Asthma #

Asthma

[Author]

[Institution]

Asthma

Question 1

Write about Asthma

Asthma is one of the most common respiratory disorders in the world. One in thirteen people around the world is suffering from asthma, with 25 million people suffering from this disease in America alone CITATION AAF18 \l 1033 (AAFA, 2018). Despite recent strides in the diagnosis and the management of this disorder, asthma remains one of the most poorly managed diseases. There is no treatment, and the patient has to prevent exposure to allergens in order to keep asthma-related inflammation at bay. While a number of biologic therapies are available, inhaled corticosteroids (ICS) and long-acting beta2-agonist inhalers (LABA) are one of the most frequently used preventive measures that can keep inflammation and asthma exacerbations at bay ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"kQn4iLTQ","properties":{"formattedCitation":"(Quirt, Hildebrand, Mazza, Noya, & Kim, 2018)","plainCitation":"(Quirt, Hildebrand, Mazza, Noya, & Kim, 2018)","noteIndex":0},"citationItems":[{"id":321,"uris":["http://zotero.org/users/local/5VyEEXyp/items/TJXAI2J8"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/TJXAI2J8"],"itemData":{"id":321,"type":"article-journal","title":"Asthma","container-title":"Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology","page":"50-50","volume":"14","issue":"Suppl 2","archive":"PubMed","archive_location":"30275843","abstract":"Asthma is the most common respiratory disorder in Canada. Despite significant improvement in the diagnosis and management of this disorder, the majority of Canadians with asthma remain poorly controlled. In most patients, however, control can be achieved through the use of avoidance measures and appropriate pharmacological interventions. Inhaled corticosteroids (ICS) represent the standard of care for the majority of patients. Combination ICS/long-acting beta(2)-agonist inhalers are preferred for most adults who fail to achieve control with ICS therapy. Biologic therapies targeting immunoglobulin E or interleukin-5 are recent additions to the asthma treatment armamentarium and may be useful in select cases of difficult to control asthma. Allergen-specific immunotherapy represents a potentially disease-modifying therapy for many patients with asthma, but should only be prescribed by physicians with appropriate training in allergy. In addition to avoidance measures and pharmacotherapy, essential components of asthma management include: regular monitoring of asthma control using objective testing measures such as spirometry, whenever feasible; creation of written asthma action plans; assessing barriers to treatment and adherence to therapy; and reviewing inhaler device technique. This article provides a review of current literature and guidelines for the appropriate diagnosis and management of asthma in adults and children.","DOI":"10.1186/s13223-018-0279-0","ISSN":"1710-1484","journalAbbreviation":"Allergy Asthma Clin Immunol","language":"eng","author":[{"family":"Quirt","given":"Jaclyn"},{"family":"Hildebrand","given":"Kyla J"},{"family":"Mazza","given":"Jorge"},{"family":"Noya","given":"Francisco"},{"family":"Kim","given":"Harold"}],"issued":{"date-parts":[["2018",9,12]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Quirt, Hildebrand, Mazza, Noya, & Kim, 2018).

Question 2

Write about treatment options the (LABA to ICS) /treating exacerbations

Asthma exacerbations are one of the most significant cause of illnesses associated with the disease. It usually enhances the existing inflammatory processes in asthma patients and is also known to promote loss of disease control among patients. Additionally, it also causes loss of lung function among asthma patients, along with an increase in healthcare costs. While the frequency of such exacerbations can be reduced to manageable extents, it cannot be fully treated. In order to reduce these exacerbations to manageable levels, patients are treated with ICS or a combination of ICS and LABA. This enables disease control among asthma patients and improves their overall wellbeing ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"6iyuI0OO","properties":{"formattedCitation":"(Castillo, Peters, & Busse, 2017)","plainCitation":"(Castillo, Peters, & Busse, 2017)","noteIndex":0},"citationItems":[{"id":316,"uris":["http://zotero.org/users/local/5VyEEXyp/items/C66LA7BJ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/C66LA7BJ"],"itemData":{"id":316,"type":"article-journal","title":"Asthma exacerbations: pathogenesis, prevention, and treatment","container-title":"The Journal of Allergy and Clinical Immunology: In Practice","page":"918-927","volume":"5","issue":"4","author":[{"family":"Castillo","given":"Jamee R."},{"family":"Peters","given":"Stephen P."},{"family":"Busse","given":"William W."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Castillo, Peters, & Busse, 2017).

Question 3

Discuss environmental control. What does it do to the patient with asthma?

One of the most effective measures to control Asthma-related exacerbations is through environmental control. The intervention practices frequently employed under environmental control focuses on a single allergen at a time. This limited approach helps reduce the effects of exposure to such allergens among asthma patients and even reduced the levels of asthma morbidity. Furthermore, environmental control can be easily tailored to an individual’s needs and decreases exposure to allergens that cause asthma-related inflammation. This is typically employed in a home-based environment or any place where the patient spends a lot of time ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"oOp3bhCQ","properties":{"formattedCitation":"(Castillo et al., 2017)","plainCitation":"(Castillo et al., 2017)","noteIndex":0},"citationItems":[{"id":316,"uris":["http://zotero.org/users/local/5VyEEXyp/items/C66LA7BJ"],"uri":["http://zotero.org/users/local/5VyEEXyp/items/C66LA7BJ"],"itemData":{"id":316,"type":"article-journal","title":"Asthma exacerbations: pathogenesis, prevention, and treatment","container-title":"The Journal of Allergy and Clinical Immunology: In Practice","page":"918-927","volume":"5","issue":"4","author":[{"family":"Castillo","given":"Jamee R."},{"family":"Peters","given":"Stephen P."},{"family":"Busse","given":"William W."}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Castillo et al., 2017).

References

BIBLIOGRAPHY AAFA. (2018). Asthma Facts and Figures. Retrieved from Asthma and Allergy Foundation of America: https://www.aafa.org/asthma-facts/

Castillo, J. R., Peters, S. P., & Busse, W. W. (2017). Asthma exacerbations: Pathogenesis, prevention, and treatment. The Journal of Allergy and Clinical Immunology: In Practice, 5(4), 918–927.

Quirt, J., Hildebrand, K. J., Mazza, J., Noya, F., & Kim, H. (2018). Asthma. Allergy, Asthma, and Clinical Immunology : Official Journal of the Canadian Society of Allergy and Clinical Immunology, 14(Suppl 2), 50–50. https://doi.org/10.1186/s13223-018-0279-0

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY

Asthma Disease Self-Management

RC 4216 Disease Management

Name

Institution Name

Date

Quiz 2

Asthma Disease Self-Management

WRITE three objectives for a patient to use a peak flow meter as part of the patient education in the disease self-management program.

1 Objective in the cognitive domain

Patient will be explained about the importance of the peak flow meter in handling and managing his asthma symptoms. Peak flow meter can help to prevent the asthma attack. During an asthma attack, the smooth muscles around the airways tighten up and causes the narrowing of the airways. This peak flow methods will measure the flow of how fast the air comes out of the lungs. Readings from the peak flow meter can indicate the tightening of the airways to alert the patient regarding the possibility of the asthma attack.

1 Objective in the psychomotor domain

Patient will be informed regarding the usage of the device, so that she can take readings from it easily.

1 Objective in the affective domain

Patient’s readiness will be checked and she will be motivated, through the process so that she can master the skill required to operate the peak flow meter.

Describe the role patient education has in disease self – management.

Disease self-management refers to the patient’s capability to understand and manage the symptoms, treatment, physical, psychological consequences regarding his chronic condition. It includes all the necessary changes that patients require to change his lifestyle to combat the condition.

Self-management and healthcare and disease preventive health programs focus on promoting the informed lifestyle choices, risk alteration and active patient self-management of diseases (Lorig & Holman, 2003).

Every patient should learn to manage and improve his own health by controlling his life, which can in long run reduce the healthcare costs in the form of ER visits and hospital utilizations. Patient spend huge amount of money on acquiring the treatment from professional, that costs them huge amount of money, self-management allows patients to keep their symptoms in check, thus creates ease in life, by reducing the symptoms. For Example in case of asthma, patient should be able to care for himself to reduce the severity of the asthma attack through appropriate diagnosis and increasing control over the condition (Clark et al., 1991).

Patients, who are able to manage the disease, suffer from fewer exacerbations, higher quality of life, slower progression of disease and less morbidity. Thus it is important that patients learn to manage their health conditions so that they avoid the consequences of diseases and maintain quality life.

References

Clark, N., Becker, M., Janz, N., Lorig, K., Rakowski, W., & Anderson, L. (1991). Self-Management of Chronic Disease by Older Adults. Journal Of Aging And Health, 3(1), 3-27. doi: 10.1177/089826439100300101

Lorig, K., & Holman, H. (2003). Self-management education: History, definition, outcomes, and mechanisms. Annals Of Behavioral Medicine, Volume 26(Issue 1). Retrieved from https://academic.oup.com/abm/article-abstract/26/1/1/4630312

Asthma Management

Title page

Asthma management

Self- management education is essential for the patients because it familiarizes them with the procedures that they can follow. Healthcare professionals have a responsibility to explain the steps involved in management care of asthma. This enables them to optimize their conditions of health and stability. A professional review is required for evaluating self-management of the patient’s that stresses on improving asthma control, reducing exacerbations and improving quality of life. Written personalized action plan is provided to the patient that explains the daily management strategy. Training skills allow the patient to take adequate care that will reduce the likelihood of their admission to the hospital. An important intervention for managing asthma is the use of peak flow meter. This will improve the patient's ability to assess asthma regularity CITATION The19 \l 1033 (Guilbert, et al., 2019). The frequency and severity of the symptoms are identified through appropriate use of meter.

An agreed personalized action plan is crucial for enhancing the quality of patient’s life that provides information on the use of peak flow meter. It includes the use of regular medications, recognition of deterioration and appropriate actions taken according to the need of the situation. The meter measures peak expiratory flow rate explaining if the lungs are open for airways. The peak flow meter allows the patient to recognize symptoms like wheezing and shortness of breadths. Monitoring demands identification of the symptoms of peak flows and specifying thresholds for individual actions. The evidence reveals that the healthcare providers face the challenged of non-adherence CITATION Hil15 \l 1033 (Pinnock, 2015). They need to provide information on different inhalers to the patients and regular use of steroids. The action plan is formulated after considering the severity of the disease.

Patients are advised to use the peak flow meter on a daily basis even when they feel that the asthma symptoms are not apparent. The meter provides information on the coughing, wheezing and shortness of breath. The most critical step for using the meter is to understand the readings. The patients are explained that the meter must read zero or show the lowest reading when it is not used. It is used while keeping it in a straight position. The patient before recording must take a deep breath. The peak flow meter is then placed in the mouth and the tongue is below the mouthpiece. The patient closes his lips tightly around the device. The patient is them advised to blow hard, without throwing the head out of the mouth. The patient breathes a few more times with a normal breath. This process is repeated for times and recordings are noted. An appropriate way is to note the highest number CITATION DWe04 \l 1033 (Wensley & Silverman, 2004). The procedure is repeated again if the tongue blocks the mouthpiece. If the patient experiences cough or spits the procedure will be performed again.

An important step for self-management and the use of peak flow meter is developing baseline measurement. It is important for the patient to get the right estimation of the peak flow value. This demands adequate practice for interpreting the reading. Three measurements are performed for assuring reliability of the obtained readings. The patient records the highest peak flow value as the measures are between 80 to 100 per cent. Readings that are below normal range reveals that the airway is narrowing CITATION DWe04 \l 1033 (Wensley & Silverman, 2004). This exhibits seriousness depicting that the patient must visit the doctor. The physicians suggest peak flow testing once a day during the morning. When the readings are below the required level of normal the patient is advised to consult the doctor.

References

Gilbert, T., Zeige, R. S., Haselkorn, T., Iqbal, A., Alvarez, C., Mink, D. R., et al. (2019). Racial Disparities in Asthma-Related Health Outcomes in Children with Severe/Difficult-to-Treat Asthma. J ALLERGY CLIN IMMUNOL PRAC, 9 (2).

BIBLIOGRAPHY Pinnock, H. (2015). Supported self-management for asthma. Breath (Sheff), 11 (2), 98–109.

Wensley, D., & Silverman, M. (2004). Peak flow monitoring for guided self-management in childhood asthma: a randomized controlled trial. Am J Respir Crit Care Med, 170 (606).

Atrial Fibrillation

Atrial Fibrillation

[Name of the Writer]

[Name of the Institution]

Atrial Fibrillation

Pathophysiology

Atrial fibrillation (AF) is one of the most common sustained cardiac arrhythmia that progress with age. Structural remodeling is the pathologic change that is seen in Atrial Fibrillation, referring to the progressive fibrosis of atria. This fibrosis is caused by the dilation of atria, taking into account structural abnormality that raises the blood pressure in the heart. Dilated atria refer to the activation of the renin-aldosterone-angiotensin system. It results in an increase in deposition of matrix metalloproteinase and disintegration in walls of atrial. Unlike other cells, cardiac cells are more towards self-stimulation. As the heart's ability to conduction fails, there is ectopic activity in the cardiac cells, resulting in atrial fibrillation. It is important to note that in atrial fibrillation, many of the atrial cells self stimulate, i.e., they behave as individual pacemakers competing with the sinoatrial node that has the ability to control cardiac activity. Normal atrial contraction is replaced with quivering movements that are rapid along with contraction of heart.

The lack of coordinated atrial contradictions may result in complications of atrial fibrillation, thrombi formation and heart failure. The formation of thrombi on the wall of atria and in left atrial appendage occurs when there is an ineffective emptying that allows blood to get pooled by these chambers. This emptiness is usually referred to as mural thrombus, these clots have the potential to dislodge and cause strokes along with other systematic thrombo-emboli. The lack of atrial contradiction may result in less blood that is entering and leaving left ventricle. (Pritchett, et, al. 2019).

Disease Classification

Atrial Fibrillation is categorized by the duration and frequency of the episodes that are further classified into five other categories such as persistent, long-standing persistent, paroxysmal, nonvalvular and permanent. It is significant to note that a patient can have both persistent and paroxysmal episodes. The categorization has an implication on the various treatment procedures such as catheter ablation and therapy decisions that refer to the medicines that are indicated for the patient.

It is important to note that atrial fibrillation occur in different clinical circumstances. Primary arrhythmia refers to the absence of the identifiable structural cardiovascular disease. Secondary arrhythmia refers to the absence of any structural heart disease however there is a presence of systematic abnormality that predisposes an individual to arrhythmia. It is significant to note that secondary arrhythmia is associated with the cardiac disease that can affect atria. (Pritchett, et, al. 2019).

There are three major types of atrial fibrillation, chronic, acute and lone/ primary.

Acute

It has an onset referring to 24-48 hours of the causative events, and it converts spontaneously or in response to an antiarrhythmic agent. It occurs in individuals who are although normal clinically but they have a temporary change in their conitiodoins.

Chronic

It is paroxysmal and one of the most debilitating forms of Atrial Fibltaion because it has an abrupt onset. Chronic Atrial Fibrillation may be permanent or persistent, taking into account the required intervention by cardio version to sinus rhythms.

Lone

Lone or primary Atrial Fibrillation occurs in the absence of any other clinical evidence that can suggest a primary cardiac disorder.

Signs and symptoms

Atrial Fibrillation is one of the most common types of irregular heartbeat. There are several people whose symptom of Atrial Fibrillation goes undetectable until a physical examination is made. While, many of the patients experience symptoms such as pain and irregular heartbeat, thumping of chest, general fatigue, shortness of breath and anxiety along with sweating. One of the most common symptoms is dizziness, weakness, and pressure on the chest. (Smeltzer, et, al. 2008).

Risk Factors

There are several risk factors of Atrial Fibrillation, such as

Age

Age is one of the risk factors; old people are more prone to Atrial Fibrillation. People above 60 years of age are more likely to get heart disease, ultimately paving the way for the causing condition of AF. (Smeltzer, et, al. 2008).

Pulmonary Embolism

Pulmonary embolism refers to a blood clot in the lungs, and it is one of the risk factors of Atrial Fibrillation.

Hypertension

Exposure to long term blood pressure can pave the way for strain in the heart, and it can increase the risk of Atrial Fibrillation. (Pritchett, et, al. 2019).

Heart Disease

Patients having a history of heart valve disease, coronary artery disease, heart failure, and any previous heart attack can increase the risk of Atrial Fibrillation

Family members with AFib

Genetic factors also play a major role in causing Atrial Fibrillation.

Excessive consumption of alcohol

Men who are taking more than two drinks each day and women who are taking more than a single drink each day are at a risk of becoming a victim of Atrial Fibrillation

Sleep Apnea

Sever condition of sleep apnea can cause Artal Fibrillation.

Chronic Conditions

Long term chronic conditions such as asthma, obesity, thyroid problems, and diabetes can act as primary risk factors for atrial fibrillation

Surgery

Surgery can become a risk factor for the subject disease because a patient after receiving heart surgery can become threatening to atrial fibrillation. (Boriani, et, al. 2018).

Medical Interventions

Atrial Fibrillation can be controlled by managing anticoagulation and heart rate along with rhythm control. It is significant to note that medical interventions are highly dependent on the degree of symptoms, along with successful cardioversion and presence of comorbidities. It also includes AF ablation, i.e. catheter-based pulmonary vein electric isolation and surgical ablation. Restoration of sinum rhythm along with regularized heart rhythm is one of the tools to improve cardiac hemodynamics and exercise. (Lin, et, al. 2019). The maintenance of atrial contraction in order to manage the symptoms of heart failure and remodeling of ventricular taking into account restoration of sinus rhythm or in some cases left ventricular dysfunction and reversed atrial silaton with new onset of AF is also an effective medical intervention. The intervention of embolism with anticoagulation therapy is also one of the potent medical interventions. It is significant to note that the priorities of the treatment are highly dependent on the patient ability to tolerate the heart rhythm. The control of heart rate is usually made with chemical cardioversion, while atrial contraction is delayed by having a follow up with the return of atrial activity. (Smeltzer, et, al. 2008).

Nursing Interventions

As the main goal of intervention is to maintain and stabilize cardiac output and perfusion of tissues, it is important to ensure that the patient does not develop thromboembolism. The medical team should be vigilant enough to be notified whenever the heart rate of the patient is rapid and when the systolic blood pressure is less than 90mmHg. Nurses incorporate emergency cardioversion that is required for hemodynamic compromise. It refers to the explanation of the procedure to the patient and to reassure the patient. Careful positioning of the patient is taken into account in order to avoid an excessive exacerbating to the current condition. It is the duty of the nurse to keep patient in a semi-recumbent position, avoiding lying flat because it can increase pre-blood load or the rate of returning blood to the heart, because it refers to an increased danger to heart failure. If the patient feels breathless, nurses impart oxygen. (Boriani, et, al. 2018).

Nursing Diagnosis

The nursing pattern for a patient suffering from Atrial Fibrillation refers to the diagnosis of three main concerns, anxiety, and decreased cardiac output and decreased activity tolerance. (Pritchett, et, al. 2019).

Anxiety and Fear

It refers to the condition when the patent is experiencing a paroxysmal onset; taking into account a fear that threatens dysrhythmia and a refusal to participate in self-care, coordination with the doctor and taking the consent form the doctor. In such a stance, the responsibility of the nurse is to assess the patient in coping strategies and the ability to cater to the situation. It also includes an assistance of the patient in the identification of problem and teaching patient about the medical diagnosis such as pathophysiology, treatment, cardiovascular management, and other treatments, Nurses usually suggest inner relaxation techniques to cater to the patient’s concerns. (Boriani, et, al. 2018).

Decreased activity tolerance

Another subject associated with nursing intervention is, the assessment of cardiac status that is prior to activity and the involvement of viral that are prior to the activity, taking into account the provision of baseline status of heath and cardiovascular stance. Nurses observe and document the tolerance activity of the patients; it is also accompanied by the assessment of exacerbation of dysthymia during the activity. (Pritchett, et, al. 2019).

Decreased Cardiac Output

It is related to the loss of atrial kick, taking into account fibrillation. Some of the major symptoms include a decrease in blood pressure, chest pain, and dyspnea. In such a case, there is a continuous monitoring of EKG, an assessment and documentation of vital physical symptoms. A nurse maintains at least one patient IV and supplemental O2. (Boriani, et, al. 2018).

Nursing Implication

Nursing implication refers to the improvement of the patient’s outcomes, taking into account the patient education and care coordination that are effective for disease management. (Smeltzer, et, al. 2008).

Nursing Prevention

It is necessary for nurses to stratify the risk associated with the patient in order to determine the risks, and benefits that are well suited for the patients. It refers to the use of certain tools that can participate in risk stratification. One of the potent tasks is to adopt for stroke prevention for the patient who is suffering from nonvalvular atrial fibrillation, assessment of the anti-thrombi agent’s measurement of the contradictions that are mandatory to chronic antithrombotic therapy. Nursing prevention also includes an assessment of the safety concerns that are associated with drug and antithrombotic gannets. Patient education is one of the undeniable section of the nursing preventions that should be adopted in order to address the needs of the patients. It also includes the management of bleeding. It is significant to note that a nurse is committed to address the discontinuation of the therapy for surgery and other procedures in accordance with the body’s requirements, taking into account the elective surgery and invasive procedures. Nurses take into account the schedules regarding low risk of bleeding and the medication should be stopped prior to surgery. (Boriani, et, al. 2018).

Nursing Interventions

There are certain interventions that are adopted by nurses. It would not be wrong to say that there is a systematic inflow of interventions. (Pritchett, et, al. 2019).

ECG

One of prime intervention is to obtain a 12 lead ECG that is then used to identify and diagnose atrial fibrillation. It is important to note that the waves are more random and chaotic and the beats are irregular.

Potential Rhythm Control

Nurse infers potential rhythm control, adhering to ablation, electrocardoversona, and pacemaker. Electrocardioversion is used to register the heart’s electricity and pacemaker is placed under the skin that is capable to sending electrical signals to the heart to make it possible for heart to beat it with the right rhythm and pacemaker. (Lin, et, al. 2019).

Heart Rate Control

Nurses use beta-blockers and calcium channel blockers in order to sustain rapid breathing for so long before it tries out. The purpose of blockers is to maintain the rate of heartbeat. The aim of these blockers is to block the Na + and K+ channel in cardiac myocytes. When the channel opens, K+ moves into the cell, and Na+ moves out of the cell also called reploralization. This procedure refers to the relaxation of heart beat. However, when it is blocked there is an increased contraction of heart.

Anticoagulants Therapy

Thinning of the blood supports the disintegration and breakup of the clot that facilitates the increase in blood flow. There are many other options for blood thinners, and each of it has its own pros and cons.

Education

It is the duty of the nurse to educate the patient about blood thinner, taking into account the risk of bleeding out if there is a hit or fall in the head. Environmental hazards are also taken into special consideration such as eliminating throw rugs and adequate lightning system. In case, a patient experience a fall and hit, there should be a quick intervention of ER.

Stroke Education

As there is a risk of blood clotting in the head and brain of the patient, a nurse teach the patient and his family members about significant signs and symptoms of stroke.

Cardiac Enzyme Monitoring

A nurse keeps a check on the initial measurement of enzymes, as it helps in the trending information, taking into account trending results over time. (Boriani, et, al. 2018)

Nursing Outcomes

Nursing outcome refers to the desired results and outcomes taking into account the successful interventions. There are certain outcomes that are assumed such as decreasing the risk of clot formation, bringing heartbeat within the normal limits and controlling the rhythm of heart. One of the ultimate outcomes of the nursing intervention is to bring normal sinus rhythm because there are many people who are living with atrial fibrillation, considering the fact that rhythm control doesn't work or it is not necessary. (Smeltzer, et, al. 2008).

Age Considerations

Atrial Fibrillation vary with age factors, taking into account medical an nursing interventions

Gerontologic patients

Atrial fibrillation is one of the most common diseases in elderly patients. Usually, elderly patients suffering from the subject disease are treated with a comprehensive assessment that includes functional, social and comorbidities status. Anticoagulation therapy is usually used, using both conventoanland newer medications. Percutaneous left atrial appendage closure is one of the invasive procedures that is evolved and is used as an alternative to the systematic anticoagulation therapy. Invasive methods include catheter ablation that is used as a new frontier of treatment to maintain even sinus rhythm. (Lin, et, al. 2019).

Pediatric patients

Atrial fibrillation is much rare in children, however, the procedure of assessment, and diagnosis is much similar to adults. Usually, EKG or ECG is used as a test to record and create the electrical pattern of the heart. Electrophysiology and stress test is used to adhere to the normal functioning of the heart. Heart monitors are applied to trace the activity of heart. Medication is used by the doctor to treat atrial fibrillation, taking into account that the child faces the risk of atrial and pulmonary embolism much like adults. (Smeltzer, et, al. 2008).

Diagnotic Labs

There are two “lab diagnosis” involved in Atrial Fibrillation, Electrocardiogram and Holter Monitor (Lin, et, al. 2019).

Electrocardiogram

It is a painless test involved in the diagnosis of AFib. It records the heart’s electrical activity, taking into account the speed of heartbeat. It traces the rhythm of heartbeat, strength and timing of electrical signals that are passing through the heart. A doctor or technician place small patches on the areas of the body including the chest, these patches signal the wave pattern, portraying the picture of the heart.

Holter Monitor

This device is used to record the electrical activity of heart. The timing ranges from 24 to 48 hours giving a better chance of picking up the normal heartbeat also known as arrhythmia. (Boriani, et, al. 2018).

Medications

Medications

Classification

Dosage

Route

Indication

Contraindication

Side Effects

acebutolol

Beta-blocker

(adult)

200 mg twice per day, an increased dosage requires 600 mg taken twice per day

(Child)

Not recommended for children

Oral capsule

Acebutolol is used to treat hypertension and high blood pressure as well as an irregular heartbeat.

(null)

Ceratin common side effects are slower heartbeat, diarrhea, tiredness, constipation, upset stomach and muscles aches or pains. Serious side effects are tiredness, fainting poor circulation, erectile dysfunction, depression, and liver damage.

pindolol

Beta-blocker

Pindolol is usually recommended as a 5 mg dose alone or in combination with other antihypertensive agents. Inconsistent disease there is an increase up to 10 mg/day taking into account that it may increase up to 60 mg/day

Intravenous route

Management of edema, atrial fibrillation, hypertension, and ventricular tachycardias.

Pindolol in counterindication in patients with hypersensitivity to a drug or any of its excipients, asthma, second and third-degree heart attack and severe bradycardia.

Drowsiness, nausea, dizziness weakness and reduction of blood flow to hands and feet. There is a risk of heart failure, nervousness, muscle pain, abdominal discomfort, bradycardia, and lethargy.

References

Boriani, G., Glotzer, T. V., Ziegler, P. D., De Melis, M., Stefano, L. M. D. S., Sepsi, M., ... & Camm, A. J. (2018). Detection of new atrial fibrillation in patients with cardiac implanted electronic devices and factors associated with the transition to higher device-detected atrial fibrillation burden. Heart rhythm, 15(3), 376-383.

Lin, Y. J., Lin, C. Y., & Chen, S. A. (2019). Ablation of persistent atrial fibrillation and beyond. Current opinion in cardiology, 34(1), 16-22.

Pritchett, R. V., Bem, D., Turner, G. M., Thomas, G. N., Clarke, J. L., Fellows, R., ... & Jolly, K. (2019). Improving the Prescription of Oral Anticoagulants in Atrial Fibrillation: A Systematic Review. Thrombosis and hemostasis, 119(02), 294-307.

Smeltzer, S. C., Bare, B. G., Hinkle, J. L., & Cheever, K. H. (2008). Textbook of medical-surgical nursing (Vol. 2). Wolters Kluwer Health.

Autonomy And Ethical Principles Of Care

Autonomy and Ethical Principles of Care

Name

Affiliation

Date

Autonomy and Ethical Principles of Care

Autonomy and ethical principles of care hold great importance in the field of nursing and healthcare. The autonomy or self-determination of the patients also holds great importance in the field of nursing and healthcare. The laws and ethics of the healthcare institution provide the patients with the opportunity of making the decisions about their health, treatment procedures and other major and minor issues. Based on the learning about the individual’s right to self-determination and autonomy, I believe that the basic patient consent form informs the patients in an adequate manner, about their medical rights. It informs the patients about the treatment options, the risks of the treatments, the care plan after the treatment, as well as the precautions that the patients have to follow during the procedure of treatment (Abushov, 2015).

The average person would not understand the basic consent form for Laparoscopic Cholecystectomy in the United States with a reading ability of a typical 8th grader. The reason behind this is that the form has used the medical terminology, consisting of words like incision, prognosis, and endoscope, etc. which cannot be understood by the common population. The people, who do not have advanced knowledge about the medical profession, would not be able to understand the form without the guidance of healthcare staff (Kennard, 2016).

The three steps that the healthcare providers can take to ensure the understanding of the patients regarding their care procedure and consent include the recognition of the rights of patients, not influencing the decision of patients and informed consent (Campbell, & Parsi, 2017).

Keeping abreast with health care trends and issues is one of the most important demands of the nursing profession. The healthcare professionals have to stay informed of the modern laws, ethics and other medical communication, in order to incorporate it into their practice and avoid any kind of problematic scenario.

References

Abushov, K. (2015). Autonomy as a Possible Solution to Self-determination Disputes: Does It Really Work? International journal on minority and group rights, 22(2), 182-201.

Campbell, K., & Parsi, K. (2017). A new age of patient transparency: an organizational framework for informed consent. The Journal of Law, Medicine & Ethics, 45(1), 60-65.

Kennard, D. K. (2016). Health literacy concepts in nursing education. Nursing education perspectives, 37(2), 118-119.

“CHRONIC RENAL FAILURE: Prevention/treatment In Diabetic Patients”

“Chronic Renal Failure: Prevention/Treatment in Diabetic Patients”

[Name of the Writer]

[Name of the Institution]

“Chronic Renal Failure: Prevention/Treatment in Diabetic Patients”

Introduction

Medical specialists encounter various sorts of medical issues on a daily basis. Some of them are simple and are solved very easily whereas some are very complicated and require extensive research and deep understanding to solve them; chronic renal failure is one of them. Chronic Renal failure, or more commonly known as chronic kidney failure is a complicated medical issue related to the kidneys and the excretory system of the body. It refers to long term damage to the kidney where the patient’s kidneys fail to perform their function normally and have to be assisted with the help of artificial means to work properly (Parving, 2001). In some cases, the artificial means work properly but if the problem persists, the main organs, i.e., kidneys, can fail to function altogether. This stage is called end-stage renal disease (ESRD) or, in simple words, kidney failure. At this stage, a patient requires dialysis or kidney transplant as a last resort to live.

This risk of kidney failure increases to multiple folds if the patient is suffering from some other medical complication as well such as diabetes. Diabetes Mellitus increases the risk of kidney failure in the patient. The patients having diabetes or a diabetic history are at a higher end of having chronic renal failure or kidney disease as well, but this is not the end. Diabetic patients can significantly reduce this risk and prevent these symptoms of chronic renal failure by taking proper preventive measures and taking regular medications with the ongoing treatment of Diabetes Mellitus.

Discussion

Kidneys perform the function of filtering wastes and excess fluids from the blood and ultimately excreting it out of the body via urine. Dangerous levels of wastes, fluids, and electrolytes can build up in the body if the kidneys fail to perform this function. The issue becomes more serious and severe if some other medical issue of complication already exists ion the patient’s body. One of the examples is the presence of Diabetes Mellitus. Diabetes mellitus, or more commonly known as Diabetes, is a medical condition in which the body fails to produce enough insulin or make use of the already present normal amounts of Insulin properly. Insulin is a hormone that regulates the amount of sugar or glucose in the bloodstream of the body. If the blood sugar level is high, it can cause serious problems in the body.

Diabetic patients have a high risk of having chronic kidney disease or chronic renal failure at an earlier or most probably at a later phase of their disease. It is one of the leading causes of kidney diseases, especially in adults (Nasri, & Rafieian-Kopaei, 2015). As per experts, every 1 out of four adults having diabetes mellitus is also suffering from kidney disease as well. Only in the United States, an estimated 30 million people are suffering from chronic renal disease, out of which 70 -75% are the patients of diabetes.

Causes:

Diabetes can injure the small blood vessels in the body after weakening them,, which makes it hard for the kidneys to clean and purify the blood passing through them. It will bring swelling on the ankles and a gain in weight, as the body will retain more water and salt than it should, the urine will have a large quantity of protein and waste materials will be accumulated in the body.

Diabetes can also bring damage to the nerves in the body, which can result in malfunctioning of the urinary bladder. As a result of the pressure coming from a full bladder, the nerves and blood vessels of the kidneys can be damaged. Moreover, if the urine stays for a longer period in the bladder, it can result in an infection which may cause a high level of sugar in the body.

Prevention:

The best way to prevent chronic renal failure or kidney disease in a patient having diabetes as well as through proper diet and adopting a healthy lifestyle. By properly regulating and controlling the diet patterns and keeping a check on the blood pressure on a daily basis, a diabetes patient can control and prevent kidney diseases (Banach, et. al, 2014). Here are some preventive measures that a diabetes patient can take to reduce the risk of renal failure:

By limiting the use of salt in the diet or keeping a low-salt or low-fat diet.

By adopting a routine of exercise of at least 30 minutes daily.

By keeping a check at blood pressure on a daily basis and preventing high blood pressure.

By eliminating the use of tobacco completely.

By limiting the use of alcohol.

By visiting the doctor regularly for regular medical checkups.

Treatment

The symptoms of chronic renal failure in a diabetic patient can be treated by using the following three methods or techniques of treatment:

Hemodialysis

Peritoneal Dialysis

Kidney Transplantation

Conclusion

In short, it can be seen that chronic renal failure or kidney failure is a serious disease that can also prove to be fatal, if not treated properly and on the proper time. The risk of having a kidney disease increases multiple times if the patient is also suffering from Diabetes Mellitus already, but it can be prevented and treated by bringing some simple changes in lifestyle. The risk of chronic renal failure can be controlled in a diabetes patient by keeping a check on daily diet and maintaining a healthy lifestyle. Moreover, it can also be treated by hemodialysis, peritoneal dialysis, and kidney transplant.

References

Banach, M., Serban, C., Aronow, W. S., Rysz, J., Dragan, S., Lerma, E. V., & Covic, A. (2014). Lipid, blood pressure and kidney update 2013. International urology and nephrology, 46(5), 947-961.

Nasri, H., & Rafieian-Kopaei, M. (2015). Diabetes mellitus and renal failure: Prevention and management. Journal of research in medical sciences: the official journal of Isfahan University of Medical Sciences, 20(11), 1112.

Parving, H. H. (2001). Diabetic nephropathy: prevention and treatment. Kidney international, 60(5), 2041-2055.

“Four Topics Approach” To Ethical Decision Making

Four Topics Approach

[Institutional Affiliation(s)]

Author Note

Case Study

Emile Nighthorse is a 77-year-old man who has been hospitalized on a ventilator with a serious kidney disease that will require him to have dialysis indefinitely. Additionally, he has severe dementia and he does not understand his condition or even where he is. The physician has determined that his dementia is getting more severe and he is showing signs of multi-system failure. It is unlikely, he will ever be stable enough to be discharged from the hospital but that he will likely live another few months on a ventilator.

There is no ‘Advance Directive’ and no evidence of his wishes. He has an estranged wife of 50 years and 2 children, all of whom live in another city. He has an adult friend, Ben, who visits him daily and have been close friends since his wife left 10 years ago. Ben asks the physician to discontinue dialysis and the ventilator. The wife says she doesn’t care but the children insist everything should be done. To save their father, neither of which are willing to come to the hospital to visit him. What does the physician do?

TABLE 2-1 Four Topics Method for Analysis of Clinical Ethics Cases

Medical Indications: The Principles of Beneficence and Nonmaleficence

What is the patient’s medical problem? Is the problem acute? Chronic? Critical? Reversible? Emergent? Terminal?

The condition of the patient is chronic and is non-curative.

What are the goals of treatment?

The treatment is aimed to achieve the maintenance of the patient (Toh et al., 2018).

In what circumstances are medical treatments not indicated?

Physiological conditions refer that the condition is non-curative.

What are the probabilities of success of various treatment options?

The probabilities of success of the treatment are scientific and ethically it is futile.

In sum, how can this patient be benefited by medical and nursing care, and how can harm be avoided?

The treatment of the patient is aimed to achieve the maintenance of the patient and to save a life.

Patient Preferences:  The Principle of Respect for Autonomy

Has the patient been informed of benefits and risks, understood this information, and given consent?

The patient was informed and the consent was conveyed, though it has to be decided by the decision-maker (Toh et al., 2018).

Is the patient mentally capable and legally competent, and is there evidence of incapacity?

The patient has been suffering from dementia and is not mentally competent.

If mentally capable, what preferences about treatment is the patient stating?

Not applicable

If incapacitated, has the patient expressed prior preferences?

The patient has expressed the preferences to the friend.

Who is the appropriate surrogate to make decisions for the incapacitated patient?

Usually, a wife and children are surrogate to make decisions for incapacitated patients (Toh et al., 2018).

Is the patient unwilling or unable to cooperate with medical treatment? If so, why?

The patient is incapacitated therefore, medical treatment is being decided by the relatives and physicians (Toh et al., 2018).

Quality of Life: The Principles of Beneficence and Non-maleficence and Respect for Autonomy

What are the prospects, with or without treatment, for a return to normal life, and what physical, mental, and social deficits might the patient experience even if treatment succeeds?

With or without treatment, no wishes are being displayed by the patient. The children want to continue the treatment for the betterment of the patient's life (Pozgar, 2019). Shortfalls may be observed to be severe conditions of dementia and kidney disease may also proliferate.

On what grounds can anyone judge that some quality of life would be undesirable for a patient who cannot make or express such a judgment?

There were no patient’s desires and preferences shown. The children can judge that the treatment given was appropriate or not. Lastly, the physicians applying the principles of non-maleficence would result in no harm by the treatment (Toh et al., 2018).

Are there biases that might prejudice the provider’s evaluation of the patient’s quality of life?

Ethically, physicians can terminate treatment however, the physician in the cases where the patient has no neurological responses may ignore the preference of the patient.

What ethical issues arise concerning improving or enhancing a patient’s quality of life?

Ethical issues such as no important and noteworthy goal other than maintenance are existing in this state. The patient is mentally incapacitated whose preferences are not expressed, so physicians are acting for the best recommendations as per law.

Do quality-of-life assessments raise any questions regarding changes in treatment plans, such as forgoing life-sustaining treatment?

Life-sustaining treatment plans are preferred by the physicians however if the result is futile, physicians are no longer under obligation to initiate or continue the management of the patient (Toh et al., 2018).

What are the plans and rationale to forgo life-sustaining treatment?

First of all, the patient's desires and preferences are favored unless the patient is mentally incapacitated. Physicians can terminate the treatment if the result is negative and if there is no hope of recovery (Pozgar, 2019). However, some laws allow the patient and physician to intervene in the treatment plan.

What is the legal and ethical status of suicide?

It is legally allowed in various countries and states including but not limited to California, Colorado, New Jersey and Montana. It is still not permitted legally in other than 9 states.

Contextual Features: The Principles of Justice and Fairness

Are there professional, inter-professional, or business interests that might create conflicts of interest in the clinical treatment of patients?

If the patient has some legal surrogate then he/she can conflict in decision making (Pozgar, 2019).

2.  Are there parties other than clinicians and patients, such as family members, who have an interest in clinical decisions?

In case the patient is mentally incapacitated then physicians and the relations can decide on behalf of the patient keeping the ethics of beneficence and no-maleficence (Toh et al., 2018).

What are the limits imposed on patient confidentiality by the legitimate interests of third parties?

The Health Insurance Probability and Accountability Act 1996 includes the standards, possibility and limits of privacy. Physicians may share the registers for discussion while managing without patient approval. The HIPPA does not deliberate the validity of sharing private material with other individuals at risk.

Are there financial factors that create conflicts of interest in clinical decisions?

Patients social and financial state is very important in making decisions such as non-affordability of expensive procedures recommended by the physicians may not be incorporated by the patients due to lack of financial resources (Bryan et al., 2019).

5.  Are there problems of allocation of scarce health resources that might affect clinical decisions?

Non-availability of funds to carry out clinical procedures such as surgeries in the critical care units. No availability of appropriate equipment, skilled staff and professions also affect the clinical decisions. If a therapy necessary for the patient is not available in the facility, the nurses or the professions may not be able to accommodate the patient and its outcome in loss of life.

6.  Are there religious issues that might influence clinical decisions?

The difficulty of education related to faith and religiousness in health care practice expresses to the statement that patient and physician morals can occasionally interconnect in a way that clues up to clash and ethical distress (Bryan et al., 2019).

What are the legal issues that might affect clinical decisions?

Numerous decisions such as decisions by the court including the legal permission of assisted suicide may encounter within patient and doctor. The doctor may or may not be willing to accept the decision but it limits him to follow the legal instructions (Pappas, 2015).

Are there considerations of clinical research and education that might affect clinical decisions?

Some studies have proved that the education, awareness and the research have a profound effect on the quality of life of a patient and it helps in prompt recovery.

9.  Are there issues of public health and safety that affect clinical decisions?

Yes, various decisions such as conflicts of interest exist for example, when a hospital facility allows for an abortion or other clinical procedure and the surgeons are not willing to do so. If a patient does not aware of the disease and the treatment and desired to retain the condition that may become fatal for the person.

10.  Are there conflicts of interest within institutions and organizations (e.g., hospitals) that may affect clinical decisions and patient welfare?

The risk occurs when independent witness would enquire whether surgeons are excessively influenced by reflections of noteworthy particular interest.

Conclusion

The decision making is directly linked with the policies and the standards of a healthcare facility. The four topics method is an effective and well-organized technique for the physicians and the nurses to decide the illnesses of the patient (Toh et al., 2018). As it has been shown that the decision making is affected by the socio-economic status of the patients, rules of a healthcare facility, court decisions and the treatment plans (Pozgar, 2019). The four topics method is an operative strategy in the healthcare facilities to improve the health of the patient. It effectively describes the principles of the beneficence, justice and the non-maleficence in healthcare decisions.

References

Pozgar, G. D. (2019). Legal and ethical issues for health professionals. Jones & Bartlett Learning.

Toh, H. J., Low, J. A., Lim, Z. Y., Lim, Y., Siddiqui, S., & Tan, L. (2018). Jonsen’s Four Topics Approach as a Framework for Clinical Ethics Consultation. Asian Bioethics Review, 10(1), 37-51.

Pappas, S. C. (2015). Ethical issues in end-stage liver disease: a framework for assessment and the challenges. In Complications of Cirrhosis (pp. 347-353). Springer, Cham.

Bryan, D. S., & Angelos, P. (2019). How to Solve Ethical Conflicts in Everyday Surgical Practice: A Toolbox. In Surgical Ethics (pp. 305-311). Springer, Cham.

Bariatric Surgery

Bariatric Surgery

Name of the Writer

Name of the Institution

Bariatric Surgery

Introduction

Bariatric surgery is a medically administered weight loss method mainly aimed for those patients who suffer from the condition of obesity or morbid obesity. There are four kinds of bariatric surgeries, adjustable gastric band, sleeve gastrectomy, biliopancreatic diversion with duodenal switch and gastric bypass. Biliopancreatic diversion with duodenal switch is the one which bound one's diet consumption and, in some circumstances, modify the digestive systemic and standard function. Gastric bypass is the most frequently used bariatric operation around the world, according to the ASMBS (Kim, 2015). Gastric operation and other categories of weight-loss surgeries are done in the hospital, and general anesthesia is used for the procedure. The particulars of the bypass depend on the patient's condition, the sort of weight-loss operation performed, and the treatment center or health professional practices. Certain weight-loss operations are done with traditional large, or open, incisions in the patient's abdomen. Nowadays, most bariatric surgeries are executed laparoscopically. A laparoscope is a small, tube-shaped apparatus with a camera. The laparoscope is injected via minor incisions in the abdomen. The tiny camera on the slope of the laparoscope permits the physician to see and operate inside the patient's stomach without making the outdated massive cuts. A laparoscopic operation can make the recovery process shorter and faster, but it's not appropriate for every person.

Recovery time from these techniques differs from patient to patient. But it might take several months for a patient to recommence their regular day-to-day activities after operation, and most patients will have to follow a fluid diet and come to conventional foods gradually. Given the developments made in the field, weight loss surgical procedure is presently conducted using minimally offensive methods. Each type of bariatric surgery has advantages and disadvantages, and it is strongly recommended that the patient talks to the specialist about them.

Surgical weight loss techniques have been continuously progressing since the times they were developed around the 1970s. Modern technologies are now considered to be reasonably safe; however, there are also a series of hazards and possible impediments that need to be recognized by a patient before deciding, as various bariatric surgical processes carry different levels of danger.

Discussion

Surgical treatment is usually the last means after the failure of other possibilities such as diet regimen and workout, pharmacotherapy or pre-packed meals. The most suitable process is a choice made by both the doctor and patient, taking comorbidities into consideration, Index and other individual characteristics as well. The key advantage of the surgical procedure is the faster, more natural weight loss; nonetheless, patients need to make specific changes in their food intake and routine actions.

The sort of weight-loss surgical treatment that is best depends on the patient's precise condition. The physician will take several elements into account, comprising your BMI (body mass index), eating habits, health issues, any previous operation and the dangers of each process. Bariatric surgery denotes a series of weight loss techniques that an overweight individual can have to lessen their food consumption, hence triggering weight loss. An individual is classified as obese if their BMI is above 30. If the BMI is above 40, they are considered severely obese. Since the 1960s, obesity in the United States has more than doubled up, and this has provoked an increasing figure of people to pursue weight loss treatments.

Before bariatric surgery, an individual may need to have several lab examinations and tests. One eating and drinking and prescriptions may get restricted before and after the surgery. Some individuals may be required to start a physical activity program and to put a break to any tobacco use. The operation typically takes some hours. After the operation, medical team observers the patient for any complications and the stay may last from for a week or less (Bray et al., 2016). Gastric banding is viewed as the safest weight loss process, due to its negligible invasiveness and the fact that the stomach is not transformed, but is reduced with the use of a band that wraps around the organ and therefore, no severe risks are present since no cut is made.

Bariatric surgeries do contain potential health threats, initially with adversarial responses to general anesthesia. Post-surgery, excessive blood loss, contamination and blood accumulations may also follow as part of operation hitches, likewise to lung or inhalation difficulties. There is also the probability of leaks in the gastrointestinal system. Added surgeries may be needed to adjust reposition or remove the band in the situation of adjustable gastric banding nonetheless; these are typically negligibly invasive and insignificant. Additionally, to the risks linked with the process itself, other difficulties may negotiate a patients' well-being in the long-term. Bowel blockade and dumping disorder may be developed as a consequence of the modifications in the digestive structure. Hernias, Gallstones, and ulcers are also threats that can result from the surgical process. Moreover, hypoglycemia (low blood sugar) and malnourishment may be concerns of the surgery. There is the infrequent, but existent, the likelihood of death. The study "Bariatric Surgery: Risks and Rewards,” discovered that weight loss operations are safe and that their benefits are more substantial than their threats (Spittal & Frühbeck2018).

As the Bariatric bypasses do possess an array of possible difficulties and some threats to the patient, but medical specialists say the benefits far overshadow the wellbeing dangers linked to obesity. For instance, a side effect of gastric banding may implicate enlargement of the food pipe (esophagus) if the patient overeats. Therefore, patients are supposed to stick to a steady diet for the remaining of their lives and have consistent follow-up appointments after their operation or surgery. Gastric bypass can also lead to lasting mineral and vitamin deficits, and so patients need to have regular supplementation as a consequence. It is suggested that females who have gone through weight loss operation, it is more probable that they have children who are small in size for gestational age.

The development of new technology is changing not only operational processes but also the approaches to answer these complications and post-operational hazards. Some researchers have noted the significance of endoluminal methods, a practice that is being considered and may aid in decreasing the risks that are linked with bariatric surgery.

Conclusion

Like all other surgeries, bariatric surgeries have threats and benefits to reflect. For some people, having a bariatric bypass, such as gastric bypass, is beneficial. For a dedicated patient who wants to be healthy and let go of bad eating and drinking habits, these weight loss treatments are useful instruments for dropping weight that in normal circumstances is not possible for them or which need immediate attention. These treatments have also displayed to be effective at decreasing the impact of numerous obesity-related disorders, for example, heart diseases, type 2 diabetes and sleep apnea. To reduce the risks of one's bariatric operation, people need to do the following:

Reduce your BMI (Body Mass Index)

Increase the amount of workout or exercises

Stop smoking

The risks may vary with each patient, and it is, therefore, essential to do your homework before going to surgical treatment and have sensible anticipations about what your life will be after the operation. It often aids if one speaks with somebody who has had bariatric surgery to get neutral understandings. Many doctors will give the patients approximately three or more months to get ready for the physical and psychological deviations that might be experienced ahead.

References

Bray, George A., Gema Frühbeck, Donna H. Ryan, and John PH Wilding. "Management of obesity." The Lancet 387, no. 10031 (2016): 1947-1956.

Kim, J., Azagury, D., Eisenberg, D., DeMaria, E., & Campos, G. M. (2015). ASMBS position statement on prevention, detection, and treatment of gastrointestinal leak after gastric bypass and sleeve gastrectomy, including the roles of imaging, surgical exploration, and nonoperative management. Surgery for Obesity and Related Diseases, 11(4), 739-748.

Spittal, M. J., & Frühbeck, G. (2018). Bariatric surgery: many benefits, but emerging risks. The Lancet Diabetes & Endocrinology, 6(3), 161-163.

Bariatric Surgery

Bariatric Surgery

[Name of the Writer]

[Name of the Institution]

Bariatric Surgery

Obesity is a crucial health issue in America. It can lead to other health issues like diabetes, stroke, heart disease, hypertension, eating disorder and sometimes cancer. Different medical interventions like bariatric surgery are used to reduce the fats from the body. Offering bariatric surgery to individuals suffering from psychiatric disorders can be beneficial. Due to obesity, individuals lose self-esteem, confidence, and face various psychological disorders like anxiety and eating disorder. Bariatric surgery not only helps in reducing weight but also improves psychological health because it results in weight loss along with resultant gains in body image. The patient takes staff support and feels the sense of taking control of his life which increase confidence and self-esteem in the patient ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"C99Xwn5T","properties":{"formattedCitation":"(Yen, Huang, & Tai, 2014)","plainCitation":"(Yen, Huang, & Tai, 2014)","noteIndex":0},"citationItems":[{"id":852,"uris":["http://zotero.org/users/local/mlRB1JqV/items/UZSNJCJC"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/UZSNJCJC"],"itemData":{"id":852,"type":"article-journal","title":"Psychiatric aspects of bariatric surgery","container-title":"Current Opinion in Psychiatry","page":"374-379","volume":"27","issue":"5","source":"PubMed Central","abstract":"Purpose of review\nBariatric surgery has been consistently shown to be effective in long-term marked weight loss and in bringing significant improvement to medical comorbidities such as metabolic syndrome. Empirical data suggest a high prevalence of psychiatric disorders among bariatric surgery candidates. In this review, we focus on the studies published recently with a high impact on our understanding of the role of psychiatry in bariatric surgery.\n\nRecent findings\nThis article reviews the specific psychopathologies before surgery, changes in psychopathologies after surgery, suicide risk related to bariatric surgery, factors associated with weight loss, and recommendations for presurgical and postsurgical assessment and management. Research indicates a decrease in certain psychiatric symptoms after weight loss with bariatric surgery. However, the risk of suicide and unsuccessful weight loss in some bariatric surgery patients make monitoring following surgery as important as careful assessment and management before surgery. Specific considerations for youth and older populations and future potential research foci are discussed.\n\nSummary\nRecent publications suggest new directions for psychiatric evaluation and interventions for bariatric surgery patients. Future research on outcomes of specific populations, effectiveness of psychopharmacotherapy, and underlying pathophysiology are warranted for the advancement of treating bariatric surgery patients.","DOI":"10.1097/YCO.0000000000000085","ISSN":"0951-7367","note":"PMID: 25036421\nPMCID: PMC4162326","journalAbbreviation":"Curr Opin Psychiatry","author":[{"family":"Yen","given":"Yung-Chieh"},{"family":"Huang","given":"Chih-Kuan"},{"family":"Tai","given":"Chi-Ming"}],"issued":{"date-parts":[["2014",9]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Yen, Huang, & Tai, 2014).

Bariatric surgery has various benefits as it reduces life-threatening health issues. It reduces the chances of heart disease, type 2 diabetes, and high blood pressure. It not only improves the psychological condition but also improves physical health and appearance by giving better body shape to the patient. It also increases energy expenditure. Besides the benefits, there are some risks related to the surgery. During the surgical procedure there are chances of excessive bleeding, leaks in the gastrointestinal system, breathing issue, infection, and sometimes death. There are also long-term risks like low blood sugar, vomiting, gallstones, malnutrition, hernias, and ulcer.

Bariatric surgery is not for every over-weighted individual. Therefore, the patient should meet specific medical guidelines to qualify for the surgery. In addition, different requirements are offered by surgeons, insurance companies, and weight loss programs to make positive changes in lifestyle. Therefore, the patient can be asked for permanent lifestyle changes, and long-term follow up plans as the post-operative period in bariatric surgery. In addition, cholecystectomy is also performed depending on the choice of surgeons ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"jloLc6J6","properties":{"formattedCitation":"(Kim, Kim, & Schafer, 2000)","plainCitation":"(Kim, Kim, & Schafer, 2000)","noteIndex":0},"citationItems":[{"id":849,"uris":["http://zotero.org/users/local/mlRB1JqV/items/54NS8BJB"],"uri":["http://zotero.org/users/local/mlRB1JqV/items/54NS8BJB"],"itemData":{"id":849,"type":"chapter","title":"Medical Management of the Postoperative Bariatric Surgery Patient","container-title":"Endotext","publisher":"MDText.com, Inc.","publisher-place":"South Dartmouth (MA)","source":"PubMed","event-place":"South Dartmouth (MA)","abstract":"Bariatric surgery can result in substantial weight loss and significant metabolic improvements. Therefore, clinicians should be prepared to taper treatments for chronic metabolic diseases. For patients with type 2 diabetes, early and dramatic improvements in glucose homeostasis require anticipatory management. This includes insulin dose reductions, discontinuation of certain oral agents, and close monitoring. Antihypertensive medications should be adjusted to avoid hypotension. Even after postoperative improvements in dyslipidemia, some patients will continue to meet criteria for statin therapy. While many obesity-related diseases will improve, clinicians should also be prepared to manage postoperative medical and nutritional complications. Micronutrient deficiencies are common, and professional guidelines provide recommendations for preoperative screening, universal postoperative supplementation, micronutrient monitoring, and repletion strategies. Changes in gastrointestinal physiology may result in dumping syndrome, and patients may report early gastrointestinal and vasomotor symptoms after eating. In contrast, post-gastric bypass hypoglycemia is a rare complication of malabsorptive procedures, resulting in insulin-mediated hypoglycemia after carbohydrate-containing meals. Rapid weight loss may increase the risk of cholelithiasis, which can be mitigated by ursodiol. After malabsorptive procedures, enteric hyperoxaluria and other factors may result in nephrolithiasis, which can be addressed with hydration, dietary interventions, and calcium. All bariatric surgeries induce a high bone turnover state, with declining bone mineral density (BMD) and increased fracture risk. Appropriate strategies include adequate calcium and vitamin D supplementation and age-appropriate BMD screening. In summary, given dramatic physiologic changes with bariatric surgery, clinicians should be prepared to taper treatments for chronic metabolic diseases, and to manage postoperative medical and nutritional complications. For complete coverage of this and all related areas of Endocrinology, please visit our FREE on-line web-textbook, www.endotext.org.","URL":"http://www.ncbi.nlm.nih.gov/books/NBK481901/","call-number":"NBK481901","note":"PMID: 29465932","language":"eng","author":[{"family":"Kim","given":"Tiffany Y."},{"family":"Kim","given":"Sarah"},{"family":"Schafer","given":"Anne L."}],"editor":[{"family":"Feingold","given":"Kenneth R."},{"family":"Anawalt","given":"Bradley"},{"family":"Boyce","given":"Alison"},{"family":"Chrousos","given":"George"},{"family":"Dungan","given":"Kathleen"},{"family":"Grossman","given":"Ashley"},{"family":"Hershman","given":"Jerome M."},{"family":"Kaltsas","given":"Gregory"},{"family":"Koch","given":"Christian"},{"family":"Kopp","given":"Peter"},{"family":"Korbonits","given":"Márta"},{"family":"McLachlan","given":"Robert"},{"family":"Morley","given":"John E."},{"family":"New","given":"Maria"},{"family":"Perreault","given":"Leigh"},{"family":"Purnell","given":"Jonathan"},{"family":"Rebar","given":"Robert"},{"family":"Singer","given":"Frederick"},{"family":"Trence","given":"Dace L."},{"family":"Vinik","given":"Aaron"},{"family":"Wilson","given":"Don P."}],"issued":{"date-parts":[["2000"]]},"accessed":{"date-parts":[["2019",7,8]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kim, Kim, & Schafer, 2000).

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Kim, T. Y., Kim, S., & Schafer, A. L. (2000). Medical Management of the Postoperative Bariatric Surgery Patient. In K. R. Feingold, B. Anawalt, A. Boyce, G. Chrousos, K. Dungan, A. Grossman, … D. P. Wilson (Eds.), Endotext. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK481901/

Yen, Y.-C., Huang, C.-K., & Tai, C.-M. (2014). Psychiatric aspects of bariatric surgery. Current Opinion in Psychiatry, 27(5), 374–379. https://doi.org/10.1097/YCO.0000000000000085

Bariatric Surgery

Bariatric Surgery

[Name of the Writer]

[Name of the Institution]

Bariatric Surgery

Introduction

Gastric bypass or other surgeries that are meant for weight loss are collectively known as Bariatric Surgery. Such surgeries are meant to make changes to the digestive system of a patient by limiting the desire to eat and reducing the absorption rate of nutrition. These surgeries are opted when exercises and diets are unable to fulfill the weight reduction stance. There are three major surgeries involved in Bariatric Surgery, such as Gastric Bypass, Sleeve Gastrectomy, Biliopancreatic Diversion with Duodenal Switch Gastric Bypass and Adjustable Gastric Band

Discussion

It is significant to follow up with Bariatric Surgery, taking into account that these surgeries are an option to be opted if the body mass index is 40 or higher than 40, referring to obesity. The underlying base of Bariatric Surgery is to overcome obesity because being overweight means an individual is at a threat of type 2 diabetes, severe sleep apnea, and high blood pressure. Although Bariatric Surgery is one of the easiest and commonly used techniques of losing weight in the United States, still it is important to consider the reliability of technique on different exceptions. (Fernandez Jr, et, al. 2019). Childhood obesity has emerged as one of the prevalent problems, where one-fifth of adolescents are obese. Due to long term consequences, when obesity is intertwined with inefficient nonsurgical options of weight loss, bariatric surgery is recommended.

It is asserted that surgery is an effective way to reduce weight, but it should be performed in accordance with specific experts from psychology, pediatric obesity, and nutrition. However, it is necessary to undergo an analysis of risk factors and after effects of surgery. It is important to consider that an adolescent is at a greater risk of comorbid conditions they may be both, short term and long term. The patient may have pain after eating; surgery may also result in a diminished eating schedule. There are a lot of chances of dumping syndrome because food passes very quickly through the stomach and intestine. An analysis of the health of an adolescent can help to incorporate the resolution of comorbidities, weight loss, and complication rates. Sometimes, there are serious problems such as infection near cuts, leaky stomach, blood clots in lungs or legs and the blockage of intestine. (Davies, et, al. 2019). If there would be a lack of coordination with other experts, Bariatric surgery may result in devastation for the patient. Before undergoing surgery, an adolescent should be educated about the impacts and consequences of surgery. A patient should be taught about the risky outcomes as well as positive outcomes on the body. The postoperative period of bariatric surgery infers that a patient is left with excessive skin so some surgical invention should be involved.

A patient should be aware of risk management and complication he may face due to a long term stance of anesthesia. In a nutshell, a patient should be counseled and briefed about the pre and post impacts, taking into account risk factors and set of instructions that should be followed after surgery in order to maintain health because adolescent is a great risk of developing infections due to age sensitivity. (Fernandez Jr, et, al. 2019). One of the major aspects to note is, as the child is not able to take his decision or give a proper consent because obesity depresses. The family will not be in a state to make a better decision as well because of the pressure of hampering that can happen to the child being overweight, it is the responsibility of the surgeon to guide the patient in a way that can not only facilitate the patient but also make him aware of the future outcomes. The overall framework infers that bariatric surgery is a successful technique to lose weight in adolescent

Conclusion

Bariatric surgery, a collection of different surgeries is one of the famous and efficient techniques that can be used to reduce weight. However, it is necessary to consider the terms and conditions, such as pre-surgery necessities, and post-surgery instructions. Moreover, a multidisciplinary approach should be inferred so that positive outcomes can be achieved.

References

Davies, N., O'Sullivan, J. M., Plank, L. D., & Murphy, R. (2019). Altered gut microbiome after bariatric surgery and its association with metabolic benefits: A Systematic Review. Surgery for Obesity and Related Diseases.

Fernandez Jr, A. Z. (2019). 9 Bariatric Surgery. Nutrition and Diabetes: Pathophysiology and Management, 149.

Barriers To Care

Barriers to Care

[Name of the Writer]

[Name of the Institution]

Barriers to Care

Suicide and homicide are becoming a serious social issue in recent times. One can hear news of various such crimes in their locality every now and then. The homicide rate in San Diego has raised to a dangerous level where the homicide rate was 14 in 2017 and in 1028 it has raised to 15. Same is the case for the suicide rate where 458 people took their lives in 2017, 27 people more than in 2016.

The lawmaking and enforcement agencies make sure that the incidents of suicide and homicide are kept under control to the maximum levels. The main reasons for the occurrence of such incidents are numerous which include stress, depression and various other psychological disorders (Cantrell, & Lucas, 2014). When an incident of suicide or homicide takes place it raises concern not only for the law enforcement agencies but also for the healthcare sector, especially the psychological department. It is an alarm for the medical practitioners working in the field of psychology that unaddressed psychological issues are prevailing in the society and they should be immediately resolved, but there are certain barriers in the way that do not allow the resolution of these problems.

These barriers include both organizational and financial problems that come in the way of treating individuals with psychological issues. One of the prominent organizational barriers among these is the persona that is affected by alcohol and substance abuse. Another barrier that is financial in nature is abused by individuals and the high cost of healthcare in the region. Both types of these barriers can be overcome by the providence of proper and appropriate health coverage plans. In addition to this, the medical companies and the insurance health providers should minimize their profit level so that the highest quality of health care can be provided to the residents of San Diego.

There are a number of resources that can help in the prevention of issues like suicide and homicide. There is a suicide prevention council that can help suicidal and depressed individuals to stay away from their aims. In addition to this homicidal issues or cases can be reported to the San Diego Homicide Unit (Martinez Jr, 2014).

References

Cantrell, L., & Lucas, J. (2014). Suicide by non-pharmaceutical poisons in San Diego County. Clinical toxicology, 52(3), 171-175.

Martinez Jr, R. (2014). Latino homicide: Immigration, violence, and community. Routledge.

Being Professional

Being Professional

[Name]

[Institute]

Author Note

Being Professional

Introduction

The sheer idea of walking into a healthcare facility and taking on the task of looking after the health and wellbeing of other people and having a stake in their lives can, at times, be really overwhelming for those in the profession of healthcare. Although it is still a while before we step up to the plate and do our part as a healthcare professional, the idea is still overpowering and the cause of many sleepless nights in the past few years. Most of us are told that feeling inexperienced, incapable and unprepared for the task at hand is common. Yet, the idea of helping another person, no matter how terrifying, is still something that most of us, aspire towards. We hope to help as many people as possible and touch as many lives as we possibly can while we have the chance. Thus, even though it may take most of us a while before we can settle into our jobs, it will be an experience that most of us will remember for the rest of our lives.

The healthcare system is a complex but well-defined and well-established body. The graduate nurses that enter this system are themselves well-trained and skilled to blend in it. Therefore, it is important to understand and trust the process. The first week of work is called ‘supernumerary’ where new nurses have many shifts with the experienced staff to give them time to settle in new environment. Though nurses are given chances to work independently to provide them the confidence and development, there is always a constant support and guidance system in the clinical setting. New nurses who work in collaboration with everyone receive more respect and trust than those who do not. The nurses go through these transition stages i.e. from ‘doing’ to ‘being’ to ‘becoming’. In the first few months, new nurses and midwives receive bit of extra support as everyone knows they are new in the system. Soon enough, these nurses start understanding the process and become competent in using the resources and support available. It is important to realize that patient outcomes are a result of a collective effort of several members within a healthcare team, and nurses are an important part of that team. Graduate nurses are considered to be more analytical, reflective and critical in their profession when their theoretical knowledge combines with clinical practice.

Critical Analysis

The history of nursing is filled with anti-intellectualism, which leads to the belief that nurses who are too academic usually tend to be constrained in terms of clinical practice. Such a belief has no basis in reality because some authorities are of the opinion that nurses need to be flexible, problem solvers, critical thinkers and should demonstrate the ability to deliver a vast range of services in various environmental settings ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"IzuSKSPm","properties":{"formattedCitation":"(Cashin et al., 2015)","plainCitation":"(Cashin et al., 2015)","noteIndex":0},"citationItems":[{"id":23,"uris":["http://zotero.org/users/local/N5zMsyXd/items/ANFXBEER"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/ANFXBEER"],"itemData":{"id":23,"type":"article-journal","title":"Development of the nurse practitioner standards for practice Australia","container-title":"Policy, Politics, & Nursing Practice","page":"27-37","volume":"16","issue":"1-2","author":[{"family":"Cashin","given":"Andrew"},{"family":"Buckley","given":"Thomas"},{"family":"Donoghue","given":"Judith"},{"family":"Heartfield","given":"Marie"},{"family":"Bryce","given":"Julianne"},{"family":"Cox","given":"Darlene"},{"family":"Waters","given":"Donna"},{"family":"Gosby","given":"Helen"},{"family":"Kelly","given":"John"},{"family":"Dunn","given":"Sandra V."}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cashin et al., 2015). Many researchers believe that the transition period from nurses to registered nurses and practitioners, requires enhancement of competencies for critically examining their own performance and comparing it with others’ performances. These characteristics are mainly associated with an ultimate learner and are considered highly important to provide professional nursing practice as per the new requirements of the industry ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"mKprF0ey","properties":{"formattedCitation":"(NSQHS, 2017)","plainCitation":"(NSQHS, 2017)","noteIndex":0},"citationItems":[{"id":15,"uris":["http://zotero.org/users/local/N5zMsyXd/items/VP4MZMKF"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/VP4MZMKF"],"itemData":{"id":15,"type":"book","title":"National Safety and Quality Health Service Standards - Australian Commission on Safety and Quality in Health Care","publisher":"Australian Commission on Safety and Quality in Health Care","publisher-place":"Sydney","edition":"Second Edition","event-place":"Sydney","ISBN":"978-1-925665-17-8","note":"OCLC: 1099921647","language":"en","author":[{"literal":"NSQHS"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (NSQHS, 2017).

Nursing has people coming in from a number of different walks of life that are motivated by concern and a willingness to understand the various means to deliver a range of services so that potential health problems and challenges can be taken care of. A number of such experiences can result in disruptions in the life of people, such as suffering, illness, loss, trauma, and grief ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qEkyoImd","properties":{"formattedCitation":"(Anderson, Moxham, & Broadbent, 2016)","plainCitation":"(Anderson, Moxham, & Broadbent, 2016)","noteIndex":0},"citationItems":[{"id":22,"uris":["http://zotero.org/users/local/N5zMsyXd/items/TUSFVT4E"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/TUSFVT4E"],"itemData":{"id":22,"type":"article-journal","title":"Providing support to nursing students in the clinical environment: a nursing standard requirement","container-title":"Contemporary nurse","page":"636-642","volume":"52","issue":"5","author":[{"family":"Anderson","given":"Carina"},{"family":"Moxham","given":"Lorna"},{"family":"Broadbent","given":"Marc"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Anderson, Moxham, & Broadbent, 2016). According to literature, a number of such experiences are not only the privilege but also a burden for nurses to share. This encourages people to reflect on the position they hold in the healthcare facility and how they can change the life of people in a number of ways ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"10VdJsYA","properties":{"formattedCitation":"(Small, Sidebotham, Fenwick, & Gamble, 2016)","plainCitation":"(Small, Sidebotham, Fenwick, & Gamble, 2016)","noteIndex":0},"citationItems":[{"id":21,"uris":["http://zotero.org/users/local/N5zMsyXd/items/L8JHRUVR"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/L8JHRUVR"],"itemData":{"id":21,"type":"article-journal","title":"Midwifery prescribing in Australia","container-title":"Australian prescriber","page":"215","volume":"39","issue":"6","author":[{"family":"Small","given":"Kirsten"},{"family":"Sidebotham","given":"Mary"},{"family":"Fenwick","given":"Jennifer"},{"family":"Gamble","given":"Jennifer"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Small, Sidebotham, Fenwick, & Gamble, 2016). It operates on the idea to help fellow human beings, while also training them to be apprehensive in case of crises and provide help, accept advice and do all that needs to be done so that the field of nursing can be epitomised ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"JgGumGSO","properties":{"formattedCitation":"(NMBA, 2016)","plainCitation":"(NMBA, 2016)","noteIndex":0},"citationItems":[{"id":17,"uris":["http://zotero.org/users/local/N5zMsyXd/items/6RWX485W"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/6RWX485W"],"itemData":{"id":17,"type":"article-newspaper","title":"Nursing and Midwifery Board of Australia - Registered nurse standards for practice","abstract":"Australian Health Practitioner Regulation Agency","URL":"https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx","language":"en","author":[{"family":"NMBA","given":""}],"issued":{"date-parts":[["2016",1,6]]},"accessed":{"date-parts":[["2019",10,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (NMBA, 2016).

RNs are required to maintain their professionalism and capability for practice. They need to coordinate, determine and provide quality and safe nursing help. A comprehensive assessment along with the development of the plan, its implementation and evaluation for positive outcomes is necessary. It is part of their practice to be accountable and responsible for supervising the activities of enrolled nurses ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"opM6ZG61","properties":{"formattedCitation":"(Fong, Buckley, Cashin, & Pont, 2017)","plainCitation":"(Fong, Buckley, Cashin, & Pont, 2017)","noteIndex":0},"citationItems":[{"id":24,"uris":["http://zotero.org/users/local/N5zMsyXd/items/ZJEYXGBK"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/ZJEYXGBK"],"itemData":{"id":24,"type":"article-journal","title":"Nurse practitioner prescribing in Australia: A comprehensive literature review","container-title":"Australian critical care","page":"252-259","volume":"30","issue":"5","author":[{"family":"Fong","given":"Jacqueline"},{"family":"Buckley","given":"Thomas"},{"family":"Cashin","given":"Andrew"},{"family":"Pont","given":"Lisa"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Fong, Buckley, Cashin, & Pont, 2017). RNs may use their nursing skills for paid and unpaid purposes. They may practice by working in a non-clinical relation with the people, by researching, for policy development and management. They have to evaluate the safe and effective impacts of their services on the lives of others. It is their responsibility to practice in a way that their relationships with other health professionals are also enhanced ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"qN1IrO06","properties":{"formattedCitation":"(NMBA, 2016)","plainCitation":"(NMBA, 2016)","noteIndex":0},"citationItems":[{"id":17,"uris":["http://zotero.org/users/local/N5zMsyXd/items/6RWX485W"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/6RWX485W"],"itemData":{"id":17,"type":"article-newspaper","title":"Nursing and Midwifery Board of Australia - Registered nurse standards for practice","abstract":"Australian Health Practitioner Regulation Agency","URL":"https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx","language":"en","author":[{"family":"NMBA","given":""}],"issued":{"date-parts":[["2016",1,6]]},"accessed":{"date-parts":[["2019",10,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (NMBA, 2016).

As per the standards of National Safety and Quality Health Service, healthcare professionals should get themselves engaged in operative partnerships which is required for providing quality care. It can be achieved when patients are treated with care, respect and relevant information is shared with them. These partnerships include the collaboration of patients, caregivers, families, practitioners and all the workforce in the department ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ggbagjZd","properties":{"formattedCitation":"(Cusack, 2015)","plainCitation":"(Cusack, 2015)","noteIndex":0},"citationItems":[{"id":25,"uris":["http://zotero.org/users/local/N5zMsyXd/items/HV46B2RU"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/HV46B2RU"],"itemData":{"id":25,"type":"article-journal","title":"Revised registration standards approved","container-title":"Australian Midwifery News","page":"14","volume":"15","issue":"4","author":[{"family":"Cusack","given":"Lynette"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Cusack, 2015). Such a system of care delivery can prove highly efficient for both patients and organisations. New nurses need to understand this standard well enough before starting their practice and integrating into the system (NSQHS, 2017). Therefore, it is important to provide support and treatment with patience and encouragement. They need to learn to integrate their teachings and lessons in practical field while adhering to the best prospective rewards for new graduate nurses ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"q6R2wTXT","properties":{"formattedCitation":"(Chang & Daly, 2007)","plainCitation":"(Chang & Daly, 2007)","noteIndex":0},"citationItems":[{"id":20,"uris":["http://zotero.org/users/local/N5zMsyXd/items/BQ6SZCTM"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/BQ6SZCTM"],"itemData":{"id":20,"type":"book","title":"Transitions in Nursing: Preparing for Professional Practice","publisher":"Elsevier Australia","URL":"https://www.elsevier.com/books/transitions-in-nursing/chang/978-0-7295-7836-3","ISBN":"978-0-7295-3836-7","author":[{"family":"Chang","given":"E."},{"family":"Daly","given":"J."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chang & Daly, 2007).

Discussion

The time in which a student becomes a graduate nurse, is identified as an intense period of socialization within the professional culture of the clinical world. However, in this specific context, the concept of socialization is a reverse process for the nurses as they need to learn and understand what others might demand from them. That time is the learning period where they have to take control of the new work environment as well. As a result, they develop a sense of inconsistent loyalty for the bureaucratic and the organisational systems in this profession ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"fyvbJZG4","properties":{"formattedCitation":"(Chang & Daly, 2007)","plainCitation":"(Chang & Daly, 2007)","noteIndex":0},"citationItems":[{"id":20,"uris":["http://zotero.org/users/local/N5zMsyXd/items/BQ6SZCTM"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/BQ6SZCTM"],"itemData":{"id":20,"type":"book","title":"Transitions in Nursing: Preparing for Professional Practice","publisher":"Elsevier Australia","URL":"https://www.elsevier.com/books/transitions-in-nursing/chang/978-0-7295-7836-3","ISBN":"978-0-7295-3836-7","author":[{"family":"Chang","given":"E."},{"family":"Daly","given":"J."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chang & Daly, 2007).

The most common issues that students face during the period of transition is the gap between theoretical and practical implementation in the workplace ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"NFLNNwct","properties":{"formattedCitation":"(White, 2015)","plainCitation":"(White, 2015)","noteIndex":0},"citationItems":[{"id":26,"uris":["http://zotero.org/users/local/N5zMsyXd/items/JNSZI3KH"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/JNSZI3KH"],"itemData":{"id":26,"type":"article-journal","title":"Becoming a competent, confident, professional registered nurse","container-title":"Transitions in Nursing-E-Book: Preparing for Professional Practice","page":"19","author":[{"family":"White","given":"Jill"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (White, 2015). When they enter the clinical practice, they realise that what they had learned in the class is much more different than what they experience or what is expected of them ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"eooIEuNE","properties":{"formattedCitation":"(Pelvin & Thompson, 2015)","plainCitation":"(Pelvin & Thompson, 2015)","noteIndex":0},"citationItems":[{"id":27,"uris":["http://zotero.org/users/local/N5zMsyXd/items/MYQFFTE5"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/MYQFFTE5"],"itemData":{"id":27,"type":"article-journal","title":"Sustaining midwifery practice","container-title":"Midwifery-E-Book: Preparation for Practice","page":"362","author":[{"family":"Pelvin","given":"Bronwen"},{"family":"Thompson","given":"Tricia"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Pelvin & Thompson, 2015). They also suffer due to inadequate proficiencies in the management and execution of technical procedures and find it hard to manage all the tasks in the given time duration. They also have issues regarding drug administration, effective assessment of the patients and report writing skills ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"T3LvC4b5","properties":{"formattedCitation":"(Tracy, Thorogood, Pincombe, & Pairman, 2011)","plainCitation":"(Tracy, Thorogood, Pincombe, & Pairman, 2011)","noteIndex":0},"citationItems":[{"id":19,"uris":["http://zotero.org/users/local/N5zMsyXd/items/687SEYY9"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/687SEYY9"],"itemData":{"id":19,"type":"book","title":"Midwifery: Preparation for Practice","publisher":"Elsevier Health Sciences","URL":"https://books.google.com.pk/books?id=D6EuzGoLSWYC","ISBN":"978-0-7295-7928-5","author":[{"family":"Tracy","given":"S. K."},{"family":"Thorogood","given":"C."},{"family":"Pincombe","given":"J."},{"family":"Pairman","given":"S."}],"issued":{"date-parts":[["2011"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Tracy, Thorogood, Pincombe, & Pairman, 2011).

In a new environment, where they have just come out of the student life, nurses are expected to learn and implement their roles in an effective way. Often, nurses face the issues of managing the care delivery of a large number of patients at the same time. They also find it hard to work in teams and cope with the expectations of newly graduated nurses while the relative job workload is quite excessive. They also have to learn to accept the concept of accountability of their performance and that they will be responsible for making decisions and taking independent actions ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"swWWx9zo","properties":{"formattedCitation":"(ICN, 2012)","plainCitation":"(ICN, 2012)","noteIndex":0},"citationItems":[{"id":28,"uris":["http://zotero.org/users/local/N5zMsyXd/items/CIUXXF3D"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/CIUXXF3D"],"itemData":{"id":28,"type":"webpage","title":"Code of Ethics for Nurses","URL":"http://www.old.icn.ch/images/stories/documents/about/icncode_english.pdf","author":[{"family":"ICN","given":""}],"issued":{"date-parts":[["2012"]]},"accessed":{"date-parts":[["2019",10,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (ICN, 2012). For the new nurses, it is hard coping with the unanticipated happenings at the work. While ensuring proper care delivery, they also have to supervise other nurses and manage their shift hours. It is important that organisations make arrangements for graduate nurses and make them understand the process before putting them on trial and expecting quality results ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"PMyQy9XW","properties":{"formattedCitation":"(Chang & Daly, 2007)","plainCitation":"(Chang & Daly, 2007)","noteIndex":0},"citationItems":[{"id":20,"uris":["http://zotero.org/users/local/N5zMsyXd/items/BQ6SZCTM"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/BQ6SZCTM"],"itemData":{"id":20,"type":"book","title":"Transitions in Nursing: Preparing for Professional Practice","publisher":"Elsevier Australia","URL":"https://www.elsevier.com/books/transitions-in-nursing/chang/978-0-7295-7836-3","ISBN":"978-0-7295-3836-7","author":[{"family":"Chang","given":"E."},{"family":"Daly","given":"J."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Chang & Daly, 2007). They should be trained to collaborate with the workforce, staff nurses and health professionals. They should also receive proper guidance for understanding the liaison and the total care of their patients. Moreover, they should also be trained to develop competence in planning the care program and organising their tasks efficiently ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LuS9gHfs","properties":{"formattedCitation":"(NMBA, 2016)","plainCitation":"(NMBA, 2016)","noteIndex":0},"citationItems":[{"id":17,"uris":["http://zotero.org/users/local/N5zMsyXd/items/6RWX485W"],"uri":["http://zotero.org/users/local/N5zMsyXd/items/6RWX485W"],"itemData":{"id":17,"type":"article-newspaper","title":"Nursing and Midwifery Board of Australia - Registered nurse standards for practice","abstract":"Australian Health Practitioner Regulation Agency","URL":"https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx","language":"en","author":[{"family":"NMBA","given":""}],"issued":{"date-parts":[["2016",1,6]]},"accessed":{"date-parts":[["2019",10,18]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (NMBA, 2016).

Conclusion

Unlike most professions, the field of nursing revolves around the process of giving and taking. This is a process through which newly registered nurses learn to behave as nurses, especially in the hospital setting. It is through this process that many students learn to behave as new registered nurses in hospital settings. They learn to behave in a manner that is culturally prescribed to the workplace and is customized to the rules and standards observed. With due time and process, the idealized role and the actualized role in the working environment come together in a manner that turns the students graduating from nursing school into RNs in a healthcare environment.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Anderson, C., Moxham, L., & Broadbent, M. (2016). Providing support to nursing students in the clinical environment: A nursing standard requirement. Contemporary Nurse, 52(5), 636–642.

Cashin, A., Buckley, T., Donoghue, J., Heartfield, M., Bryce, J., Cox, D., … Dunn, S. V. (2015). Development of the nurse practitioner standards for practice Australia. Policy, Politics, & Nursing Practice, 16(1–2), 27–37.

Chang, E., & Daly, J. (2007). Transitions in Nursing: Preparing for Professional Practice. Retrieved from https://www.elsevier.com/books/transitions-in-nursing/chang/978-0-7295-7836-3

Cusack, L. (2015). Revised registration standards approved. Australian Midwifery News, 15(4), 14.

Fong, J., Buckley, T., Cashin, A., & Pont, L. (2017). Nurse practitioner prescribing in Australia: A comprehensive literature review. Australian Critical Care, 30(5), 252–259.

ICN. (2012). Code of Ethics for Nurses. Retrieved October 18, 2019, from http://www.old.icn.ch/images/stories/documents/about/icncode_english.pdf

NMBA. (2016, January 6). Nursing and Midwifery Board of Australia—Registered nurse standards for practice. Retrieved from https://www.nursingmidwiferyboard.gov.au/Codes-Guidelines-Statements/Professional-standards/registered-nurse-standards-for-practice.aspx

NSQHS. (2017). National Safety and Quality Health Service Standards—Australian Commission on Safety and Quality in Health Care (Second Edition). Sydney: Australian Commission on Safety and Quality in Health Care.

Pelvin, B., & Thompson, T. (2015). Sustaining midwifery practice. Midwifery-E-Book: Preparation for Practice, 362.

Small, K., Sidebotham, M., Fenwick, J., & Gamble, J. (2016). Midwifery prescribing in Australia. Australian Prescriber, 39(6), 215.

Tracy, S. K., Thorogood, C., Pincombe, J., & Pairman, S. (2011). Midwifery: Preparation for Practice. Retrieved from https://books.google.com.pk/books?id=D6EuzGoLSWYC

White, J. (2015). Becoming a competent, confident, professional registered nurse. Transitions in Nursing-E-Book: Preparing for Professional Practice, 19.

Benchmark - Community Teaching Plan: Community Teaching Work Plan Proposal

Community Teaching Work Plan Proposal

Planning and Topic

Directions: Develop an educational series proposal for your community using one of the following four topics:

Bioterrorism/Disaster

Environmental Issues

Primary Prevention/Health Promotion

Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

Name and Credentials of Teacher:

Estimated Time Teaching Will Last:

Location of Teaching:

Supplies, Material, Equipment Needed:

Estimated Cost:

Community and Target Aggregate:

Topic:

Identification of Focus for Community Teaching (Topic Selection):

Diabetes is the selected condition for which community teaching plan would be proposed.

Epidemiological Rationale for Topic (Statistics Related to Topic):

The basic rationale behind choosing this topic is simply the elevated prevalence of diabetes among children, middle aged and elderly individuals in the United States. According to the Center of Disease Control and Prevention (2017), approximately 30.3 million Americans are currently suffering from diabetes whereas 84.1 million American adults have been diagnosed with pre-diabetics.

Teaching Plan Criteria

Nursing Diagnosis: Diabetes

Readiness for Learning: Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn.

Attentiveness, calmness, readiness to answer the questions, query making, responding to the presented facts, development of the arguments and enthusiasm to apply this knowledge within their real life instances and making constructive changes are some indicators of their readiness to learn.

Learning Theory to Be Utilized: Explain how the theory will be applied.

Human being is the product of his genetics and environmental learning. Apart from genetic predispositions, environmental factors put substantial influences on the behaviors and mental processes of human beings; his perceptions, feelings, emotions, motivations and all the other personal attributes are directly stimulated by social forces. Similar things can be said for learning; what motivates us to learn falls between two types of factors—intrinsic and extrinsic ones. Intrinsic factors are our personal preferences for learning certain things whereas extrinsic factors encapsulate environmental rewards that are offered upon learning. In the present case, the basic motivator that galvanizes audience’s interest to learn is to nurture their needs of safety and security as suggested by renowned Humanistic Psychologist Abraham Maslow in his Hierarchy of Human Needs (Maslow, 1970). Apart from this theory, B. F. Skinner’s model of operant conditioning would be applied here because it best explains the basic rationale behind learning; human beings learn new things on the basis of their consequences; positive consequences strengthen the learning whereas negative consequences diminish it (Skinner, 1938). Hence, people will learn new things because they will get constructive knowledge (ways to avoid risk factors for diabetes) and ensuring their safety in the future.

Goal: Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals.

Healthy People 2020 (HP2020) objective for Diabetes D-2 is to reduce the death rate among diabetics (HP, 2019). The rationale behind using D-2 is to spread awareness regarding diabetes and its preventive strategies so that it could be avoided in the later life stages along with its potential mortalities.

How Does This HP2020 Objective Relate to Alma Ata’s Health for All Global Initiatives

Alma Ata’s Health for All Global Initiatives 1V suggests that every individual is having a full fledge authority to participate in his healthcare plans individually and collectively (WHO, n.d). Hence, diabetes and its associated death rate can be reduced when the individual takes keen interest in the active mitigation of his illness.

Develop Behavioral Objectives (Including Domains), Content, and Strategies/Methods:

Behavioral Objective and Domain

Content

Strategies/Methods

1. Individuals diagnosed with pre-diabetes would be taught during an informational session held at clinic.

(cognitive domain)

They would be able to figure biological basis of diabetes at the end of session.

1. Diabetes is an endocrine disorder that originates from the abnormal production and/or functioning of the insulin—a hormone that converts glucose (sugar) into glycogen. When there is no insulin present or it functions ineffectively, our body becomes enriched with sugar.

1. Pre-diabetics would be presented with the informational video regarding interrelation between diabetes, insulin and sugar levels. They will be allowed to discuss and ask questions freely. Their personal perspectives would be acknowledged.

2. Individuals diagnosed with pre-diabetes would be taught during an informational session held at clinic.

(cognitive domain)

They would be able to figure the incorporation of obesity in diabetes at the end of the session.

2. As a result of obesity, the body mass index becomes high and insulin finds it hard to reach each and every cell of the body and convert glucose into glycogen. The outcome becomes obvious—elevated levels of sugar in the blood.

2. Pre-diabetics would be presented with informational models and chart papers with drawing and sketching for highlighting the association between obesity and diabetes.

3. Diabetics will be educated about the importance of healthy diet during and informational session held at clinic and would be encouraged to use healthy diet.

(behavioral domain)

3. Healthy diet such as vegetables, fruits and beans help reducing weight gain and in turn lower the levels of diabetes.

3. They will be presented with the success stories of the persons who combated diabetes through weight loss and healthy diet. Moreover, they will be given pamphlets having appropriate weekly diet plans.

4. Diabetics will be educated about the importance of exercise during and informational session held at clinic and would be encouraged to use exercise on daily basis.

(behavioral domain)

4. Exercise helps reducing body weight and keeps us active; our workout keeps the insulin operational and reduces the levels of sugar in the blood constantly.

4. They will be presented with the success stories of the persons who combated diabetes through exercise. Moreover, they will be given pamphlets having appropriate DIY exercises and resource centers.

Creativity: How was creativity applied in the teaching methods/strategies?

Psychological principles validate the utilization of audio-visual aids such as chart papers, models, pamphlets, videos and audio messages in learning. I used creativity through making the tools colorful and eye-catching and using success stories of real life figures. Moreover, my body language was pleasant and conductive for the learning environment particularly for those who were previously alien to biological terms.

Planned Evaluation of Objectives (Outcome Evaluation): Describe what you will measure for each objective and how.

Their knowledge regarding biological mechanism of diabetes will be determined through oral testing.

Their knowledge regarding obesity and diabetes association will be determined through oral testing.

Their diet modifications would be measured through the number of calories burned.

Their exercise modifications would be measured through the kilograms of weight lost.

Planned Evaluation of Goal: Describe how and when you could evaluate the overall effectiveness of your teaching plan.

I would measure it after one week of implementation through verbal and practical testing as mentioned above.

Planned Evaluation of Lesson and Teacher (Process Evaluation):

The face validity of education plan will be measured for identifying the effectiveness of teaching tools used; audience will be asked at the end of the lesson about how effective it was for them.

Barriers: What are potential barriers that may arise during teaching and how will those be handled?

Individual differences in learning such as motivation, aptitude, attention span and readiness to change were potential barriers for learning.

Therapeutic Communication

4.2 Communicate therapeutically with patients.

How will you begin your presentation and capture the interest of your audience? Describe the type of activity will you use with your audience to exhibit active listening? Describe how you applied active listening in tailoring your presentation to your audience? How will you conclude your presentation? What nonverbal communication techniques will you employ?

I will start is by asking a question that will galvanize their interest and attention; I will ask questions frequently for identifying their level of listening; I would answer their questions in a pleasant way encouraging their participation and conclusion will revolve around deducing meaningful inferences from it.

References

Diabetes Objectives (2019). Healthy People.govt. Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/diabetes/objectives

National Diabetes Statistic Report (2017). CDC. Retrieved from https://www.cdc.gov/features/diabetes-statistic-report/index.html

Declaration of Alma-Ata (n.d). World Health Organization. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0009/113877/E93944.pdf

Maslow, A. H. (1970a). Motivation and personality. New York: Harper & Row.

Skinner, B. F. (1938). The Behavior of organisms: An experimental analysis. New York: Appleton-Century.

Benchmark - Effective Approaches In Leadership And Management

Effective Approaches in Leadership

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Effective Approaches in Leadership

Response 1

In contract-based appointments, there is no job security, no continuous appraisals, and no increments based on experience. The staff facing the issues of non-increments will leave the job after some time. There is a chance that during a haphazard act or activity, the employer will ask the staff member to leave the job without even resolving or identifying the issue. The management is equally responsible for staff negligence ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1u526l5lsp","properties":{"formattedCitation":"(Boamah, Laschinger, Wong, & Clarke, 2018)","plainCitation":"(Boamah, Laschinger, Wong, & Clarke, 2018)"},"citationItems":[{"id":200,"uris":["http://zotero.org/users/local/p8kwKNoG/items/CYXEJJSK"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/CYXEJJSK"],"itemData":{"id":200,"type":"article-journal","title":"Effect of transformational leadership on job satisfaction and patient safety outcomes","container-title":"Nursing outlook","page":"180-189","volume":"66","issue":"2","author":[{"family":"Boamah","given":"Sheila A."},{"family":"Laschinger","given":"Heather K. Spence"},{"family":"Wong","given":"Carol"},{"family":"Clarke","given":"Sean"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Boamah, Laschinger, Wong, & Clarke, 2018). However, it is the staff member who would be suffering the consequences in the end. It is also observed in contract-based employment that the employees have to accomplish additional tasks other than the duties assigned. However, they would not be paid for these additional tasks and duties. The staff on the contract will suffer deductions based on funds and other government taxes and levies. The contract-based employees of healthcare facilities, particularly nurses, have to face the forfeits and the penalties for insignificant mistakes.

Response 2

The quality care delivery and the safety of the patient is the priority of a healthcare organization. In the case of contract-based employees, the rude and other negative concerns will be made the employee upset. Ultimately, it would result in the form of poor performance and a lack of interest from the employees. The healthcare delivery centers are the organizations that require attention and dedication, along with hard work. Absence and negligence of nurses can lead to serious consequences in terms of quality care and patient safety. Lack of financial resources also outcome in the form of negative and impaired behaviors from the employees. It includes abuse, negligence, and patient referral from one institute to the other for the earning of additional money. The employees will look for substandard approaches to earn money from the organizations. The employees have to look for sidetracks to earn money when their financial requirements are not achieved by the salary. The healthcare delivery system would be disturbed, and the provision of quality care and patient safety would be interrupted by the distressed employees ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1s91d7tc36","properties":{"formattedCitation":"(Boamah et al., 2018)","plainCitation":"(Boamah et al., 2018)"},"citationItems":[{"id":200,"uris":["http://zotero.org/users/local/p8kwKNoG/items/CYXEJJSK"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/CYXEJJSK"],"itemData":{"id":200,"type":"article-journal","title":"Effect of transformational leadership on job satisfaction and patient safety outcomes","container-title":"Nursing outlook","page":"180-189","volume":"66","issue":"2","author":[{"family":"Boamah","given":"Sheila A."},{"family":"Laschinger","given":"Heather K. Spence"},{"family":"Wong","given":"Carol"},{"family":"Clarke","given":"Sean"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Boamah et al., 2018).

Response 3

The issue of contract-based employees can be resolved easily at the managerial level. The staff that is employed based on the contract should be satisfied with their salaries, job time, and assigned duties should be mentioned to them at the time of hiring. Additional assigned duties from time to time should be paid. Additional time and other referral duties should also be paid by the organization. In case of serious negative feedback of the clients or patients, the concerned employee should be called to discuss the matter as the information shared by the employee is also important while taking any decision. Organizations should not be very strict with those who are working with the organization for a long period. In rigid and non-cooperative management, delivery of quality care, and patients, safety is found to be observed at risk.

Response 4

The classical structure of an organization where every employee is respected and valued is suitable for the fields of health care providers. Healthcare organizations and foundations are projected to grow in health equity, develop excellence, and support removes health care inequalities by induction of a proposal for safety and health care administrations. They are planned to implement principal ethics in all aspects of management in healthcare. The goal is to implement these standards in management, staff, and governance, broadcast, and verbal support. Culturally and administratively suitable facilities and the facilities which are courteous and amicable for the staff and management members are considered as the best management ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"au2vaeqc3b","properties":{"formattedCitation":"(Kangasniemi, Pakkanen, & Korhonen, 2015)","plainCitation":"(Kangasniemi, Pakkanen, & Korhonen, 2015)"},"citationItems":[{"id":180,"uris":["http://zotero.org/users/local/p8kwKNoG/items/H7CMHHJ6"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/H7CMHHJ6"],"itemData":{"id":180,"type":"article-journal","title":"Professional ethics in nursing: an integrative review","container-title":"Journal of advanced nursing","page":"1744-1757","volume":"71","issue":"8","author":[{"family":"Kangasniemi","given":"Mari"},{"family":"Pakkanen","given":"Piiku"},{"family":"Korhonen","given":"Anne"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kangasniemi, Pakkanen, & Korhonen, 2015). The credit always goes to the managers and higher management who implement those policies over employees. Respectable and user-friendly environments grow faster than usual.

Response 5

To attain equity and improve excellence, hospitals and healthcare leaders had to train the managing team and staff for addressing the people with an emphasis on excellence, threat management, and recognition ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"acmcgg3iv4","properties":{"formattedCitation":"(Avolio, 2007)","plainCitation":"(Avolio, 2007)"},"citationItems":[{"id":24,"uris":["http://zotero.org/users/local/p8kwKNoG/items/NHZXIDSE"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/NHZXIDSE"],"itemData":{"id":24,"type":"article-journal","title":"Promoting more integrative strategies for leadership theory-building.","container-title":"American psychologist","page":"25","volume":"62","issue":"1","author":[{"family":"Avolio","given":"Bruce J."}],"issued":{"date-parts":[["2007"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Avolio, 2007). Managers having the best skills in communication and conflict resolution will be appreciated by the staff. The staff members of these organizations would be better-off and satisfied. Healthcare facilities highlighting the morals and values for delivering respect and encouragement to the staff are more economically stable ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ajvk2bhn4e","properties":{"formattedCitation":"(Boamah et al., 2018)","plainCitation":"(Boamah et al., 2018)"},"citationItems":[{"id":200,"uris":["http://zotero.org/users/local/p8kwKNoG/items/CYXEJJSK"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/CYXEJJSK"],"itemData":{"id":200,"type":"article-journal","title":"Effect of transformational leadership on job satisfaction and patient safety outcomes","container-title":"Nursing outlook","page":"180-189","volume":"66","issue":"2","author":[{"family":"Boamah","given":"Sheila A."},{"family":"Laschinger","given":"Heather K. Spence"},{"family":"Wong","given":"Carol"},{"family":"Clarke","given":"Sean"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Boamah et al., 2018). It has also been observed that the employees stay longer in those organizations where they have found respect, appreciation, and encouragement ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2lvh8vrmp0","properties":{"formattedCitation":"(Tucker, Gallagher-Ford, Baker, & Vottero, 2019)","plainCitation":"(Tucker, Gallagher-Ford, Baker, & Vottero, 2019)"},"citationItems":[{"id":194,"uris":["http://zotero.org/users/local/p8kwKNoG/items/BX9IDMFN"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/BX9IDMFN"],"itemData":{"id":194,"type":"article-journal","title":"Promoting Nurse Retention Through Career Development Planning","container-title":"AJN, American Journal of Nursing","page":"62-66","volume":"119","issue":"6","author":[{"family":"Tucker","given":"Sharon J."},{"family":"Gallagher-Ford","given":"Lynn"},{"family":"Baker","given":"Manisa"},{"family":"Vottero","given":"Beth A."}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Tucker, Gallagher-Ford, Baker, & Vottero, 2019). The managers should implement the rules, ethical standards, and provisions announced by the American Nursing Association. The appraisals in the form of appreciation, encouragement, and financial bonuses also encourage staff to deliver services with motivation and care ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"at9arqq7fc","properties":{"formattedCitation":"(Wolf, 2019)","plainCitation":"(Wolf, 2019)"},"citationItems":[{"id":199,"uris":["http://zotero.org/users/local/p8kwKNoG/items/L2ZDMJWQ"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/L2ZDMJWQ"],"itemData":{"id":199,"type":"book","title":"The Right to a Caring Relationship","publisher":"Springer","ISBN":"1091-5710","author":[{"family":"Wolf","given":"Zane Robinson"}],"issued":{"date-parts":[["2019"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Wolf, 2019).

Response 6

The transformational style of leadership is very effective in the management of healthcare facilities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1mubrkj9b5","properties":{"formattedCitation":"(Ekstrand et al., 2018)","plainCitation":"(Ekstrand et al., 2018)"},"citationItems":[{"id":198,"uris":["http://zotero.org/users/local/p8kwKNoG/items/QRIXMXC7"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/QRIXMXC7"],"itemData":{"id":198,"type":"article-journal","title":"Is there a correlation between coaches’ leadership styles and injuries in elite football teams? A study of 36 elite teams in 17 countries","container-title":"Br J Sports Med","page":"527-531","volume":"52","issue":"8","author":[{"family":"Ekstrand","given":"Jan"},{"family":"Lundqvist","given":"Daniel"},{"family":"Lagerbäck","given":"Lars"},{"family":"Vouillamoz","given":"Marc"},{"family":"Papadimitiou","given":"Niki"},{"family":"Karlsson","given":"Jon"}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Ekstrand et al., 2018). This leadership involves every staff member to work for the same vision. This leadership approach encourages and motivates staff nurses to provide and deliver quality healthcare services to the patients (Cummings et al., 2018). This is the approach of an appointment, constant expansion, and obligation, which is to create an ethnically and socially suitable job description with appropriate hours for the staff. To ensure job security aims, strategies, and administration responsibility, and impart them in the administration's preparation and procedures can promote staff members to continue working with the same organizations. This would be achieved by producing conflict and complaint resolution measures that are ethically and morally suitable to notice, stop, and resolve genuine contests or grievances of the staff. This is achievable by utilizing the transformational leadership style.

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Avolio, B. J. (2007). Promoting more integrative strategies for leadership theory-building. American Psychologist, 62(1), 25.

Boamah, S. A., Laschinger, H. K. S., Wong, C., & Clarke, S. (2018). Effect of transformational leadership on job satisfaction and patient safety outcomes. Nursing Outlook, 66(2), 180–189.

Ekstrand, J., Lundqvist, D., Lagerbäck, L., Vouillamoz, M., Papadimitiou, N., & Karlsson, J. (2018). Is there a correlation between coaches’ leadership styles and injuries in elite football teams? A study of 36 elite teams in 17 countries. Br J Sports Med, 52(8), 527–531.

Kangasniemi, M., Pakkanen, P., & Korhonen, A. (2015). Professional ethics in nursing: an integrative review. Journal of Advanced Nursing, 71(8), 1744–1757.

Tucker, S. J., Gallagher-Ford, L., Baker, M., & Vottero, B. A. (2019). Promoting Nurse Retention Through Career Development Planning. AJN, American Journal of Nursing, 119(6), 62–66.

Wolf, Z. R. (2019). The Right to a Caring Relationship. Springer.

Benchmark - Human Experience Across The Health-Illness Continuum

Benchmark - Human Experience across the Health-Illness Continuum

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Benchmark - Human Experience across the Health-Illness Continuum

There are various models and frameworks related to human health and illness, and these factors are not static in any human being. The fluctuation occurs according to the condition of a human being. Health is considered as the experiences of humans concerning their perceptions and beliefs that configure a response to the wellness or illness of a person. The World Health Organization (WHO) characterizes wellbeing as the condition of complete physical, mental, and social prosperity and not just the nonappearance of malady or ailment (WHO, 2018). The importance of maintenance of health and wellbeing is determined through the analyses of human experience with health-illness continuum. The health-illness continuum proposes the prosperity, which comprises of emotional and psychological health, also the absence or presence of the disease or ailment in patients. Therefore, this paper will analyze the experience of humans across the continuum of health-illness in healthcare organizations.

The nurses or medical caretakers can use to help manage their patients the correct way is the wellbeing continuum, likewise called the health-illness continuum (Kaakinen et al., 2018). The disease wellbeing continuum is an outline that draws an association between the treatment worldview and the health worldview. Where the compromise is viewed as the an unbiased point. A few instances of the continuum incorporate the six parts of individual wellbeing. These are classes inside every one of our days by day experience that must be adjusted to achieve ideal prosperity.

This is an incredible apparatus that medical attendants can use to enable their patients to envision, plan and accomplish their objectives for a more advantageous way of life. Consider the more remote down the continuum your patients go towards disease, the closer they are to death; instead, the more distant up the continuum your patients go towards wellbeing, the closer they are to ideal wellbeing. Medical attendants are in charge of regarding their patients as well as instructing them on how anticipation and way of life decisions can enable them to move towards wellbeing and health (Stará & Charvát, 2015).

The present human services concentrate more on ailment and sickness and less on healthcare and wellbeing. Every individual characterizes his or her wellbeing depends on how they feel, are there any indications of a disease, and would they be able to capacity and do day by day obligations (Fries, 2019). The ailment also is exceptionally close to home. Just the individual can decide whether they are decreased physically, inwardly, mentally, formative or profoundly. The disease could be possibly identified with an infection state. Wellbeing is a human encounter, not a rundown of specific findings. Inside the human experience is a definitive beneficial encounter of essentialness. Essentialness is a sentiment of being alive and full of energy. A misfortune in essentialness can leave one depleted or unfilled, unfit to discover inspiration, and influencing mental prosperity and physical wellbeing. Imperativeness isn't seen distinctly as a mental state but likewise a material condition of substantial working.

The main activity in structure a guide of the human wellbeing ailment continuum is to perceive that, comprehensively, we can put the component of social wellbeing sickness on a continuum that comprises of two related measurements. The first is the element of abstract trouble (i.e., as a rule enduring versus joy/fulfilment) and the second is level of brokenness. Here is an original schematic of the wellbeing disease continuum (Edelman, Mandle & Kudzma, 2017). The various individual wellbeing comprises of physical, mental, emotional, social, natural another spiritual wellbeing. These are factors that influence which course our patients go on the sickness wellbeing continuum. These states are not fixed, and even the scarcest of changes can have any effect on their general wellbeing.

Lamentably, as hard as we attempt to dispense with the causative operators of different malady forms, we can't be 100% safe, except if we live in an air pocket. We can be that as it may, give our bodies a battling chance through counteractive action techniques, for example, hand washing, inoculations, wellbeing screenings and legitimate eating regimen and exercise. Components that we have no influence over, yet enormously affect our physical wellbeing, are our age and hereditary qualities. As hard as we may endeavour to stop or switch the hands of time, it is inescapable. In like manner, we have no influence over our hereditary cosmetics. The presence of such options like to sufficiently express sentiments in a useful way, while troublesome, can be extremely illuminating to ourselves as well as to everyone around us too. It's impossible to envision an existence with no contention, yet it is reasonable to envision an actual life where emotions can be tended to in a manner that is the least harming to every one of those included.

Nursing is the investigation of minding in human wellbeing knowledge. Therefore, this paper analyzed and explored the experience of humans across the continuum of health-illness in healthcare organizations. This focal point of view of the control manages that information determination must rose up out of minding and the encounters acquired by the individual. This causes it to vary from different callings that concentrated on human wellbeing. It is insisted that prosperity is a standout amongst the most valuable qualities in life, especially amid this cutting edge times. Therefore, to ultimately ensure and improve the wellbeing of the general population, seeing every one of the points of life being-in-this-world must be investigated.

References

Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (2017). Health Promotion Throughout the Life Span-E-Book. Elsevier Health Sciences.

Fries, C. J., (2019). Healing Health Care: From Sick Care Towards Salutogenic Healing Systems. Social Theory & Health, 1-17.

Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Family health care nursing: Theory, practice, and research. FA Davis.

Stará, J., & Charvát, M., (2015). Wellness: Its Origins, Theories and Current Applications in the United States. Acta Salus Vitae, 1(2).

Benchmark - Nursing Process: Approach To Care

Benchmark - Nursing Process: Approach to Care

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Benchmark - Nursing Process: Approach to Care

Cancer; the Diagnosis and Staging

Cancer is an umbrella term used for many diseases that commonly appear after the development of some abnormal cells that divide uncontrollably and have the ability to infiltrate and destroy normal body tissue. Cancer is not fully curable but it has become a preventable disease if the treatment starts when it is in its initial stages, thanks to advanced medical researches. Two steps occur in the treatment of cancer: diagnosis and staging.

The Diagnosis refers to the methods we use for the identification of cancer. The methods like X-Rays, Ultrasonography, or Computed Tomography (CT) are used to identify if the disease exists in a person. The diagnosis methods are used according to the symptoms that appear in the person. If a person is suffering from chronic cough, the x-rays method is applied to his/her chest. On the other side Computed Tomography (CT) method is applied to the brain if the person is suffering from recurrent headaches (Kaakinen, et.al, 2018).

Staging of cancer refers to the process of deciding at what stage cancer has reached to use a more appropriate method of treatment by the doctors. In fact, staging is another kind of diagnosis but it is a more thorough examination of the disease presence and proper treatment starts quickly after this step. The patient goes through imaging tests like such as x-ray, CT, MRI, bone scans with radioactive materials, or positron emission tomography (PET) on this level of identification. Sometimes doctors use biopsies to determine the actual stage of cancer. It is a process of obtaining a tumor from the body of the patient for examination (American Cancer Society, 2019). After the kind of cancer is decided at the staging level, the doctor’s grade cancer and start the treatment.

Complications of Cancer and Side effects of Treatment

The diagnosis and staging are important to use relevant and appropriate methods of treatment to cure the disease, but during these steps and even during the treatment patient might face other complications that add to his/her mental and physical suffering. These complications include the Increasing Link between Cancer and Alzheimer’s disease, the  Frequency of Late Anorectic Disease in Childhood Cancer Survivors after Pelvic Radiation, and Chemo Brain.

The side effects that the cancer patients suffer from during the treatment include Anemia, Appetite Loss, and Constipation. Anemia is a kind of disease that causes the patient to feel very tired, dizzy, and short of breath. It appears after the patient goes through chemotherapy or radiation therapy. It affects the bones and muscles of the patient and obliges him/her to suffer. Appetite Loss is another kind of side effect that appears during the treatment. Side effects such as mouth and throat problems, or nausea and vomiting appear and the patient loses his/her appetite. The other important kind of the side effects that appear during the treatment is Constipation (Kaakinen, et.al, 2018). The symptoms of this side effect include infrequent bowel movements and stool that may be hard, dry, and difficult to pass. The patient may also have stomach cramps, bloating, and nausea when he/she is constipated. Constipation is the result of chemotherapy, pain killer medicines, and the absence of activity.

Some methods can help to lessen the physical and mental suffering of the patient. Lessening the physical activity and seeking help for laborious tasks can be helpful in Anemia. Additionally, it is useful to have good nutrition. Fruits and other diets that can give strength to the body are helpful. Constipation on the other side is the result of inactivity. Here occurs this new kind of complication in the treatment of cancer. The doctors suggest the use of fiber foods and excessive use of liquids. They can be helpful for both constipation and the loss of appetite. Moreover, cancer must not be left alone to just lie down and think about his/her suffering rather they should be under the proper watch of their relative(s) and the doctors (Kaakinen, et.al, 2018).

The Causes of Cancers in Americans

The most common types of cancer in America are Breast Cancer, Prostate Cancer, Skin Cancer, and Lung Cancer. These four kinds are major kinds of cancer in the United States of America which affect millions of people yearly. The factors that are responsible for these kinds include Skin Surgery, Smoking, Chemicals Use at Home, and Tattooing. Many rich Americans are nowadays conscious about their rapid aging and other imperfections in their natural skin. They have skin surgery that causes cancer if goes wrong. Similarly, tattooing is a popular culture in America. Tattoos are drawings and pictures on one's body. Tattoos are incorporated into the human body by applying irremovable colors that go under the upper layer of human skin. This also results in skin infection if not applied properly (DeSantis, et.al, 2016). Smoking is a major cause of cancer in America.

American Cancer Society

American Cancer Society is a volunteer health organization throughout the country since 1913. It can educate the people of America to fight against this fatal disease. The executives of the society announced that they would plan to broaden their scope by approaching more people and educate them about how this disease born, and to provide support to those who already are suffering because of cancer (American Cancer Society, 2019). They announced that they would start countrywide awareness campaigns about the causes of the disease and precautionary steps that the people can take to prevent cancer. They would spread awareness against the factors that cause cancer. It is likely that they would submit a petition to the government to impose a ban on the defective materials of tattooing, harmful tobacco, and the chemicals that are used in houses and cause cancer. Moreover, they will provide the facilities of the diagnosis and staging to those patients who cannot afford such an expensive treatment. I also suggest the diagnosis, staging, and trading facilities of the ACS for they have the best doctors and environment plus machinery to treat people with minimum possibility of mistake. The ACS has an issue that as it is a volunteer society, it depends upon the donations (American Cancer Society, 2019). If the donations do not grow as the number of patients is growing, it might affect the performance of the American Cancer Society.

The Phases of the Nursing Process

The nursing process is utilized to provide safe and effective care for cancer patients across their life spam. The five phases of nursing are applied to deal with cancer patients. Those five phases include Assessment, Diagnosis, Planning, Implementation, and Evaluation. The case of the cancer patient is assessed at the first stage. He/she is provided first aid if he/she is ailing at the time of admission at the hospital. Then occurs the stage of diagnosis where some initial methods of identifying the disease are applied. These methods include X-rays, Ultrasonography, and Computed Tomography (CT) that are used to identify the disease. The third phase is Planning that is based upon SMART goals. SMART is the abbreviation of five words Specific, Measurable, Attainability, Realistic, and Time-Oriented. Goals are set in this phase to handle the patient in an organized manner. The goals are set by staying practical. The goals are specific without any generalization. For example to treat the patient who is in the particular stage of cancer and the methods that will be applied to him/her to treat (Furseth, Taylor, & Kim, 2016). The goals are clearly defined and the resources that are required are also described. A particular time period is defined and the goals that will be achieved in that time spam. In the final phase, the nurse evaluates the plans and revises if there is some vagueness or impracticality, or imperfection in the plans.

Undergraduate Education and Nursing

Undergraduate education in liberal arts and sciences contributes to the foundation of nursing. The field of nursing requires enough literacy by the nurses to handle the patients. It is an old argument that nurse is not required to be qualified formally to get allocated to the job rather nursing has become a proper profession and field of study in the contemporary era. A nurse must be a half psychologist because she has to deal with any kind of patients. Moreover, many complicated medical reports and description of medicines is supposed to be read by a nurse. Basic knowledge of biology, mathematics, chemistry, sociology, psychology helps a nurse to perform her duties well at workplace. The knowledge of sociology and psychology helps the nurse to understand the psyche of the patient and treat him/her accordingly (Furseth, Taylor, & Kim, 2016).

Since, working with a cancer patient is a highly risky job because of the gravity of the disease type, least unprofessional attitude at the job can cause a death or more. The undergraduate education of fine arts teaches a student the moral duties of a person and the importance of being a responsible citizen (Furseth, Taylor, & Kim, 2016). Apart from that, the basic knowledge of sciences enables the nurse to learn the professional challenges at the workplace like understanding the chemicals, the internal system of a human body, and the role of medicines for particular symptoms.

References

American Cancer Society. (2019). Cancer Staging. Retrieved 24 December 2019, from https://www.cancer.org/treatment/understanding-your-diagnosis/staging.html

DeSantis, C. E., Siegel, R. L., Sauer, A. G., Miller, K. D., Fedewa, S. A., Alcaraz, K. I., & Jemal, A. (2016). Cancer Statistics for African Americans, 2016: Progress and Opportunities in Reducing Racial Disparities. CA: a cancer journal for clinicians, 66(4), 290-308.

Furseth, P. A., Taylor, B., & Kim, S. C. (2016). Impact of Interprofessional education among nursing and paramedic students. Nurse educator, 41(2), 75-79.

Kaakinen, J. R., Coehlo, D. P., Steele, R., & Robinson, M. (2018). Health Care Nursing: Theory, Practice, and Research. FA Davis.

Benchmark - Nursing Process: Approach To Care

Nursing Process

Name

[Institutional Affiliation(s)]

Author Note

Nursing Process

Diagnosis

Imaging study or screening such as computed tomography, Ultrasonography, and x-rays are performed by the physicians in case they suspect cancer. A chronic chest pain, cough, trouble seeing and concurrent headaches might help physicians in diagnosing cancer. The tests performed helped physicians to detect mass or presence of tumor in any organ. A biopsy is another way to perform a test by taking a mass or piece of cells from tumors to confirm cancer ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2kdrs5oc8k","properties":{"formattedCitation":"(Carlson, 2016)","plainCitation":"(Carlson, 2016)"},"citationItems":[{"id":885,"uris":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"itemData":{"id":885,"type":"article-journal","title":"Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review","container-title":"Journal of pain research","page":"515","volume":"9","author":[{"family":"Carlson","given":"Cathy L."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Carlson, 2016). Measurement of biomarkers in the bloodstream can also help physicians to diagnose cancers. For example, HER2 and EGFR are some biomarkers that can help diagnose cancer or tumor cells ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1e7vm7keqo","properties":{"formattedCitation":"(Hammer et al., 2015)","plainCitation":"(Hammer et al., 2015)"},"citationItems":[{"id":882,"uris":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"itemData":{"id":882,"type":"article-journal","title":"Self-management for adult patients with cancer: an integrative review","container-title":"Cancer Nursing","page":"E10-E26","volume":"38","issue":"2","author":[{"family":"Hammer","given":"Marilyn J."},{"family":"Ercolano","given":"Elizabeth A."},{"family":"Wright","given":"Fay"},{"family":"Dickson","given":"Victoria Vaughan"},{"family":"Chyun","given":"Deborah"},{"family":"Melkus","given":"Gail D’Eramo"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hammer et al., 2015). These are tumor markers present on tumors.

Stages of Cancer

Clinical Stage

It is based on the identification tests. The extent of cancer-based results such as CT scans and x-rays or biopsy help in marking stages of cancer. This stage is significantly considered as an important stage for treatment. This stage is considered as an important stage for the reaction of cancer to treatment.

Pathological Stage

This is a pathological stage that is determined based on surgery. If surgery is performed then the stage is marked based on this. Based on surgery, the pathological stage of the cancer is identified ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a178v37gc86","properties":{"formattedCitation":"(Dine, Gordon, Shames, Kasler, & Barton-Burke, 2017)","plainCitation":"(Dine, Gordon, Shames, Kasler, & Barton-Burke, 2017)"},"citationItems":[{"id":880,"uris":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"itemData":{"id":880,"type":"article-journal","title":"Immune checkpoint inhibitors: an innovation in immunotherapy for the treatment and management of patients with cancer","container-title":"Asia-Pacific journal of oncology nursing","page":"127","volume":"4","issue":"2","author":[{"family":"Dine","given":"Jennifer"},{"family":"Gordon","given":"RuthAnn"},{"family":"Shames","given":"Yelena"},{"family":"Kasler","given":"Mary Kate"},{"family":"Barton-Burke","given":"Margaret"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dine, Gordon, Shames, Kasler, & Barton-Burke, 2017). If the cancer is proliferating, then nurses and physicians provide more accurate information about cancer location and proliferation. Cancer is named based on treatment and surgery, outcomes and prognosis.

TNM System

The system of TNM is also classified based on tumors. T represents tumor, N for nodes and M for metastasis. T shows that a tumor cannot be measured. T0 represents that the primary tumor is not found ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aq2ogmn970","properties":{"formattedCitation":"(Jackson, Oman, Patel, & Vega, 2016)","plainCitation":"(Jackson, Oman, Patel, & Vega, 2016)"},"citationItems":[{"id":477,"uris":["http://zotero.org/users/local/p8kwKNoG/items/4TQFZWFX"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/4TQFZWFX"],"itemData":{"id":477,"type":"article-journal","title":"Health disparities in colorectal cancer among racial and ethnic minorities in the United States","container-title":"Journal of gastrointestinal oncology","page":"S32","volume":"7","issue":"Suppl 1","author":[{"family":"Jackson","given":"Christian S."},{"family":"Oman","given":"Matthew"},{"family":"Patel","given":"Aatish M."},{"family":"Vega","given":"Kenneth J."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Jackson, Oman, Patel, & Vega, 2016). Tis is a sign that shows cancer cells growing in superficial layer form without damaging deeper tissues. T1, T2, T3, T4 are different stages of tumor state shows that represent the basis of tumor size.

Neutropenia

As a result of treatment with chemotherapy, white blood cells decrease in number. The body's defense system is not working properly therefore, systems are working inappropriately after receiving chemotherapy. As a result of chemotherapy, cells are damaged and their growth is interrupted. In chemotherapy ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1fc2i3okd0","properties":{"formattedCitation":"(Hammer et al., 2015)","plainCitation":"(Hammer et al., 2015)"},"citationItems":[{"id":882,"uris":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"itemData":{"id":882,"type":"article-journal","title":"Self-management for adult patients with cancer: an integrative review","container-title":"Cancer Nursing","page":"E10-E26","volume":"38","issue":"2","author":[{"family":"Hammer","given":"Marilyn J."},{"family":"Ercolano","given":"Elizabeth A."},{"family":"Wright","given":"Fay"},{"family":"Dickson","given":"Victoria Vaughan"},{"family":"Chyun","given":"Deborah"},{"family":"Melkus","given":"Gail D’Eramo"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hammer et al., 2015). Fast-growing cells are damaged and because of this healthy white blood cells are also damaged. To treat neutropenia, antibiotics are recommended. Granulocyte colony-stimulating factors are suggested to treat this condition. Medications are often changed to the treatment of neutropenia. Granulocyte transfusion is very rarely recommended to treat this condition.

Deep Vein Thrombosis

It has been observed that after treatment with chemotherapy, blood clots are formed in veins. Thrombosis can be found in any part of the veins. The deep vein is more susceptible to form vein thrombosis. The most occurring vein thrombosis is a lower leg, pelvis, and lungs. The patients receiving chemotherapy are mostly observed with the signs of DVT ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a21fanikkok","properties":{"formattedCitation":"(Jackson et al., 2016)","plainCitation":"(Jackson et al., 2016)"},"citationItems":[{"id":477,"uris":["http://zotero.org/users/local/p8kwKNoG/items/4TQFZWFX"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/4TQFZWFX"],"itemData":{"id":477,"type":"article-journal","title":"Health disparities in colorectal cancer among racial and ethnic minorities in the United States","container-title":"Journal of gastrointestinal oncology","page":"S32","volume":"7","issue":"Suppl 1","author":[{"family":"Jackson","given":"Christian S."},{"family":"Oman","given":"Matthew"},{"family":"Patel","given":"Aatish M."},{"family":"Vega","given":"Kenneth J."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Jackson et al., 2016). The treatment of deep vein thrombosis includes the use of blood thinners and anticoagulants. Blood thinners are used to treat various kinds of vein thrombosis and their drugs can be injected or prescribed as pills. These drugs decrease blood clots formed in veins.

Cancer Pain

It has been observed that patients often complain that the treatment of cancer has caused severe pain in various parts of the body. The treatment with chemotherapy has resulted in pain specifically started with this treatment ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a205b3oh1ms","properties":{"formattedCitation":"(Carlson, 2016)","plainCitation":"(Carlson, 2016)"},"citationItems":[{"id":885,"uris":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"itemData":{"id":885,"type":"article-journal","title":"Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review","container-title":"Journal of pain research","page":"515","volume":"9","author":[{"family":"Carlson","given":"Cathy L."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Carlson, 2016). Controlling and management of pain is a major part of cancer treatment. The treatment of pain due to cancer is based on how it has been started and which part is painful ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"asigbknvra","properties":{"formattedCitation":"(Hammer et al., 2015)","plainCitation":"(Hammer et al., 2015)"},"citationItems":[{"id":882,"uris":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"itemData":{"id":882,"type":"article-journal","title":"Self-management for adult patients with cancer: an integrative review","container-title":"Cancer Nursing","page":"E10-E26","volume":"38","issue":"2","author":[{"family":"Hammer","given":"Marilyn J."},{"family":"Ercolano","given":"Elizabeth A."},{"family":"Wright","given":"Fay"},{"family":"Dickson","given":"Victoria Vaughan"},{"family":"Chyun","given":"Deborah"},{"family":"Melkus","given":"Gail D’Eramo"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hammer et al., 2015). Treatment of pain due to cancer is treated with pain relievers. Physicians often recommend Acetaminophen and Tylenol for cancer pain. Noninflammatory drugs are also recommended to treat cancer pain such as ibuprofen and aspirin.

Incidence of Cancer and Mortality Rates

According to an estimate, 1,735,350 new cancer cases have been diagnosed in the United States and around 609,640 have been reported that died due to this disease. The most common cause of cancer death in breast cancer and lung cancer. It has been reported that prostate, melanoma, and colon cancer are also significantly associated with the increasing number of deaths in the United States. The new number of cases are reported to be 439.2 in 100,000 males and females annually estimated in the year 2011-2015 ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2naq4p9o1m","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Cancer Statistics,\\uc0\\u8221{} 2015)}","plainCitation":"(“Cancer Statistics,” 2015)"},"citationItems":[{"id":878,"uris":["http://zotero.org/users/local/p8kwKNoG/items/42Q3TEQW"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/42Q3TEQW"],"itemData":{"id":878,"type":"webpage","title":"Cancer Statistics","container-title":"National Cancer Institute","genre":"cgvArticle","abstract":"Basic information about cancer statistics in the U.S. and how they are used to understand the impact of cancer on society and to develop strategies that address the challenges that cancer poses.","URL":"https://www.cancer.gov/about-cancer/understanding/statistics","language":"en","issued":{"date-parts":[["2015",4,2]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Cancer Statistics,” 2015). Several deaths due to cancer are reported as 163.5 per 100,000 males and females annually as reported in the year 2011-2015. It has been reported that around 38.4% of people are diagnosed with cancer in some stage of their life.

According to an estimate, 15270 children from age 0 to 19 are diagnosed with cancer and children dies due to cancer are reported to be 1790 (“Cancer Statistics,” 2015). Cancer has been considered as one of the leading causes of death globally. Around 57% of cases of cancer were diagnosed in the year 2012 in developed countries ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1dpg24gm4j","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Cancer Statistics,\\uc0\\u8221{} 2015)}","plainCitation":"(“Cancer Statistics,” 2015)"},"citationItems":[{"id":878,"uris":["http://zotero.org/users/local/p8kwKNoG/items/42Q3TEQW"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/42Q3TEQW"],"itemData":{"id":878,"type":"webpage","title":"Cancer Statistics","container-title":"National Cancer Institute","genre":"cgvArticle","abstract":"Basic information about cancer statistics in the U.S. and how they are used to understand the impact of cancer on society and to develop strategies that address the challenges that cancer poses.","URL":"https://www.cancer.gov/about-cancer/understanding/statistics","language":"en","issued":{"date-parts":[["2015",4,2]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Cancer Statistics,” 2015). Certain biological and genetic factors are associated with the rise in cancer patients. Certain environmental factors such as UV and radiations are often associated with the onset of cancer among communities. Lifestyle-related factors and occupational factors including materials and objects that are considered carcinogenic are the cause of cancer. It has been reported in studies that various factors such as carcinogenic elements found in food, working areas are significantly associated with the onset of cancer among individuals ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1ahjngp3if","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Cancer Statistics,\\uc0\\u8221{} 2015)}","plainCitation":"(“Cancer Statistics,” 2015)"},"citationItems":[{"id":878,"uris":["http://zotero.org/users/local/p8kwKNoG/items/42Q3TEQW"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/42Q3TEQW"],"itemData":{"id":878,"type":"webpage","title":"Cancer Statistics","container-title":"National Cancer Institute","genre":"cgvArticle","abstract":"Basic information about cancer statistics in the U.S. and how they are used to understand the impact of cancer on society and to develop strategies that address the challenges that cancer poses.","URL":"https://www.cancer.gov/about-cancer/understanding/statistics","language":"en","issued":{"date-parts":[["2015",4,2]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Cancer Statistics,” 2015). It has been estimated that around 23.6 million people would be diagnosed with cancer in 2030.

American Cancer Society

The American cancer society is working on the prevention and anticipation of cancer. They are educating people and communities to reduce the use of smoking. The society is working with physicians and nurses to engage community workers to educate and train people for the prevention of cancer among communities ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a3d8lcqrhm","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Staying Healthy | How To Stay Healthy | American Cancer Society,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Staying Healthy | How To Stay Healthy | American Cancer Society,” n.d.)"},"citationItems":[{"id":876,"uris":["http://zotero.org/users/local/p8kwKNoG/items/8HG4M8BU"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/8HG4M8BU"],"itemData":{"id":876,"type":"webpage","title":"Staying Healthy | How To Stay Healthy | American Cancer Society","abstract":"Learn how staying healthy can help lower your chances of getting cancer. Discover tips on cancer screening recommendations and making healthy choices.","URL":"https://www.cancer.org/healthy.html","language":"en"}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Staying Healthy | How To Stay Healthy | American Cancer Society,” n.d.). It has been observed that minimizing exposure with the carcinogens can significantly reduce the burden of communities from communities. According to an estimate, it has been reported that occupational hazards include exposure of individuals with carcinogens such as radiation. Regular and timely screening for the patients to rule out cancer is also essential for the prevention of cancer ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a23kvglpvou","properties":{"formattedCitation":"{\\rtf (\\uc0\\u8220{}Staying Healthy | How To Stay Healthy | American Cancer Society,\\uc0\\u8221{} n.d.)}","plainCitation":"(“Staying Healthy | How To Stay Healthy | American Cancer Society,” n.d.)"},"citationItems":[{"id":876,"uris":["http://zotero.org/users/local/p8kwKNoG/items/8HG4M8BU"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/8HG4M8BU"],"itemData":{"id":876,"type":"webpage","title":"Staying Healthy | How To Stay Healthy | American Cancer Society","abstract":"Learn how staying healthy can help lower your chances of getting cancer. Discover tips on cancer screening recommendations and making healthy choices.","URL":"https://www.cancer.org/healthy.html","language":"en"}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“Staying Healthy | How To Stay Healthy | American Cancer Society,” n.d.). Educating people for acquiring healthy lifestyles is an essential part of prevention and anticipation programs.

American Cancer Society should initiate regular courses for community workers to promote health education among communities. They should sponsor education for all and health for all through prevention and anticipation programs (“Staying Healthy | How To Stay Healthy | American Cancer Society,” n.d.). By utilizing the efforts and struggles of nurses and community workers, the burden of the disease can be significantly reduced ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"ab7cu5k8f2","properties":{"formattedCitation":"(Hammer et al., 2015)","plainCitation":"(Hammer et al., 2015)"},"citationItems":[{"id":882,"uris":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"itemData":{"id":882,"type":"article-journal","title":"Self-management for adult patients with cancer: an integrative review","container-title":"Cancer Nursing","page":"E10-E26","volume":"38","issue":"2","author":[{"family":"Hammer","given":"Marilyn J."},{"family":"Ercolano","given":"Elizabeth A."},{"family":"Wright","given":"Fay"},{"family":"Dickson","given":"Victoria Vaughan"},{"family":"Chyun","given":"Deborah"},{"family":"Melkus","given":"Gail D’Eramo"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hammer et al., 2015). Adopting a healthy lifestyle is essentially important for people to learn how to prevent them from diseases such as cancer. Occupational hazards can also be reduced from the communities such as limiting the exposure of individuals with carcinogenic rays and radiations.

Informing and educating people to acquire a healthy lifestyle including healthy food and diet along with that regular screening and checkups can significantly improve the health of people. American cancer society should start school and college-based educational programs to educate children and adolescents from the communities to have a long-term impact on education on societies. Children learn and adopt changes more often as compared to individuals. Educating high-risk areas and communities to acquire healthy lifestyles is essentially important to reduce the proliferation of disease.

Nursing Process

The five-step process of nursing care includes assessment, diagnosis, planning, implementation, and evaluation.

Assessment

Assessment is the first step of the nursing process. Nurses need to recode objective and subjective data for patients to assess the condition and disease. Objective and subjective data are important to diagnose cancer in the early stages. Vital signs, weight, and height assessment are also indicators to assess the condition in early stages ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a79bscu273","properties":{"formattedCitation":"(Carlson, 2016)","plainCitation":"(Carlson, 2016)"},"citationItems":[{"id":885,"uris":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"itemData":{"id":885,"type":"article-journal","title":"Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review","container-title":"Journal of pain research","page":"515","volume":"9","author":[{"family":"Carlson","given":"Cathy L."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Carlson, 2016). The electronic health record is also helpful for the record of patient data to evaluate when required.

Diagnosis

Diagnosis is the 2nd stage of the nursing process. Recording assessment of patient's data is helpful for the diagnosis purpose. After recording and assessing, physicians and nurses focus on the diagnosis of disease. Physiological and psychological health is also helpful in the diagnosis of cancer such as changes in health status that can significantly change various metabolic functions of the body. Potential changes in the functions of the body are helpful in the diagnosis of diseases such as the growth of patients usually decreases and the weight of the body is suddenly decreased in cases of cancer.

Planning

This is the 3rd step in the nursing process. This step includes the outcomes and goals of patient diagnosis and assessment. It includes specific planning for the treatment of cancer, measurable goal setting to measure the stage and proliferation of the disease ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2j5mrhnj43","properties":{"formattedCitation":"(Dine et al., 2017)","plainCitation":"(Dine et al., 2017)"},"citationItems":[{"id":880,"uris":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"itemData":{"id":880,"type":"article-journal","title":"Immune checkpoint inhibitors: an innovation in immunotherapy for the treatment and management of patients with cancer","container-title":"Asia-Pacific journal of oncology nursing","page":"127","volume":"4","issue":"2","author":[{"family":"Dine","given":"Jennifer"},{"family":"Gordon","given":"RuthAnn"},{"family":"Shames","given":"Yelena"},{"family":"Kasler","given":"Mary Kate"},{"family":"Barton-Burke","given":"Margaret"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dine et al., 2017). The step of planning is attainable in terms of assessing the outcomes and plan of care for patients. This is a realistic and result-oriented step where results are formulated to reach successfully to the treatment plan.

Implementation

This is the 4th step of the nursing process. It involves the actions that are suggested in assessment, diagnosis, and planning for the management of the disease. This is a plan of care to implement the plan for patients to treat the disease. The plan of care for cancer patients is planned and then implemented to treat the case. It can vary from patient to patient depending on the stage and proliferation of cancer ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2a3khpirrv","properties":{"formattedCitation":"(Carlson, 2016)","plainCitation":"(Carlson, 2016)"},"citationItems":[{"id":885,"uris":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/WUWEBVQB"],"itemData":{"id":885,"type":"article-journal","title":"Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review","container-title":"Journal of pain research","page":"515","volume":"9","author":[{"family":"Carlson","given":"Cathy L."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Carlson, 2016). Intervention and interferences are implemented to treat the patients. Medications are administered to manage the conditions and to prevent it from further proliferation particularly in the last stages of cancer ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1bo1ijem6e","properties":{"formattedCitation":"(Dine et al., 2017)","plainCitation":"(Dine et al., 2017)"},"citationItems":[{"id":880,"uris":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"itemData":{"id":880,"type":"article-journal","title":"Immune checkpoint inhibitors: an innovation in immunotherapy for the treatment and management of patients with cancer","container-title":"Asia-Pacific journal of oncology nursing","page":"127","volume":"4","issue":"2","author":[{"family":"Dine","given":"Jennifer"},{"family":"Gordon","given":"RuthAnn"},{"family":"Shames","given":"Yelena"},{"family":"Kasler","given":"Mary Kate"},{"family":"Barton-Burke","given":"Margaret"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dine et al., 2017). Standard treatment plans are suggested and implemented in this stage or nursing process in the form of protocols.

Evaluation

This is the last step for disease management in the nursing process. This step is the evaluation of all the steps implemented in the management and treatment of the disease. This phase is the evaluation of the disease intervention whether the interference is effective or not. Without utilizing the evaluation process, a patient cannot be assessed that he is recovering or not ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1bqlahq8gq","properties":{"formattedCitation":"(Dine et al., 2017)","plainCitation":"(Dine et al., 2017)"},"citationItems":[{"id":880,"uris":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"itemData":{"id":880,"type":"article-journal","title":"Immune checkpoint inhibitors: an innovation in immunotherapy for the treatment and management of patients with cancer","container-title":"Asia-Pacific journal of oncology nursing","page":"127","volume":"4","issue":"2","author":[{"family":"Dine","given":"Jennifer"},{"family":"Gordon","given":"RuthAnn"},{"family":"Shames","given":"Yelena"},{"family":"Kasler","given":"Mary Kate"},{"family":"Barton-Burke","given":"Margaret"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dine et al., 2017). Patient outcome is based on an evaluation process to assess the condition and its severity.

Blending Social Sciences with nursing care

Humanities and social sciences are a part of the nursing curriculum. It has been observed that these disciplines are specifically included in the curriculum to teach nurses with communication skills. And decision making the power of nurses is improved ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a2jjplejet7","properties":{"formattedCitation":"(Jackson et al., 2016)","plainCitation":"(Jackson et al., 2016)"},"citationItems":[{"id":477,"uris":["http://zotero.org/users/local/p8kwKNoG/items/4TQFZWFX"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/4TQFZWFX"],"itemData":{"id":477,"type":"article-journal","title":"Health disparities in colorectal cancer among racial and ethnic minorities in the United States","container-title":"Journal of gastrointestinal oncology","page":"S32","volume":"7","issue":"Suppl 1","author":[{"family":"Jackson","given":"Christian S."},{"family":"Oman","given":"Matthew"},{"family":"Patel","given":"Aatish M."},{"family":"Vega","given":"Kenneth J."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Jackson et al., 2016). Various studies have shown that blending social sciences, arts and literature with the nursing curriculum are significantly helping for nurses to improve their creative skills, decision making, learning, religious concerns and economic understanding ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1t4pv9c76b","properties":{"formattedCitation":"(Dine et al., 2017)","plainCitation":"(Dine et al., 2017)"},"citationItems":[{"id":880,"uris":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/5376HRBT"],"itemData":{"id":880,"type":"article-journal","title":"Immune checkpoint inhibitors: an innovation in immunotherapy for the treatment and management of patients with cancer","container-title":"Asia-Pacific journal of oncology nursing","page":"127","volume":"4","issue":"2","author":[{"family":"Dine","given":"Jennifer"},{"family":"Gordon","given":"RuthAnn"},{"family":"Shames","given":"Yelena"},{"family":"Kasler","given":"Mary Kate"},{"family":"Barton-Burke","given":"Margaret"}],"issued":{"date-parts":[["2017"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Dine et al., 2017). It has been observed that nurses with good communication skills are good in understanding patient’s psychology and are also good in arts and literature. They have better knowledge regarding religion, arts, music and social sciences ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"a1h13782m28","properties":{"formattedCitation":"(Hammer et al., 2015)","plainCitation":"(Hammer et al., 2015)"},"citationItems":[{"id":882,"uris":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"uri":["http://zotero.org/users/local/p8kwKNoG/items/U74AMDD2"],"itemData":{"id":882,"type":"article-journal","title":"Self-management for adult patients with cancer: an integrative review","container-title":"Cancer Nursing","page":"E10-E26","volume":"38","issue":"2","author":[{"family":"Hammer","given":"Marilyn J."},{"family":"Ercolano","given":"Elizabeth A."},{"family":"Wright","given":"Fay"},{"family":"Dickson","given":"Victoria Vaughan"},{"family":"Chyun","given":"Deborah"},{"family":"Melkus","given":"Gail D’Eramo"}],"issued":{"date-parts":[["2015"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Hammer et al., 2015). Blending these subjects with the nursing curriculum is important in making interdisciplinary approaches. Mathematics, literature, physical sciences are also a part of the curriculum of nursing education.

References

ADDIN ZOTERO_BIBL {"custom":[]} CSL_BIBLIOGRAPHY Cancer Statistics [CgvArticle]. (2015, April 2). Retrieved from National Cancer Institute website: https://www.cancer.gov/about-cancer/understanding/statistics

Carlson, C. L. (2016). Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review. Journal of Pain Research, 9, 515.

Dine, J., Gordon, R., Shames, Y., Kasler, M. K., & Barton-Burke, M. (2017). Immune checkpoint inhibitors: an innovation in immunotherapy for the treatment and management of patients with cancer. Asia-Pacific Journal of Oncology Nursing, 4(2), 127.

Hammer, M. J., Ercolano, E. A., Wright, F., Dickson, V. V., Chyun, D., & Melkus, G. D. (2015). Self-management for adult patients with cancer: an integrative review. Cancer Nursing, 38(2), E10–E26.

Jackson, C. S., Oman, M., Patel, A. M., & Vega, K. J. (2016). Health disparities in colorectal cancer among racial and ethnic minorities in the United States. Journal of Gastrointestinal Oncology, 7(Suppl 1), S32.

Staying Healthy | How To Stay Healthy | American Cancer Society. (n.d.). Retrieved from https://www.cancer.org/healthy.html

Benchmark - Patient's Spiritual Needs: Case Analysis

Case analysis

[Author Name(s), First M. Last, Omit Titles and Degrees]

[Institutional Affiliation(s)]

Author Note

[Include any grant/funding information and a complete correspondence address.]

Question 1

According to the principles of Beneficence, the treatment of the individual is based on those interventions having the finest and suitable results for the patient. James is in a state where his ailment would become worse if not preserved timely but he believed that parents constantly display love for their child by taking decisions that are best for their child. Parents always follow non-maleficence when it is about their child. Physicians always choose the best suitable treatment for patients. Mike tried to create the best for his child by autonomy to choose with justice and fairness ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"704pA6zu","properties":{"formattedCitation":"(Askitopoulou & Vgontzas, 2018)","plainCitation":"(Askitopoulou & Vgontzas, 2018)","noteIndex":0},"citationItems":[{"id":21,"uris":["http://zotero.org/users/local/4I4SgYzi/items/W47HRC5K"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/W47HRC5K"],"itemData":{"id":21,"type":"article-journal","title":"The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times","container-title":"European Spine Journal","page":"1481-1490","volume":"27","issue":"7","author":[{"family":"Askitopoulou","given":"Helen"},{"family":"Vgontzas","given":"Antoniοs N."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Askitopoulou & Vgontzas, 2018). The idea that health specialists and scholars would continually practice Beneficence appears normal to most individuals, however, each health interference or research interference has the possibility to damage the receiver ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"Jb0IatFP","properties":{"formattedCitation":"(Beever & Brightman, 2016a)","plainCitation":"(Beever & Brightman, 2016a)","noteIndex":0},"citationItems":[{"id":16,"uris":["http://zotero.org/users/local/4I4SgYzi/items/EGCA677P"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/EGCA677P"],"itemData":{"id":16,"type":"article-journal","title":"Reflexive principlism as an effective approach for developing ethical reasoning in engineering","container-title":"Science and Engineering Ethics","page":"275–291","volume":"22","issue":"1","source":"Google Scholar","author":[{"family":"Beever","given":"Jonathan"},{"family":"Brightman","given":"Andrew O."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Beever & Brightman, 2016a). There are numerous diverse examples in the medical field and research for steering a cost–advantage examination and mediating whether a particular procedure would be an adequate principle of beneficence, and also whether the procedure chosen is best for the patient ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"VVfoV672","properties":{"formattedCitation":"(Beever & Brightman, 2016a)","plainCitation":"(Beever & Brightman, 2016a)","noteIndex":0},"citationItems":[{"id":16,"uris":["http://zotero.org/users/local/4I4SgYzi/items/EGCA677P"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/EGCA677P"],"itemData":{"id":16,"type":"article-journal","title":"Reflexive principlism as an effective approach for developing ethical reasoning in engineering","container-title":"Science and Engineering Ethics","page":"275–291","volume":"22","issue":"1","source":"Google Scholar","author":[{"family":"Beever","given":"Jonathan"},{"family":"Brightman","given":"Andrew O."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Beever & Brightman, 2016a). Though Beneficence is the best practice in the medical field. Keeping given the James situation, physicians would recommend for the kidney transplant. Parents would never choose something harmful to their children. In this case, Mike would not harm, nor he can practice evil for James. Physicians would not recommend Mike to keep making decisions that are irrational and harmful for the patient, but it will not disrespect their autonomy as Mike has already experienced the terrible condition of James because of the previous delay in treatment.

Question 2

Christian thinks Beneficence is the greatest persistent belief of the biomedical profession. Keeping given the principles of Beneficence, Christian ought to take the medical profession as a diverse field with complicated decisions at every stage. However, he thinks that the principle of Beneficence is the topmost secret of physicians in health and sickness. As physicians and surgeons always choose what is best for the patients, Christian would keep viewing the principles of beneficence which means the best outcome for the patient in terms of health and improved quality of life.

Since Christian believes beneficence, Christian should make medical decisions as best decided by the physicians. Physicians do not always want harmful decisions for the patients, instead, they would choose the best principles which may follow a painful procedure. Christian should think health and sickness are in the hands of God, but physicians know what is the best intervention and interference for the patient ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"zD4zaZhC","properties":{"formattedCitation":"(Askitopoulou & Vgontzas, 2018)","plainCitation":"(Askitopoulou & Vgontzas, 2018)","noteIndex":0},"citationItems":[{"id":21,"uris":["http://zotero.org/users/local/4I4SgYzi/items/W47HRC5K"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/W47HRC5K"],"itemData":{"id":21,"type":"article-journal","title":"The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times","container-title":"European Spine Journal","page":"1481-1490","volume":"27","issue":"7","author":[{"family":"Askitopoulou","given":"Helen"},{"family":"Vgontzas","given":"Antoniοs N."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Askitopoulou & Vgontzas, 2018). Interventions depend on the conditions and the stage of the disorder so physicians would decide what is the best and fruitful procedure.

Mike should also decide and look for autonomy but keeping in view that the physicians will show him ultimately the course that would follow the best interventions and interferences for the patient ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"HuCQb6bc","properties":{"formattedCitation":"(Askitopoulou & Vgontzas, 2018)","plainCitation":"(Askitopoulou & Vgontzas, 2018)","noteIndex":0},"citationItems":[{"id":21,"uris":["http://zotero.org/users/local/4I4SgYzi/items/W47HRC5K"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/W47HRC5K"],"itemData":{"id":21,"type":"article-journal","title":"The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times","container-title":"European Spine Journal","page":"1481-1490","volume":"27","issue":"7","author":[{"family":"Askitopoulou","given":"Helen"},{"family":"Vgontzas","given":"Antoniοs N."}],"issued":{"date-parts":[["2018"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Askitopoulou & Vgontzas, 2018). As a Christian, Mike should also believe the principles of beneficence and that will lead to the fruitful interventions chosen by the Physicians, but may take a painful procedure. Mike should keep faith in God that ultimately what is best for James would happen at the end ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"aTBiEsmM","properties":{"formattedCitation":"(Beever & Brightman, 2016a)","plainCitation":"(Beever & Brightman, 2016a)","noteIndex":0},"citationItems":[{"id":16,"uris":["http://zotero.org/users/local/4I4SgYzi/items/EGCA677P"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/EGCA677P"],"itemData":{"id":16,"type":"article-journal","title":"Reflexive principlism as an effective approach for developing ethical reasoning in engineering","container-title":"Science and Engineering Ethics","page":"275–291","volume":"22","issue":"1","source":"Google Scholar","author":[{"family":"Beever","given":"Jonathan"},{"family":"Brightman","given":"Andrew O."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Beever & Brightman, 2016a). The principles of beneficence and non-maleficence are the best principles to be followed in the medical profession but it may take rigorous prayers along with hard and painful procedures. Physicians will help assist Mike to take the decision of beneficence that is best for James (Askitopoulou & Vgontzas, 2018b). Mike should believe these principles that what he is choosing is best for his child, however, the interventions are suggested by the physicians. Honoring the principles of beneficence and non-maleficence, a patient needs both of the principles applied and followed justly and honestly. Consequently, Mike would have to go with the principles of beneficence, following physicians, and the best treatment they can choose for James. Whether they choose rigorous prayers or principles of Beneficence, ultimately God is there to relief James. This is the only way of truthfully glorifying the values of beneficence and non-maleficence.

Question 3

Before steering a spiritual valuation, surgeons must deliberate their faith custom, principles and performs, optimistic and negative conclusions, approaches on faith and remedial, and relief and aptitude to contribute to another's piety. Certain surgeons may not reflect themselves spiritually. Some surgeons often choose their level of competency to treat patients and to assess the patient's requirements. Emphasizing on spiritual assessment, patient and his parents would always keep on believing their own decision but what is best for the patient, this depends on the reality of the situation (Carr & Winslow, (2017). Keeping given the James condition, Mike will keep on believing the thoughts he had, but side by side he will always want what is best for his child. After the spiritual assessment, physicians would recommend Mike to follow and make decisions that are best for James ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"w6ixhwA9","properties":{"formattedCitation":"(\\uc0\\u8220{}How the Four Principles of Health Care Ethics Improve Patient Care,\\uc0\\u8221{} 2017)","plainCitation":"(“How the Four Principles of Health Care Ethics Improve Patient Care,” 2017)","noteIndex":0},"citationItems":[{"id":25,"uris":["http://zotero.org/users/local/4I4SgYzi/items/CLJ4GZVR"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/CLJ4GZVR"],"itemData":{"id":25,"type":"webpage","title":"How the Four Principles of Health Care Ethics Improve Patient Care","container-title":"online.sju","abstract":"Whether your role is that of a doctor or a health care administrator, working in the field of health care is both highly rewarding and challenging. Many medical procedures and treatments have both merits and downsides, and patients have their own input and circumstances to consider. The four principles of health care ethics developed by Tom Beauchamp and James Childress in the 1985 Principles of Biomedical Ethics provide medical practitioners with guidelines to make decisions when they inevitably face complicated situations involving patients.","URL":"https://online.sju.edu/graduate/masters-health-administration/resources/articles/four-principles-of-health-care-ethics-improve-patient-care","language":"en","issued":{"date-parts":[["2017",2,13]]},"accessed":{"date-parts":[["2019",10,12]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (“How the Four Principles of Health Care Ethics Improve Patient Care,” 2017). In this way, physicians would suggest and support Mike's beliefs along with deciding the best for James too ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"XDcthKXv","properties":{"formattedCitation":"(Beever & Brightman, 2016b)","plainCitation":"(Beever & Brightman, 2016b)","noteIndex":0},"citationItems":[{"id":19,"uris":["http://zotero.org/users/local/4I4SgYzi/items/N47HFWLF"],"uri":["http://zotero.org/users/local/4I4SgYzi/items/N47HFWLF"],"itemData":{"id":19,"type":"article-journal","title":"Reflexive principlism as an effective approach for developing ethical reasoning in engineering","container-title":"Science and Engineering Ethics","page":"275-291","volume":"22","issue":"1","author":[{"family":"Beever","given":"Jonathan"},{"family":"Brightman","given":"Andrew O."}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Beever & Brightman, 2016b). After realizing, Mike decided to take James to the hospital, where he found out that the James situation is becoming worse because of the delay in treatment. According to the principles of healing and autonomy, Mike fluctuates and fights to choose as he has his other son Samuel who can donate a kidney. Mike still believes that whatever decision he will be making, God will do a miracle to save his child whether he chooses a kidney transplant option or to wait for the miracle. After transplant, it is still God who will help and recover his child or perhaps it is always God who does miracles. Consequently, physicians will assess the situation and will assist Mike to decide what is best for James, taking care of the spiritual requirements.

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Askitopoulou, H., & Vgontzas, A. N. (2018). The relevance of the Hippocratic Oath to the ethical and moral values of contemporary medicine. Part I: The Hippocratic Oath from antiquity to modern times. European Spine Journal, 27(7), 1481–1490.

Beever, J., & Brightman, A. O. (2016a). Reflexive principlism as an effective approach for developing ethical reasoning in engineering. Science and Engineering Ethics, 22(1), 275–291.

Beever, J., & Brightman, A. O. (2016b). Reflexive principlism as an effective approach for developing ethical reasoning in engineering. Science and Engineering Ethics, 22(1), 275–291.

How the Four Principles of Health Care Ethics Improve Patient Care. (2017, February 13). Retrieved October 12, 2019, from Online.sju website: https://online.sju.edu/graduate/masters-health-administration/resources/articles/four-principles-of-health-care-ethics-improve-patient-care

Carr, M. F., & Winslow, G. R. (2017). From conceptual to concrete. In World Religions for Healthcare Professionals (pp. 31–45). Routledge.

How the Four Principles of Health Care Ethics Improve Patient Care. (2017, February 13). Retrieved September 26, 2019, from online.sju website: https://online.sju.edu/graduate/masters-health-administration/resources/articles/four-principles-of-health-care-ethics-improve-patient-care

Benchmark - Policy Brief

Policy Brief

[Name]

[Institution]

Policy Brief

Public wellbeing has consistently been impacted by variations in the climate. Variations in the climate affect the environment that offers us shelter, clean air, food, water, and security. Climatic variations coupled with other stress factors undermine human wellbeing and prosperity in a number of ways. A portion of these impacts have also been witnessed in the United States. People more often than not confuse climate with weather, but both the concepts are poles apart. Weather actually represents an environmental state at any given place and time. On the contrary climate represents such weather conditions which last for multiple decades or longer. There is no doubt that the earth’s temperature has risen over the past decades and is still rising at a steady pace.

Effects of Climate Change

Climatic variations normally affect certain people or groups of people. The variation in climatic effects depends mainly upon the geographic location and the ability of people to cope with calamities owing to climate change. It has been experienced that more often than not climatic variations deteriorate the prevailing vulnerabilities. Geographic location is considered the main factor to influence the vulnerability to climatic variations. In case of US population has been increased in the Southern and Western regions and these areas are most vulnerable to coastal storms ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"KfkHVlI3","properties":{"formattedCitation":"(Melillo, 2014)","plainCitation":"(Melillo, 2014)","noteIndex":0},"citationItems":[{"id":512,"uris":["http://zotero.org/users/local/jsvqEXt1/items/XVK7HECZ"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/XVK7HECZ"],"itemData":{"id":512,"type":"book","title":"Climate change impacts in the United States: the third national climate assessment","publisher":"Government Printing Office","source":"Google Scholar","title-short":"Climate change impacts in the United States","author":[{"family":"Melillo","given":"Jerry M."}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Melillo, 2014). Moreover, people living in the Mountain West are most likely to experience water shortages. Coastal regions of the US coupled with its western regions are most likely to face water, transportation and energy related problems owing climatic variations and population growth ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"D96eNfcl","properties":{"formattedCitation":"(Melillo, 2014)","plainCitation":"(Melillo, 2014)","noteIndex":0},"citationItems":[{"id":512,"uris":["http://zotero.org/users/local/jsvqEXt1/items/XVK7HECZ"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/XVK7HECZ"],"itemData":{"id":512,"type":"book","title":"Climate change impacts in the United States: the third national climate assessment","publisher":"Government Printing Office","source":"Google Scholar","title-short":"Climate change impacts in the United States","author":[{"family":"Melillo","given":"Jerry M."}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Melillo, 2014).

The ability to cope with climatic variations does not remain constant rather it depends upon the people. There is a large share of older people living in the warmer areas of the US. Such regions will probably witness extremely hot temperatures, famine, and storms in the years to come ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"LrAfNAmQ","properties":{"formattedCitation":"(Melillo, 2014)","plainCitation":"(Melillo, 2014)","noteIndex":0},"citationItems":[{"id":512,"uris":["http://zotero.org/users/local/jsvqEXt1/items/XVK7HECZ"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/XVK7HECZ"],"itemData":{"id":512,"type":"book","title":"Climate change impacts in the United States: the third national climate assessment","publisher":"Government Printing Office","source":"Google Scholar","title-short":"Climate change impacts in the United States","author":[{"family":"Melillo","given":"Jerry M."}],"issued":{"date-parts":[["2014"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Melillo, 2014)

In addition, people living in rural areas depend upon the environment and environmental resources for their survival are most vulnerable to climatic variations. People living in isolated communities will also be the victims of such climatic variations. People living in urban areas are also not safe from the climatic variations, albeit, their vulnerabilities are different from those living in rural areas. Cities are most likely to witness heat waves owing to their dense population ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"CCmnhUsy","properties":{"formattedCitation":"(Frumkin, 2016)","plainCitation":"(Frumkin, 2016)","noteIndex":0},"citationItems":[{"id":517,"uris":["http://zotero.org/users/local/jsvqEXt1/items/3JDF47ZV"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/3JDF47ZV"],"itemData":{"id":517,"type":"article-journal","title":"Urban sprawl and public health","container-title":"Public health reports","source":"Google Scholar","author":[{"family":"Frumkin","given":"Howard"}],"issued":{"date-parts":[["2016"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Frumkin, 2016). So, precisely speaking, the issue of climatic variations is neither local or a state issue, but a national issue. A thought provoking and effective policy must be introduced to cope with climatic catastrophes.

Problem Statement

The impacts of climate change are likely to get dreadful in the years to come. This essay will provide a policy brief to cope with varying climate conditions and its deteriorating impacts on human health. The aim of this essay is to provide an insight to the mitigation plan, suggest priorities to deal with future climate change and its deteriorating impacts on human health.

Suggestions for Policy

The impacts of climatic variations on public health are great in number. It is inevitable to recognize such effects prior to suggest policy measures in order to make the health policy more effective. Designing policy sans recognizing the climate change impacts on public health issues would amount to jumping in the sea with blindfolds. Climate change can impact the public health in following ways.

Heat Waves

Air Quality

Water Quality

Vector-Borne Diseases

Increasing in the temperature is considered as the most abrupt and obvious impact of climate change on public health. Heat waves actually owe the rise in temperature generally in summer months depending upon the geographical location coupled with high level of humidity in the air. Elderly population and young children will most likely to get effected from the heat waves along with urban populace at large. USCDCP (United States Centers for Disease Control and Prevention) demonstrated with the help of graphical representation that which group is most vulnerable to heat waves ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"lB0WM6ww","properties":{"formattedCitation":"(Kent, McClure, Zaitchik, Smith, & Gohlke, 2013)","plainCitation":"(Kent, McClure, Zaitchik, Smith, & Gohlke, 2013)","noteIndex":0},"citationItems":[{"id":525,"uris":["http://zotero.org/users/local/jsvqEXt1/items/CUWN7M2X"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/CUWN7M2X"],"itemData":{"id":525,"type":"article-journal","title":"Heat waves and health outcomes in Alabama (USA): the importance of heat wave definition","container-title":"Environmental health perspectives","page":"151–158","volume":"122","issue":"2","source":"Google Scholar","title-short":"Heat waves and health outcomes in Alabama (USA)","author":[{"family":"Kent","given":"Shia T."},{"family":"McClure","given":"Leslie A."},{"family":"Zaitchik","given":"Benjamin F."},{"family":"Smith","given":"Tiffany T."},{"family":"Gohlke","given":"Julia M."}],"issued":{"date-parts":[["2013"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Kent, McClure, Zaitchik, Smith, & Gohlke, 2013). The graphical representation given by USCDCP is given below

Suggestions

Data on environmental conditions must be tracked.

Climate related modeling and forecasting of health issues must be expanded.

Those people who are at greater risk or most vulnerable to the heatwave must be identified on priority basis.

All the stakeholders must devise a policy with consensus and the stakeholders are as follows:

State government

Local government

NGOs

Healthcare professionals

Community leaders

Faith-based communities

All the aspects of climate change concerning heat wave must be communicated to the public, decision makers, and healthcare professionals. These aspects must incorporate risk of the heat wave and mitigation plan for such risks.

All the stakeholders must be prepared and response plan concerning the health issues of heat wave must be developed.

Technical advice must be available to all the stake holders especially local and state healthcare institutions in order to implement national readiness measures related to the heatwave effects of climatic variations.

Budgeting must be proper and local governments must be given due share to deal with climatic catastrophes.

Carbon emission must be reduced in the urban areas use of materials responsible for ozone depletion must be prohibited at all levels i.e. local, state and national.

Impacts on Healthcare Delivery System

The impact of adopting aforementioned measure for policy making will affect the healthcare delivery system profoundly. It will make the healthcare delivery system more resilient to the climatic change. Suitable funding to healthcare institutions will definitely reduce the burden on contemporary budget of such institutions. This will allow healthcare institutions to dedicate department only for patients who will be affected by the heatwave owing to climate change ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"W8lgPuud","properties":{"formattedCitation":"(Haines, Kovats, Campbell-Lendrum, & Corval\\uc0\\u225{}n, 2006)","plainCitation":"(Haines, Kovats, Campbell-Lendrum, & Corvalán, 2006)","noteIndex":0},"citationItems":[{"id":518,"uris":["http://zotero.org/users/local/jsvqEXt1/items/LQBAKARD"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/LQBAKARD"],"itemData":{"id":518,"type":"article-journal","title":"Climate change and human health: impacts, vulnerability and public health","container-title":"Public health","page":"585–596","volume":"120","issue":"7","source":"Google Scholar","title-short":"Climate change and human health","author":[{"family":"Haines","given":"Andy"},{"family":"Kovats","given":"R. Sari"},{"family":"Campbell-Lendrum","given":"Diarmid"},{"family":"Corvalán","given":"Carlos"}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Haines, Kovats, Campbell-Lendrum, & Corvalán, 2006). Budget allocation will also help the poor people who cannot afford to bear the healthcare cost. It will also encourage the development of workforce by ensuring the training of competent healthcare professionals.

Climate change is a global change and almost every region and country in the world is being affected by the climate change. Albeit, it is difficult to cope with abrupt climate changes but adopting efficient policy and can actually help us to deal with the monster of climate change ADDIN ZOTERO_ITEM CSL_CITATION {"citationID":"bKvsQRmi","properties":{"formattedCitation":"(Haines et al., 2006)","plainCitation":"(Haines et al., 2006)","noteIndex":0},"citationItems":[{"id":518,"uris":["http://zotero.org/users/local/jsvqEXt1/items/LQBAKARD"],"uri":["http://zotero.org/users/local/jsvqEXt1/items/LQBAKARD"],"itemData":{"id":518,"type":"article-journal","title":"Climate change and human health: impacts, vulnerability and public health","container-title":"Public health","page":"585–596","volume":"120","issue":"7","source":"Google Scholar","title-short":"Climate change and human health","author":[{"family":"Haines","given":"Andy"},{"family":"Kovats","given":"R. Sari"},{"family":"Campbell-Lendrum","given":"Diarmid"},{"family":"Corvalán","given":"Carlos"}],"issued":{"date-parts":[["2006"]]}}}],"schema":"https://github.com/citation-style-language/schema/raw/master/csl-citation.json"} (Haines et al., 2006).

References

ADDIN ZOTERO_BIBL {"uncited":[],"omitted":[],"custom":[]} CSL_BIBLIOGRAPHY Frumkin, H. (2016). Urban sprawl and public health. Public Health Reports.

Haines, A., Kovats, R. S., Campbell-Lendrum, D., & Corvalán, C. (2006). Climate change and human health: Impacts, vulnerability and public health. Public Health, 120(7), 585–596.

Kent, S. T., McClure, L. A., Zaitchik, B. F., Smith, T. T., & Gohlke, J. M. (2013). Heat waves and health outcomes in Alabama (USA): The importance of heat wave definition. Environmental Health Perspectives, 122(2), 151–158.

Melillo, J. M. (2014). Climate change impacts in the United States: The third national climate assessment. Government Printing Office.

Vincent, G. K., & Velkoff, V. A. (2010). The next four decades: The older population in the United States: 2010 to 2050. US Department of Commerce, Economics and Statistics Administration, US ….