Select one of the below-listed topics to use for your final project. Submit topic choice and a minimum of three references related to your topic to your instructor for approval. References should be five years or less since publication and be listed in the current APA Style. No Blog sites, WIKI, or another school of nursing references, please. The Final Project may be presented in your choice from the following: PowerPoint Presentation (PPT), Infographic, or Pamphlet.

  1. Nurse managers must work with staff to foster respect of different lifestyles. As a future manager, how can you provide culture-centered leadership to influence your team members and care for a culturally diverse patient population? Please incorporate concepts of cultural humility, sensitivity, or competence and one cultural theory into your response.  
  2. Use Kouzes and Posner model to show how the nurse manager on a 30-bed rehabilitation unit would decide the best approach to finding out the cause of increasing urinary tract infections (UTIs) on her unit over the past 6 months. 
  3. Quadruple Aim of Healthcare
    1. What are the guidelines for the quadruple aim?
    1. What is the importance of achieving the quadruple aim?
    1. What outcomes may be seen from promoting the leader-follower relationship?
  4. The Chief Nursing Officer (CNO) of an acute care hospital is interested in becoming a Magnet-designated hospital. The CNO would like to create a strategic plan for nursing excellence. If you were the CNO, what would the mission statement for nursing say? What would the vision statement for nursing say? What would be the core values of the nursing department? Create an Incivility Statement/Policy. 

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  1. You are assigned some risk management activities in the nursing facility where you work. In investigating incident reports filed by staff, you discover that this is the third incident this week in which a patient has fallen while attempting to get out of bed and sit in a chair. How would you begin to address this issue? Decide how you would start a more complete investigation of this issue. For example, is it a facility-wide issue or one that is confined to one unit? Does it affect all shifts or only one? What safety issues are you going to discuss with your staff, and how are you going to discuss these issues? Do these falls involve the same staff member? 
  2. Analyze differences among research, evidence-based practice, practice-based evidence, comparative effectiveness research, outcomes research, and quality improvement. How do these practices affect nursing and patient outcomes? 
  3. Review the educational program TeamSTEPPS. Identify two strategies you can incorporate into your practice. Present your rationale for selecting those and create an action plan to incorporate those strategies into your practice. 

Questions about APA? Visit the WCU Library’s APA Help guide.

Rubric

Topic and References Rubric

Topic and References Rubric
CriteriaRatingsPts
This criterion is linked to a Learning OutcomeTopic Choice5 pts Meets or Exceeds Expectations Submitted topic choice from one of the options listed. 0 pts Does Not Meet Expectations No topic submission5 pts
This criterion is linked to a Learning OutcomeAPA formatting10 pts Mostly Meets Expectations All three articles listed are in the correct APA format, no errors noted 8 pts Mostly Meets Expectations 1-2 APA errors noted in formatting OR 2 references listed 4 pts Below Expectations 3-4 APA errors noted in formatting OR 1 reference listed 0 pts Does Not Meet Expectations > 5 APA errors noted OR no references listed10 pts
This criterion is linked to a Learning OutcomeReference time frame5 pts Meets or Exceeds Expectations All three articles published within the past 5 years 3 pts Mostly Meets Expectations 1-2 of the articles published within the past 5 years 0 pts Does Not Meet Expectations Articles listed are all greater than 5 years old5 pts
Total Points: 20

Peer 1

Discuss the Mr. Rodriquez’s history that would be pertinent to his gastrointestinal problem. Include chief complaint, HPI, Social, Family and Past medical history that would be important to know.

Chief Complaint: worsening abdominal pain over the past several months” and is “worried that something is wrong.”

HPI: Started probably a year ago. It used to happen a few times a week, now it hurts every day. It usually burns right here

Family: Father had high blood pressure and mother had diabetes

Past Medical History: None

Social: Takes ibuprofen if tired and sore after work, probably most days of the week. Drinks some tea that’s good for the stomach—Yerba Buena—but it doesn’t really help.”. Drinks 3-4 beers weekly, use to smoke regularly but has quit approximately 6 months ago. Also recently came from Dominican Republic and does not have health insurance; thus explaining why he has not come sooner for his issue

Describe the physical exam and diagnostic tools to be used for Mr. Rodriguez. Are there any additional you would have liked to be included that were not?

  • Temperature is 36.9 C (98.5 F)
  • Pulse is 78 beats/minute, regular
  • Respiratory rate is 16 breaths/minute
  • Blood pressure is 123/72 mmHg
  • Body mass index is 24.8 kg/m2

General: Well-appearing, middle-aged man.

Head, eyes, ears, nose, and throat (HEENT): Sclera anicteric, no conjunctival pallor, oropharynx without lesion or significant dental abnormality.

Neck: Supple, no mass, lymphadenopathy, or thyromegaly.

Cardiovascular: Regular heart rate and rhythm, S1, S2, no murmurs, rubs, or gallops.

Respiratory: Bilaterally clear to auscultation and percussion without wheezes, rales or rhonchi.

Abdominal: Symmetric appearance without scars or ecchymosis. Normoactive bowel sounds heard in four quadrants. Soft, nondistended, with minimal epigastric tenderness on deep palpation without rebound tenderness or guarding, no hepatosplenomegaly, and no hernia or masses.

Skin: Tanned; no jaundice, several tattoos on his upper extremities, no suspicious lesions.

Extremities: Warm and well-perfused, no cyanosis, clubbing or edema.

Please list 3 differential diagnoses for Mr. Rodriguez and explain why you chose them.  What was your final diagnosis and how did you make the determination?

  • The three different diagnosis that I initially chose included gastritis, peptic ulcer disease and GERD. I chose these three because they all deal with the abdominal area and considering he takes ibuprofen regularly; there are different elements and components within the medication that can cause issues with the stomach.
  • GERD is the diagnosis that I made upon completion of his physical exam. While his physical exam did not show any specific physical indications of GERD; his overall symptoms and current life habits prove to be the primary indication of this specific ailment.

What plan of care will Mr. Rodriquez be given at this visit, include drug therapy and treatments; what is the patient education and follow-up?

  • The first component to assisting Mr. Rodriquez is his diet; ensuring he understands the importance of cutting back on caffeine, alcohol, and the amount of ibuprofen that he is consuming.
  • Kulinna (2019) discusses the element of swallowing MRI which provides a inside look into the esophagous and overall abdominal system. It allows for a more extensive outlook of the abdominal area. This type of testing is also said to “better understand GERD” (Kulinna, 2019, p237).
  • It is imperative that Mr. Rodriquez also be referred to a gastroenterologist as well to better review and observe his symptoms.

Reference

Kulinna-Cosentini, C., Arnoldner, M. A., Kristo, I., Jomrich, G., Schima, W., Riegler, M., Schoppmann, S. F., & Cosentini, E. P. (2019). Swallowing MRI for GERD—diagnosis and treatment monitoring. European Surgery: ACA Acta Chirurgica Austriaca, 51(5), 231–238. https://doi-org.su.idm.oclc.org/10.1007/s10353-019-0601-1

Peer 2

the patient is from Dominican Republic, is 39-year-of age, who is a recent immigrant and does not have any insurance. He complains of pain in the upper abdomen that started a year earlier and was getting worse. When he eats, the pain either eases or becomes worse. The patient denies any loss of weight, recent illness, vomiting, nausea, anorexia, regurgitation, constipation, and diarrhea. He appears anxious, and his lack of health insurance prevented him from asking for help earlier. The patient has no allergies, has not had hospitalization, and has no surgical history. He does not smoke, having quit half an year earlier and works in a farm. He drinks alcohol regularly. The father had high blood pressure, and mother had diabetes. No family member has a history of stomach problems. The patient uses herbal tea and ibuprofen for pain.

For physical examination, the patient needs to have their vital signs, skin, extremities, neck, respiratory, HEENT, checked.

Some differential diagnosis include Gastritis which is the irritation or inflammation of the stomach resulting in sharp pains. With eating, the pain can get better or worse. The inflammatory forms of gastritis may be caused by chronic infectious such as H. Pylori or acute infections such as enterovirus. When noninflammatory, they can be caused by chemical irritants to the stomach such as alcohol and medication (Vries, 2017). Another important case to consider is GERD that may have mild epigastric pain and symptoms that can worsen with meals. The pain is explained as burning and is located in the substernal rather than epigastric area. Nausea, vomiting, and hematochezia, are not associated with GERD. finally, there is peptic ulcer disease which is main characterized by epigastric abdominal pain that improves with meals. In some cases, the symptoms can get worse with meals. NSAID is associated with the problem and hematemesis shows the disease is complicated.

Plan for care for the patient is omeprazole medication to help in reducing the pain and help with the healing. This is because the medication will help with the reduction of production of stomach acid. The patient needs to take the drug 30 minutes before eating for a period of four weeks. A bismuth quadruple therapy can also be effective (Vries, 2017).  The patient should be asked to reduce alcohol consumption

References

Aquifer. (n.d.). Family medicine 19: 39-year-old male with epigastric pain. South University College of Nursing and Public Health Graduate Online Nursing Program. https://southu-nur.meduapp.com/document_set_document_relations/30239

Vries, J. D. (2017). Stomach and bowel disorders. Random House.