NR 601 Week 5 Case Study (NR601) Chamberlain

NR 601 Week 5 Case Study (NR601) Chamberlain College of Nursing

The purpose of this case study assignment is to:

1. Analyze provided subjective and objective information to diagnose and develop a management plan for the case study patient.
2. Apply national diabetes guidelines to case study patient management plan.
3. Demonstrate mastery of SOAP note writing.

NR 601 Week 5 Case Study Course Outcomes

Through this assignment, the student will demonstrate the ability to:

1. Employ appropriate health promotion guidelines and disease prevention strategies in the management of mature and aging individuals and families.
2. Formulate appropriate diagnoses and evidence-based plans of care for mature and aging individuals and families using subjective and objective data.
3. Incorporate unique patient cultural preferences, values, and health beliefs in the care of mature and aging individuals and families
4. Integrate theory and evidence based practice in the care of mature and aging individuals and their families
5. Conduct pharmacologic assessment addressing polypharmacy, drug interactions and other adverse events in the care of mature and aging individuals and their families.
6. Apply evidence-based screening tools to perform functional assessments with aging individuals and their families as appropriate.

PREPARING THE NR 601 Week 5 Case Study

The assignment is a paper which is to be written in APA format. This includes a title page and reference page.

Review the attached patient visit information.

The patient has presented for an acute care visit. You are provided with the subjective and objective exam findings. As the provider, you are to diagnose and develop the management plan for this case study patient. Use the categories below to create section headings for your paper.

• Introduction: briefly discuss the purpose of this paper.
• Assessment: review the provided case study information.

Chamberlain College of Nursing NR601 

Identify the primary, secondary and differential diagnoses for the patient. Use the 601 SOAP note format as a guide to develop your diagnoses. Each diagnosis will include the following information:

• ICD 10 code.
•  A brief pathophysiology statement which his no longer that 2 sentences, paraphrased and includes common signs and symptoms of the diagnosis.
• The patient’s pertinent positive and negative findings, including a brief 1-2 sentence statement which links the subjective and objective findings (including lab data and interpretation).
• A rationale statement which summarizes why the diagnosis was chosen.
• Do not include quotes, paraphrase all scholarly information and provide an intext citation to your scholarly reference. Use the Reference Guidelines document for information on scholarly references.

NR 601 Week 5 Case Study Plan (there are five (5) sections to the management plan)

1. Diagnostics. List all labs and diagnostic test you would like to order. Each test includes a rationale statement which includes the diagnosis for the test, the purpose of the test and how the test results will contribute to your management plan. Each rationale statement is cited.
2. Medications: Each medication is listed in prescription format. Each prescribed and OTC medication is linked to a specific diagnosis and includes a paraphrased EBP rationale for prescribing.
3. Education: section includes detailed education on all five (5) subcategories: diagnosis, each medication purpose and side effects, diet, personalized exercise recommendations and warning sign for diagnosis and medications if applicable. All education steps are linked to a diagnosis, paraphrased, and include a paraphrased EBP rationale. Review the NR601 SOAP note guideline for more detailed information.
4. Referrals: any recommended referrals are appropriate to the patient diagnosis and current condition, is linked to a specific diagnosis and includes a paraphrased EBP rationale for ordering
5. Follow up: Follow up includes a specific time frame to return to PCP office for next scheduled appointment. Includes EBP rationale with in text citation.

Resources

• PubMed Central
• WebMd

NUR 504 Module 5 Discussion CASO 1

NUR 504 Module 5 Discussion Case number 3 ( Gastrointestinal & Endocrine) ( select a case number)

NURS 8100 – Healthcare Policy and Analysis

NURS 8100 – Healthcare Policy and Analysis

In the first two Discussions, you identified a vulnerable or marginalized population for whom you can determine an issue that could be addressed through engaging in policy advocacy. Now it is time to present this advocacy area with evidence to support and defend your selection. Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior cells lead to health issues.

For this Assignment, you will explain and defend your selected advocacy issue. Using evidence and experience, you will determine the advocacy issue most important to your practice and organization. Why are you selecting this issue? Why is this an area of high need? How might this area be improved with policy? What can you do to advocate for this area of need?

To prepare,

Review resources associated with vulnerable or marginalized populations to determine an advocacy issue.Dawes, Daniel E. (2020). The political determinants of health. Johns Hopkins University Press. Chapter 3, “The Political Determinants of Health Model” (pp. 41-77)Consider which advocacy issue you find most important, and why.Consider how policy might help to mitigate this need.The Assignment Question – I page

NURS 8100 week 3 assignment policy Introduction

Since the establishment of the Affordable Care Act of 2010 (ACA), there has been a shift from acute and specialty patient care to more of a focus on primary care that coordinates the healthcare of the patient with a focus on prevention and wellness and the prevention of adverse events[ CITATION Ins11 \l 1033 ]. Meeting the shift in patient care is essential that Nurse Practitioners (NPs) are given the ability in their state of practice to provide patient care to the fullextent of their education and scope of practice[ CITATION Hud191 \l 1033 ]. This paper will briefly explain the background of the scope of practice (SOP) for NPs and the recommendations for policy changes from the Institute of Medicine (IOM) that allow NPs to practice to their full

NURS 8100 week 4

Select an issue you find most important, and then defend your position in a persuasive paper.

Submit a  persuasive argument defending why you selected the advocacy issue to move forward with as your priority in this course. Support—with evidence—why this advocacy issue is most important, and how it might be mitigated or eliminated through policy. Consider how this issue might set your policy agenda.

Identify the policy you have selected. Describe the framework that you would use for this particular issue, and provide your rationale. At what other stages in the policy process might an analysis framework provide guidance?

MSW 531 MODULE 4: Theories of Psychosocial Aging

MSW 531 MODULE 4: Comparing Theories of Psychosocial Aging

INSTRUCTION

Identify an older adult you know, or an older adult who is a character from a film or book. Please choose a character who is complex and portrayed in their social context. Provide a summary of your subject’s personal history and present circumstances, being sure to include significant environmental and personal factors.

Choose two theories of psychosocial aging from this Module that fit well with your subject’s experience of adapting to change.

Review the relevant material from the psychosocial aging readings, and read at least one article on each theory, using the references given in the readings or in the module content. Explain your subject’s psychosocial development in old age in terms of each theory. Compare how each theory maps onto the reality of what you know about your subject, and conclude with your argument for whether one theory or an integration of the two is most effective in describing your subject’s experience of aging and the degree of well-being that has been achieved within their Social Context.

MSW 531 MODULE 4 INTRODUCTION TO GERONTOLOGY

Understand Each Theory, And Critical Thinking in Analyzing and Synthesizing them as they Apply to Your Subject.

THEORIES

Prescriptive Theories of Psychosocial Aging

As discussed in McInnis-Dittrick (2020), prescriptive theories of successful aging.

How should we adapt to the forces of change that come with aging? Each theory has a rather monolithic answer to that question. Explore these theories below.

Activity Theory (Havighurst, 1961)

According to Activity Theory, when older adults stay connected to their social environments, and can both depend on others and be depended upon, they experience more positive paths through the aging process. An older lesbian couple known to the author has become more isolated for several reasons: being gay makes them more guarded in forming connections in a largely conservative community; health problems often keep them at home; and they find many of their social needs are met through each other and through the healthcare providers that make home visits. The partner with the more debilitating health problems became depressed, but when her wife went through cancer treatment, she became more functional and less depressed as she took on a caregiving role within the constraints of her own health.

Role Theory (Turner, 1978)

When older adults lose roles like employee, active parent, or spouse, role theory predicts that they will be happier and more fulfilled if they can shift into new roles that provide meaning and relationship. For example, an older adult known to the author retired early from work in the deli section of a supermarket when his health worsened. He became adept at digital art and shared it on a social media platform and enjoyed receiving accolades from around the world.

Atchley, 1989)

This theory is a synthesis of Activity Theory and Role Theory, with a dash of Disengagement Theory thrown in. It hypothesizes that in order to be happy, older adults must both strive to maintain roles and activities, but also develop the ability to creatively adapt to changes and relinquish roles and activities that no longer fit. The examples given above under each theory also fit here. Another: an older African-American man who was hospitalized for altered mental status and discharged to an Assisted Living Facility where he was the only Black resident and overheard racial slurs, recovered his cognitive faculties, exercised diligently, and was able to go back to his home in a rural area and maintain relationships through the phone, visits from neighbors, and paid caregivers.

How would you Integrate the Prescriptive Theories?

compare your answer to an expert’s suggestion. What do both responses have to offer?

Answer: Expert suggestion:”As our roles and capabilities change with age, we can best adapt by letting go of roles, relationships, and activities that are no longer possible or beneficial, while embracing those that we will find most rewarding – many of which will be a continuation of our lifelong interests, values, and strengths.”

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Descriptive Theories of Psychosocial Aging

Descriptive theories of psychosocial aging seek to capture people’s lived experiences in a social context and avoid placing all of the burden of success on the individual.

How do we adapt to the challenges of aging in a world that is socially constructed?

Social Constructionism (Berger & Luckmann, 1966)

Although Role Theory, Activity Theory, and Continuity Theory implicitly advocate for the importance of meaningful relationships and activities, Social Constructionism places the act of social meaning-making at the center of psychosocial aging. The uneasy relationship between imposed narratives from society, and those that are authored by the individual, determines how older adults understand and navigate their lives. Social meanings, rather than deterministic relationships among variables, are the drivers of life, and must be understood from the older adult’s perspective.

When the author realized that a family patriarch’s diagnosis of dementia threatened a whole family’s organization, the author began to listen to family stories about the gifts and values of the patriarch and help family members build on them. Formerly a master gardener, this patriarch now discovered beautiful stones laid out in the backyard. He collected them and they were placed in a new pattern the next day. It wasn’t important for the family to accept the diagnosis, but to help their father and grandfather maintain a sense of dignity that in turn made them feel continuity in the family structure.

The Life Course Perspective (Elder, 1985)

This theoretical approach marries well with Social Constructionism, but turns its sites backward in time, to see how timing, processes, and context – events and circumstances together with individual and family interpretations and responses – have shaped life patterns leading up to the present moment. Advantages and disadvantages based on social and economic inequality are incorporated but are not seen as fixed variables given the human capacity to grown through adversity.

The GI Bill, which has allowed qualifying veterans to pursue higher education with free tuition since World War II, has changed the life course of many people and their families. Yet the identity of “college student” is not as easy to embrace for those whose academic self-concept was never positive, whether due to a poor fit with the educational approach of the times, or internalized racist myths of mental inferiority.

The Person-Environment Perspective (Lawton, 1989)

In contrast to the prescriptive theories’ focus on the individual as responsible for their own adaptation, the Person-Environment Perspective sees the importance of the social and physical environment itself as a source of limitations and possibilities, and as a target for change.

For example, the simple addition of a ramp from the door to the driveway often helps to restore older adults’ connection to the community when they are no longer able to safely negotiate stairs. One couple insisted that their new ramp be built so that the stairs were still accessible, so that they could go up the stairs to re-enter their home and maintain some strength in their legs – a key to fall prevention and, had they known it, one protective factor against dementia.

SOC theory: Selectivity with Optimization and Compensation (Baltes & Baltes, 1990)

Selectivity with Optimization and Compensation. As adults age, they narrow their interests, activities and relationships to conserve energy, optimize what is still available to them, and compensate for losses with alternatives. An example might be sitting with the same people at dinner every night in an assisted living facility, getting to know one’s dining companions well and forming trusting relationships, and compensating for an embarrassing difficulty feeding one’s self with Parkinson’s-related tremors by using weighted utensils and choosing less messy foods.

Queer Theory (Jagose, 1996)

In his early 60s, the man in a heterosexual couple was finally able to embrace his identity as a woman and underwent top surgery. She and her wife divorced, but later, as the transgender woman’s health declined, her ex-wife moved back in and assumed the roles of caregiver and best friend. Queer Theory evolved from deconstructionism to confront the biases and social norms that would pathologize such lives by calling into question the binary categories most of us assume are just “the way things are.”

By understanding and applying Queer Theory to gerontology, social workers can be open to and celebrate the gender diversity and fluidity that exists, while being sensitive to the extra barriers and internalized negative self-concepts that people of older generations often face.

How would you integrate the Descriptive theories?

Can we combine these theories into one integrative perspective?

What do both responses have to offer?

Answer: How we adapt to the challenges of aging depends on where we come from, how we construct the narrative of our lives, how we make meaning of the present social context, and how we continually create our identities as we negotiate between societal stories and our lived experiences. ”

Applying and Comparing Theories of Psychosocial Aging

1. Personal History

Describe with a High Degree of Clarity and Empathy the Subject’s Personal History and Present Circumstances, Including BOTH Environmental and Personal Factors Relevant to Their Psychosocial Development.

2. Application of Theory #1

Accurately applies a theory of psychosocial aging to explain how the subject has tried or is trying to adapt to the constraints and opportunities of old age. Supports each point with references.

3. Application of Theory #2

Accurately applies a theory of psychosocial aging to explain how the subject has tried or is trying to adapt to the constraints and opportunities of old age. Supports each point with reference

4. Comparison of Theories of Psychosocial Aging

Compare with Great Depth How Each Theory Maps onto the Subject’s Experience of Psychosocial Aging. Concludes with a Very Persuasive Argument for Whether One Theory or a Combination of the Two is Most Effective in Describing the Subject’s Experience of Aging and the Degree of Well-Being that Has Been Achieved Within Their Social Context.

Readings

McInnis-Dittrich, K. (2020).  Social work with older adults: A biopsychosocial approach to assessment and intervention (5th ed.). Pearson.

· Chapter 3: Psychosocial Adjustments to Aging, pp 67-80

Ferraro, K., & Wilmoth, J. (Eds.) (2013).  Gerontology: Perspectives and Issues (4th ed.). Springer.

· Chapter 6: Social and Emotional Development in Adulthood

Social and Emotional Health

Theories that Incorporate Emotional Health and the Quality of Relationships – not just the presence of relationships – into their predictions of successful psychosocial aging.

Summarizing the research findings described in Chapter 6 of Ferraro and Wilmoth (2013):

· Quality of relationships depends on ascribed and achieved characteristics, social institutions from micro to macro levels, cohort membership and historical period.

· Patterns of mutual assistance vary with cultural beliefs, attitudes, and accepted patterns of behavior.

· Happiness and functioning are determined by developmental stage, motivation, social cognition, personality, interpersonal interactions, and emotions.

· Older adults are not necessarily lonelier than others, and they may be happier that younger adults.

· The strength of social relationships reduces risk of depression and increases lifespan. Social support and buffering against stress, positive emotions and meaning and purpose connected to relationships all contribute.

· Family connections should be augmented by non-family ties for the best outcomes.

Socioemotional Selectivity Theory 

This theory suggests that older adults compensate for loss of relationships and roles and are motivated by the knowledge that they have limited time left, by withdrawing from less rewarding relationships, not seeking new relationships, and deepening remaining ones. A stark counter-example is that of elder suicide. The Interpersonal Theory of Suicide (Van Orden et al, 2010) postulates that people are more likely to kill themselves when they lack reciprocal belongingness and experience perceived burdensomeness. The reciprocal nature of belonging is important – people need to feel needed, as well having their social needs satisfied. This is the opposite of seeing oneself as a burden.

Social Input Model of Socioemotional Aging

This Theory asserts that a number of factors unique to older adults account for the overall positivity of their relationships:

1. More older adults live alone, allowing them to avoid problematic relationships.

2. Older adults can avoid problematic relationships that are unavoidable for younger adults, such as at work.

3. Older adults deal with conflict more often by avoiding it than younger adults.

4. Older adults have more experience with regulating emotions than younger adults.

5. Older adults may be more skilled at social cognition (interpreting social cues and determining best responses) than younger adults.

6. Because older adults are more likely to avoid negative interactions and choose positive ones, they elicit positive reactions from people close to them in a positive feedback loop.

7. Older adults’ remaining relationships tend to have endured for a long time and thus have already worked through conflicts.

Although all the news from research that supports this theory is good news, it does not account for the potential for older adults to suffer quite destructive interpersonal conflict, depressing levels of isolation, and frank abuse at the hands of those who should love them. We should not allow the overall surprisingly heartening data on older adult relationships to inure us to the needs of individuals. What we can do is use the good news to be unbiased and avoid pathologizing age – a topic we will return to in the next model when we explore diversity in older adults.

 Strength and Vulnerability Integration (SAVI)

Factors and Responses

According to this model of emotional development across adulthood (Charles, 2010), many older adults experience an increase in positive emotions and a decrease in negative emotions. Here is a summary of contribution factors:

1. Older adults have more experience in regulating their emotions.

2. Older adults, sensing their mortality, prioritize positive emotions.

3. Older adults use selection strategies to enhance well-being:

a. Avoiding negative social environments

b. Altering situations to improve social environments

c. Attending to positive experiences more than negative ones

d. Appraising experiences in positive ways

e. Reconstructing memories with an emphasis on the positive

SAVI also predicts which older adults will have difficulty attaining a positive emotional tone in their lives: those who for various reasons cannot implement the above strategies. This would include older adults who are under chronic stress and are unable to achieve a state of equanimity from which to view and alter their circumstance; older adults who have lost the cognitive capacity to manage complex or negative emotional experiences; and older adults who have lost too many sources of social support through death or distance.

Demographic and personality factors also play a major role, consistent with the Life Course Perspective. One form of chronic stress is that of poverty, which disproportionally affects people of color. Poverty is also associated with other stressors, such as vulnerability to trauma and abuse. Personality traits of agreeableness and extraversion, and lower levels of neuroticism, favor the ability to use emotion regulation strategies and elicit positive responses from others.

Health Promotion Proposal Part 1

Health Promotion Proposal Part 1 Description

Over the duration of this course,  you will submit a scholarly PowerPoint “Health Promotion Program Proposal,” addressing existing nursing knowledge related to health promotion and a written proposal.

In the written proposal, you will also develop a health promotion proposal program to meet the health needs of a vulnerable

population in your potential concentration area or community. The PowerPoint portion is your presentation of that proposal.

The proposal must demonstrate graduate school-level writing and critical analysis. The final version of your health promotion proposal is due in week 8.

For this assignment you will submit  Part One of your proposal, detailing a health problem that is prevalent within your selected group and demonstrating your research of health promotion proposal strategies for addressing this specific health problem. At this point, you already developed in your discussions the core ideas of the topic contained in this assignment. You will use the same information, but it won’t be a copy-and-paste exercise. The purpose is that you enhance your ideas with the comments and outcomes of the weekly discussions and previous evaluations.

Directions

1. Introduction. Describe the health problem. Don’t type “Introduction”.  (1 paragraph at least).

Using data and statistics, support your claim that the issue you selected is a problem.

What specifically will you address in your proposed health promotion program?

Be sure your proposed outcome is realistic and measurable.

2. Describe the vulnerable population.  (1-3 paragraphs).

What are the risk factors that make this a vulnerable population?

Use evidence to support the risk factors you have identified.

3. Provide a review of literature from scholarly journals (at least 2) of evidence-based interventions that address the problem. (2 paragraphs, one for each article).

After completing a literature search related to effective interventions for your chosen health promotion activity, write a review that evaluates the strengths and weaknesses of all the sources you have found. (2-3 paragraphs).

4. Select and present an appropriate health promotion/disease prevention theoretical or conceptual model that best serves as the guiding framework for the proposal.  (2-3 paragraphs).

For this assignment, a conclusion paragraph is not required.

Writing Assignment Requirements

Three to five pages in length (excluding title page, references, and appendices)

Follow APA format

Cite a minimum of five research articles- 6 references in total.

Please review the rubric prior to submission.

Sample APA paper for your reference:

Resources Samples

PubMed Central

World Health Organization