describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

/in /by

While HIV/AIDS is still currently incurable, the prognosis for patients with this infectious disease has improved due to advancements in drug treatments. Consider the case of Kristy Aney. Kristy was diagnosed with HIV in 1992 and was told she would survive, at most, 10 more years. Despite unfavorable odds, Kristy is still alive 20 years later. Since her diagnosis, she has witnessed tremendous improvements in HIV/AIDS treatments which have helped patients live longer with fewer side effects. While she acknowledges that these drug treatments have kept her alive, she fears that improvements in drug therapy have led to more people becoming complacent about the disease (Idaho Statesmen, 2012). In fact, the number of people living with HIV/AIDS in the United States is higher than it has ever been (CDC, 2012). This poses the question: Is there a relationship between drug advancements, societal complacency, and infection?

To prepare:
  • Review Chapter 49 of the Arcangelo and Peterson text, as well as the Krummenacher et al. and Scourfield articles in the Learning Resources.
  • Reflect on whether or not the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options for HIV/AIDS.
  • Consider how health care professionals can help to change perceptions and make people more aware of the realities of the disease.
  • Think about strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

With these thoughts in mind:

By Day 3

Post an explanation of whether or not you think the prevalence of HIV cases might be attributed to increased complacency due to more advanced drug treatment options.Then, explain how health care professionals can help to change perceptions and increase awareness of the realities of the disease. Finally, describe strategies to educate HIV positive patients on medication adherence, as well as safe practices to reduce the risk of infecting others.

Which of the following data would be most significant for this patient?

/in /by

Question 1 2 / 2 points

Osteoarthritis is primarily a noninflammatory condition.

Question options:

a) True

b) False

Question 2 2 / 2 points

Which of the following medications for type 2 diabetes mellitus should not be prescribed during pregnancy?

Question options:

a) Insulin

b) Metformin

c) Glucotrol

d) Precose

Question 3 2 / 2 points

After removing a tack from a type 2 diabetic’s heel and evaluating the site for infection, what is the best plan for this patient?

Question options:

a) Suggest she use a heating pad to improve circulation.

b) Refer to a podiatrist for a foot care treatment plan.

c) Send her for acupuncture treatments.

d) All of the above

Question 4 2 / 2 points

Sam is a 25-year-old who has been diagnosed with low back strain based on his history of localized low back pain and muscle spasm along with a normal neurological examination. As the clinician, you explain to Sam that low back pain is a diagnosis of exclusion. Which of the following symptoms would alert the clinician to the more serious finding of a herniated nucleus pulposus or ruptured disc?

Question options:

a) Morning stiffness and limited mobility of the lumbar spine

b) Unilateral radicular pain symptoms that extend below the knee and are equal to or greater than the back pain

c) Fever, chills, and elevated erythrocyte sedimentation rate

d) Pathologic fractures, severe night pain, weight loss, and fatigue

Question 5 2 / 2 points

John is a 16-year-old boy who presents to the emergency room after hurting his knee in a football game. He described twisting his knee and then being unable to extend it completely. John tells the clinician that he heard a pop when the injury occurred and has been experiencing localized pain.The clinician suspects a meniscal tear. Which test would be most appropriate to assess for the presence of a meniscal tear?

Question options:

a) Valgus stress test

b) McMurray circumduction test

c) Lachman test

d) Varus stress test

Question 6 2 / 2 points

The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort.Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs?

Question options:

a) “You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage.”

b) “You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication.”

c) “You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain.”

d) “It is important to take NSAIDs on an empty stomach in order to increase absorption.”

Question 7 2 / 2 points

The clinician is caring for Diane, a 22-year-old woman who presents with an injured ankle. Diane asks the clinician if she will need an x-ray. The clinician explains to Diane that an x-ray is not always necessary for an injured ankle and that the decision to obtain radiographs is dependent on the examination and Diane’s description of her injury. Which of the following clues in Diane’s examination or history would alert the clinician to the need for obtaining radiographs?

Question options:

a) Inability to bear weight immediately after the injury

b) Development of marked ankle swelling and discoloration after the injury

c) Crepitation with palpation or movement of the ankle

d) All of the above

Question 8 2 / 2 points

The clinician finds numerous nodules on the thyroid of a 65-year-old woman. The clinician suspects thyroid cancer. Which of the following data would be most significant for this patient?

Question options:

a) A history of tonsillectomy in the 1940s

b) Recent exposure to mumps

c) Vegetarian diet

d) Allergy to iodine

Question 9 2 / 2 points

A vegetarian patient with gout asks the clinician about food he should avoid. The clinician should advise the patient to avoid which of the following foods?

Question options:

a) Rice

b) Carrots

c) Spinach

d) Potatoes

Question 10 2 / 2 points

One of the most frequent presenting signs/symptoms of osteoporosis is:

Question options:

a) Goiter

b) Abnormal serum calcium

c) Elevated urine biochemical markers

d) Bony fracture

Question 11 2 / 2 points

After 6 months of Synthroid therapy, the clinician should expect which of the following in the repeat thyroid studies?

Question options:

a) Elevated TSH

b) Normal TSH

c) Low TSH

d) Undetectable TSH

Question 12 2 / 2 points

Which of the following signs or symptoms indicate an inflammatory etiology to musculoskeletal pain?

Provide an example from your own work history and experience as to how the patient safety movement has affected your practice. 

/in /by

Throughout history, major events have influenced quality improvement efforts in health care. For example, the Institute of Medicine’s report To Err is Human: Building a Safer Health System revealed statistics about errors in patient safety that result in thousands of deaths annually. Health care providers must be cognizant of the purpose and philosophy of quality improvement efforts as they lead the charge for improving health outcomes and patient safety. This Discussion is intended to help you understand how various developments have shaped contemporary perspectives and approaches to promoting health care quality.

By tomorrow 11/28/17, write a minimum of 550 words essay in APA format with 3 references from the list below which addresses the level one headings as numbered below:

Post a cohesive scholarly response that addresses the following:

When “To Err is Human” was published in 1999, it marked an important milestone in Quality Improvement Science.

1) Analyze how this milestone has influenced the health care delivery system and nursing practice.

2) Provide an example from your own work history and experience as to how the patient safety movement has affected your practice.

Required Readings

Joshi, M.S., Ransom, E.R., Nash, D.B., & Ransom, S.B., (Eds.). (2014). The Healthcare Quality Book, 3rd ed. Chicago, IL: Health Administration Press.

  • Chapter      1: “Healthcare Quality and the Patient”
  • Chapter      2: “Basic Concepts of Healthcare Quality”

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (Eds). (2000). To err is human: Building a safer health system. Washington, D.C.: National Academy Press.

Executive summary: Released in 1999, this groundbreaking report provides the rationale for implementing comprehensive improvements in patient safety, an important subset of health care quality. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Institute of Medicine, Committee on Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. 

Executive summary: This report was published by the Institute of Medicine in 2001 to highlight the significant gap between the state of health care quality and where it should be. The report draws attention to the need to improve the U.S. health care delivery system as a whole, and identifies six areas for improvement: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Although only the executive summary is required this week, you are strongly encouraged to read additional sections of this report as you proceed through the course.

Wachter, R. M. (2010). Patient safety at ten: Unmistakable progress, troubling gaps. Health Affairs, 29(1), 165–173.

This article presents an analysis of progress in patient safety since the publication of the IOM report, To Err is Human. As you read this article, evaluate the author’s critique, and consider recent developments that continue to shape patient safety efforts in health care.

Required Media

Laureate Education, Inc. (Executive Producer). (2011). Organizational and systems leadership for quality improvement: Concepts of quality and patient safety. Baltimore: Author.

This video examines the recent history of the quality improvement movement, including two pivotal IOM reports, To Err is Human and Crossing the Quality Chasm. Dr. Donald Berwick introduces six dimensions of quality: safety, effectiveness, patient-centeredness, timeliness, efficiency, and equity. Other topics addressed include transparency, the prevention of adverse events, and the usefulness of international comparisons for quality assessment and improvement.

Describe what was done right, what was done incorrectly, and what education needs to be discussed in each scenario.

/in /by

Health care professionals play a crucial role in helping to prevent and control infectious disease. Nurses are an important factor in helping to prevent the spread of infection. As a nurse it is extremely important to understand the infection process, the chain of infection, and prevention techniques.

In the TWO scenarios below, describe in paragraph form what you as a health care provider would do in these situations. Describe what was done right, what was done incorrectly, and what education needs to be discussed in each scenario.

Scenario 1

A man is recovering from a minor surgical procedure. His son, daughter-in-law, and grandson come to visit him. His daughter-in-law is suffering from what appears to be a bad cold and, although hospital policies prohibit children under the age of 10 from visiting patients in this ward, the 3-year-old grandson still came up.

You notice that the woman is sneezing and coughing into her hands. You also notice that the child keeps moving from his mother’s lap to the patient’s lap in the hospital bed. In addition, you observe that the woman is changing the television stations on the remote control to find something the child can watch.

Scenario 2

A charge nurse on a medical/surgical unit approaches a computer and notices that the keyboard is visibly soiled. She goes to a supply closet to get some disinfectant wipes to clean the keys. When she returns, she notes that a nurse is sitting at the computer using the soiled keyboard. As she watches, the nurse picks up a patient chart, makes a note, and then returns to the keyboard. When she is finished typing, the nurse walks away from the computer and heads for one of the patient rooms.