Professor X?s reprimand of ?Was it perhaps because his had brainwashed him??(69) as reason for Nima?s siding against him is similar to the use of the Carnivale in the Medieval/Early Renaissance. And Nabokov is part of the same genre of Realist literature as Wilde. The realist subject matter was to present a social commentary of the inequities and difficulties of race and class through the fin-de-si?cle anxiety. Many, if not most, realist literature ends with the death of the character who questions social conventions (Lolita, Anna Karenina, Death in Venice, Madame Bovary). The dominant culture tends to see the death as justice for the offender, exactly the way that Salome is received. Consider the anxiety of sexuality in the different cultural periods.
Human Perspective on Sex Roles Essay Writing Guidelines
In your essay, trace the anxiety as both a masculine and feminine traits in the readings (the Bible passages, Wilde?s text, Nafisi?s text, and Adler?s text) and discuss how the anxiety is different for masculinity and femininity and show how it is part of masculine and feminine gender construction and what Butler calls gender performance.
Some in text citation needed please, I will upload some of the reading documents, outside sources might be used but not necessary (I will have to submit this through safe assign which checks for plagiarism).
"essay should portray understanding of the text, not completely own opinions instead point of view"
Human Perspective on Sex Roles Essay Requirements and Sources of References
It has to be a single cohesive essay, no subheading and a thesis needs to be included.
essay must reflect on course objective:
In an effort to not eat the menu, this course is intended to reveal the myth and metaphor behind some of the most prevailing themes of women?s lives. These themes, or rather metaphors, have developed throughout civilization and have, as we will examine, generated barriers for women even in our contemporary culture. We will examine specifically woman as warrior, woman as temptress, women as mothers and daughters, and we will investigate the recreation of each of these metaphors as represented through the art, literature, and stage of the various periods (ancient, medieval, Renaissance, and the modern) as particular constructs of the society in which women functioned and look for the re/construction of metaphor in our own contemporary culture. Gender, we will come to understand, is a social construct and the construction is a process that begins at birth. Judith Lorber states, in The Social Construction of Gender, ?As a social institution, gender is a process of creating distinguishable social statuses for the assignment of rights and responsibilities.
Human Perspective on Sex Roles and Major Social Roles
As part of a stratification system that ranks these statuses unequally, gender is a major building block in the social structures built on these unequal statuses.? It is the society that creates the barriers of the metaphor this course seeks to reveal. As part of our investigation, we will ask ourselves, what part does the society and the cultural period play in the shaping of the metaphor we will examine. Aristotle said ?Society is something in nature that precedes the individual.? Indeed, society is not made up of individuals but rather constitutes the individual, or gives meaning to the individual. This course is designed to reveal how each cultural period constructs meaning for women by creating and then recreating these metaphors through the various disciplines of the period.
Discourse Community Analysis Paper Discourse Community topic: gym and university students
Purpose: Drawing from Jean Lave and Etienne Wenger?s definition of ?communities of practice,? Ann M. Johns describes academic discourse communities as ?complex collections of individuals who share genres, language, values, concepts, and ?ways of being,? often distinct from those held by other communities? (500).
Discourse Community Analysis Paper
During your time in the university, you will move through and be expected to write for many of these disciplinary communities and discursive contexts, each of which will have a specific set of genres and language practices through which members of the disciplines communicate.
Discourse Community Analysis Paper Purpose of the Essay
Your purpose in this paper is to use the theoretical backdrop for discussing discourse communities that we established in the first unit of the course to explore the language practices and rhetorical genres of a discourse community of your choice. As the primary focus of the unit will be on academic discourse communities, focusing on a discipline on campus is highly recommended. If you wish to focus on a non-academic discourse community, you may do so (pending instructor approval).
Discourse Community Analysis Paper Primary and Secondary Sources
You should synthesize primary and secondary sources to compose a well-researched analysis of a disciplinary community here at OU. Your paper will employ field research methods such as observation, interview, and architectural and geographical analysis, as well as traditional library and web-based research methods to present a well-informed and analytical argument about your disciplinary community.
Discourse Community Analysis Paper Investigation of the Chosen Community
As you are researching your chosen disciplinary community, you should investigate the discourse practices, forms, and genres which are specific to the discipline as well as the identities, social languages, and conversations which are typical of the discipline more generally. How does the community as a whole use language in a distinct and unique manner? What values and ideologies might underpin the specialized vocabularies, symbol systems, vernaculars, codes, and citation styles that are typical of the discipline and which community members use to communicate with one another? What physical or intellectual markers distinguish members of this disciplinary community from others? Are there specific technologies, dress codes, tools, and interactions unique to or required by the community for participation? What role does identity play in this community?
Your paper should be driven by a clear, analytical thesis which is well supported using a minimum of 5 primary and secondary sources. You should not deliver a report of your research in which you simply describe your research process and your journey through disciplinary campus resources; instead, you should make an argument which synthesizes your research in thoughtful and analytical ways.
Discourse Community Analysis Paper Audience and Writing Guidelines
Audience: You should consider an audience who is well-informed but who does not know the articles/sources you incorporate. As you write, you should remember this audience and consider what this person will need to know about the articles, terms, and campus spaces to understand your argument and be sure to explain them as needed.
Social Factors Influencing Alcoholism You must use at least 6 peer reviewed articles for this assignment and have a total of 10 references. You can use other sources like government websites, agency websites, creditable newspapers, but not Wikipedia or blogs.
Social Factors Influencing Alcoholism
You should be finding the latest research that is relevant to your topic. However, there may be a “landmark” article in the area that many people cite in their work. You could include such an article, but for the most part, seek the most current scholarship on your topic (i.e. within the last 10 years).
Social Factors Influencing Alcoholism Essay Paper Format and Requirements
You must write in complete sentences with proper ASA (not APA) citing throughout the paper and a proper ASA reference page at the end. You will use a 12 point font with 1” margins. Your word count should be no less than 2500 words (excluding your reference page). No title page is needed. The goal is to write without biases but to explain in an objective way what is happening. You will not use text lingo, slang or I/Me/My. Remove yourself from the study.
Introduction to Social Factors Influencing Alcoholism
1. Introduction to topic (200-300 words)
1. Summarize the qualitative project you worked on. State the importance of your topic by using the peer reviewed journals as supporting citations. Example, if you are looking at gun laws and want to know how people are reacting to new gun laws, show to your reader how research has shown an increase/decrease in violent murders with guns, or how new gun laws are impacting purchasing power for citizens.
2. Next, briefly tell me about your dependent variable. Based on research what independent variables do you think have an effect on your dependent variable?
3. Next, briefly tell me about what you are doing (hint: survey design).
2. Review of Qualitative Literature (1700-1900 words)
1. Locate at least 6 research articles in academic journals that present research that is relevant to a single topic of
research. (The articles need not be on exactly the same topic, but they must be relevant.) –
2. Note the details on data collection for each article, including (as relevant): number of key informant interviews, time spent in the field, type of field research (e.g., participant observation), number of focus groups, and composition of focus groups.
Social Factors Influencing Alcoholism and Method Section of the Information
This information should be identifiable in the methods section of the article.
3. Note the key findings of each article, as stated in the abstract (or in the absence of the abstract, in the findings
section of the article).
4. For each article, discuss the limits to generalizability of findings based on the field research. How has the researcher
(or researchers) dealt with this problem?
a.This should all come from your annotated bibliography and critical thinking on your end.
The work of an organization in trying to solve a social problem
The work of an organization in trying to solve a social problem
Case Study Essay question:
Discuss the work of an organization in trying to solve a social problem. You need to situate the social problem in its economic and political context.
The social problem could be anything. For example homelessness, underage drinking and so on.
Companies can be a solution for social problems. For that, we refer to a TED talk that made Michael Porter with the title “Why business can be good at solving social problems”.
This talk made in 2013 and Porter explained that all the world was full of serious and pressing problems, for example, poor nutrition, access to water, climate change, deforestation, lack of skills, insecurity, not enough food, not enough healthcare or pollution. Two years later, unfortunately, this problems are already in the world.
More people already believe that only NGOs have the solutions for this problems. It’s true that this organizations have had a growth through the years, but this growth is too slow, thus, the solutions that they are achieving and their impact are small because of lack of resources.
NO TABLE OF CONTENT PLEASE.
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Immigration on Social Cohesion in Present day Britain An evaluation of the Impact of Immigration on Social Cohesion in Present day Britain.
Immigration on Social Cohesion in Present day Britain
The topic of my Major Project is : An evaluation of the impact of immigration on Social Cohesion in present day Britain.
According to some, immigration is the true heart and soul of society. There is an argument that without immigration, Europe, especially the UK, would not have developed in the way it has. I personally believe immigrants are the fabric of our society. However the immigration integration is not easy as we think about it. That is why I have chosen as a topic the Social Cohesion of the immigration. I would like to investigate and analyse how immigrants are integrated to the society once they are here.
As you know, There are several factors that can be taken into consideration; however, I will focus on only three factors, which are : families, education, and work (economic integration). So you can divide the Literature REview part into 3 parts (Families / Education / Work)
The researcher can take and use whatever he thinks is useful for the literature review. I need more and less 20 sources. ( be careful for the Harvard referencing)
The aim of the literature review is to show my reader (mytutor) that I have read, and have a good grasp of, the main published work concerning a particular topic or question in my field.
The writer may use whatever sources he or she feels are most appropriate.( books, newspapers, websites, pdf documents)
the writer may also put some images/figures to be more creative.
This hand-out assumes that you will end up with at least 3 chapters:
• Chapter 1: Introduction
• Chapter 2: Literature review
• Chapter 3: Conclusion
At the end of the whole work there should be a full bibliography. Any appendices should come after the full bibliography.
The longest chapters will be the Literature review. The Introduction and Conclusion chapters will be short in comparison
Immigration on Social Cohesion in Present day Britain Chapter 1: Introduction
Make sure that the readers of your work will be able to find the answers to these questions in Chapter 1:
• How was the topic chosen?
• What were the main aims and objectives of the research?
• What is the scope of the research project? (If your dissertation/project is focussed on one particular industry or technology you might include introductory remarks about this here.)
• How is the text (chapters) arranged in the dissertation/project?
Chapter 2: Literature review
You will be rewarded for:
• providing a short introductory paragraph which explains what is discussed in the chapter
• demonstrating that you conducted a thorough literature search and have read widely
• demonstrating that you have read up to date material
• summarising what you have read thematically (and not author by author). You will think of the headings for the Literature review
• evaluating what you have read
• identifying gaps in the literature in your opinion (if you are able!)
Immigration on Social Cohesion in Present day Britain Chapter 3: Conclusion
This should be a conclusion to the whole project. Check that your work answers the following questions:
• Did the research project meet its aims (check back to introduction for stated aims)?
• What are the main findings of the research?
• Are there any recommendations for further research? How could the study be continued?
Immigration on Social Cohesion in Present day Britain Bibliography
Your bibliography should use Harvard Referencing. You do not need to group books, journals, web sites.
Appendices
Appendices follow after the bibliography.
No worries if you are confused with the Introduction. The most important is the Literature review. I count on you. Books, newspapers, pdf documents (UK governement, other essays),etc.. are welcome. Just be careful for the plagiarism.
Examining Family and Marriage Threat in Current Trend It could be argued that family and marriage have never been more under threat than at the present time.
Examining Family and Marriage Threat in Current Trend
Examine this claim in the light of current trends and government policies Research report/essay (80% of total marks) (2500 words + or – 10%)
Assignment lay out nuclear family how I am going to tackle itIntro: I need to show my understanding of the essay title ( a particular family form is been under threat which is the nuclear family how I am going to tackle it
Main part: examine the claim that family and marriage are under threat show evidence. Can use statistic on how the family is been relating to divorce and marriage
Family theory need to talk on how people are no longer getting married in the traditional way
How the family is been seen in government perspective
How family are seen in media how they still promote about family structure .etc
Can also include cultural prospective within sociology,
Conclusion pro summarizes your response to the essay question.
Please follow the module outcome as well.
Module learning outcome =Assessment criteria The student can:
1. Understand the complexity of the idea of family life, and appreciate different ideologies of the family. =Discuss family complexity and demonstrate
awareness of different ideas about ‘the family’/childhood.
2. Understand the key theoretical approaches to social inquiry.=Discuss clearly and accurately key sociological theories, concept, and evidence relating to ‘the
family’/childhood.
3. Analyze different aspects of family life using sociological themes and concepts.= Examine family life through the use of sociological theory, drawing upon a range of literature to do so.
4. Evaluate arguments and debates about family life. =Use a range of academic literature to demonstrate awareness of, and assess, key issues relating to ‘the
family’/childhood.
5. Use their knowledge of the complexity of family life in real life settings and situations. =Use evidence from, for example, research studies and real-life
examples in the news to demonstrate awareness of the complexity of family life.
6. Apply their knowledge and understanding of family life in a written report. =Use sociological theories, concepts, and evidence on ‘the family’/childhood to
support discussion in the research report.
Examining Family and Marriage Threat in Current Trend Journals
Relevant journals include:?Child Abuse Review?Childhood?Children and Society?European Journal of Women’s Studies Journal of Child and Family Studies Journal
of European Social Policy Sociology
Websites
Useful websites include:?Centre for Research on Family, Kinship, and Childhood at the University of Leeds www.leeds.ac.uk/family
Family and Parenting Institute
http://www.familyandparenting.org
Institute of Social and Economic Research at the University of Essex
www.iser.essex.ac.uk
Joseph Rowntree Foundation
www.jrf.org.uk
National Children’s Bureau
www.ncb.org.uk
Office of Public Sector Information (Acts of Parliament)
www.opsi.gov.uk
Social trends
http://data.gov.uk/dataset/social_trends
Troubled families
www.communities.gov.uk/communities/troubledfamilies
Current Social Issue and Effects for Informing Readers Write an essay about a current social issue whereby both cause and effect can be presented in a way that both informs and engages readers Topics to consider but not limited to- Gun control, immigration reform, GMOs, prison rights, ObamaCare.
Current Social Issue and Effects for Informing Readers
-Title your essay
-Write in the same tense
-Write in the third person
-Provide specific details and examples
-A clear thesis statement
-Include a photograph
-Two sources. The forces which affect homelessness are complex and often interactive in nature. Social forces such as addictions, family breakdown, and mental illness are compounded by structural forces such as lack of available low-cost housing, poor economic conditions, and insufficient mental health services.
This assignment is going to focus on hypertension among black Americans. Studies have reported that in African Americans record the highest prevalence of hypertension in the United States. According to Hicken et al., (2014), approximately 40% of African Americans have been diagnosed with hypertension. Additionally, hypertension develops early in life and is often very severe.
The issue of hypertension is important in the profession because it is the role of clinicians across the globe to educate, advice as well as measure peoples’ blood pressure. The education entails modifying behavior associated with physical activity, diet, stress, weight, alcohol intake, and smoking. The African Americans are important in this health profession due to the high prevalence they present with. Clinicians can use the population to study what environmental, genetic, sociological, economic or even cultural issues that are associated with development of hypertension. Additionally, practitioners can use the population to study the impact of various pharmacological as well as non-pharmacological interventions such as effect of smoking cessation, weight reduction, salt restriction, and physical activity.
Lifestyle is one of the social risk factors that has an impact on development of hypertension. The hypertensive contribution of alcohol truly matters among African Americans because alcohol induced hypertension is the most prevalent form of secondary high blood pressure. A 2012 survey on drug abuse reported that the rate of binge drinking among African Americans above the 12 years is at 21. 6% compared to the national coverage which stands at 23 percent. The researchers reported that African-American youths are more affected with the risks associated with alcohol drinking. This can therefore be used to explain the high prevalence of hypertension among the African American population. Cigarette smoking is another lifestyle factor that has a significant effect on the etiology of hypertension. About 29.8% of African Americans have been reported to use tobacco (Jamal et al., 2014). Nicotine in cigarettes is a major contributor of hypertension development. It acts by narrowing the arteries and hardening their endothelial wall which eventually increases the heart rate as well as the blood pressure. Moreover, nicotine cause blood clotting which stresses the heart inducing stroke which worsens the severity of hypertension (Rasool et al., 2016).
Poverty is another social factor that has been implicated for the high prevalence of hypertension among African Americans. Studies by Zapolski et al., (2014) have reported that among the different racial and ethnic populations, African Americans have the highest rates of poverty at 27.4% followed by the Hispanics at 26% and whites at 10 percent. As healthcare improves for the wealthy, a reversal socio-economic gradient is seen among the poor, disadvantaged African Americans who are subjected to the largest burden of hypertension. Despite the general provision of effective pharmacological interventions for hypertensive patients in the United States, economies link to the cost: benefit ratio as well as sociological consideration have a great impact on the low rates of early diagnosis, management, and control of high blood pressure among the African Americans.
Poverty promotes poor nutrition contributing to etiology of hypertensions. Poor diet is a risk factor that promotes development of diabetes and obesity. Both diabetes and obesity are linked with high blood pressure with obese patients recording higher rates of hypertension than individuals with normal Body Mass Index (BMI). Additionally, obesity increases cardiac diseases by increasing the levels of Low Density Lipoproteins (LDL) to cholesterol ratio this prompts the development of hypertension which can cause myocardial infractions as well as hypertension. Poverty is also associated with stress and depression which increases the release of cortisol that increases high blood pressure.
References
Hicken, M. T., Lee, H., Morenoff, J., House, J. S., & Williams, D. R. (2014). Racial/ethnic disparities in hypertension prevalence: reconsidering the role of chronic stress. American journal of public health, 104(1), 117-123.
Jamal, A., Agaku, I. T., O’Connor, E., King, B. A., Kenemer, J. B., & Neff, L. (2014). Current cigarette smoking among adults—United States, 2005–2013. MMWR Morb Mortal Wkly Rep, 63(47), 1108-1112.
Rasool, A. H., Man, C. N., Sanip, Z. B., Yusoff, H., & Suhaimi, M. Z. (2016). Relationship between hair nicotine levels with blood pressure, body composition, lipid profile and leptin among healthy male smokers in Kelantan.
Zapolski, T. C., Pedersen, S. L., McCarthy, D. M., & Smith, G. T. (2014). Less drinking, yet more problems: Understanding African American drinking and related problems. Psychological bulletin, 140(1), 188.
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Researching on a Social Control Issue You are a criminal justice consultant for a criminal justice related agency (e.g., District Attorney?s Office, Law Enforcement Agency, Prison, or Corrections
Agency, etc.).
Researching on a Social Control Issue
Your boss, the head of the agency, has charged you with identifying a current criminal justice related community problem of which he/she would like to address.
Researching on a Social Control Issue Task
You are tasked with researching a social control issue such as, but not limited to gangs, juvenile justice, criminalities, homeland security related issues, a citizen’s academy, etc., towards building a criminal justice program, policy, or community initiative that addresses the problem in attempt to better society.
Your program or policy must be grounded in sound criminological theory as evidenced by the empirical research.
Your program or policy must be multifaceted in order to address causation of crime or issue of your choice.
Your program must contain a strategic plan that addresses and responds to using empirical data and research a societal issue you are passionate about.
Example: Gangs wreak havoc on communities. There are numerous community initiative programs, such as Gang Of One in Charlotte, North Carolina designed to address and respond to the broad scope societal problem gangs create. Gang related programming aims to decrease membership in gangs and gang related criminal
activity. What kind of program do you think might work?
Please research a topic you would like to have considered for approval by your instructor that is criminal justice related and also a societal problem, such as gang violence, domestic violence, etc. You must narrow the scope of your topic immensely to something like ?Gang Violence of the MS-13s in Los Angeles?.
Your topic cannot be too broad. It must be narrow enough that you are able to complete the project this term. Too broad and you will not be able to complete it in only 12 weeks.
Researching on a Social Control Issue Essay Paper Format
Compose a paper entitled Capstone Project Topic Proposal using formal APA format.
Using Bloom?s Taxonomy as your framework, design an outline that Identifies, Describes, Discusses, and Analyzes your proposed topic. Transfer the concepts of your outline into the headings of your proposal draft. Flesh out each section using credible research and persuade your instructor why your selected topic is
important to research towards designing a new public policy or community initiative with the overall goal in mind remaining focused on public safety and/or criminal justice.
This assigning is to be 1000 words minimum or three and 1/4 pages in length excluding the title page and references page. Remember that an average academic sentence at the graduate level is approximately 20-25 words and an average paragraph is approximately 250 words. Therefore, a 1000 word proposal is merely
four paragraphs at minimum.
Community Home Visit with Sallie Mae Fisher Order Instructions: THIS ASSIGNMENT HAS 2 PARTS:
1- ESSAY PORTION (750 WORDS)
Community Home Visit with Sallie Mae Fisher
2- SCRIPTED DIALOGUE PORTION (ABOUT 900 WORDS)
Collaborative Learning Community: Home Visit with Sallie Mae Fisher
Details: This is a CLC assignment.
As a group, observe the simulated “Home Visit With Sallie Mae Fisher” video (http://lc.gcumedia.com/zwebassets/courseMaterialPages/nrs410v_vp01Alt.php).
Refer to “Sallie Mae Fisher’s Health History and Discharge Orders” for specifics related to the case study used to inform the assignment.
Using “Home Visit With Sallie Mae Fisher” and “Sallie Mae Fisher’s Health History and Discharge Orders,” complete the following components of this assignment:
Essay Portion
After viewing the home visit, write an essay of 500-750-words in which you do the following:
1. Identify, prioritize, and describe at least four problems.
2. Provide substantiating evidence (assessment data) for each problem identified.
3. Identify and describe at least four medical and/or nursing interventions.
4. Discuss your rationale for the interventions identified.
Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Scripted Dialogue Portion
Utilizing the information learned from the home visit, health histories, and discharge orders, write a scripted dialogue in which you provide Sallie Mae with the education that describes her problems and the interventions identified to improve her condition. Consider Sallie Mae’s physiological, psychosocial, educational, and spiritual needs when developing your dialogue.
Your dialogue should resemble a script. The following is an example of a few sentences from a scripted dialogue:
Nurse: “Good morning, Salle Mae, my name is ______ and I will be your nurse today. I understand you are experiencing problems with ________.”
APA format is not required for this part of the assignment, but solid academic writing is expected.
Refer to “Home Visit With Sallie Mae Fisher Grading Criteria.”
Entire 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.
NRS410V.R.SallieMaeFishersHealthHistoryandDischargeOrders_Student_02-11-13.docx NRS410V.R.HomeVisitWithSallieMaeFisherGradingCriteria_Student_02-11-13.docx
Please Note: Assignment will not be submitted to the faculty member until the “Submit” button under “Final Submission” is clicked.
Sallie Mae Fisher’s Health History
and Discharge Orders
Sallie Mae Fisher Health History
Ms. Fisher is an 82-year-old female with a history of chronic congestive heart failure (CHF), atrial fibrillation, and hypertension. During the last 6 months, she has been hospitalized four times for exacerbation of her CHF. She was discharged home last Saturday from the hospital after a 3-day stay to treat increased dyspnea, an 8-pound weight gain, and chest pain.
Ms. Fisher is recently widowed and lives alone. She has a daughter, Thelma Jean, who lives in town but works full time and has family issues of her own. Therefore, family support is limited.
Hospital Discharge Instructions
• Mountain Top Home Health to evaluate cardio-pulmonary status, medication management, and home safety.
• Medical Equipment Company to deliver oxygen concentrator and instruct patient in use. O2 at 2 liters per nasal prongs PRN.
• Prescriptions are given at discharge:
o Digoxin 0.25 mg once a day
o Lasix 80 mg twice a day
o Calan 240 mg once a day
• An order was written to continue other home meds.
Sallie Mae’s Home Medication List
• Zocar 50 mg once a day
• Minipres 1 mg once a day
• Vasotec 10 mg twice a day
• Prilosec 20 mg once a day
• Furosemide 40 mg once a day
• Effexor 37.5 mg at bedtime
• Lanoxin 0.125 mg every other day
• Multivitamin once a day
• Potassium 40 mEq once a day
• Ibuprofen 400 mg q 4 hours as needed for pain
• Darvocet N 100 mg q 4 hours as needed for pain
• Nitroglycerin ointment, apply 1 inch every day
Home Visit With Sallie Mae Fisher Grading Criteria
REQUIREMENTS:
Essay Portion
1) Identified and prioritized at least four problems from the simulated home visit with Salle Mae.
2) Summarized each problem identified with evidence to substantiate findings (assessment data).
3) Identified and discussed at least four medical and/or nursing interventions to meet client needs.
4) Provides rational for interventions identified. Discussion of rationale includes support from outside resources (current evidence-based literature).
Scripted Dialogue Portion
1) Utilizes information learned from the home visit, health history, and discharge orders presented in the simulation to develop a patient dialog.
2) Dialog addresses the physiological, psychosocial, educational, and spiritual needs of the client.
Format/Style
1) Essay Portion
Prepare this step of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
Information is paraphrased and not copied/pasted from other sources, including dictionaries, textbooks, e-books, and electronic links.
2) Scripted Dialogue Portion
APA format is not required for this part of the assignment, but solid academic writing is expected.
Total______pts / 100 x 200=_______% of grade Possible
10
20
40
80
10
20
10
Actual
______
______
______
______
______
______
______
Community Home Visit with Sallie Mae Fisher Sample Answer
Collaborative Learning Community: Home Visit with Sallie Mae Fisher
Identify, Prioritize, and Describe At Least Four Problems
Ms. Fisher has chronic congestive heart failure (CHF) history. She has been experiencing CHF exacerbation. She has a history of hypertension and atrial fibrillation. From the review of the system, the patient has the following problems (Albert, 2012);
a) Decreased cardiac output: this is attributable to the fact that the patient heart has reduced capacity to meet her body`s metabolic requirements. The decrease in blood flow that supplies the heart results into a reduced cardiac output, which the causes the insufficient blood fail to circulate to all the other body parts. This causes an altered heart rate, weakness, and paleness. This problem is clinically manifested by irregular pulse rhythm, tachycardia, and generalized body weakness.
b) Fluid and electrolyte imbalance: the patient has not been taking a lot of fluids. The imbalances are related to low fluid intake and use of diuretics.
c) Dyspnea episodes had been indicated in the discharge report, but the patient declined the proposed intervention of using oxygen supplement.
d) A risk for imbalanced nutrition: associated with poor dietary intake.
Provide Substantiating Evidence (Assessment Data) For Each Problem Identified
The decreased cardiac output is indicated by the blood pressure of 90/56. The insufficient blood circulation to the other parts of the body is the main cause of tachycardia. The fluid and electrolyte imbalance is indicated by the patient’s skin condition. The patient skin is tenting and coarse. This is an indicator that the patient’s body is not well hydrated. When pinched, a hydrated skin goes back to the original state immediately. The assessment also indicated that the mucous membranes are dry. The hypoactive bowel movement bowel movement sounds, low blood pressure and her complaints that her mind is cloudy are the indicator for fluid and electrolyte imbalance (Hughes, 2013).
The episodes of dyspnea are evident by the fact that the patient discharge report had requested for oxygen gas supplementation but the patient declined the treatment. This indicates that the condition is still persistent as it was not managed. The patient risk for imbalanced nutrition is indicated by the fact that the patient has lost 14 pounds within a span of one week. This indicates that the patient has not been able to cook or she has no caregiver to help her with her daily routine activities such as hygiene or feeding. She says that she has no appetite and is still undergoing grief due to the loss of her husband (Apostolo et al. 2012)
Identify and describe At Least Four Medical and/or Nursing Interventions and Their Rationales
Nursing diagnosis
Nursing intervention
Rationale
Decreased cardiac output
Abnormal heart lungs and sounds will be assessed
Assess patient consciousness and mental status
Assess skin temperature as well as the peripheral pulses
This facilitates the detection of the renal failure associated with fluid and electrolytes imbalance
This can be caused by toxicity due to an accumulation of waste products caused by impaired blood circulation. This is manifested by the patient condition of legarthy, altered consciousness and “cloudy mind’
Reduced perfusion of oxygen to the secondary tissue could lead to decreased temperature and diminished peripheral pulses
Fluid and electrolyte imbalance
Monitor diagnostic tests and laboratory findings
Implement strategies to manage fluid and electrolyte imbalances
Administer cardiac glycoside agents as indicated, the nurse should monitor toxicity
Assess risk for skin integrity complication such as bed sores
Important as they provide clues on patients response to medication and statues of the disease.
This helps reduce risks associated with decreased cardiac output
Digitalis is associated with the positive inotropic effect on the myocardium. It also strengthens contractility which improves cardia output
Patient skin is at risk of developing skin complication. The patient should remain hydrated reposition every two hours to prevent bed sores
Episodes of dyspnea
Oxygen saturation and ABGs should be monitored
A patient should be given oxygen as indicated by oxygen saturation and ABGs report
A patient is encouraged to make adequate rest
This provides insights into hearts ability to circulate and perfuse the distal tissues with oxygenated blood
This will provide the patient with enough gas for gaseous exchange. This will help alleviate hypoxia and activity intolerance
This facilitates reduction of cardiac overload, which reduces myocardial oxygen consumption.
Imbalanced nutrition
Assess patient ability to carry out daily living activities such as cooking, taking medication right dosage and appropriate time, shopping from the groceries, cleaning the house and self-hygiene
This will help check if the patient has the capacity to take care of herself, or there is a need to have a caregiver with her. This will also help identify if there is medication adherence.
Part B: SCRIPTED DIALOGUE PORTION
A: Health care: quality of life
Nurse: Good morning Salle Mae, I am Myre from Mt view Hospital. I am your nurse today. I comprehend that you have not been feeling fatigued and shortness of breath. In general, how would you describe your health?
Patient: In comparison to my health status a week ago, I would say my health fairly good. But I am extremely weak and cannot do anything without loss of breath.
Nurse: I will read a list of activities that you would normally do on any typical day. After I read each of them, please state if your current health limit’s them a little or more?’
(Patient intercepts)
Patient: Nurse, lately I have not been doing any activity other than resting on this couch.
Nurse: Why is so? Is that because of your health status?
Patient: Yes, I can barely manage to get myself a glass of water. Cooking has also become an issue and I am relying on frozen foods.
Nurse: Okay, Salle, how do you feel? How things have things been with you since you were discharged from the hospital?
Patient: I feel helpless. I have not known peace for the last two weeks especially because I am depending on other people for help. I am overburdening them. They would so much better if I was not alive.
Nurse: What are some of the things do enjoy doing? How often do you get to do them nowadays? What do you do on the weekends?
Patient: I love golfing. Normally, I would spend the weekends with my friend Penny playing golf. However, since the regular hospitalization incidences, I am unable to join her and all I do during the weekend is sleep.
Nurse: I have noticed that you have been to the hospital a lot lately. How does this make you feel? Would you like to tell me what else has been going on with your health?
Patient: This has made me lose energy. I am unable to understand why life has been this tough. (She is acute distress). My energy levels are low and I seem to be very forgetful lately.
Nurse: Salle, how has the heart failure affected you and how it kept you from living life the way you have always wanted?
Patient: I am no longer able to do things the way I have always wanted because I have to sit and rest a lot during the day. I lose breath even when walking for short distances like from the bed room to the toilet. The shortness of breath has makes it difficult to sleep at night. I feel tired and fatigued throughout the day.
Nurse: Salle, I would like to make you understand your symptoms. You have a health condition which makes your heart fail to function properly. This makes it difficult to propel enough blood to the other body organs of the body. This explains why you have been experiencing shortness of breath, activity intolerance and fatigue.
Patient: Is this why I have all these medications. They are just too many and sometimes I forget to take some.
Nurse: Salle, the medications will help reduce your signs and symptoms. You must adhere to medication. To ensure that you take medication all the time, you can put an alarm for a reminder.
Patient: My mind is cloudy, what can I do to have a peaceful life?
Nurse: Salle, you need to have adequate rest. You must also adhere to medication. Try as much as possible to maintain an active lifestyle such as taking a walk around the neighborhood. Importantly avoid prescribed medication alcohol or cigarettes.
Salle, do you feel sad living alone?
Patient: Ever since Eddy left me (her eyes tears), I feel depressed.
Nurse: You really loved your husband, tell me more about him
Patient: He is the best thing that has ever happened to me. He was the funniest person ever and kept very happy. He was hardworking and my best friend.
Nurse: Are there members of the family or community who regularly check on you? Whom can you call for help when you are not feeling okay?
Patient: My daughter and best friend Penny. She lives a few blocks down the street. Penny is always checking on me and would prepare dinner for me when she visits.
Nurse: What about social workers and case managers? Do you mind if I contacted them to discuss ways they can help you?
Patient: I do not really think that I am that needy, but it is okay, may be they too have additional instructions of benefit to me
Nurse: that is okay, I will reach a social worker; she could be having ample solutions to that will help you manage your health condition and obtain the appropriate social support.
Patient: Thank you so much.
Nurse: Meanwhile Salle, I would encourage you to remain active in church and prayer groups. This will help you have an improved sense of belonging. I will also enroll you to a cardiac rehabilitation program at a health facility that targets the elderly population diagnosed with CHF; it is a community where you meet with other people experiencing the same condition.
I will see in five days. I want you to take the medication as requested, eat nutritious food to help the body retain its energy. Try to remain active to avoid other complications associated with congestive heart failure.
Patient: Alright nurse; thanks for checking on me.
Community Home Visit with Sallie Mae Fisher References
Albert, N. (2012). Fluid Management Strategies in Heart Failure. Critical Care Nurse, 32(2), 20-32. doi:10.4037/ccn2012877
Apostolo, A., Giusti, G., Gargiulo, P., Bussotti, M., and Agostoni, P. (2012) Lungs in Heart Failure. Pulmonary Medicine Volume 2012, Article ID 952741, doi:10.1155/2012/952741
Hughes, R. (2013). Treatments to achieve fluid balance in heart failure. Br J Cardiac Nursing, 8(11), 537-540. doi:10.12968/bjca.2013.8.11.537
