What is the role of physical activity in managing HF?

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In October 2012, changes were made in Medicare payment rules. Hospitals are now penalized when a patient returns within 30 days for treatment of the same problem. One of the targeted medical diagnoses for this payment change is heart failure (HF). Therefore, it is essential that the interdisciplinary team be utilized to ensure a safe transition between the acute care setting and home for the patient with HF.

Using APA format, write a six (6) to ten (10) page paper (excludes cover and reference page) that addresses the disease management needs of adult patients with HF for a safe transition between the acute care setting and home and the role of the interdisciplinary team in that transition.

A minimum of three (3) current professional references must be provided. Current references include professional publications or valid and current websites dated within five (5) years. Additionally, a textbook that is no more than one (1) edition old may be used.

 

The paper will consist of four (4) parts and must be submitted by the close of week 6.

Parts 1, 2, and 3 will focus on a disease management issue for the patient with HF and the role of the interdisciplinary team in this issue.

Part 4 is the evaluation of the effectiveness of the interdisciplinary team in this safe transition to home.

 

Part 1: Medication Adherence

Part 1 must include the following:

    1. Three (3) common classes of medications used to manage HF are beta adrenergic blockers, diuretics and ACE Inhibitors.  Why are these medications used to manage HF?
    2. What are some common side effects of these classes of medications?  Which of these side effects would be reported and why? Which side effects would not be reported and why?
    3. Describe any special instructions that would be included with each class of these medications.  For example, food-drug interactions and medications that should be avoided.
    4. Which health care discipline, in addition to the RN, is best suited to help with medication adherence?  How will this team member collaborate with the RN, the patient and the family to help promote medication adherence and a safe transition to home?

Part 2: Dietary Modifications

Part 2 must include the following:

    1. What is the role of diet in managing HF?  What changes need to be made to the present diet?  What role does culture play with diet?
    2. What obstacles might be encountered when informing the patient about the changes in diet?
    3. Which health care discipline, in addition to the RN, is best suited to help with dietary modifications?  How will this team member collaborate with the RN, the patient and the family to help promote healthy eating and a safe transition to home?

Part 3: Physical Activity

Part 3 must include the following:

    1. What is the role of physical activity in managing HF?
    2. How would the RN promote adherence to a daily physical activity routine?
    3. Which health care discipline, in addition to the RN, is best suited to help with physical activity? How will this team member collaborate with the RN, the patient and the family to help promote physical activity and a safe transition to home?

Write a Brochure on Early Intervention Services

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Week 1: Write a Brochure on Early Intervention Services

 

As you have learned this week, early intervention services can include programs for infants and toddlers who may be at risk from biological or environmental issues that could lead to developmental delays or other special needs. One challenge to early intervention service providers is to ensure that they reach out and connect with families. All of the various types of infant and toddler programs in a community, including family day care homes, Early Start, faith-based programs, community organizations, can play an important role in connecting families to available early intervention services.

 

For your Application Assignment this week, imagine that you have been hired as a Child Development Community Liaison for a community organization called The Guidance Center Inc. In reality, this respected, not-for-profit organization serves the communities of Cambridge and Somerville in Massachusetts. As part of The Guidance Center’s Early Childhood Services for ages 0–6 , their Infant-Toddler Services include four programs that provide services to pregnant women, infants, toddlers, and their families.

 

As the Child Development Community Liaison, your job is to connect with infant and toddler program directors and caregivers and communicate both a strong message about the importance of early intervention and the services The Guidance Center provides. Your supervisor has asked you to:

 

  1. Draft a two-page brochure that emphasizes why early intervention is important and the ways it is addressed through The Guidance Center.*

 

  1. Include in the brochure, an idea for an additional program or a way to improve a current program in order to better meet the goal of providing quality early interventions services for pregnant women, infants, toddlers, and/or their families.

 

* Though The Guidance Center is a real organization, this scenario has been created only for this course. The brochure you create is intended only to further your own knowledge of early intervention services and not to be used for distribution.

 

To complete this Application Assignment, do the following:

 

Step 1: Learn About Infant-Toddler Services at The Guidance Center

 

Click on the link below for the “Early Childhood Services” overview page on The Guidance Center Inc. Web site:

 

http://guidancectr.org/our-services/

 

From the “Early Childhood Services” menu on the left of the page, click on and read about the Infant-Toddler Services programs. You may also choose to visit the Elizabeth Peabody House web site for further information. Be sure to refer to the Home Visiting section located under the Resources tab.

Explain the technique you identify, and give an example of how it is used in the manufacturing, retail, and health care industries

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As the company prepares to meet demand and capacity requirements for its planned future growth, you have been asked to review the current forecasting strategy and help implement a new strategic plan for forecasting demand. The new forecasting plan ties directly to the overall strategic planning methodology established by the company. The company historically has used a time series method. The forecasting methods under consideration are the following:

  • Qualitative: human judgment, usually best used when little data is available
  • Simulation: the use of computer models or judgment to imitate customer behavior
  • Causal: used when there is a direct tie between demand and an environmental factor, such as cold weather
  • Time series: the use of historical data to predict future needs

Using course materials and other research, complete the following:

  • Identify which forecasting technique or multiple techniques should be used in the future for the company’s strategy. Are there other techniques available that are not listed above?
  • Explain the technique you identify, and give an example of how it is used in the manufacturing, retail, and health care industries.
  • Detail if 1 of the 4 techniques listed above should NOT be used and why.
  • Evaluate the significance of forecasting error for the technique or techniques you have selected. What is the impact of error on your chosen technique?

Individual Project Rubric

 

Grading Criteria

Percentage
Deliverable requirements addressed; understanding of material and writer’s message and intent are clear.

35{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}
Scholarly research that supports the writer’s position is properly acknowledged and cited. Direct quotations may not exceed 10{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119} of the word count of the body of the assignment deliverable (excluding title page, abstract, or table of contents if used and tables, exhibits, appendices, and reference page). Inclusion of plagiarized content will not be tolerated and may result in adverse academic consequences.

20{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}
Critical thinking: Position is well-justified, there is logical flow, and there are examples.

20{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}
Structure: Includes introduction and conclusion, proper paragraph format, and reads as a polished, academic paper or professional presentation, as appropriate for the required assignment deliverable.

10{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}
Mechanical: No spelling, grammatical, or punctuation errors.

10{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}
APA: Deliverable is cited properly according to the APA Publication Manual (6th ed.).

5{0e601fc7fe3603dc36f9ca2f49ef4cd268b5950ef1bbcf1f795cc00e94cdd119}

How might Dr. Romaro’s ambivalence toward the death penalty influence his decision to offer a forensic diagnosis of intellectual disability?

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Case Study One Worksheet

Dr. Eduardo Romaro, a clinically trained forensic psychologist, was retained by the

prosecution to evaluate the intellectual competence of John Stone, a 50-year-old

man convicted of first-degree murder of a guard during a bank robbery. John had

claimed he was innocent throughout the trial. In the state in which the trial was

conducted, individuals convicted of such an offense face the death penalty. John’s

attorney challenged the death penalty option for his client, claiming that the defendant

is intellectually disabled. The U.S. Supreme Court ruled in Atkins v. Virginia

(2002) that the execution of those with intellectual disability (formerly known as

mental retardation) is unconstitutional. Dr. Romaro had worked with the prosecution

before on intellectual disability cases, but this is the first time he had been

retained for a capital punishment case. He is personally ambivalent about whether

states should implement the death penalty.

The psychologist meets John in a private room in the prison and administers a

battery of intellectual and adaptive behavior tests with proven psychometric validity

for determining forensically relevant intellectual ability. Just as he ends the formal

test administration, John becomes distraught and appears to be experiencing

an anxiety attack. In his distress the psychologist hears the prisoner repeatedly

asking God for forgiveness for killing the guard and for murdering another person,

who he keeps calling “the boy waiting for the bus.” The psychologist shifts into an

emergency crisis intervention mode to help calm the defendant and rings for assistance.

Dr. Romaro was shocked to hear John “confess” not only to the bank murder

but also to the murder of a “boy waiting for a bus.”

The Diagnostic and Statistical Manual of Mental Disorders, fourth edition

(DSM-IV-TR) diagnosis of intellectual disability (currently termed “mental retardation

developmental disability”) requires that individuals demonstrate significantly

sub-average intellectual functioning, impairments in adaptive functioning,

and onset before 18 years of age. Similarly, the state standard for intellectual disability

includes a developmental history of intellectual impairment. Prior to testing,

FOR THE USE OF UNIVERSITY OF PHOENIX STUDENTS AND FACULTY ONLY.

NOT FOR DISTRIBUTION, SALE, OR REPRINTING.

ANY AND ALL UNAUTHORIZED USE IS STRICTLY PROHIBITED.

Copyright © 2013 by SAGE Publications, Inc.

Appendix B——355

Dr. Romaro had asked the prosecutor for all available childhood mental health or

school records to determine if John meets these criteria. No formal educational

or psychological evaluations were included in the materials he received. The

records indicated that John had a poor academic record, was retained in fifth

grade, was suspended several times for coming to school drunk, and had left

school when he was 15. State criteria also include an IQ score less than 70 and

poor adaptive skills.

That evening Dr. Romaro scores the test battery. John’s IQ score is 71, his performance

on other cognitive tests fell close to the intellectual disability cutoff score

(some above, some below). His adaptive functioning score is a standard deviation

below average. However, given the prisoner’s age, without a more detailed set of

childhood records, it is difficult to clearly conclude that he meets the DSM-IV-TR

or state legal criteria for intellectual disability. Dr. Romaro had not been asked to

administer assessments for mood, schizophrenia, or other psychotic disorders that

might impair intellectual and adaptive performance.

 

Ethical Dilemma

Dr. Romaro is not sure what forensic opinion to give regarding whether or not

John meets the legal criteria for intellectual disability. Without evidence of intellectual

disability in his youth, a diagnosis of intellectual disability may not be possible

and, thus, could not be used to support John’s death penalty appeal. He is also

unsure whether he has an ethical responsibility to include in his report John’s

“confession” or John’s statement about the “boy waiting for a bus.”

 

Respond to the following questions in 300 words each question

  1. Why is this an ethical dilemma? Which APA Ethical Principles help frame the nature of the dilemma?

 

 

  1.         How might Dr. Romaro’s ambivalence toward the death penalty influence his decision to offer a forensic diagnosis of intellectual disability? How might John’s “confession” or his comment about the “boy waiting for the bus” influence the decision? To what extent should these factors play a role in Dr. Romaro’s report?

 

  1. How are APA Ethical Standards 2.0f, 3.06, 4.04, 4.05, 5.01, 9.01a and 9.06 relevant to this case? Which other standards might apply?

 

 

http://www.apa.org/ethics/

 

  1. What steps should Dr. Romaro take to ethically implement his decision and monitor its effect?