Mark, a 48 year-old male, presents to the office with mild-to-moderate chest pressure with radiation to his back. Mark reports that he was awakened from sleep at 0700 with chest pressure.

Subjective
Mark, a 48 year-old male, presents to the office with mild-to-moderate chest pressure with radiation to his back. Mark reports that he was awakened from sleep at 0700 with chest pressure. Initially described as soreness across his anterior chest and through to his back. He rates his pain +6/10. He felt as though if he could just belch, he would feel better. His wife drove him to the office to be here when it opened at 0900. She tried to convince Mark to go to the emergency room, but he emphatically refused, insisting on going to the office first. Upon arrival to the office, you take Mark back to an examination room and instruct the receptionist to call 911.

Past medical/surgical history: Diabetes mellitus type 2

Family history: He has a family history of premature coronary artery disease. His father died of acute myocardial infarction (AMI) at age 45. One brother died of AMI at age 49.

Social history: He has smoked for 25 years but has reduced his smoking to 1 pack per day since his brother’s death 2 years ago. He has put on 25 pounds in the past 2 years and is generally sedentary

Medications: Metformin XR 500mg daily, Last A1C was 7.4

Allergies: Latex

Objective

General: Anxious and shows Levine’s sign as you enter the office room. He is slightly diaphoretic.
Vital signs: BP 192/96, P: 102, RR-22, T-98.8, SpO2 is 90%
ECG: ST segment depression and T wave inversion in leads II and III
CV: Heart tones are muffled with an S3 gallop. Hands and feet are cool to touch. Radial pulses are 2+. Pedal and posterior tibial pulses are 1+. Neck vein distention of 5cm with HOB at 90 degrees.
Respiratory: Rhonchi in upper lobes bilaterally and a non-productive cough
Abdomen: Positive bowel sounds in all 4 quadrants, soft, non-tender, no masses felt.

The provider sent the patient immediately to the Emergency Department. Upon arrival and within 2 hours of arrival for care, troponin was 6 ng/dl, Chemistry panel: Na, K, CL were WNL, BUN 20, Creatinine 0.8, serum glucose 189.

Question answers should be based on evidence found in readings and from peer-reviewed literature. At least two sources must be used and cited in APA format for each question. Only one source can be a textbook. Resources should generally be within 5 years unless you are explaining the pathophysiology of a disease or providing pertinent background information.

Discussion Questions:

  1. Describe the similarities and differences of necrosis and apoptosis in regards to the above clinical scenario and diagnosis.
  2. What is the role of hydrostatic and oncotic pressure in regulation of blood pressure for this patient?
  3. Explain the role of free radicals and myocardial death

The post Mark, a 48 year-old male, presents to the office with mild-to-moderate chest pressure with radiation to his back. Mark reports that he was awakened from sleep at 0700 with chest pressure. appeared first on Infinite Essays.

Performing health assessments as an APRN will help you to develop a collaborative partnership with your patients

Performing health assessments as an APRN will help you to develop a collaborative partnership with your patients.  After reading Chapter 4 and 12 in your Pender text, think about the vulnerable population that you choose during Week 1 – consider what you perceive / know about this group in relation to the following topics:

  1. Health assets
  2. Health problems
  3. Health-related lifestyle strengths
  4. Key health-related beliefs
  5. Health behaviors that put the person at risk
  6. Changes that could improve their quality of life

Now consider the pros and cons of implementing a Community-Based Participatory Research health promotion project with the vulnerable group. You should consider not only the benefit of the actions but the active role the vulnerable will play in the development and implementation of the health promotion plan. How does your population’s health disparities and health inequities benefit and/or hinder this type of project’s success? Remember that you should include citations/references from at least three scholarly sources.

Rubric:

 

Discussion Question Rubric

Note: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.

Discussion Question Rubric – 100 PointsCriteriaExemplary
Exceeds ExpectationsAdvanced
Meets ExpectationsIntermediate
Needs ImprovementNovice
InadequateTotal PointsQuality of Initial PostProvides clear examples supported by course content and references.

Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.

All instruction requirements noted.

40 pointsComponents are accurate and thoroughly represented, with explanations and application of knowledge to include evidence-based practice, ethics, theory, and/or role. Synthesizes course content using course materials and scholarly resources to support importantpoints.

Meets all requirements within the discussion instructions.

Cites two references.

35 pointsComponents are accurate and mostly represented primarily with definitions and summarization. Ideas may be overstated, with minimal contribution to the subject matter. Minimal application to evidence-based practice, theory, or role development. Synthesis of course content is present but missing depth and/or development.

Is missing one component/requirement of the discussion instructions.

Cites one reference, or references do not clearly support content.

Most instruction requirements are noted.

31 pointsAbsent application to evidence-based practice, theory, or role development. Synthesis of course content is superficial.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No references cited.

Missing several instruction requirements.

Submits post late.

27 points40Peer Response PostOffers both supportive and alternative viewpoints to the discussion, using two or more scholarly references per peer post. Post provides additional value to the conversation.

All instruction requirements noted.

40 pointsEvidence of further synthesis of course content. Provides clarification and new information or insight related to the content of the peer’s post.

Response is supported by course content and a minimum of one scholarly reference per each peer post.

All instruction requirements noted.

35 pointsLacks clarification or new information. Scholarly reference supports the content in the peer post without adding new information or insight.

Missing reference from one peer post.

Partially followed instructions regarding number of reply posts.

Most instruction requirements are noted.

31 pointsPost is primarily a summation of peer’s post without further synthesis of course content.

Demonstrates incomplete understanding of content and/or inadequate preparation.

Did not follow instructions regarding number of reply posts.

Missing reference from peer posts.

Missing several instruction requirements.

Submits post late.

27 points40Frequency of DistributionInitial post and peer post(s) made on multiple separate days.

All instruction requirements noted.

10 pointsInitial post and peer post(s) made on multiple separate days.

8 pointsMinimum of two post options (initial and/or peer) made on separate days.

7 pointsAll posts made on same day.

Submission demonstrates inadequate preparation.

No post submitted.

6 points10OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas

5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.

4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work.

Purpose statement is noted.

3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.

Demonstrates incomplete understanding of content and/or inadequate preparation.

No purpose statement.

Submits assignment late.

2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.

The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).

Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.

There are no spelling, punctuation, or word-usage errors.

5 pointsCorrect and consistent APA formatting of references and cites all references used. No more than two unique APA errors.

The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.

There are minimal to no grammar, punctuation, or word-usage errors.

4 pointsThree to four unique APA formatting errors.

The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.

Multiple grammar, punctuation, or word usage errors.

3 pointsFive or more unique formatting errors or no attempt to format in APA.

The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).

The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.

Grammar and punctuation are consistently incorrect. Spelling errors are numerous.

Submits assignment late.

2 points5Total Points100

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 Identify two organizational structures used in health care. What are the central characteristics of each? To what extent is bureaucracy necessary in health care organizations? Explain.

A

I need 120 words for each question. Please ensure to post individual reference with each question

Unit 1

Q 1; Identify two organizational structures used in health care. What are the central characteristics of each? To what extent is bureaucracy necessary in health care organizations? Explain.

Q 2; How does a doctorally prepared nurse work across and between levels of an organization? What are the challenges and/or rewards to be gained? Does one outweigh the other? Resources   Delmatoff, J., & Lazarus, I. R. (2014). The most effective leadership style for the new landscape of healthcare. Journal of Healthcare Management, 59(4), 245-249. URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=97206195&site=ehost-live&scope=site  Arbab Kash, B., Spaulding, A., Johnson, C. E., & Gamm, L. (2014). Success factors for strategic change initiatives: A qualitative study of healthcare administrators’ perspectives. Journal of Healthcare Management, 59(1), 65-81. URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=94059299&site=ehost-live&scope=site   Kritsonis, A. (2004/2005). Comparison of change theories. International Journal of Scholarly Academic Intellectual Diversity, 8(1) 1-7.  URL:http://qiroadmap.org/?wpfb_dl=12   Suter, E., Goldman, J., Martimianakis, T., Chatalalsingh, C., Dematteo, D. J., & Reeves, S. (2013). The use of systems and organizational theories in the interprofessional field: Findings from a scoping review. Journal of Interprofessional Care, 27(1), 57-64. doi:10.3109/13561820.2012.739670 URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx?direct=true&db=a9h&AN=84423842&site=ehost-live&scope=site  Narayana, E. A. (1992). Bureaucratization of non-governmental organizations: An analysis of employees’ perceptions and attitudes. Public Administration and Development, 12(2), 123-137. URL:https://lopes.idm.oclc.org/login?url=http://search.proquest.com.lopes.idm.oclc.org/docview/194674953?accountid=7374     Klemsdal, L. (2013). From bureaucracy to learning organization: Critical minimum specification design as space for sensemaking. Systemic Practice & Action Research26(1), 39-52. doi:10.1007/s11213-012-9267-3 URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=84739308&site=ehost-live&scope=site

Unit 2

Q 1: What are three payment structures used in the health care industry across the care continuum? How are they similar? How are they different? Is there a single problem that transverses all three of the identified payment structures? Explain.

Q 2: Identify a significant problem with one of the three payment structures used in the health care industry across the care continuum (from DQ 1) and propose a solution from one of the other two payment structures.  Resources   Financial and Business Management for the Doctor of Nursing Practice Read chapters 1 and 3.   URL: http://gcumedia.com/digital-resources/springer-publishing-company/2012/financial-and-business-management-for-the-doctor-of-nursing-practice_ebook_1e.php  Institute of Medicine. (2013). Best care at lower cost: The path to continuously learning health care in America. Washington, DC: The National Academies Press.   URL: http://www.nap.edu/catalog/13444/best-care-at-lower-cost-the-path-to-continuously-learning  Kingsley, T. (2014). Diagnosing the Current Problems of the United States Health Care System Requires Examining the History of Health Reform. Kennedy School Review1463-69. URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=109211112&site=eds-live&scope=site

Unit 3

Q 1: Does staffing contain, as opposed to elevate, costs? Is there a point where the care delivery model and staffing become a detriment to cost control? That is, where does the law of diminishing returns kick in, both cost-wise and care-wise?

Q 2: How might health care leaders determine appropriate nursing and care delivery models to address rapidly changing populations?   Resources    Financial and Business Management for the Doctor of Nursing Practice  Read chapters 2, 4, and 5.    URL: http://gcumedia.com/digital-resources/springer-publishing-company/2012/financial-and-business-management-for-the-doctor-of-nursing-practice_ebook_1e.php  Sage, W. M. (2016). Minding Ps and Qs: The political and policy questions framing health care spending. Journal of Law, Medicine & Ethics44(4), 559-568 URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=120397894&site=ehost-live&scope=site

Unit 4

Q 1: What are two bills or laws that influence the doctorally prepared nurse? How do these bills or laws influence doctorally prepared nurses specifically and on nursing practice in general?

Q 2: How does a doctorally prepared advanced practice nurse advocate for patients as well as the nursing profession? Is there a symbiotic relationship between the two goals? How is advocacy advanced effectively?    Resources   Nurses Making Policy: From Bedside to Boardroom   Read chapters 1 and 2.    URL: http://gcumedia.com/digital-resources/springer-publishing-company/2014/nurses-making-policy_from-bedside-to-boardroom-custom_ebook_1e.php  Camargo Jr., K., & Grant, R. (2015). Public health, science, and policy debate: Being right is not enough. American Journal of Public Health, 105(2), 232-235. doi:10.2105/AJPH.2014.302241 URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx?direct=true&db=ofs&AN=100375771&site=ehost-live&scope=site

Unit 5

Q 1: What is the reasoning behind the need for doctorally prepared advanced practice nurses to be politically active? How is this accomplished? What ethical or other considerations must be taken into account as a nurse becomes politically active?

Q 2: Why is it meaningful to have doctorally prepared advanced practice nurses as members of health care boards? What is the role of the nurse on these boards?  Resources    Nurses Making Policy: From Bedside to Boardroom   Read chapter 4, 12, and 15.   URL: http://gcumedia.com/digital-resources/springer-publishing-company/2014/nurses-making-policy_from-bedside-to-boardroom-custom_ebook_1e.php   Lucia, L., Dietz, M., Jacobs, K., Chen, X., and Kominski, G. F. (2015). Which Californians will lack health insurance under the Affordable Care Act? Berkeley/Los Angeles, CA: UC Berkeley Center for Labor Research and Education/UCLA Center for Health Policy Research. URL: http://ucla-dev-web01.reliam.com/publications/Documents/PDF/2015/uninsuredbrief-jan2015.pdf   Totten, M. K. (2010). Nurses on healthcare boards: A smart and logical move to make. Healthcare Executive, 25(3), 84-87. URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com.lopes.idm.oclc.org/login.aspx?direct=true&db=bth&AN=52411351&site=ehost-live&scope=site

Unit 6

Q 1: How do servant leaders, as compared with leaders who follow the transformational model of leadership, manage organization dynamics and lead change to ensure the continued success of the stakeholders to be served? Is servant leadership or transformational leadership the best approach to these tasks?

Q 2: Considering the various virtues or dimensions of character for a servant leader (e.g., virtue, credibility, trust), how might the application of servant leadership be appraised in a health care setting? Is servant leadership, versus transformational leadership, plausible in the health care setting that often depends on a hierarchy of command for the safety of patients?  Resources   Smith, M. A. (2011). Are you a transformational leader? Nursing Management 42(9), 44-50. doi:10.1097/01.NUMA.0000403279.04379.6a URL:https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=fulltext&AN=00006247-201109000-00008&LSLINK=80&D=ovft   Yaslioglu,M. M., & SelenayErden, N. (2018). Transformational leaders in action:Theory has been there, but what about practice? IUP Journal of Business Strategy, 15(1), 42-53. URL:https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=bth&AN=128932995&site=ehost-live&scope=site   George, B. (2005). Authentic leaders. Leadership Excellence, 22(10), 3-4. URL:https://lopes.idm.oclc.org/login?url=http://search.proquest.com/docview/204611923?accountid=7374  Humphries, J. H. (2005). Contextual implications for transformational and servant leadership: A historical investigation. Management Decision, 43, 1410-1431. URL:https://lopes.idm.oclc.org/login?url=http://search.proquest.com/docview/212084894?accountid=7374   Russell, R. F. (2001). The role of values in servant leadership. Leadership and Organization Development Journal, 22(2), 76-84. URL:https://lopes.idm.oclc.org/login?url=http://search.proquest.com/docview/226915965?accountid=7374   Schneider, M. (2002). The stakeholder model of organizational leadership. Organization Science, 13(2), 209-222. URL:https://lopes.idm.oclc.org/login?url=http://search.proquest.com/docview/213834613?accountid=7374   Explore the Robert K. Greenleaf Center for Servant-Leadership website. URL: http://www.greenleaf.org/   Use this to assist with Part One of the Comparison of Leadership Models and Styles assignment. URL:http://lc.gcumedia.com/zwebassets/courseMaterialPages/ldr802_leadershipChart.php Use this chart to assist with the Comparison of Leadership Models and Styles assignment. URL: http://lc.gcumedia.com/zwebassets/courseMaterialPages/mgt410_core-values-v1.1.php Use this questionnaire to assist with Part Two of the Comparison of Leadership Models and Styles assignment.  URL: http://www.nursingleadership.org.uk/test1.php 

Unit 7

Q 1: Should all nurses be considered leaders? What characteristics of a nurse makes one a leader? How does the doctorally prepared advanced practice nurse collaborate with others for company resources? Explain.

Q 2: Reflecting back on this and all previous courses, how has your thinking about your DPI Project changed? What will you take from this course and apply directly to your DPI Project? Resources   Financial and Business Management for the Doctor of Nursing Practice  Read chapters 7, 8, and 12.   URL: http://gcumedia.com/digital-resources/springer-publishing-company/2012/financial-and-business-management-for-the-doctor-of-nursing-practice_ebook_1e.php  Aligned To: 0 Learning ObjectivesMurray, A. (2014). What is the difference between leadership and management? Wall Street Journal. URL: http://guides.wsj.com/management/developing-a-leadership-style/what-is-the-difference-between-management-and-leadership/  Scott, K.A., & Mensik, J. S. (2010). Creating the conditions for breakthrough clinical performance. Nurse Leader 8(4), 48–52. doi:10.1016/j.mnl.2010.05.004  URL:https://lopes.idm.oclc.org/login?url=http://dx.doi.org.lopes.idm.oclc.org/10.1016/j.mnl.2010.05.004Aligned To: 0 Learning ObjectivesAligned To: 0 Learning Objectives

Unit 8

Q 1: How is ethical behavior an integral part of the doctorally prepared advanced practice nurse’s role? Why is the doctorally prepared advanced practice nurse considered a role model? How does one display the characteristics of a role model? Does a doctorally prepared advanced practice nurse have a legitimate right and/or ethical foundation to interject their ideas into business practice?

Q 2: Locate the “Comprehensive Assessment Part One: Competency Matrix” assignment in this topic and identify any competency “blank spaces” that were left unmet by either programmatic or course-based assignment completion thus far. Also locate the instructor feedback notes you made while completing the matrix regarding both programmatic and course-based assignments to date. What program competencies were left unmet in your matrix?  What content areas do you need to address and strengthen based on instructor feedback? Develop and post an action plan to address these two areas as you move forward into the practicum stage of the program  Resources   Review three or four DPI Project Examples from the DPI Project Examples document at the links provided in the DNP Program Documents folder on the DC Network. URL: https://dc.gcu.edu/dnp  American Nurses Association. (2015). Code of ethics for nurses with interpretive statements. Silver Spring, MD: Author. URL:http://www.nursingworld.org/MainMenuCategories/EthicsStandards/CodeofEthicsforNurses/Code-of-Ethics-For-Nurses.html  Financial and Business Management for the Doctor of Nursing Practice  Read chapters 11, 13, and 16.   URL: http://gcumedia.com/digital-resources/springer-publishing-company/2012/financial-and-business-management-for-the-doctor-of-nursing-practice_ebook_1e.phpAligned To: 0 Learning ObjectivesAligned To: 0 Learning Objectives Silverman, H. J. (2000). Organizational ethics in healthcare organizations: Proactively managing the ethical climate to ensure organizational integrity. HEC Forum, 12(3), 202-215. URL:https://lopes.idm.oclc.org/login?url=http://search.proquest.com.lopes.idm.oclc.org/docview/229344211/483ED71DE7304704PQ/3?accountid=7374#

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2025 DQ 4 RESP

Readings and Discussion Post: Rational Emotive/Behavior Therapies
3 3 unread replies. 21 21 replies.
Readings: Okun: Ch. 5; Stolorow, R. D. (2012)

Okun-05-Chapter05_Evolution_and_Key_Concepts.pdfPreview the document

Discussion post: What are the core elements of Rational Emotive Behavior Therapy and System of Personality?

REBCS RESPOND TO THE MAIN POST

Hello class!

After reading the assigned chapter from Okun (1990), rational emotive behavior therapy was a theory developed by Albert Ellis in the 1950s (p. 133). Rational emotive behavior therapy is based off of personality and has the technique of psychotherapy (Okun, 1990). Ellis believes that humans are both irrational and rational individuals whom both their emotions and thoughts overlap. However, emotion is related to other responses (Okun, 1990). Emotions are controlled by our thoughts, while our feelings are controlled by our senses. Ellis believed that humans have the ability to have rational behavior and also develop free will. He explains that when a person comes into this world, they are only learning and influencing from other individuals, which ends up leading to irrational thinking (Okun, 1990). Irrational thinking are negative thoughts that an individual has on themselves and the thoughts of harming oneself. Our emotions can be highly influenced from traumatic events, which gets us in touch with our vulnerability (Stolorow, 2012). In rational emotive behavior therapy, Ellis developed an ABC theory, which is based off of (A)ctivating events, (B)elief system, and (C)onsequence (Okun, 1990). The activating event is when something traumatic happens in our lives. The belief system is what we think about the event that happened. Lastly, the consequence is our emotional reaction about the belief (Okun, 1990). What ends up happening is that when an individual has irrational thinking, then it causes emotional interruptions. Therefore, in a rational emotive behavioral approach, the therapists role is to change those irrational thoughts of the client and change them to rational and logical thoughts.

The goal of rational emotive behavior theory is to make the patient have more control over their lives and improve the way they think and feel. An example of this therapy would be if a client came in to see their therapist for their depression. Depression creates feeling of unhappiness and hopelessness. Therefore, this is when the therapist can give some tasks for the patient to do when they are feeling hopeless. When the patient is feeling sad, mad, or hopeless, then it would be their job to think positive at the moment they are feeling depressed. The patient can also write down moments when the client feels sad, and that will give them the chance to go back and find out why they felt that emotion at that moment.

References

Okun, B. F. (1990). Seeking connections in psychotherapy. San Francisco, CA: Jossey-Bass.

Stolorow, R. D. (2012). The renewal of humanism in psychoanalytic therapy. Psychotherapy, 49(4), 442-444. doi:10.1037/a0027053.