The IOM published report, “Future of Nursing: Leading Change, Advancing Health,” makes recommendations for lifelong learning and achieving higher levels of education.

In 1,000-1,250 words, examine the importance of nursing education and discuss your overall educational goals.
Include the following:

• Discuss your options in the job market based on your educational level
• Review the IOM Future of Nursing Recommendations for achieving higher levels of education.
• Describe what professional certification and advanced degrees (MSN, DNP, etc.) you want to pursue and explain your reasons for wanting to attain the education. Discuss your timeline for accomplishing these goals. Discuss how increasing your level of education would affect how your competitiveness in the current job market and your role in the future of nursing.
• Discuss the relationship of continuing nursing education to competency, attitudes, knowledge, and the ANA Scope and Standards for Practice and Code of Ethics. Discuss whether continuing nursing education should be mandatory. Provide support for your response.

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Mental Status Examination (MSE) is a critical neurological and psychiatric practice diagnostic tool.

case study

Mr Fred Robinson is a 24-year-old man from Derby (2392 km from Perth) in the Kimberley Region of Western Australia. He has a supportive family consisting of his father, mother, three brothers, and friends. Fred is usually presented well. when found, he is dishevelled, unwashed, wearing one shoe, a woollen jumper, beany, and boardshorts.

The police escorted him to the local public hospital after he was observed muttering to himself and pacing near the railing of a bridge next to the railway yard. They found a bag of ripped clothing and papers, a bible, a wallet, and an unlabeled medicine bottle containing numerous coloured tablets near him.

Initially, Fred was uncooperative when questioned by the police, and he accused them of trying to take thoughts from his head. He subsequently became aggressive and displayed violent behaviour by attempting to punch a police officer and shouting at the others. He was restless, overactive, singing loudly, and it was difficult to calm him.

Following scrutiny of his bag, the hospital staff contacted Fred’s parents and informed them of his whereabouts. They reported that Fred had been missing for five days, and they feared for his safety as he recently revealed to them that he had been hearing voices telling him to jump from the bridge that was located near the town.

Following examination by a doctor at the hospital, he was sedated and restrained and referred via the Royal Flying Doctor Service, with a nurse and police escort for admission to a medium-security ward at an ‘approved hospital’ in Perth.

Based on the above case scenario, address the following questions:

An introductory paragraph Presents a brief overview of the main presenting issues outlined in the case scenario. Briefly describe what the psycho-social issues pertaining to this client are that need to be taken into account by the nurses to ensure that Fred receives the most therapeutic care and outcome. In your answer, you need to consider issues of safety, the consumer (Fred) focus, and self-efficacy.

 

MSE: Gather the available information (evidence) from the case scenario, and document the client’s Mental State Examination in the form of progress notes (medical record) under the appropriate MSE headings (Present your information in the MSE format using the provided sequencing).

Explain why the MSE is important in capturing a ‘picture’ of the patient at the time of the assessment. Provide a provisional diagnose(s) that could be made (based on the MSE) as to Fred’s possible presenting condition (s) in the way of a critical discussion.

Risk Assessment: Based on your MSE of Fred’s presentation (in Derby) in the above case scenario, clearly list and briefly describe THREE potential risks (in order of priority) that Fred is likely to pose over the next 24 hours when admitted to the ‘authorized hospital’ in Perth.

Describe Fred’s management plan based on your identified (3) risks within the 24 hours in the approved hospital in Perth.

Conclusion: Effectively and comprehensively summarises main points within the report – highlighting key areas.

Write a 3-4 page critical response paper on Clinical-Community Engagement in which you reflect on the readings, class discussions from the unit. You should incorporate your own personal experiences and/or observations, but they must be interwoven with ideas, excerpts, theories, and references from the readings/focus groups. Your paper should NOT be a summary of the arguments, but a critical response to 2-3 themes from the unit that most resonated with you.

The discussion should be about clinical community engagement and the importance of understanding the community hospitals and healthcare facilities are working with. Vulnerable communities have often lacked trust in large healthcare systems because of mistreatment.

Understanding that clinical community engagement should focus on the patient and not motives that hospitals think that the community needs. Community Health Workers are important because these workers are able to form a relationship with patients and often time can meet the needs of the patients.

I believe that hospitals can play a major role in stemming these inequities in health in vulnerable populations by understanding the needs of the community. Identifying that health is larger than a hospital visit or meeting with a physician but the identifying structural barriers to health like food insecurity, lack of insurance, access to hospitals.

White hospitals and Black communities must share power. The ideology driving the course is that health equity cannot be achieved without engagement between individuals and communities in the context of social determinants of health, and the researchers, policy-makers, and clinicians who work in those spaces.

Use the Davidhizar Transcultural Assessment Model to assess the Hispanic ethnic group. You will identify factors that affect communication of the Hispanic ethnic group and barriers to the provision of culturally competent healthcare. You will use your selected cultural assessment model to address the needs of the chosen ethnic group and include your role as a cultural broker to meet the multicultural needs of the assigned ethnic group.

Use a review of the literature with at least 5 peer-reviewed articles to support and inform your body of work. This assignment should demonstrate cultural competence, cultural sensitivity, and humility in providing culturally appropriate care.

J.C is an 82-year-old white man who was evaluated by GI specialist due to abdominal discomfort, loss of appetite, weight lost, weakness and occasional nausea.

Past Medical History (PMH):
Patient is Diabetic, controlled with Metformin 500 mg by mouth twice a day, Lantus 15 units SC bedtime. Hypertensive, controlled with Olmesartan 20 mg by mouth once a day. Atrial Fibrillation, controlled with Rivaroxaban 15 mg by mouth once a day and bisoprolol 10 mg by mouth once a day.

Labs:
Hb 12.7 g/dl; Hct 38.8% WBC 8.2; Glycemia 74mg/dl; Creatinine 0.8 mg/dl; BUN 9.8 mg/dl; AST 21 U/L ALT 17 U/L; Bil T 1.90 mg/dl; Ind 0.69 mg/dl; Dir 1.21 mg/dl.

Diagnostic test:
Endoscopic Ultrasound of the Pancreas. Solid mass in the head of pancreas 4 cms, infiltrating Wirsung duct. The solid mass impress to infiltrate the superior mesenteric vein. Perilesional node is detected, 1.5 cms, metastatic aspect. Fine needle aspiration (FNA) biopsy: Ductal adenocarcinoma.

Case study questions:

Please name the potential most common sites for metastasis on J.C and why?
What are tumor cell markers and why tumor cell markers are ordered for a patient with pancreatic cancer?
Based on the case study described, proceed to classify the tumor based on the TNM Stage classification. Why this classification important?
Discussed characteristic of malignant tumors regarding it cells, growth and ability to spread.
Describe the carcinogenesis phase when a tumor metastasizes.
Choose the tissue level that is affected on the patient discussed above: Epithelial, Connective, Muscle or Neural. Support your answer.

Submission Instructions:

Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Your initial post is worth 8 points.
You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
All replies must be constructive and use literature where possible.