Nursing: Worldview foundations of Sprirituality and ethics

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Personal Worldview Inventory

Write an 800-1,000 word essay on your personal worldview. Briefly discuss the various possible meanings of the term “spirituality,” and your understanding of the concepts of pluralism, scientism, and postmodernism. Primarily, address the following seven basic worldview questions: What is prime reality? What is the nature of the world around you? What is a human being? What happens to a person at death? Why is it possible to know anything at all? How do people know what is right or wrong? What is the meaning of human history?

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.

 
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Case Study: Institute of Medicine Reports Analysis

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In 1999 and 2001, the Institute of Medicine published two reports on patient safety concerns and identified alarming problems within our healthcare system during this time. To Err is Human (IOM, 1999) identified high levels of avoidable medical errors in our hospitals resulting in many patients dying. Six aims to improve patient safety were identified in the Crossing the Quality Chasm(IOM, 2001).

Examine the ways in which the U.S. healthcare system has improved since the publication of these reports. What still needs to be done to make our healthcare system better? Discuss whether or not the U.S. healthcare system is meeting all of the six aims (safe, effective, patient-centered, timely, efficient, and equitable) necessary to improve quality of care delivered to our patients. You will also assess the role of patient care technologies in meeting the six aims. Include at least two references in your responses and analysis. 

You Must Read and use Chapter 2 as a reference of E-book which is attached below – Crossing the Quality Chasm: A New Health System for the 21st Century
Chapter Two, “Improving the 21st Century Healthcare System,” outlines the Institute of Medicine’s six aims for improving patient care and offers methods to improve healthcare delivery.

It is a follow-up on the IOM’s 1999 report on medical errors, “To Err is Human: Building a Safer Health System

For additional details, please refer to the Case Study Guidelines and Rubric document.

 
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LDR-615-D8Q2

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Field of study:  Nursing

(minimum of 250 words with peer review reference)

 

What is your reaction to change in your personal history? What personal tools do you implement to help yourself navigate change?

 
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Case Study, 3 References min, Similaritis less 5%, APA 6

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Case Study

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? 

Thanks!

 
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