What Is The Diagnosis For Kristopher

The Case of Kristopher

Kristopher is a 14-year-old boy who was recently accused by a female classmate of forcing her to have sex with him. He claimed that she agreed to have sex with him and then became angry because he went out with other girls. Kristopher is known as a bully and often fights with other students. He was removed from his biological mother’s home when he was 4-years-old because she was unresponsive when he was repeatedly abused by her boyfriend. Kristopher was adopted by his current parents when he was 7-years-old after he had lived in a series of foster homes. He was a known charmer. Despite his charm, however, he had difficulty controlling his temper and seemed to take pleasure in being cruel to other children and animals.

During the next few years, Kristopher’s adoptive parents tried to help him. They worked with the school to help him control his temper and provided him with therapy. However, his behavior became increasingly difficult to manage. He frequently lied and sometimes stole money from his mother. He began to spend time with other adolescents who were known to use drugs. His school performance, which had never been satisfactory, deteriorated even further. Soon after he was accused of the sexual assault, he ran away from home but was caught by police and arrested.

 

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What is the role of histamine and kinins in the inflammatory process?

1. Mr. Smith, a 52-year old patient, is admitted to the coronary care unit with the diagnosis of acute inferior myocardial infarction. The patient has a history of smoking two packs per day of cigarettes for 35 years, and he drinks a six-pack of beer on weekend nights, but does not drink the rest of the week. He is the sole financial support for his family. He is a consultant for a company and is out of town during week days. Over the past year, Mr. Smith has gained 20 pounds. He is 5 foot 6 inches, weighing 200 pounds. His diet consists mostly of fast food. He rarely exercises. His wife cares for their three teenage children. The eldest son, 17 years of age, totaled the family car when drinking and driving 2 days ago and he is in the local children’s hospital in the intensive care unit in critical condition. Mr. Smith developed chest pain and slumped over in his chair during an argument with his wife about their teenage daughter, who is 15 years of age and wanted to get birth control pills. The wife is in the waiting room while the nurses settle Mr. Smith into his room. The youngest son, 13 years of age, is at a friend’s house. The teenage daughter is staying at the bedside of the critically ill eldest son. The wife blames her eldest son for her husband’s heart attack and told the emergency department nurse that she does not care to see her son at all.

  1. What maladaptive responses to stress may have contributed to Mr. Smith’s development of an illness?
  2. Based on the case study, what family assessment data may be used to determine coping strategies being currently used by the family in crisis?
  3. What nursing interventions should be used to promote effective coping for the patient and his family?

2. Mary Turner stepped on a nail 5 days ago and sustained a puncture about 1 inch deep. She immediately cleaned the area with soap and water and hydrogen peroxide, and applied triple antibiotic ointment to the site. Today she comes to the clinic with complaints of increased pain and swelling in her foot. On assessment, the nurse notes that the puncture site is red and edematous, and has a moderate amount of yellowish drainage.

  1. Describe the sequence of events that caused the local inflammation seen in Mary’s foot.
  2. What is the role of histamine and kinins in the inflammatory process?
  3. Which of the five cardinal signs of inflammation does Mary exhibit?
  4. Because Mary’s injury occurred 5 days ago, the nurse should assess for what systemic effects?

 

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Reimplementation of bedside shift report

Proposal Change Topic: Reimplementation of bedside shift report

Make an outline of Section V (Evaluation Plan) of your Change Proposal.

In your evaluation plan post, be sure to cover the following:

Propose steps for evaluating your suggested changes based on your change theory and evidence on existing best practices. Include the indicators that you will use to measure success, both in implementing the change itself and in ensuring quality outcomes for diverse patients.
Identify appropriate benchmarks from which to measure the effectiveness of the change.
Discuss the processes you will use for gathering feedback from relevant stakeholders—including nurses, patients, and their families—on what is and is not working in order to support continuous improvement.
Running head: REIMPLEMENTATION OF BEDSIDE SHIFT REPORT 1

REIMPLEMENTATION OF BEDSIDE SHIFT REPORT 4

Reimplementation of Bedside Shift Report

Student’s name

Instructor

Course

Date

Introduction

My present work environment has neglected to comply with The Joint Commission principles concerning patient-focused care and struggling to improve patient fulfillment scores based on Press Ganey overviews. Thus, my proposal plan will focus on the implementation of bedside shift reporting to facilitate collaboration between staff, patients, and relatives, promoting patient commitment and improve patient recognition, experience, and fulfillment. The reason for implementing the bedside shift report is basically to meet patients’ satisfaction by monitoring their wellbeing situations since they listen to their wellbeing report as medical caretakers change shifts; reduced expenses by removing additional time pay and scrubbing off legal errors which bring about lawful charges, and improving quality of health care by allowing patients and relatives to contribute their emotions on their wellbeing and that of their friends and family (Meyers, 2020).

Justification of Need

During the change of shift report, lack of proper communication has resulted in about 65% of sentinel events (Joint Commission, 2016). With healthcare’s focus shifted to patient-centered care, many concepts and proposals have come about to improve the patient experience. With my facility needing to improve upon patient experience and satisfaction, the goal for my clinical practice project was to implement a change that would positively affect all involved, including the patient and their families, nurses, and the organization.

Pre-Implementation Plan

In this proposal, I decided to use Lewin’s theory of planned change to ensure that my project implementation will be successful and achieve its primary purpose. Lewin’s Theory of Change is straightforward and execute as it centers on changing people’s behaviors. Support from the organization group and key leaders to the nursing staff during the moving and refreezing stages is fundamental for the viability and consistency of the change.

Our facility’s mission is to care, serve, and heal with a mission to provide world-class care to our patients and community. Right now, there is no standard in nurse handoffs or changes in inpatient care. Every unit unexpectedly performs shift change handoffs. During transitions in care, patients are being ignored and left unattended. Patients are avoided from accessing their plan of care, frequently not realizing what prescriptions they are on, what they are going after, where their treatment plan is going. My proposed solution to improve patient perception, experience, and fulfillment was to execute mandatory bedside shift reporting for medical attendants. The objective of the bedside shift is to promote a more patient-centered approach to care (Meyers, 2020).

When implementing the plan, education and tip sheets are to be provided to each attendant, and afterward, everyone to take an interest in bedside shift reporting for both day and night shifts. The nursing staff has to be watched, approved, studied, and assessed during shift change implementing bedside shift reporting. Direct feedback on how the patients felt about the new adjusting process, their preferences of the procedure, and what should be possible contrastingly to improve their experience during a move change has to be recorded. Lastly, I must assess the staff’s thoughts and emotions on bedside reporting and evaluate criticism from the patients with the team and make changes accordingly.

My proposal will engage different healthcare professionals such as case managers, social workers, physical therapists, physicians’ assistants, nurse practitioners, and physicians. My central organizational resource will be the Agency for Healthcare Research & Quality (AHRQ). The agency will align with my hospital’s mission of providing quality care, safer healthcare, affordable, accessible, and equitable care. Also, my plan should comply with standards highlighted by other stakeholders such as the U.S department of health and human services to ensure evidence-based care is the ultimate aim of the program (Grimshaw et al., 2016).

References

Grimshaw, J., Hatch, D., Willard, M., & Abraham, S. (2016). A qualitative study of the change-of-shift report at the patients’ bedside. The health care manager, 35(4), 294-304.

Joint Commission. (2016). Guide to Patient and family engagement in hospital quality and safety.

Meyers, S. (2020). Bedside Shift Report Improves Patient Safety.

 

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Analysis Of The Nursing Education draft

Post first draft of Capstone Project goals, content outline, and strategies for critique and input by colleagues.paste your draft of your grid from Module 3 Assignment 2 of 2 for Peer review.

Flott, E. A., & Linden, L. (2016). The clinical learning environment in nursing education: a concept analysis. Journal of Advanced Nursing, 72(3), 501-513.

Xu, J. H. (2016). Toolbox of teaching strategies in nurse education. Chinese Nursing Research, 3(2), 54-57.

Raymond, C., Profetto-McGrath, J., Myrick, F., & Strean, W. B. (2018). Balancing the seen and unseen: Nurse educator as role model for critical thinking. Nurse education in practice, 31, 41-47.

N4685 Capstone Seminar

Please review this example for the grid:

Outcomes

Content

Strategies

Time

By the end of the presentation, 98% of the audience will be able to identify three ways to prevent falls in the LTC until.

(Be sure to make any needed changes based on comments from Module 2’s graded assignment).

Fall Prevention

Doe, J. (2014). How to prevent falls in a long term care unit. Journal of Fall Prevention, 8(26), 23-32. Retrieved from ESBOhost.

Nursing Interventions

Smith, T. (2013). When a patient falls: What the nurse should do. American Journal of Geriatrics, 7(12), 23-31. Retrieved from ESBOhost.

Complications from falls in the elderly

Ying, X. (2015). What can we do to stop falls among the elderly. Journal of Fall Prevention, 10(3), 14-23. Retrieved from EBSOhost.

PPT

Lecture

Guided Discussion

15 minutes

Complete the rest of the grid as shown above.

Remember that you will need at least three references per outcome.

Complete for all outcomes

Complete for all outcomes

Below is a table that you can utilize to complete your assignment. Please remember to ask questions if you are unclear. Add as many extra rows to the grid as you need.

Outcomes

Content

Strategies

Time

References

Please write out your references in proper APA format. Your evaluation submission for your project will include a formal reference page, so this portion of the assignment will allow your coach to make comments for improvement.

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