The document discusses the nursing process and how it is used to create individualized care plans for patients. It outlines the 5 steps of the nursing process - assessment, diagnosis, planning, implementation, and evaluation. For each step, it provides details on how to perform that step, such as collecting comprehensive assessment data, identifying nursing diagnoses, setting goals and interventions, and evaluating outcomes. It also discusses concept maps as an alternative approach to traditional nursing care plans.
Write a 3 page evidence-based health care delivery plan for one .docxowenhall46084
Write a 3 page evidence-based health care delivery plan for one component of a heart failure clinic.
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
In an effort to improve the patients' health literacy concerning heart failure, it is important that the clinic staff and the hospital staff present a consistent, evidence-based message on self-care to these patients and their families in order to decrease acute exacerbation and re-admissions. Review current evidence for clinical practice guides or protocols when developing your patient teaching plans and materials. Consider the following:
What does the patient know about the disease process as a baseline?
What does the patient need to do understand as far as the best self-care processes?
Can the patient identify proper medication compliance?
Is there a financial issue that affects compliance?
Who buys and prepares the food in the home?
Can the patient verbalize when to seek medical assistance?
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocol.
ITS IMPORTANT TO MEET THE COMPETENCES (Thats how they evaluate the mariuse18nolet
ITS IMPORTANT TO MEET THE COMPETENCES (That's how they evaluate the work).
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
(IMPORTANT) -Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
(IMPORTANT) -Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
(IMPORTANT) -Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
Preparation
Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment.
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.
As a member of the nurse team, you have been asked to develop
one
component
of the clinic.
The hospital leadership established these objectives ...
The American Nurses Association (ANA) defines the nursing process as “the essential core of practice for the registered nurse to deliver holistic, patient-focused care.
Or
Defined as a systematic approach to care, using the fundamental principles of critical thinking, client-centered approaches to treatment, goal-oriented tasks, evidence-based practice (EBP) recommendations, and nursing intuition.
It is considered the framework upon which all nursing care is based.
Nursing Diagnosis for Care Plans
This section is the list or database of the common NANDA nursing diagnosis examples
DIAGNOSTIC LABEL
Activity Intolerance
Acute Pain
Anxiety
Chronic Pain
Constipation
Decreased Cardiac Output
Deficient Fluid Volume
Deficient Knowledge
Diarrhea
Excess Fluid Volume
Fatigue
Fear
Grieving
Hopelessness
Hyperthermia
Hypothermia
Imbalanced Nutrition: Less Than Body Requirements
Impaired Gas Exchange
Impaired Tissue (Skin) Integrity
Impaired Urinary Elimination
Ineffective Airway Clearance
Ineffective Breathing Pattern
Ineffective Tissue Perfusion
Risk for Falls
Risk for Impaired Skin Integrity
Risk for Infection
Risk for Injury
Risk for Unstable Blood Glucose Level
Patient problem present during A nursing assessment is known as A problem-focused diagnosis
Risk factors require intervention from the nurse and healthcare team prior to A real problem developing
Improve the overall well-being of an individual, family, or community
A cluster/group of nursing diagnoses that occur in a pattern or can all be addressed through the same or similar nursing interventions
A possible diagnosis is a statement about a health problem that the client might have now, but the nurse doesn’t yet have enough information to make an actual diagnosis.
An example of a possible diagnosis is: Possible fluid volume deficit in case of frequent vomiting for three days .
Cerebrovascular accident (CVA), also known as stroke, acute ischemic stroke, cerebral infarction, or brain attack.
Definition:
It is the sudden impairment of cerebral circulation in one or more blood vessels supplying the brain caused by hemorrhage from a tear in the vessel wall or impairs cerebral circulation by partial or complete occlusion of the vessel lumen
Strokes can be classified into 2 main categories:
Ischemic strokes. These are strokes caused by blockage of an artery (or, in rare instances, a vein). About 87% of all strokes are ischemic.
Hemorrhagic stroke. These are strokes caused by bleeding. About 13% of all strokes are hemorrhagic.
2 main categories, Ischemic strokes :
Thrombotic strokes. These are caused by a blood clot that develops in the blood vessels inside the brain.
Embolic strokes. These are caused by a blood clot or plaque debris that develops elsewhere in the body and then travels to one of the blood vessels in the brain through the bloodstream.
2 main categories, Hemorrhagic strokes”
Intracerebral hemorrhage.
Bleeding is from the blood vessels within the brain.
Subarachnoid hemorrhage.
Clinical Audit is a method of confirming the quality of clinical services and identify the need for improvement. A skill hospital administrator should learn and practice.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
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Write a 3 page evidence-based health care delivery plan for one .docxowenhall46084
Write a 3 page evidence-based health care delivery plan for one component of a heart failure clinic.
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
In an effort to improve the patients' health literacy concerning heart failure, it is important that the clinic staff and the hospital staff present a consistent, evidence-based message on self-care to these patients and their families in order to decrease acute exacerbation and re-admissions. Review current evidence for clinical practice guides or protocols when developing your patient teaching plans and materials. Consider the following:
What does the patient know about the disease process as a baseline?
What does the patient need to do understand as far as the best self-care processes?
Can the patient identify proper medication compliance?
Is there a financial issue that affects compliance?
Who buys and prepares the food in the home?
Can the patient verbalize when to seek medical assistance?
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocol.
ITS IMPORTANT TO MEET THE COMPETENCES (Thats how they evaluate the mariuse18nolet
ITS IMPORTANT TO MEET THE COMPETENCES (That's how they evaluate the work).
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
(IMPORTANT) -Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
(IMPORTANT) -Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
(IMPORTANT) -Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
Preparation
Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment.
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.
As a member of the nurse team, you have been asked to develop
one
component
of the clinic.
The hospital leadership established these objectives ...
The American Nurses Association (ANA) defines the nursing process as “the essential core of practice for the registered nurse to deliver holistic, patient-focused care.
Or
Defined as a systematic approach to care, using the fundamental principles of critical thinking, client-centered approaches to treatment, goal-oriented tasks, evidence-based practice (EBP) recommendations, and nursing intuition.
It is considered the framework upon which all nursing care is based.
Nursing Diagnosis for Care Plans
This section is the list or database of the common NANDA nursing diagnosis examples
DIAGNOSTIC LABEL
Activity Intolerance
Acute Pain
Anxiety
Chronic Pain
Constipation
Decreased Cardiac Output
Deficient Fluid Volume
Deficient Knowledge
Diarrhea
Excess Fluid Volume
Fatigue
Fear
Grieving
Hopelessness
Hyperthermia
Hypothermia
Imbalanced Nutrition: Less Than Body Requirements
Impaired Gas Exchange
Impaired Tissue (Skin) Integrity
Impaired Urinary Elimination
Ineffective Airway Clearance
Ineffective Breathing Pattern
Ineffective Tissue Perfusion
Risk for Falls
Risk for Impaired Skin Integrity
Risk for Infection
Risk for Injury
Risk for Unstable Blood Glucose Level
Patient problem present during A nursing assessment is known as A problem-focused diagnosis
Risk factors require intervention from the nurse and healthcare team prior to A real problem developing
Improve the overall well-being of an individual, family, or community
A cluster/group of nursing diagnoses that occur in a pattern or can all be addressed through the same or similar nursing interventions
A possible diagnosis is a statement about a health problem that the client might have now, but the nurse doesn’t yet have enough information to make an actual diagnosis.
An example of a possible diagnosis is: Possible fluid volume deficit in case of frequent vomiting for three days .
Cerebrovascular accident (CVA), also known as stroke, acute ischemic stroke, cerebral infarction, or brain attack.
Definition:
It is the sudden impairment of cerebral circulation in one or more blood vessels supplying the brain caused by hemorrhage from a tear in the vessel wall or impairs cerebral circulation by partial or complete occlusion of the vessel lumen
Strokes can be classified into 2 main categories:
Ischemic strokes. These are strokes caused by blockage of an artery (or, in rare instances, a vein). About 87% of all strokes are ischemic.
Hemorrhagic stroke. These are strokes caused by bleeding. About 13% of all strokes are hemorrhagic.
2 main categories, Ischemic strokes :
Thrombotic strokes. These are caused by a blood clot that develops in the blood vessels inside the brain.
Embolic strokes. These are caused by a blood clot or plaque debris that develops elsewhere in the body and then travels to one of the blood vessels in the brain through the bloodstream.
2 main categories, Hemorrhagic strokes”
Intracerebral hemorrhage.
Bleeding is from the blood vessels within the brain.
Subarachnoid hemorrhage.
Clinical Audit is a method of confirming the quality of clinical services and identify the need for improvement. A skill hospital administrator should learn and practice.
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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2 Case Reports of Gastric Ultrasound
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
2. Nursing Care Plans/Concept Maps
Utilize the Nursing Process to construct
an individualized plan of care for a
patient based on a critical analysis of
patient assessment data
Nursing Process: Systematic method of
giving humanistic care that focuses on
achieving outcomes in a cost effective
manner.
3. Nursing Care Plans
Written guidelines for client care
Organized so nurse can quickly identify
nursing actions to be delivered
Coordinates resources for care
Enhances the continuity of care
Organizes information for change of
shift report
4. The Nursing Process is a Systematic
Five Step Process
Assessment
Diagnosis
Planning
Implementation
Evaluation
5. Why Use the Nursing Process for Care
Plans
Requirement set forth by national
practice standards (ANA, TJC)
Basis for NCLEX exams
Based on principles and rules that
promote critical thinking in nursing
6. Putting it All Together
Assessment: The first step in determining a
patients’s health status.
Gather information, put pieces of the health
puzzle together.
Entire plan is based on the data you collect,
data needs to be complete and accurate
Collect, verify, and organize data, identify
patterns, report and record the data.
Report significant abnormalities immediately.
7. Case Scenario
Mr. Jones complains his throat and
mouth are dry. He is allowed fluids, but
has had almost nothing to drink all
evening. He tells you he would like to
drink, but doesn’t like water, especially
the warm water in the pitcher. He also
hates to bother the nurse. The nurse
notes his oral mucosa is dry and
cracked and his urine output for the last
shift is low.
8. Assessment
First step in determining health status
Gather information
Gather all the “puzzle pieces” to put
together a clear picture of health status
Entire plan is based on data collected
Data needs to be complete and
accurate, make sense of patterns
9. 5 Activities Needed to Perform a
Systematic Assessment
Collect data
Verify data
Organize data
Identify Patterns
Report & Record data
10.
11. Comprehensive Data Collection
Begins before you actually see the patient
(Nurse report from ER, Chart reviews)
Continues with admission interview and
physical assessment once you meet patient.
Other information resources include: family,
significant others, nursing records, old
medical records, diagnostic studies, relevant
nursing literature.
Consider age, growth & development
13. Comprehensive Physical Assessment
Vital signs
Height & weight
Review of systems (neurological/mental
status, musculoskeletal, cardiovascular,
respiratory, GI, GU, skin and wounds.
Standardized risk assessments:
Pressure ulcers, falls, DVT
14.
15. Organizing Assessment Data
Cluster data into groups according to a
nursing or medical model (Maslow’s Basic
Human Needs Model)
Clustering data helps maintain a nursing
focus, allows patterns to be recognized
Cluster by body system or need deficit
Helps to identify nursing diagnosis pertinent
to your client
Example: All information gathered regarding
nutritional status may help to identify
nutritional alterations
16.
17. Diagnosis
AssessmentCritical analysis of data
Diagnosis or Problem Identification
Laws & standards continue to change to
reflect how nursing practice is growing
(APN role)
Novice nurse responsible for
recognizing health problems,
anticipating complications, initiating
actions to ensure appropriate and timely
treatment.
18. Identifying Nursing Diagnosis
Common language for nurses
A clinical judgment about an individual, family
or community response to an actual or
potential health problem or life process,
Nursing diagnosis provide a basis for
selection of nursing interventions so that
goals and outcomes can be achieved
NANDA list of acceptable diagnoses, updated
every 2 years.
19. Diagnostic Reasoning
Apply critical thinking to problem
identification
Requires knowledge, skill, and
experience
Big Picture
20. Fundamental Principles of Diagnostic
Reasoning
Recognize diagnoses
Keep an open mind
Back up diagnosis with evidence
Intuition is a valuable tool for problem
identification
Independent thinker
Know your qualifications & limitations
21. Nursing Diagnosis
Actual or Potential problems identified
Actual: actual evidence of
signs/symptoms of diagnosis exist.
(Fluid Volume Deficit)
Potential/Risk for Diagnosis: client’s
data base contains risk factors of
diagnosis, but no true evidence (Risk for
altered skin integrity)
22. Writing a Nursing Diagnosis
Actual Problems: Problem (NANDA
label) & Etiology & Supporting Signs
and Symptoms
Impaired Communication related to
language barrier as evidenced by
inability to speak English
23. Writing a Nursing Diagnosis
Potential or Risk Problems: Problem
(NANDA label) & etiology or problem &
risk factors with related to statement
linking problem to risk factors.
Risk for Impaired skin integrity related to
obesity, excessive diaphoresis, and
immobility.
24. Writing A Nursing Diagnosis
Use accepted qualifying terms (Altered,
Decreased, Increased, Impaired)
Don’t use Medical Diagnosis (Altered
Nutritional Status related to Cancer)
Don’t state 2 separate problems in one
diagnosis
Refer to NANDA list in a nursing text
books
25. Planning: 4 Part Process
Set your priorities of care, what needs to be
done first, what can wait.
Apply Nursing Standards, Nurse Practice Act,
National practice guidelines, hospital policy
and procedure manuals.
Identify your goals & outcomes, derive them
from nursing diagnosis/problem.
Determine interventions, based on goals.
Record the plan (care plan/concept map)
26. Planning
Risk for Impaired skin integrity related to
immobility
Now restate the first clause in a statement
that describes improvement, control or
absence of problem
The patient will have no signs of skin
breakdown during hospital stay.
Outcome needs to be time related. ( state
time period to achieve goal)
27. Short Term vs. Long Term Goals
Short term goal can be achieved in a
reasonable amount of time ( few hours to few
days)
Long term goals may take weeks/months to
be achieved
Client will ambulate down the hall within 2
days.
Client will walk the length of the hallway
independently by the end of 2 weeks
28. Achieving Goals/Outcomes
Be realistic in setting goals. (look at overall
health state, growth & development level,
prognosis)
Set goals mutually with client
Goals should be measurable, use
measurable, observable verbs
Identify one behavior per outcome
When indicated use short-term vs. long tern
goals
29. Determining Interventions
Nursing interventions are actions performed
by nurse to reach goal or outcome
Monitor health status
Minimize client risks
Direct Care Intervention: Direct action
performed to client (inserting foley catheter)
Indirect Care Intervention: actions performed
away from client ( looking at lab results)
30. Determining Interventions
Interventions will be collaborative,
combining nursing actions and
physician orders.
Ineffective Airway Clearance related to
incisional pain
Nursing Actions: Ascultate breath
sounds every four hours, Assist with
coughing and deep breathing every
hour etc.
Physician orders: pain medication,
31. Implementation
Putting your plan into action
Set priorities after report
Assess and reassess
Perform interventions
Chart client responses
Give report to next shift
32. Implementation of Nursing
Interventions
Describes a category of nursing
behaviors in which the actions
necessary for achieving the goals and
outcomes are initiated and completed
Action taken by nurse
33. Types of Nursing Interventions
Protocols: Written plan specifying the
procedures to be followed during care of
a client with a select clinical condition or
situation
Standing Orders: Document containing
orders for the conduct of routine
therapies, monitoring guidelines, and/or
diagnostic procedure for specific
condition
34. Implementation Process involves:
Reassessing the client
Reviewing and revising the existing care
plan
Organizing resources and care delivery
(equipment, personnel, environment)
35. Evaluation
Evaluation of individual plan of care includes
determining outcome achievement
Identify variables/factors affecting outcome
achievement
Decide where to continue/modify/terminate
plan
Continue/modify/terminate plan based on
whether outcome has been met (partially or
completely)
Ongoing assessment of QI
36. Evaluation
Step of the nursing process that
measures the client’s response to
nursing actions and the client’s progress
toward achieving goals
Data collected on an on-going basis
Supports the basis of the usefulness
and effectiveness of nursing practice
Involves measurement of Quality of
Care
37. Evaluation of Goal Achievement
Measures and Sources: Assessment
skills and techniques
As goals are evaluated, adjustments of
the care plan are made
If the goal was met, that part of the care
plan is discontinued
Redefines priorities
38. Concept Map Care Plans
Innovative approach to planning & organizing
nursing care.
Essentially a diagram of patient problems and
interventions
Ideas about patient problems and
interventions are the “concepts” to be
diagrammed.
Enhances critical thinking and clinical
reasoning
Used to organize patient data, analyze
relationships, establish priorities
39. Theoretical Basis of Concept Maps
Roots in education and psychology
Also known as mind maps, cognitive
maps
Concept mapping requires critical
thinking
New knowledge is built on preexisting
knowledge, new concepts are
integrated by identifying relationships
40. Steps in Concept Map Care Planning
Develop a Basic Skeleton Diagram
Analyze and Catagorize Data
Analyze Nursing Diagnoses
Relationships
Identifying Goals, Outcomes, &
Interventions
Evaluate patient responses