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Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities, and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with 7th edition APA format. 

Neuro Case Study

You are consulted to visit a 72 year old male client who had a stroke last year which left both his upper and lower right sided extremities weakened. He is obese and has a history of smoking for 57 years. His history also includes being diagnosed with type 2 diabetic, high blood pressure, coronary artery disease, polycythemia, and atrial fibrillation. His father died of an MI at age 53. Both of his parents had type 2 diabetes. His mother dies of cancer. His paternal grandfather had 2 strokes, 0neyear apart, dying two weeks after the second stroke.

1. What types of extremity paralysis ( weaknesses) can occur in strokes and how do they differ? What type of weakness does this patient exhibit?

2. The lesion that caused the motor function problem in this patient is located on which side of the brain? Why does it occur in this manner?

3. Given the history of this patient, what type of stroke did this patient have,

ischemic, or hemorrhagic? Please provide your rationale.

4. What is the relationship between atrial fibrillation, and the stroke

5. What other risk factors are identified for this patient and what is the relationship of these to a stroke?

6. Your patient’s wife tells you “My husband’s grandfather had a stroke and could not talk, but he could talk> My husband can not walk, but can talk. I do not understand Why?” The APN would address this issue in what manner? What information is shared?

7. The patient’s wife adds, the doctor said to call him if he suffered a TIA. I thought TIA’s go away. Why is this important and how will I know it is happening? The APN addresses this situation in what manner. What information will be shared?

8. How do adult strokes differ from pediatric strokes?

 

Soap Note 1 is based on the Case Study # 1 (10 Points)

You MUST use the Case Study #1 as the base of this SOAP NOTE #1 

Must use the sample template for your soap note, keep this template for when you start clinicals.

Templates used from another classes will not be accepted. Student must use the template provided in this class which must clearly contain the progress note (in the Assessment section) of the encounter with the patient ( this section is clearly mark in bold, highlighted  and underlined). No passing grade will be granted if this section is not completed properly. 

Late Assignment Policy

Assignments turned in late will have 1 point taken off for everyday assignment is late, after 7 days assignment will get grade of 0 (zero). No exceptions 

Follow the MRU Soap Note Rubric as a guide

Use APA format and must include minimum of 2 Scholarly Citations.

 

EVIDENCE BASE IN DESIGN

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

RESOURCES

Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources. 

WEEKLY RESOURCES

·  Milstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Jones & Bartlett Learning.

o  Chapter 5, “Public Policy Design” (pp. 87–95 only)

o  Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)

o  Chapter 9, “Interprofessional Practice” (pp. 152–160 only)

o  Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)

·  American Nurses Association (ANA). (n.d.). AdvocacyLinks to an external site.. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/

·  Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementationLinks to an external site.. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdf

·  Congress.govLinks to an external site.. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/

·  Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementationLinks to an external site.. Academy of Management Review, 21(4), 1055–1080.

·  Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patientLinks to an external site.. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017.

·  Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretionLinks to an external site.. Public Management Review, 16(4), 527–547.

To Prepare:

·  Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.

·  Review the health policy you identified and reflect on the background and development of this health policy.

·  Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Which social determinant most affects this policy? Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:

• The Nursing Legislation and Advocacy page on the FNA website identifies 4-different ways for you to get involved with advocacy.  Discuss which way(s) you would most likely get involved with and why?

One way I would get involved with is by participating in the FNA advocacy days. Each Advocacy Days, nurses from across the state gather in Tallahassee during legislative sessions to learn about current legislative issues and specific bills that may affect their practice or the overall healthcare environment in Florida. This allows nurses to meet with legislators face to face. Nurses are able to voice their concerns and take part in helping shape the life of nurses. 

• Find and peruse the Barbara Lumpkin Toolkit (BLT).  What are your thoughts about the information provided in the toolkit and what did you learn that you didn’t know before?

The Barbara Lumpkin Toolkit is a resource that can be used by nurses to speak to legislators. The toolkit discusses ways for nurses to get in contact with legislators as well as offering tips on how to do so. The BLT also details the correct way to communicate nursing concerns to legislators. Something I didn’t know is that it would be more helpful to communicate with new legislators than legislators who have a lot of experience. As new legislators could be more sympathetic to our concerns then experienced ones would. 

• The Florida Keys community experiences unique healthcare needs.  Identify 1-healthcare issues or trends you would consider advocating for that would have an impact on nursing in the Florida Keys.  Based on the BLT how would you go about advocating for the healthcare issue?

In the Florida Keys there is a critical nursing shortage. Leading to higher nurse-patient ratios that are unsafe. Per BLT to advocate for safe nurse-patient ratios I would make a list of the media in the Florida Keys. In the Keys news travels very quickly. An advantage we have is that Key West is a fairly small town and alot of people know each other. If we use the correct media tools we can recruit nurses while also providing benefits, higher pay, and different incentives to retain our staff. If this does not work, writing letters and using other ways of getting in contact with legislators to decrease the turnover and patient-nurse ratios can be also helpful. As well as joining the Advocacy Days to advocate for a safe work environment.

Florida Nurses Association. Barbara Lumpkin Institute. (n.d.). https://www.floridanurse.org/Links to an external site.