APA A Must- Time roman 12- Cover and reference. Citation needed. No Plagarsim, and be detailed.

Instructions:

Your boss is the Director of Medical Records at a large academic medical center. He is finding it difficult to monitor the ongoing legislative and policy changes related to Health Information Management. He has asked that you do the following:

1. Visit the website http://www.ahima.org/about/advocacy/efforts
2. Prepare a one-to-two page report highlighting the two most important items your boss should be aware of.
3. Recommend a course of action for each.

The concept of leadership is addressed at length in chapter two and throughout the textbook. Of equal importance and often not mentioned is the concept of followership. In fact, Bennis, 2006 stated, “In our society leadership is too often seen as an inherently individual phenomenon” and acknowledges that no change can occur without committed and willing follower. Leaders, therefore, can be leaders only if they have followers.

The cartoon below provides a picturesque concept of the the importance of followership.

Figure: Leaders need Followers

What key leadership characteristics attract followership? Be sure to support your answer with evidence from available literature. Remember to cite your reference.

Focusing on the brighter side of life, while not bad advice, does not account for the numerous biochemical malfunctions that prevent those with depression from doing just that. The impact of depression extends beyond disrupting work and personal relationships. It also can influence the development of a whole bounty of serious illnesses. Stress, depression, and the persistent immune response of inflammation can influence the development of chronic and autoimmune illnesses that permanently alter the direction of a person’s life. With stakes as high as these, the manner in which stress and depression manifests in the body to impact the immune system cannot be underestimated.

For this Application Assignment, review this week’s Learning Resources including the Chronic Disease and Autoimmune Disease sections of the “Stress, The Immune System, Chronic Illness, and Your Body” handout. Then select an illness that has a high co-occurrence with depression. Finally, consider teaching strategies that may reduce the effects of the stress related-illness.

The Assignment (3–5 page APA-formatted essay)

• Describe the connection between depression and the illness you selected and explain the factors of the disease you selected that account for its high co-occurrence with depression.
• Explain the role of stress hormones and inflammation in this depression related illness
• Explain at least three teaching strategies that might reduce the effects of the stress related-illness you select.
• Explain the methods you might use to encourage the adoption these strategies to reduce the effects of the stress related-illness.

Support your Application Assignment with specific references to all resources used in its preparation. You are to provide a reference list for all resources, including those in the Learning Resources for this course.

1. The Master’s Entry Program in Nursing requires a great deal of commitment, flexibility, and at times, personal sacrifice. Consider the following scenario: Your clinical day is reassigned two weeks prior to the beginning of the next semester. You will be assigned a different hospital and clinical faculty. You have a pre-planned schedule conflict (i.e work, vacation, purchased flight ticket, family commitment etc.) How will you resolve this dilemma?

2. Your clinical professor suggests that you need practice on your skills and wants you to spend additional hours in the skills lab. You disagree with this. How do you handle this issue?

3. There is a conflict between you and your professor over a test grade. You received a B and are very disappointed. How would you handle this?

Word limit is 500 each, be sure to at least have 300 words!

Case Scenario 1

Ms. G., a 23-year-old diabetic, is admitted to the hospital with a cellulitis of her left lower leg. She has been applying heating pads to the leg for the last 48 hours, but the leg has become more painful and she has developed chilling.

Subjective Data

• Complains of pain and heaviness in her leg.
• States she cannot bear weight on her leg and has been in bed for 3 days.
• Lives alone and has not had anyone to help her with meals.

Objective Data

• Round, yellow-red, 2 cm diameter, 1 cm deep, open wound above medial malleolus with moderate amount of thick yellow drainage
• Left leg red from knee to ankle
• Calf measurement on left 3 in > than right
• Temperature: 38.9 degrees C
• Height: 160 cm; Weight: 83.7 kg

Laboratory Results

• WBC 18.3 x 10¹² / L; 80% neutrophils, 12% bands
• Wound culture: Staphylococcus aureus

Critical Thinking Questions

1. What clinical manifestations are present in Ms. G and what recommendations would you make for continued treatment? Provide rationale for your recommendations.
2. Identify the muscle groups likely to be affected by Ms. G’s condition by referring to “ARC: Anatomy Resource Center.”
3. What is the significance of the subjective and objective data provided with regard to follow-up diagnostic/laboratory testing, education, and future preventative care? Provide rationale for your answer.
4. What factors are present in this situation that could delay wound healing, and what precautions are required to prevent delayed wound healing? Explain.

II

Case Scenario 2

Mrs. J. is a 63-year-old woman who has a history of hypertension, chronic heart failure, and sleep apnea. She has been smoking two packs of cigarettes a day for 40 years and has refused to quit. Three days ago, she had an onset of flu with fever, pharyngitis, and malaise. She has not taken her antihypertensive medications or her medications to control her heart failure for 4 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure.

Subjective Data

1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is so exhausted she cannot eat or drink by herself.

Objective Data

1. Height 175 cm; Weight 95.5 kg
2. Vital signs: T 37.6 C, HR 118 and irregular, RR 34, BP 90/58
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint; all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%
5. Gastrointestinal: BS present: hepatomegaly 4 cm below costal margin

Critical Thinking Questions

What nursing interventions are appropriate for Mrs. J. at the time of her admission? Drug therapy is started for Mrs. J. to control her symptoms. What is the rationale for the administration of each of the following medications?

1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)

Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.

Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide rationale for each of the interventions you recommend.

III

Case Scenario III

Mr. C., a 32-year-old single man, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He reports that he has always been heavy, even as a small child, but he has gained about 100 pounds in the last 2–3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control with sodium restriction. He current works at a catalog telephone center.

Objective Data

1. Height: 68 inches; Weight 134.5 kg
2. BP: 172/96, HR 88, RR 26
3. Fasting Blood Glucose: 146/mg/dL
4. Total Cholesterol: 250mg/dL
5. Triglycerides: 312 mg/dL
6. HDL: 30 mg/dL

Critical Thinking Questions

What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?

Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:

1. Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
2. Ranitidine (Zantac) 300 mg PO at bedtime.
3. Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.

The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.

1. Assess each of Mr. C.’s functional health patterns using the information given. (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance.)
2. What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.