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Maintain a persuasive tone

Assignment 2: Scenario Analysis

You are a member of the training division at your law enforcement agency. The Sergeant of the unit has asked that you create an informative voice-over PowerPoint presentation that explains the normative and applied prevailing criminal justice models of ethical reasoning. This PowerPoint presentation will be played at all roll calls and shift briefing training(s) for your department. The instruction set delivered to you indicates that (at a minimum) the PowerPoint should address the history, tenets, and applications of each of the theories. The presentation will assume the normative judgment model, which emphasized the three moral judgment imperatives (the human act, free will, effect upon others). This presentation requires that an embedded audio recording be included with the presentation, which serves to explain the slides that are presented. A suggested outline for the slideshow is listed below.

  1. Title slide (required)
  2. The Ethics of Virtue (title slide)
  3. History of the Ethics of Virtue
  4. Tenets of the Ethics of Virtue
  5. Provide a criminal justice based, ‘real world’ example of the ethics of virtue
  6. Ethical Formalism (Deontological Ethics) (title slide)
  7. History of Ethical Formalism
  8. Model of Ethical Formalism
  9. Provide a criminal justice based, ‘real world’ application of Deontological ethics
  10. Consequentialism (Teleological Ethics) (title slide)
  11. History of Consequentialism
  12. Model of Consequentialism
  13. Provide a criminal justice based, ‘real world’ example of Utilitarianism
  14. Ethics of Care (Restorative Justice)
  15. History of the Ethics of Care
  16. Tenets of the Ethics of Care
  17. Provide a criminal justice based “real world” example of the Ethics of Care
  18. Where does the concept of Noble Cause corruption fits within the ethical models?
  19. Summary
  20. References Slide (required)

PowerPoint Format:

  • Use the slide notes section in the presentation to include information that follows your narration, being sure to follow the conventions of Standard English.
  • Slide content should include brief points that identify the areas that will be addressed in the narration.
  • In-text citations should be included with any brief points that were researched from outside sources and the narration should fully explain the points
  • Cite all sources on a separate reference slide at the end of the PowerPoint and reference each source in the body of the presentation using APA format.
  • Identify the source of any pictures you use, being sure to cite them correctly in APA style using in-text citations.

Narration Guidelines:

  • Maintain a persuasive tone by summarizing observations and evaluations for each slide.
  • Ensure that your presentation is highly ordered, logical, and unified.
  • Words should be clearly enunciated and professional tone should be sustained throughout the presentation narration.
  • Audio recording should be free of background noise and interruptions.

For additional help with APA, visit the University Writing Center.

For assistance with embedding the audio into your PowerPoint presentation, please make use of this tutorial.

 

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No information regarding social support

Please use the patient information provided below for this paper.

This assignment assesses intended course outcome(s)

#4 Use information found in patients’ health histories, genograms, and assessments to formulate an individualized plan of nursing care that focuses on the patient’s individual health promotion and disease prevention needs

Students will use the information found in Tina’s history, physical exam, and problem list to formulate an individualized health promotion and disease prevention plan of care. Recommendations should be evidence-based and from credible sources. The readings in module eight contains some suggested sources for obtaining health and screening recommendations for your patient.

The plan for addressing the health promotion and disease prevention needs for your patient should include:

Demographics:

–          Age, gender and race of patient

–          Education level (health literacy)

–           Access to health care

Insurance/Financial status

–          Is the patient able to afford medications and health diet, and other out-of-pocket expenses?

Screening/Risk Assessment

–          Identified health concerns based on screening assessments and demographic information

Nutrition/Activity

–          What is the patients activity level, is the environment where the patient lives safe for activity

–          Nutrition recommendations based on age, race gender and pre-existing medical conditions

–          Activity recommendations

Social Support

–          Support systems, family members, community resources

Health Maintenance

–          Recommended health screening based on age, race, gender and pre-existing medical conditions

Patient Education:

–          Identified knowledge deficit areas/patient education needs (medication teaching etc).

–          Self-care needs/ Activities of daily living

* The paper should be written and referenced in APA format and be no longer than 4 pages (excluding cover page and references).

Your paper will be evaluated based on the following criteria:

Criteria

Level 3

Level 2

Level 1

Demographics

(5%)

Includes age, race and gender of patient

Missing one data item

Missing 2 or more data items

Insurance/Financial status

(10%)

Includes information regarding patient’s insurance status and ability to afford medications and other  out-of-pocket expenses

Missing some information regarding insurance status and ability to pay for medications and other out-of-pocket expenses.

Missing information regarding the patients insurance status, ability to pay of medications and other out-of-pocket expenses

Screening /risk assessment

(10%)

Identifies health concerns based on screening assessments and demographic information.

Missing some information regarding health concerns, by excluding information from screening assessments and demographics

Health concerns are not identified due to information missing from screening assessments and demographics

Nutrition/activity

(20%)

Completely asses patient’s nutrition and activity levels and makes recommendations based on age, race, gender and pre-existing medical conditions

Missing some information regarding the patients nutrition and activity levels, make recommendations based on age, race, gender and pre-existing medical conditions

Most of the information regarding the patient’s nutrition and activity levels are missing, recommendations are missing or not based on the patient’s age, race, gender and pre-existing medical conditions

Social support

(10%)

Identifies support systems such as family members and community resources

Missing some information regarding support systems such as family members and/or community resources

Little to no information regarding social support

Health Maintenance

(20%)

Overall health maintenance recommendations made based on age, race, gender and pre-existing medical conditions

Missing some recommendations, mostly based on age, race, gender and pre-existing medical conditions

Missing many recommendations, loosely related to age, race, gender and pre-existing medical conditions

Patient Education

(20%)

Identified knowledge deficit areas/patient education needs including self-care needs and activities of daily living

Missing one or more areas of knowledge deficit/patient education needs including self-care and activities of daily living

Lacks identification of knowledge deficit areas/patient education needs. Does not consider self-care needs or activities of daily living.

Organization, spelling and grammar, APA

(5%)

Organized, easy to read, no spelling or grammar mistakes, appropriate use of APA

Organized and easy to read, few spelling or grammar mistakes, few errors in APA

Disorganized, difficult to read, many spelling and grammar errors mistakes. Does not use APA

Overall score

Points

(60-100)

Points

(24-59)

Points

( 0-23)

 

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Patient involvement is a core factor

Additionally, you are expected to reply to two other students and include a reference that justifies your post.  Your reply must be at least 3 paragraphs.

the following answer is the post to another student that I have to reply to.

Question 1

I am a doctor’s nurse at a local clinic where I meet Alex who, while the M.D. examining his genitalia and me as the provider’s assistant nurse, informs us that he is HIV positive. I counsel Alex to inform his sex partner Ann so that she can also get to know her HIV status. Twelve months later, Ann is expecting a baby in three months.

Clearly, Alex is yet to inform Ann of his status yet steps needed to be taken to know the status of Ann and the unborn baby so that necessary treatment can commence. Alex threatens that if his status is disclosed to Ann without his consent, he would stop coming for treatment. I found myself in a dilemma on whether to inform Ann of Alex status or hid to Alex words.

To utilize critical thinking, I ought to refer to paragraph 53 of the GMC guidelines on confidentiality. The principle explains that disclosure of confidential information is justified when the failure to do so exposes a third party to risk of death or serious harm (Dolan, 2004).

Question 2

Patients can avoid medical errors to ensure their safety taking their medication as prescribed, communicating effectively with their caregivers and clinicians and lowering infection rates. Patients must also keep the health care team involved and learning more about their conditions (Keohane & Bates, 2008).

Family caregivers need to have adequate training on how to handle the patient and ensure adequate communication between the patient and the clinician to ensure patient safety. The family should also ensure that the patient is free from household hazards. Clinicians can promote safety and reduce errors by adhering to procedures, listening to patients and effectively communicating with the health care team (Keohane & Bates, 2008).

.

The healthcare team should embrace teamwork to eliminate issues of burnouts that may lead to medical errors. The team should also work together to solve problems that may lead to medical errors. The system can improve communication skills among members of staff in the facility, develop team strategies and develop safety culture in the hospital setting to ensure safety and reduce errors.

Question 3

Patient involvement is a core factor in creating the culture of safety. Clinicians must involve patients in decisions pertaining to their treatment and discharge plans (Clancy, Farquhar & Sharp, 2005). Such practices allow patients know much about their care to avoid misunderstanding.

Teamwork also creates a culture of safety. The skills generated in interprofessional communication encourage safety culture. Teamwork is critical during transitions in care.

Access to accurate information is another factor that creates a culture of safety. Access patient records, evidence-based-practice protocol and lab reports enhance the culture of safety in health care. The formation required must be accurate and received in good time.

References

Clancy, C. M., Farquhar, M. B., & Sharp, B. A. C. (2005). Patient safety in nursing           practice. Journal of Nursing Care Quality20(3), 193-197.

Dolan, B. (2004). Medical records: Disclosing confidential clinical information. Psychiatric             Bulletin28(2), 53-56.

Keohane, C. A., & Bates, D. W. (2008). Medication safety. Obstetrics and gynecology clinics of North America35(1), 37-52.

 

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Previous history of MI 1 year ago

Chief complaint: “I’m here for a medication refill because I ran out of my medicines”.

HPI:  Mrs. Allen is a 68-year-old African American who presents to the clinic for prescription refills. The patient indicates that she has noticed shortness of breath which started about 3 months ago. The SOB gets worse with exertion, especially when she is walking fast, and it is resolved when she is resting. She reports that she is also bothered by shortness of breath that wakes her up intermittently during her sleep. Her symptoms of shortness of breath resolve after sitting upright on 3 pillows. She also has lower leg edema pitting 1+ which started 2 weeks ago. She indicates that she often feels light headed at times with intermittent syncope episodes while going up a flight of stairs, but it resolves after sitting down to rest. She has not tried any over the counter medications at home.

She started taking her medications, but failed to refill the prescriptions because she cannot afford the medications as she only works part-time and lives alone. In addition, she reports that she does not think taking all these medications would help her condition anyway.

PMH: Primary Hypertension, Previous history of MI 1 year ago

Surgeries:

1 year ago-Left Anterior Descending (LAD) cardiac stent placement

Allergies: Penicillin

Vaccination History:  Up-to-date

Social history:

High school graduate married and no children. Drinks one 4-ounce glass of red wine daily. She is a former smoker and stopped 5 years ago.

Family history:

Both parents are alive. Father has history of MI and valvular heart disease; mother alive and cardiac history is unknown. He has one brother who is alive and has history of MI 5 years ago at age 52.

ROS:

Constitutional: Lightheaded and faint with exertion. Respiratory: Shortness of breath with exertion. + Orthopnea. Cardiovascular: + 2 pitting leg edema for 3 weeks.

Psychiatric: Non-contributory.

Physical examination:

Vital Signs: Height: 5 feet 1 inches Weight: 175 pounds BMI: 32, Obese, BP 160/92, T 98.0, P 111,  R 22 and non-labored

HEENT: Normocephalic/Atraumatic, Bilateral cataracts; PERRLA, EOMI; Teeth intact. Negative for gum disease. NECK: Neck supple, no palpable masses, no lymphadenopathy, no thyroid enlargement. LUNGS: + Mild Crackles on inspiratory phase not clearing with cough. Equal breath sounds. Symmetrical respiration. No respiratory distress. HEART: Normal S1 with S2 during expiration. An S4 is noted at the apex; + systolic murmur noted at the right upper sternal border without radiation to the carotids. Pulses are 2+ in upper extremities and 2+ in pedal pulses bilaterally. 2+ pitting edema to her knees noted bilaterally. ABDOMEN: No abdominal distention. Nontender. Bowel sounds + x 4 quadrants. No organomegaly. Normal contour; No palpable masses. GENITOURINARY: No CVA tenderness bilaterally. GU exam deferred. MUSCULOSKELETAL: + Heberden’s nodes at the DIP joints, hands. + Crepitus, bilateral knees. Slow gait but steady. No Kyphosis. PSYCH: Normal affect. Cooperative. SKIN: No rashes. Positive for dry skin.

Labs: Hgb 13.2, Hct 38%, K+ 4.0, Na+137, Cholesterol 228, Triglycerides 187, HDL 37, LDL 190, TSH 3.7, glucose 98.

A:

Primary Diagnosis: Congestive Heart Failure (CHF)

Secondary Diagnoses: Primary Hypertension, Obesity, Osteoarthritis (OA)

Differential Diagnosis: Peripheral Vascular Disease (PVD)

Plan:

Medications: Tylenol 650 mg PO Q4 hours as needed for arthritis pain

Labs: UA; Brain natriuretic peptide (BNP); LFTs and TSH; 12-lead EKG, Chest X-ray; Initial 2D echo with Doppler; Ankle-brachial index.

Additional lab results: Echo results 1 week ago: Left ventricular EJ Fraction decreased to 35 %

BNP – not available.

As a future FNP, you need to determine the medications for CHF/ASCVD. (Arteriosclerotic Cardiovascular Disease).

Questions:

1.     According to the ACC/AHA guidelines, what medications should this patient be prescribed?

2.     Does he need medication(s) given his history of MI?

 

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