How does Human virtual stimulate patient encounter

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Advanced physical assessment: How does Human virtual stimulate patient encounter help meet the goals of the competencies from the NONPF Independent Practice Competency: 1. Practices independently managing previously diagnosed and undiagnosed patients?

Describe how this helped accomplish the NONPF Independent Practice Competency: 1. Practices independently managing previously diagnosed and undiagnosed patients in detail?

 

Provide at least two specific examples.

Verbal and nonverbal contact during interactions

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We engage in a variety of interactions with people every day whether at work or elsewhere. We build opinions based on their verbal and nonverbal contact during interactions. According to Riley (2017), “when our verbal message does not match our posture, tone of voice, body language, or facial expression, client or coworkers decode the disparate information as two dissimilar messages.” (p.87).

Once when I arrived to work ten minutes late during a shift change.

My colleague casually asked me the reason for being late. Even though I was late because I had left late from home, I explained that it was because of the heavy traffic on the way.

My facial expressions did not seem to go along with what I was saying, and I could not maintain eye contact. She was rolling her eyes, though, so it appeared as though she could tell that my spoken message and body language were not coordinated.

Our vocal communication can be planned; however, our nonverbal communication can reveal concealed facts. By analyzing a person’s body language or the manner they transmit a message, we can ascertain whether they are telling us the truth (Riley, J.B, 2017).

2. Discrepancies between you and the external world:
We occasionally come across circumstances with which we disagree. However, we keep moving forward, accepting the discrepancies.

For instance, in nursing, documentation is critical; however, keeping the paperwork up to date takes away time from bedside nursing.

Additionally, the workload can be excessive, sometimes compromising patient care quality.

A nurse must care for sick people, so she should spend more time at the bedside rather than documenting. I understand that documentation is essential, but it can be planned more straightforwardly, taking less time and leaving more time to provide patient-centred care.

3. Discrepancies between you and the client:
Making others aware of their behaviour’s destructiveness or lack of productivity is the first step in confrontation. The second is offering suggestions for how they may conduct themselves more constructively or productively. At the same time, we know some people tend to argue when challenged.

As a result, we do not want to discuss their behaviours. People encounter problems because of their misdirected actions/behaviour; at this moment, we might regret not discussing the destructive behaviour before (J.B. Riley, 2017).
According to Riley (2017), confrontation can be done in such a way that the other person does not feel offended and will also appreciate your opinion.
If I would have a dispute with my client at any time, I would first listen to what my client has to say, then clarify the problematic behaviour and explain why I believe this behaviour is the issue—additionally making a polite request to change the behaviour and making a respectful suggestion in a way that the client is not offended.

Finally, I would encourage the client to change their behaviour by emphasizing the positive consequences of changing or negative implications (J.B. Riley, 2017)

Reference

Riley, J.B. (2017). Communication in Nursing: Learning confrontation skills. (8th Ed.). Elsevier.

Risk Labor and Birth Case Study

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Lisa in Labor: An At-Risk Labor and Birth Case Study. On October 1st of the current year, L.G., a 16-year-old Caucasian female who is a G4 P0030, presents at a local hospital in labour. She reports that her due date is “the beginning of September of this year.” Based on her last menstrual period, her EDD is October 15th.

Coming to the labour and delivery unit alone, she states that she does not have any family or support. Upon further questioning, she states that a friend “gave me a ride and dropped me off here.” L.G. reveals during her admission assessment that she has had no prenatal care during this pregnancy. She reports that she’s been in labour at home for the past few hours but that the contractions got “too hard for me to breathe through them” so she came to the hospital.

A vaginal exam reveals that her cervix is 6 cm dilated, 80% effaced and her fetus is at the -2 station. Her amniotic membranes are intact and bulging and the fetal presenting part cannot be palpated. Her vital signs reveal BP 170/92, P 80, R 16, and T 98.8 degrees Fahrenheit. After you (the nurse) perform Leopold’s maneuvers, you place the fetal heart toco on the left upper quadrant of the patient’s abdomen.

Her uterine contraction pattern shows she is having contractions every 2-3 minutes lasting between 50 and 60 seconds. When you palpate the fundus during contractions, her fundus palpates firm.

Answer the following questions:

  • What stage of labor is L.G. experiencing?
  • What are six additional questions that you would ask L.G. in order to complete her admission assessment, including questions regarding her prenatal health history and factors that take her psychosocial, emotional support, and cultural factors into consideration? Write and discuss why you chose these questions.
  • In addition to the foregoing assessment, list two additional laboratory and diagnostic tests that are routinely drawn and performed when a laboring woman is admitted to the Labor and Delivery unit.

Case Study Continued:

Since you are monitoring fetal heart tones in the upper left quadrant of L.G.’s abdomen, you suspect that the fetus is mal-positioned. A quick ultrasound scan confirms that the fetal head is not vertex in the mother’s pelvis. Further, L.G.’s amniotic membranes ruptured spontaneously during a uterine contraction, the fetal heart rate dropped from its baseline of 130-140 bpm to 90 bpm and you immediately see that the fetus’s umbilical cord has prolapsed.

Answer the following questions:

  • What initial nursing interventions would you perform to improve maternal and fetal outcomes given the prolapsed cord?
  • Why is a prolapsed cord an obstetrical emergency?
  • Given the obstetrical emergency, what is the safest method of L.G.’s fetus and why?

the NONPF Independent Practice Competency

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How did the Human help achieve the goals of competency from the NONPF Independent Practice Competency: Provides patient-centred care recognizing cultural diversity and the patient or designee as a full partner in decision-making?

Describe how the iHuman virtual learning helped meet this competency.

Provide at least two specific examples.

The political process surrounding health care

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How has this course, Healthcare Policy, Regulation, and Finance changed views on becoming involved in the political process surrounding health care? Discuss and reflect on the assigned topics in terms of:

How do the content and assignments meet the course objective(s)?

Provide examples of actual or potential applications of the course week’s concepts.

Successes or challenges had for the week regarding the course content.

What is different about the American Recovery and Reinvestment Act of 2009?

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What is different about the American Recovery and Reinvestment Act of 2009? , and more recent programs compared to past programs? What did it do for healthcare? What did it do for analytics?

How did globalization change some people’s lives?

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Mexican Government Advises Migrants (page 9). How did globalization change some people’s lives, How did the changes lead to a conflict? What was the proposed solution(s) to the conflict? How satisfactory was the solution to each party?

  • Can you imagine a way to avoid or resolve similar conflicts in the future, even if rapid globalization continues?
  • Over the years, in what ways has your region become more globalized?
  • How can you see the results of this today? If you cannot see the results of this today, why?

What are some signs that an infant is ready to try solid foods

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What are some signs that an infant is ready to try solid foods (also called complementary foods)? How should new foods be introduced, and how often should a new food be introduced?

Unstable ischaemic heart disease

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Mr. Jack Charles owns and manages a Market Garden mainly producing celery and herbs. He has hypercholesterolemia managed with Lipitor 40mg nocte. He and his son “Thomas” share this business together. Thomas has a wife and three young children aged 2, 4 and 6.

Mr. Jack Charles is a 78-year-old type 2 diabetic. He was first diagnosed in 1999 with hypertension then 2 years later as a type 2 diabetic. His wife Gladys has been managing his diet and medications until she died in 2010., his hypertension is managed with Aldomet 50mg daily, and his type 2 diabetes is managed with diet and Metformin 500mg slow release BD. He has been struggling to manage his health and work on the Farm.

Mr. Charles was admitted to a Private Hospital 65 days ago with unstable ischaemic heart disease. On admission, his BGL was 20 mmol/litre and he had polyuria, polydipsia and polyphagia. He required emergency Quadruple Coronary Artery Bypass Grafts (CABGs)that were complicated post-operatively by a Right Cerebrovascular Accident (RCVA).

 

After ten (10) days he was transferred to a Private Rehabilitation Centre to receive specialized post-stroke management. He has L leg weakness, L arm weakness and dysphasia as a result of his ischaemic stroke.

Medications in Rehabilitation 

Hypertension is now managed by Captopril 50mg TDS

Diabetes is now managed by TDS Actrapid Insulin 10 units

Hypercholesterolaemia us managed by Lipitor 80mg

Clexane 80mg BD subcutaneously

He will require Oral warfarin on discharge, dosage to be determined.

 

Q1.2  Seek information from Mr. Charles, and as appropriate, with family or carer to confirm their understanding of the condition and its impact.

What question/s would you ask Mr. Charles and his son “Thomas “to determine if they have an understanding of one of Mr. Charles’ chronic health conditions and its impact on their lives and activities of daily living?

 

Q1.3  In the Post Stroke Rehabilitation Program,

identify the current treatments given by teach of the following members of  the interdisciplinary health team

Medical Doctor, Nurse, Physiotherapist, Occupational Therapist, Speech Therapist

to Mr. Charles in rehab and on discharge.

 

Q1.4   Identify community-based care services that are available for Mr. Charles with a need for restorative or rehabilitation care.

 

 

Q1.5  Actively involve Mr Charles in the development of strategies to self-manage his condition. Describe the strategies, or design a program to help teach Mr Charles how to self-manage his Type 1 Diabetes and the introduction of insulin therapy.

Please make reference to:

  • Sugar free diet
  • The importance of BGL’s

The storage of insulin

 

Q2.1  Identify current contribution of other agencies and professionals in supporting Mr Charles. For the following agencies and professionals, determine their contribution in providing care for Mr Charles in hospital, or following discharge.

Please make reference to the following:

  • GP
  • Pharmacist
  • Centrelink
  • RDNS
  • Physiotherapy
  • Hydrotherapy
  • Diabetic nurse educator
  • Wound care nurse
  • Q2.2   Identify the level and type of contribution and support made by family or carer.
  • Q2.3   As a nurse, identify four (4) situations you will communicate with allied health professionals to describe Mr Charles progress.  Provide an example for each situation of how and what is communicated.
  •  Q2.4   Respond to variations in Mr Charles needs in the context of a coordinated service approach. Mr Charles is very sad and writes: “I can’t live like this.  I just want to die- and I know how to do it.”  As a nurse, how will you respond and what members of the health care team will you contact to help deal with this situation?

Q2.5 After consultation with the Endocrinologist and Diabetic Nurse Educator, Mr Charles has been told he will need to manage his insulin injections to help control his Type 1 Diabetes.  How will you as a nurse, educate and evaluate Mr Charles understanding of his diabetes and new management regime? Please make reference to the following:

  • Sugar free diet
  • Checking of BGL
  • Storage of insulin
  • Injection of insulin

The electronic health record

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Two state troopers have just burst into your healthcare facility demanding immediate help in tracking down a prisoner on the run. They believe the man may be responsible for an area carjacking, and they have a written request for a description of any distinguishing physical characteristics, such as scars and tattoos. The electronic health record reveals that the man has a large heart on his upper arm with the name “Pookie” written inside it. However, the officers do not have a warrant for the information. Can you give it to them? Does it matter whether the fugitive has committed a violent or a nonviolent offence?