Tappen, R. M. (2009). Essentials of Nursing Leadership and Management. Philadelphia: F.A. Davis Co.

Wojcieszak, D & Houk, C. (2006). The sorry works! Coalition; making the case for full disclosure. Journal on Quality and patient Safety.

Yonda- Wise, P. (2014). Leading and managing nursing. St. Louis, Mo: Elsevier Mosby.

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Critical Review on Diabetes Essay Paper

Critical Review on Diabetes
Critical Review on Diabetes

Critical Review on Diabetes

Order Instructions:

Write a critical review of published research article: Trief, P.M., Sandberg, J. G., Dimmock, J. A., Forken, P. J., Weinstock, R. S. (2015). Personal and Relationship Challenges of Adults with Type 1 Diabetes: A Qualitative Focus Group Study. Diabetes Care (36) 2483 – 2488 DOI: 10.2337/dc12-1718

1. Your critical review will identify the study design (including research methods) and critically analyse the design in relation to achieving the author(s) aims.
2. The authors of the article address psychosocial factors which are associated with the chronic disease(s). Your critical review will identify and explain how these psychosocial factors impact individuals and/or family and their responses to the chronic illness.
3. Your critical review will explain how (if at all) the article contributes to interdisciplinary knowledge (from the behavioural health sciences) for best practice management of chronic illness.

Referncing :
6. Correct use of APA (6th ed.) formatting of references in-text and in reference list which should include additional academic references to support your claims. You are not expected to provide an extensive list of references for this assignment, as your focus is primarily on your chosen article. However, any resources you use to justify your critique, including reference to the article which you are reviewing, should be referenced according to APA (6th ed.) standards.

SAMPLE ANSWER

Critical Review on Diabetes

Trief and colleagues investigated the psychosocial challenges of adults who live with diabetes type 1, and ways the psychosocial challenges impact the relationship of their partners. The aim of the study was to gain better understanding of these psychosocial issues in order to practice effective management of chronic diseases.  The study design is focus group research. The research method is qualitative research. This research method befits this research study because data generated from the focus group is based on insights (not rules) of human behaviors. This is because the study allows all the participants to contribute in discussion as the researchers listen to discussion content such as tone and emotions of the participants, which help the study to either learn or confirm facts. In addition, this method of research helps to paint a portrait of local perspectives such as the regions knowledge of diabetes Type 1, and educational resources available. The focus group selection criteria ensured people have similar characteristics are invited to a single session.  For example, there four focus groups where two had patients diagnosed with diabetes type 1 and two with their partners- which increased the quality of data (Trief et al. 2013).

Ways psychosocial challenges influence patient/family response to chronic illness

The research indicate that patients diagnosed with type 1 diabetes face unique emotional as well as interpersonal challenges such as substance abuse disorders, medication non-adherence, eating disorders and poor quality of life. The study identifies four domains including a) impact of diabetes on patient relationship with the caregiver/partner including the emotional impact of diabetes and issues regarding child rearing; b) learning the importance of hypoglycemia; c) stress associated to potential complications; d) advantages of technology (Trief et al. 2013).

According to the article, a small group of people highlighted that the disease had brought their relationship closer. Patients with supportive was associated with defined acceptance of the chronic illness, which in turn assured the patient that she/he could get through the hard times. However, some participants indicated negative impact of diabetes type 1 on their relationship. This indicated included increase emotional distance such as sexual intimacy issues, difficult decision making processes, and concerns of children care.  Generally, the increase of emotional stress was associated with constant risks of hypoglycemia (Trief et al. 2013).

Concerns about child bearing issue that was identified by patients as a factor that negatively impacted their response to type 1 diabetes.  Most of the participants had specific concerns about their ability to bear and raise their children actively. Others had fears of passing their susceptible genes to their children. The patient stated that they had advices about pregnancy complications which would put their lives at risk. This stress level was associated with threat of hypoglycemia. According to this article, the issue of hypoglycemia is identified as the worst feeling in their lives. Research indicates that this feeling is associated with great fears and anxiety. Some patients indicated that they had learnt effective coping strategies to help the patient avoid lows. This included healthy food choices, placing glucagon tablets in each room and use of insulin pump to reduce hypoglycemia intensity and frequency.  The patient partners seem to be the most worried about hypoglycemia. This is because the ‘low’ just happen at any time of the day and it is crazy. The low moment is described with increased irritability, moodiness and conflict which affects their relationship negatively and consequently affected their response and coping ability to the chronic illness (Trief et al. 2013).

Patients and their partners also highlighted about the constant looming threat of complication. The patient and their partners were terrified at the thought of blindness and amputation. Although the patients and their partners were keenly aware that they had to save organs through proper practice of the disease, most felt frustrated  especially when the doctor identified their condition as brittle or in poor control of their condition. The patient stated that when blamed for their bad diabetic condition increased their distress as they had sincere efforts to control the condition. Overall, the patients were aware of potential complications and emphasized their need for reassurance and non blaming response from their physician and their partners. The patient partners also experienced similar levels of stress and anxiety of potential complications associated with diabetes. They also identified specific challenges they went through such as battling with insurance companies, complete dependence of the patient during the hypoglycemic episodes and issues of weight control and exercise. These individual factors cumulatively resulted to higher levels of stress. This indicates that family support is associated with positive self management practices (Trief et al. 2013).

Ways the article contributes to interdisciplinary knowledge

The study was performed in order to gain better understanding of a richer understanding of psychosocial factors that affects people diagnosed with diabetes 1. The  main themes that have emerged from this article indicates that  partner involvement vary, but the anxiety and fear levels of  hypoglycemia and future complications have significant impact on their well being and their relationship. From this study several  behavioral human aspects in chronic illness is clear; a) relationships are unique and it is not obvious that all patients have supportive partners or are overwhelmed by the disease; b) the patient-partner relationship changes are influenced by the health demands at a particular time. This implies that healthcare providers must assess individuals relationship so as to tailor make his/her intervention based on the patient unique needs, so as to cope with the unique challenges effectively and improve their self management practices (Trief et al. 2013).

References

Trief, P.M., Sandberg, J. G., Dimmock, J. A., Forken, P. J., Weinstock, R. S. (2013). Personal and Relationship Challenges of Adults with Type 1 Diabetes: A Qualitative Focus Group Study. Diabetes Care (36) 2483- 2488 DOI: 10.2337/dc12-1718

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Application of the Nursing Process

Application of the Nursing Process
Application of the Nursing Process

Application of the Nursing Process

Order Instructions:

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.

A minimum of three (3) current professional references must be provided. 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.
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.

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® dressing was ordered daily.

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 with good outcomes. How does the RN use nursing process to make decisions about priority of care for a single patient and within a group of patients?

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 desire outcomes for the patient.

How is the plan of care modified when the outcomes are not met?

Part 2 (3 pages)

Develop a Plan of Nursing Care for this patient that includes all steps of the nursing process:

One (1) actual NANDA-I nursing diagnosis addressing the priority problem the patient is experiencing. 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?
One (1) expected outcome 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.
Four (4) nursing interventions that includes at least one (1) nurse-initiated, one (1) dependent, one (1) interdependent intervention. Provide a rationale for each intervention that is evidence-based.
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.  Consider the information 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 process but demonstrating the ability 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. Assistance with APA citations and references is available through the free resource Citation Machine™. Assistance with APA format, grammar, and avoiding plagiarism is available for free through the Excelsior College Online Writing Lab (OWL). Be sure to check your work and correct any spelling or grammatical errors before you submit your assignment.

You are required to submit your paper to Turnitin (a plagiarism prevention service) prior to submitting the paper in the course submission area for grading. Access is provided by email to the email address on record in your MyExcelsior account during week 2 of the term. Once you submit your paper to Turnitin check your inbox in Turnitin for the results. After viewing your originality report correct the areas of your paper that warrant attention. You can re-submit your paper to Turnitin after 24-hours and continue to re-submit until the results are acceptable. Acceptable ranges include a cumulative total of less than 15% for your entire paper, and no particular area greater than 2% (excluding direct quotes and/or references).

See the videos below for instructions on how to submit your paper to Turnitin and view your Originality Report.
Video – Submitting a Paper
Video – Viewing Your Originality Report

When you’re ready to submit your work for grading, click Browse My Computer and find your file. Once you’ve located your file click Open and, if successful, the file name will appear under the Attached files heading. Scroll to the bottom of the page, click Submit and you’re done.

This activity will be assessed according to the NUR104 M6A3: Application of the Nursing Process Paper Rubric.

SAMPLE ANSWER

Application of the Nursing Process

Introduction

Nursing process is the scientific methodology used by Registered Nurses to perfect provision of quality health care to their patients. The overall nursing process is broken into five distinct steps that include: assessment, diagnosing, care-planning, implementation, and evaluation phases. The process does not always produce expected results, but it can call for its repetition in order to address cons from the process. Therefore, the following article will indulge to discuss the meaning and use of the nursing process in making good nursing judgments that effect patient care. The discussion will also go ahead to describe a plan of care using the nursing process for patient with a history of CHF, hypertension and lower extremity weakness.

The meaning and use of the nursing process in making good nursing judgments that effect patient care

The first phase in the nursing process is the assessment phase. The meaning behind this step is that the RN gathers information about a particular patient’s physiological, psychological, spiritual and sociological status (Timby, 2009).  The main method used by RNs to garner this data is through interviews, physical assessment, digging out of patient’s health history and general observation of the patient’s health behavior. This phase completes by documenting the relevant information in retrievable forms. Diagnosing phase follows as the second phase in nursing process. During this phase, The RN involves himself or herself in making an intellectual judgment about the likelihood or actual health disorder with a client (Timby, 2009). This phase can incorporate multiple diagnosis techniques directed to a single client. The diagnosis can be done to a single patient rather to a group of patient if a specific condition from an already disorder in the course of treatment. This assessment not only comprises of actual description of the problem, but also whether or not the patient is susceptible to developing another complication (Timby, 2009). The other reasons behind diagnosis are to gauge patient’s readiness for health improvement and to determine whether or not the patient has developed a syndrome. The meaning of diagnosis phase is crucial is in suggesting the appropriate course of treatment to undertake to that particular diagnosed disorder.

Planning phase is the third step used in nursing process. In this face, plan of action is developed. The plan is developed as a result of patient and the nurse agreeing on the diagnosis Timby (2009). This phase still suggest that if there is multiple diagnosis that need to be addressed, the RN will focus or prioritize each assessment and concentrate to severe symptoms and high risks conditions. For each single problem, it is assigned a clear, measurable objective for the expected beneficial result. In this phase, therefore, Registered Nurse overly refer to the evidence based Nursing Outcome Classification, which is a program of standardized terms and measurements for tracking client wellness.

According to Timby (2009), in the book Fundamental nursing skills and concepts, Nursing Intervention Classification (NIC) can also be employed as a resource for planning. In planning phase, independent nursing interventions are nurse actions started by RN that do not need any direction or any order from another nurse in planning medication for a patient (Timby, 2009).inter-dependent nursing interventions are activities of a RN and other  practitioners with sole role of addressing a single factor. Nurse-imitated nursing intervention is a treatment imitated by a nurse in response to a nursing diagnosis.

The fourth phase in nursing process, which is the crucial one, is the implementation phase.  During this phase, the RN follows through the already Plan of Action (POA). Timby (2009) argued that the plan is particular to each and every patient and aims at achievable outcomes. Actions and activities involved in a nursing care plan comprises monitoring of the patient for signs of change or improvement, directly caring for the patient or engaging crucial medical roles, educating and giving directions to a patient about further health management, and contacting the patient follow-up (Timby, 2009). The duration in implementation phase can vary and can take hours, days, weeks or even months (Timby, 2009). During implementation phase, indirect care comprises, for example, Emergency Cart Checking and interventions for communities such as social, economic and political aspects. Direct care implies that the patient will have to attend herself or himself with medication without assistance of medical practitioners near him or her.

The last step is provided by Timby (2009), in the book Fundamental nursing skills and concepts, is the evaluation phase which comprises all nursing intervention action that has taken place to the above steps. Once all the intervention activities have taken place, the RN completes an evaluation for client wellness to have been met (Timby, 2009). Possible client outcomes are generally provided under by three terms: patient’s disorder improved, patient’s disorder stabilized, and patient’s disorder deteriorated, died or discharged. If the condition of the client does not show any improvement, or if the set objectives are not met, the nursing process starts afresh and cycle repeats itself (Timby, 2009). The Registered Nurse can evaluate the entire use of nursing process by its outcomes. One of the outcomes to consider is whether the client has been vindicated from the disorder. Another important variable to put into practice in evaluating the process is susceptibility of the patient to develop another disorder from the previous one (Timby, 2009). Most importantly, the RN should be able to evaluate the nursing process by observing outcome of a patient being able to be discharged from the hospital. After the above evaluation of outcomes, the RN can grade the nursing process as either not productive, productive or more productive based on the apparent condition of the client.

The development of a plan of care using the nursing process for a for patient with a history of CHF, hypertension and lower extremity weakness

Timby (2009) contends that the nursing process can assist a RN to develop a plan of care by using its five stages. In the above scenario of a 78-year-old man, the RN will have to gather important information to assist the client. One of the vital data to be recorded is that the man has ability to walk short distances and transports himself to the communal dining room. The man is able to administer himself medication and can bath himself. The RN should also note that the man has a history of CHF, hypertension and lower extremity. Another data to collect is that the client was continuing with direct care. The diagnosis will first begin by rapid assessment of the patient’s personal information. The assessment data that support use of this nursing diagnosis is a pressure ulcer over the ischium on the right buttocks. The other important clinical manifestation is an oval wound about 10mm by 8mm with red and yellow areas in the middle and black areas on some surrounding tissue producing a smelling foul. The doctor uses independent nursing intervention to direct the client to receive intravenous antibiotic therapy so as wound care can be initiated. The outcome that meets the criteria is that similar medication that was dispensed to the man in the first place is still the same one administered after diagnosis. This is because the RN nurse known that development of the wound was as a result of methicillin-resistant staphylococcus aureus. The outcome of the patient is psychomotor because the old man uses his physical abilities and procedures to aid himself to get healed.

The RN uses dependent nursing interventions to prescribe the old man to undergo surgical debridement of the black tissue. Time frame decision was one of interdependent nursing interventions to ensure that there is a connection between earlier medication and the current medication (Timby, 2009). To perfect the medication, the RN uses independent nursing intervention to ensure that the client is administered with saline intravenously three times a day. This period is to ensure complete neutralization of staphylococcus aureus. Implementation will also involve dressing of the wound daily. Evaluation will aim to determine whether SIlvaSorb will heal the entire wound and whether intravenously administered Saline will suppress the activities of Staphylococcus aureus. The RN will also incorporate other medical practitioners in scrutinizing the performance of the wound to see if it would heal. If these symptoms persist, the RN will have to repeat the same nursing process again and find other way to deal with the disorder.

Nursing teaching plan to avoid recurrence of the above condition

To assist the patience in preventing a recurrence of a similar incident once he returns to the assisted living environment, RN will need to develop an individualized plan. In this case, the RN will decide the format of the teaching plan to be in verbal form. The RN comes to this conclusion by the fact that the client can talk, walk for short distances and count transport himself to the communal living room by himself. The information that needs to be included in the plan will include dressing the wound daily with SilvaSorb, saline intravenously three times per day and correct adherence to the prescribed drugs including Metoprolol and others. All this information will be used evaluation where all nursing interventions used converge. Looking into results at the evaluation stage, can guide a registered nurse (RN) to make effective decision on when and how to evaluate teaching-learning process. The appropriate time for RN to determine how and when to evaluate the teaching-learning process is when the patient start demonstrating psychomotor features, that is, ability to use physical skills or procedures.  The RN can also determine to evaluate teaching-learning process by identifying priorities of learning needs within the overall plan of care. In this case, the important learning needs is how to change the SIlvaSorb dressing within the prescribed time.

Conclusion

In conclusion, nursing process has to be done tremendously to perfect nursing activities towards provision of quality services to patients. Through the process assessment, diagnosis, planning, implementation, and evaluation, RNs are able to address a particular disorder systematically. If a disorder is not dealt with completely by the process, RNs are advised to use the same nursing process to rectify areas of mistakes, and as a consequence, develop other strategies within the process to holistically eradicate the disorder.

Reference

Timby, B. K. (2009). Fundamental nursing skills and concepts. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.

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Nursing Reflection Paper Assignment

Nursing Reflection Paper
Nursing Reflection Paper

Nursing Reflection Paper

Order Instructions:

In a reflection of 450-600 words, explain how you see yourself fitting into the following IOM Future of Nursing recommendations:

Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020.
Recommendation 5: Double the number of nurses with a doctorate by 2020.
Recommendation 6: Ensure that nurses engage in lifelong learning.
Identify your options in the job market based on your educational level.

How will increasing your level of education affect how you compete in the current job market?
How will increasing your level of education affect your role in the future of nursing?
While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

SAMPLE ANSWER

Nursing Reflection Paper

Nursing is one of the fields that experience continuous changes as new strains of disease crop up as well as development of new technologies. Nurses, therefore, have the obligation to remain steadfast by equipping themselves with more skills and knowledge to render high quality healthcare. To manage the changes, Institute of Medicine (IOM) has been in the forefront in formulating appropriate strategies as well as recommendations (Institute of Medicine, 2013). In this reflection paper, the author expounds on the personal strategies to meet the IOM recommendations, and also deliberates on job markets based on different educational qualifications.

In line with the IOM recommendations, nurses will render quality healthcare to their patients. IOM has recommended increase in the proportion of nurses with a baccalaureate degree to 80% by 2020, double the number of nurses with a doctorate degree by 2020, and ensure that nurses engage in lifelong learning (Initiative on the Future of Nursing, 2014). I am optimistic that the recommendations are essential and by 2020, I will be well equipped and ready to execute the duties as a nurse.

As per now, I already have acquired a baccalaureate degree and I am on the process of enrolling for a doctorate degree. Increase in the number of nurses with a baccalaureate degree is a good start and an indication of the commitment of the institute and the government to equip nurses with more skills. This increase is an indication of commitment to render quality healthcare services. Increasing the number of nurses with doctorate degree by 2020 is a positive initiative to the healthcare too. I do believe that I will be among the nurses with doctorate degrees to help impact positively on the society. I do hold the view that nurses need to engage in lifelong learning. This is the only avenue that will make them knowledgeable and competent to deal with the ever-changing issues in health care. Even as a student and an employee for a number of years, I have always welcomed new ideas and concepts. I have gained more skills working and sharing with other people on health issues.  I have attended committees and seminars on health care, which have helped to expand my scope of thinking and knowledge. Furthermore, through exchange programs, I have as well gained more skills and experience. I also embrace research and for many years, I have participated in various researches and will continue to carry out more to gain more insights on diseases and on healthcare as a whole. I, therefore, welcome the recommendations. They are not a surprise to me because they rhyme with my vision and objectives.

Acquiring more skills has become essential as the demand of competent nurses increase.  Having higher education level, it means that one will have many chances to work in different job levels. In line with my educational qualification, I can work as a registered nurse in any healthcare setting. Increasing my level of education will allow me to have an upper hand in the current job markets.  Having the skills or expertise required in the market will definitely make me valuable, as every employer will be in need of such skills as mine.

My role in future as a nurse with increased level of education will impact on my nursing roles extensively. The nursing field keeps on changing, hence, gaining more skills and knowledge gives me an opportunity to manage various health problems in nursing (Muehlbauer, 2012).  Technology is very essential in healthcare and with high skill, rendering quality care is guaranteed (Institute of Medicine, 2013).

I am well equipped and my vision rhymes with IOM recommendations.  My desire is to see every citizen receives quality healthcare regardless of demographic factors. I am still learning and believe that as I do acquire more skills, I will impact positively on the heath of the members of society. I do believe that nothing is impossible with passion and dedication.

References

Initiative on the Future of Nursing. (2014). IOM Recommendations. Retrieved from:             http://thefutureofnursing.org/recommendations

Institute of Medicine. (2013). The future of nursing leading change, advancing health: Report             recommendations. Retrieved from:    http://www.iom.edu/~/media/Files/Report%20Files/2010/The-Future-of-Nursing/Future%20of%20Nursing%202010%20Recommendations.pdf

Muehlbauer, P. (2012). The future of nursing. ONS Connect, 27(12): 12-15.

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Evolving Practice of Nursing and Patient Care

Evolving Practice of Nursing and Patient Care
Evolving Practice of Nursing and Patient Care

Evolving Practice of Nursing and Patient Care Delivery Models

Order Instructions:

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by CCNE and AACN using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, their specific care discipline and their local communities.

As the country focuses on the restructure of the U.S. health care delivery system, nurses will continue to play an important role. It is expected that more and more nursing jobs will become available out in the community, and less will be available in acute care hospitals.

Write an informal presentation (500-700 words) to educate nurses about how the practice of nursing is expected to grow and changes. Include the concepts of continuity or continuum of care, accountable care organizations (ACO), medical homes, and nurse-managed health clinics.
Share your presentation with nurse colleagues on your unit or department and ask them to offer their impressions of the anticipated changes to health care delivery and the new role of nurses in hospital settings, communities, clinics and medical homes.
In 800-1,000 words summarize the responses shared by three nurse colleagues and discuss whether their impressions are consistent with what you have researched about health reform.
A minimum of three scholarly references are required for this assignment.
While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

You are required to submit this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

SAMPLE ANSWER

Evolving Practice of Nursing and Patient Care Delivery Models

Registered Nurses and BSN play a critical role in the delivery of healthcare to patients. Regardless of the role they play, they are as well faced with a myriad of challenges that require immediate address. The field of nursing is growing and changing every day and, therefore, nurses must be abreast with the new developments and changes to remain effective in their duty. The paper exemplifies on the shared impressions about anticipated changes to healthcare delivery and the new roles of nurses in communities, hospital, clinical, and medical homes settings. The paper further discuses whether these views are consistent with the findings pertaining to health reform.

The colleagues noted that the medical care in US has been marred with extremely high costs and poor quality as well as fragmented delivery. The high cost of accessing quality medication has hindered many people from receiving quality healthcare, and this has compromised healthcare. However, with the new reforms in the healthcare, nurses are optimistic of new changes. They have already begun experiencing positive outcomes in terms of delivery of services.  The new concepts of integrated healthcare delivery have been developed including, Accountable Care Organizations (ACOS) and patient centered medical homes that will to greater extent impact positively on the field of nursing. Accountable care organizations are partnerships between the healthcare providers and aim to coordinate and manage patient care. The aim of this program is to ensure that quality care is delivered at reduced cost to help control huge amount of Medicare spending.

The Accountable Care Organizations groups include hospitals, nursing homes, physical groups, and home health cares services. The alliances are created through contracts that create a circle of service agreements aimed at bringing patient care under one umbrella. This concept ensures that health care costs are low as services are provided at one single corporate structure hence, eliminates duplication of services.

The nurses also postulated that the new changes will ensure provision of better care to all the individuals. The six dimensions of quality including effectiveness, safety, patient centeredness, timeliness, efficiency, and equity are guaranteed (Longworth, 2013). With home based care, nurses are in a better position to provide quick and effective care to patients.   Healthcare is no longer going to be provided at the acute care centers, but the changes will see more people get better and quick healthcare in their homes. Citizens are also going to receive better services through education on the major causes of illnesses, health, poor nutrition, substance abuse, physical activity, and poverty among many others. This means that preventive measures are going to be embraced such as physical examination and vaccinations, including influenza and polio among others, thereby helping to improve the quality of life.

The nurses as well agreed that integrated delivery system models are very effective in cost savings and at the same time improving quality of care.  Through these changes and reforms, hosipital admissions will reduce and visits to emergency departments will as well come to a minimum, hence, saving costs.  The group health cooperative of Puget was able to reduce the total costs of health by $10 per member in every month and recorded 16% reduction in new hospital admissions as well as 29% reduction in emergency visits (Longworth, 2013). This statistics is a clear indication that indeed with the emergence of these new concepts in nursing, quality is guaranteed at a lower cost.

Indeed, the impression elicited by the nurse colleagues is consistent with the studies on health reforms.  Government and other stakeholders in the health sector have instituted  various changes in health to help enhance the quality of services.  The government through such policies such as Affordable Care Act aims at ensuring that all the members of the U.S can access quality health care at an affordable cost (Daemmrich, 2013). Through partnerships with insurance companies such as Medicare and Medicare, many citizens will get the opportunity to access to quality healthcare.

According to Longworth (2013), the concept of ACOs, which was spawned by Elliott Fisher in 2006 aimed at improving coordination of care within the Accountable Care Organizations (Longworth, 2013). It was also intended to reduce fragmented care, control the costs of accessibility to care, and improve the outcome. This resonates with the colleagues’ impression of the new reforms of ensuring that quality care is provided at an affordable cost. Nurses have the responsibility to ensure that they improve the quality of care of their patients. In doing so, they must at all times ensure that they adhere to the professional codes of ethics and legislations. Even as these reforms in healthcare are implemented, it will require that nurses undergo further training to equip themselves with more skills to help in management of different diseases. ACO’s will require increase in the number of nurses to render their services to the members of the communities (Kelly, 2011). They will as well be required to embrace technology and innovation to handle health problems in the society.

In conclusion, nurses must be always be updated on the new developments in health profession. They have a greater role to play in healthcare and must be able to address the new changes and challenges they face. They must adhere to ethical standards in their execution of duties and must at all times ensure that they promote positive healthcare. The new reforms in the healthcare such as integrated patient centered care and ACOs have become important and are revolutionizing this sector. Nurses must be ready to adapt to these changes in order to help transform and impact positively on the quality of healthcare among the members of the community.

References

Daemmrich, A. (2013).U.S. healthcare reform and the pharmaceutical market: Projections from             institutional history.  Pharmaceuticals Policy & Law, 15(3/4): 137-162.

Kelly, E. (2014). Patient care delivery and integration: Stimulating advancement of ambulatory    care pharmacy practice in an era of healthcare reform Am J Health Syst Pharm, 71(16):1357-1365

Longworth, D. (2013). Accountable care organizations, the patient-centered medical home, and   health care reform: What does it all mean? Retrieved from:        http://www.ccjm.org/content/78/9/571.long

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Interview with Nursing Information Expert

Interview with Nursing Information Expert
Interview with Nursing Information Expert

Interview with Nursing Information Expert

Order Instructions:

Criteria Fill in the answers in this column.
Demographics: Provide initials of the RN, official job title of interviewee, and the date the interview was conducted. CF, RN, 08/08/2014

Required Questions
(answer EVERY question in this section)
1. Describe your career path to your current position. Include information about education and experiences. I earn my Bachelor’s in Nursing degree in a basis regular program of 4 years that typically focuses on the sciences and principles of nursing career practice.

I have been a nurse for 22 years. My first 12 years were spent working in Labor and Delivery and I have spent the past 10 years on the Mother Baby unit.  This past December I took a Clinical Unit Leader (CUL) position on the Mother Baby Unit.  Our OB unit is very busy.

2. Discuss the value of best evidence as a driving force in delivery of nursing care at your facility. You can’t turn around in nursing without encountering the term

Evidence-Based Practice (EBP).
Many computer systems are now installed with software called Computerized Decision Support (CDS). In the very near future, we can expect to see more computers with hyperlinks or guidelines for evidence based practice. Nurses are so important in the development of CDS. We have the knowledge and skills to provide guidance to nurses in practice. Nursing informatics is a growing field and nurses are strongly recognized as vital to the information technology of the future!

Standardization goes a long way in not only meeting the financial needs of the organization, but also the improved patient safety and care objectives. We can all agree that the ultimate goal of standardization is, in fact, patient safety resulting from clear, concise communication of evidence-based clinician instructions.

Use of a standardized nursing language for documentation of nursing care is vital both to the nursing profession and to the bedside/direct care nurse. Some of the benefits and advantages for the direct care/bedside nurse would include: better communication among nurses and other health care providers, increased visibility of nursing interventions, improved patient care, enhanced data collection to evaluate nursing care outcomes, greater adherence to standards of care, and facilitated assessment of nursing competency.

3. What safeguards and decision-making support tools are embedded in patient care technologies and information systems that support safe practice at your facility? Throughout the years technology has evolved  to shape the nursing profession by moving from manual applications to now technology driven.  Technology has evolved from nurses having to manually calculate IV drip rate to now using an IV pump when administering IV solution or certain medications , Nurses also had to manually calculate medications then go to the pharmacy and get the medications now with the EHR system in place most of the units the nurse uses the pic system  when administering medications.  Positive aspects of using the EHR and pic system when administering medications is when properly used this system help to prevent medication errors and provide clear and concise documentation from the physician order to the nurse charting what and how much medication was given .  Negative aspect is that a nurse can possible administer too much of the medication by not verifying the correct dosage or order or simple not following the 6 rights to medication administration.

4. Tell me about patient care technologies that have improved patient care at your facility. Data from monitors of physiological processes can be integrated into an electronic record. Some monitoring systems require that the client be connected in some way to the device. For client assessments, nurses use ecg rhythms, cardiac output, blood pressure, oxygen saturation, and other measurable data. This data can be integrated into the patient’s medical record.

Monitoring systems that use wireless technology enable automatic nurse-paging capabilities when client measurements fall outside normal parameters. For example, a patient connected to a centralized telemetry system experiences a run of multifocal premature ventricular contractions. The monitoring system immediately pages the nurse. If the nurse fails to respond in a specified time, the system sends pages to other nurses working on the unit.

This enables a faster response to abnormal findings. Advanced technology is improving healthcare by leaps and bounds.

5. What groups of healthcare workers rely on you to collect high-quality information or data and how is it utilized? As we move to toward greater interoperability and sharing data within networks, it will become even more critical to involve the nursing staff in identifying and understanding the value and uses, as well as the input and other requirements, of information included in the record. Nurses are an essential part of the team and play critical role of the nurse in implementation of the EHR.

Optional Questions
(Answer only ONE question from the choices below.)
1. Please tell me what challenges you have faced in dealing with other disciplines who may not “understand the needs of nurses/nursing?”
2. Please share an example of how GIGO (garbage in, garbage out) impacted a decision related to your information or data collection.
3. Please give me an example of how the lack of interprofessional collaboration impacted your role.
4. Please describe what a typical day on the job is like for you.

Follow-Up Questions
(Answer all of these. Please do not ask them during the interview.
Instead, reflect and answer them afterwards.)
1. How will completing this interview impact your practice as a BSN-prepared nurse? Give specific examples.
2. Resources (scholarly articles or texts). Indicate 2 scholarly resources or texts used prior to the interview to familiarize yourself with the individual’s organization, role, or any of the questions you asked to make you a more knowledgeable interviewer. Resource #1:
Resource # 2:

SAMPLE ANSWER

Interview with Nursing Information Expert

Interviewer Form

Your Name:                                                               Date:

Your Instructor’s Name:

Directions: After completing your interview, you must use this form to submit your assignment to the Dropbox. You may use the form to capture information as you conduct your interview, or fill it in later. The form is expandable and will enlarge the textbox to accommodate your answers. Do not rely only on this form for everything you must include! Please look in Doc Sharing for specific instructions in the Guidelines for this assignment.

Criteria Fill in the answers in this column.
Demographics: Provide initials of the RN, officialjob title of interviewee, and the date the interview was conducted. RN, Nurse, 08/08/2014
Required Questions

(answer EVERY question in this section)
1.    Describe your career path to your current position. Include information about education and experiences.  I pursued a Bachelor’s degree in nursing for four years, whereby I focused on sciences and principles of nursing career practice. I have practiced nursing for 22 years working in various units, such as Labor, Delivery unit, and Mother Baby unit. I enrolled for a Clinical Unit Leaders course in one the units last December to increase my knowledge base.
2.    Discuss the value of best evidence as a driving force in delivery of nursing care at your facility.  Evidence-based practice has become valuable and a driving force in delivery of nursing care in my facility in many ways. It has contributed to achievement of the goals as it has enabled clear and effective communication of instruction. Quality of healthcare has improved through better communication among nurses and other health providers; it has enhanced data collection aimed at evaluating nurse outcomes and helped in facilitating assessment of nursing competency.
3.    What safeguards and decision-making support tools are embedded in patient care technologies and information systems that support safe practice at your facility?    Technologies have evolved in healthcare over the years. Various safeguards and decision-making support tools exist to support safe practice.  One of them is the use of IV pump instead of IV drip in administering of Medications or IV solution.  EHR and pic systems are also new technologies that are used to enhance service delivery.
4.    Tell me about patient care technologies that have improved patient care at your facility. Various patient care technologies exist and aim to improve quality of practice. Some of them are ECG rhythms, blood pressure, cardiac output, oxygen saturation, and other measurable data. Other technologies are centralized telemetry system that monitor the state of a patient. The  system is able to relay information to other nurses in the unit in case the nurse assigned to  a  patient fails.
5.    What groups of healthcare workers rely on you to collect high-quality information or data and how is it utilized?  Nurses are the group of healthcare workers that rely on me to collect high quality information. I have the requisite skills and knowledge in data collection and, therefore, able to render better services. The data is utilized differently including, research, to understand the  health condition of the patient, and in making  decisions  concerning the medication of the patient among many others.
Optional Questions

(Answer only ONE question from the choices below.)
1.    Please tell me what challenges you have faced in dealing with other disciplines who may not “understand the needs of nurses/nursing?”  I have faced a number of challenges dealing with other disciplines that do not understand the needs of nursing. One of the challenges is insufficient knowledge in other areas assigned. This deterred me from delivering quality work.  Further challenge is lack of teamwork among the members. I, therefore, could not deliver quality services. Communication barriers and different cultural backgrounds have also been a challenge, since working with other colleagues that come from different backgrounds brings a cultural diversity complication.
2.    Please share an example of how GIGO (garbage in, garbage out) impacted a decision related to your information or data collection.
3.    Please give me an example of how the lack of interprofessional collaboration impacted your role.
4.    Please describe what a typical day on the job is like for you.
Follow-Up Questions

(Answer all of these. Please do not ask them during the interview.

Instead, reflect and answer them afterwards.)
1.    How will completing this interview impact your practice as a BSN-prepared nurse? Give specific examples.  Completing this interview will enable me understand the scope of knowledge and skills I have. It will enable me to appreciate the skills I need to acquire to render my services well. I will be able to get versed with new technologies available in healthcare and how they are used to enhance quality healthcare.
2.    Resources (scholarly articles or texts). Indicate 2 scholarly resources or texts used prior to the interview to familiarize yourself with the individual’s organization, role, or any of the questions you asked to make you a more knowledgeable interviewer. Resource #1: .

Ives Erickson, J., Ditomassi, M., & Adams, J. (2012). Attending Registered Nurse: An Innovative Role to Manage Between the Spaces.  Nursing Economic, 30(5): 282-287.

 
Resource # 2:

Rajagopal, N. (2013). Impact of Information Technology on Service Quality of Health Care Services.

The XIMB Journal of Management, 10(1):79-96.

 

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Integrated approach to care Assignment

Integrated approach to care
Integrated approach to care

Integrated approach to care

Order Instructions:

Integrated approach to care

Details:
Write a paper (1,250-1,750 words) describing the approach to care of cancer. In addition, include the following in your paper:
1. Describe the diagnosis and staging of cancer.
2. Describe at least three complications of cancer, the side effects of treatment, and methods to lessen physical and psychological effects.
3. Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

SAMPLE ANSWER

Integrated approach to care

Cancer could be complex and difficult, and it typically necessitates the involvement of several specialists in an integrated or integrative approach to care. If one chooses a care center that provides multidisciplinary care, then the individual will be able to receive a uniquely effective and convenient approach to cancer treatment. When all the cancer specialists meet within a single place, more options for cancer treatment are likely to be discussed (American Cancer Society, 2014). Moreover, differences of opinion could be resolved at that moment, and the patient gets a treatment program which is more comprehensive that focuses on a physical treatment plan, as well as social and emotional needs of the patient. With an integrated approach, the patient will be an active member of the team and gets to listen to the discussions, ask any questions, and voice his or her concerns. The team will guide the patient in understanding his/her options, although the patient remains the final and very well-informed decision-maker (American Cancer Society, 2014).

Diagnosis and staging of cancer

Diagnosis: a medical history particularly the history of symptoms, and physical examination are the initial steps in cancer diagnosis. Usually, the doctor would order several tests, many of which would be determined by the kind of cancer, as well as where the cancer is thought to be situated in, or on the body of the patient. Additionally, physicians would order electrolyte levels, a complete blood count, in addition to other blood studies which might provide more information, for instance a prostate specific antigen test might guide the physician to carry out more tests like prostate biopsy (American Cancer Society, 2014). Imaging studies are usually utilized in helping the doctor detect any abnormalities within the body that might actually be cancer. Ultrasound, MRI and CT scans, and X-rays are the common tools employed in examining the patient’s body. Other tests like endoscopy could allow visualizations of tissues within the intestinal tract, bronchi or throat that might be cancerous. Radionuclide scanning is commonly utilized in areas which cannot be visualized properly, for instance some lymph nodes or inside bones. The test will involve IV injection or ingestion of a weakly radioactive substance which could be concentrated and detected in the tissue which is abnormal (American Cancer Society, 2014).

Staging of cancer is understood as the process used by the physician to find out how much cancer there is within the body of a person, and where it is situated. It is, in essence, how the physician learns the stage of an individual’s cancer. Staging information is used by physicians in planning treatment and to help in predicting an individual’s prognosis or outlook (American Cancer Society, 2014). It is of note that cancers that have similar stage typically have the same outlooks and are usually treated the same way. The stage of cancer is also a way that physicians use in describing the degree of the cancer whenever they converse with one another regarding a person’s cancer.

Staging is of major importance given that it tells the specialist the best possible treatments that the cancer patient actually needs. For instance, the treatment for early stage cancer of the breast might be radiation and surgery, whilst a more advanced cancer of the breast might also necessitate treatment with chemotherapy (American Cancer Society, 2014). Moreover, specialists also utilize the stage to help in predicting the course that a given cancer is likely to take. When staging cancer, the specialist looks for the primary cancer, which is the original tumor, in addition to other tumors. The doctor looks at the number, size, as well as locations of any tumors to find out if the cancer has actually extended far away. The physician also looks at the nearby lymph nodes to see if the cancer has spread into them (American Cancer Society, 2014).

Complications of cancer

Depending on the health of the individual as well as the stage of the tumor, complications of cancer could be life-changing, inconvenient, painful and even deadly. Amongst the most common complications of cancer include fatigue, metastasis, sleep disorders, pain and depression. (i) Emotional and mental complications of cancer: generally, patients with cancer have the risk of developing mood disorders such as major depression and anxiety. A lot of cancer patients experience grief, sadness, as well as anxiety in response to the diagnosis and treatment of the disease. Whenever these feelings interfere with the capacity to lead a productive life or to undergo treatment, nevertheless, the cancer patient might have developed a mood disorder which calls for professional treatment (American Cancer Society, 2014).

            (ii) Physical complications of cancer: the main physical complication is pain. As a tumor is growing, it could extend into the nearby tissues or exert pressure on a surrounding nerve, which makes the patient to feel pain. The pain falls into 3 key types: neuropathic pain – this is pain as a result of injury to the central nervous system; somatic pain – pain that affects the particular area of the skin, bone or muscle; and visceral pain – pain as a result of damaged organ tissue (American Cancer Society, 2014). The other physical complications associated with cancer are as follows: vomiting and nausea; hypercalcemia, which is high amount of calcium within the blood; malignant pleural effusion, which is the accumulation within the lung cavity that makes breathing to be difficult. Lymphedema, which is the swelling as a result of damage to lymph nodes; sexual issues for instance vaginal dryness and erectile dysfunction; as well as pruritus, which is a sensation of itchiness.

Side effects of treatment

Radiation therapy and chemotherapy cause several side effects, considering that chemotherapy medications are very strong. The main side effects include Pain: this could be as a result of certain treatments for instance surgery. Vomiting and nausea: these are amongst the most dreaded side effects of cancer treatments. Fatigue: this is a distressing and common side effect of cancer and its treatment (American Cancer Society, 2014). Other treatment side effects include anemia and bleeding problems, confusion and memory problems, diarrhea and constipation, lymphedema, skin changes, hot flashes and night sweats, tiredness as well as hair thinning and hair loss. Other side effects include anxiety, reactivity to unpleasant stimuli, tension, depression, confusion, and hostility.

Methods to lessen physical and psychological effects

Patients with cancer who experience overwhelming feelings of despair, worthlessness, anxiety, hopelessness or sadness need to talk with a physician regarding the symptoms as well as possible treatment of these complications. In essence, psychological effects could be lessened through relaxation therapy, which eases symptoms of anxiety. Relaxation techniques which are known to ease the psychological side effects include mental imagery, hypnosis, as well as progressive muscle relaxation. They help in reducing tension, anxiety and depression (American Cancer Society, 2014). Fatigue can be lessened by establishing a sleep pattern, developing a routine for going to sleep, trying to those avoid activities which makes him/her most fatigued, and beginning an endurable everyday exercise regimen to decrease fatigue and improve sleep. To reduce physical effects, there are medications that the patient can take. There are drugs to reduce or totally eliminate the pain, which can also be lessened through massage that soothes the body

References

American Cancer Society. (2014). About Cancer. Available at http://www.cancer.org/treatment/understandingyourdiagnosis/staging (Accessed August 16, 2014).

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