Describe how quality areas 1 and 5 form the National Quality Standard address the integration of children culture in the practice of ECEC services.
Access the guide to the National Quality Framework, last updated October 2018 to support your answer. -
Quality area
Quality Area 1
Title Educational Program and Practice"
National Quality Standard (NQS) – Quality Areas 1 & 5; Aboriginal and/or Torres Strait Islander children’s cultural competence in ECEC services.
In Australia there are the following Quality Areas that are embedded in the National Quality Standard (NQS) that seek to assure quality in early Childhood Education and Care (ECEC) services. Quality Area 1 had a relative importance in realising the cultural context of children in ECEC practices more than the other quality areas, especially Quality Area 5. Here's how each quality area contributes:Here's how each quality area contributes:
Quality Area 1: Programme and Practice
Focus: This quality area also has to do with the provision of a curriculum that meets each child’s needs and abilities. It entails the formulation and execution of learning packages, practices and services for children in their personal-social-emotional, physical, and cognitive domains.
Integration of Children’s Culture:
Culturally Responsive Curriculum: Quality Area 1 mentio for educators to incorporate culture into programs and classrooms. This implies, making use of children cultural and linguistic background as well as their cultural practices. In terms of teaching, culturally responsive education requires teachers to enhance the items children bring from their culture; the things they like and the things they have learnt or seen before to what they learn at school.
Inclusive Practices: Cultural diversity is well present among children in the service and there is a need to portray the culture of children in the program. This can be done with the use of cultural diversity resources, undertaking cultural diversity activities and honoring cultural diversity events. For instance, using multicultural books, music, and art allows children to understand and find a reflection of their culture and be introduced to the rest.
Family and Community Engagement: They should embrace the families and communities to get information concerning the cultural aspects of the kid. It assists in overcoming such barriers by partnering in the development of education that individually meets the culturally sensitive children.
Cultural Competence: School personnel are provided with the framework known as cultural competencies or learning how to work effectively in culturally diverse environments. Cultural competence is especially important in programs for minorities and such training and professional development should be a part of such programs.
Children’s relationship quality (also known as Quality Area 5):
Focus: Quality Area 5 also acknowledge relationships with children as one that needs to be kept as quality relationships that are supportive and reciprocal. It involves the provision of a child-friendly environment through which children are made to feel wanted and protected in order to achieve a wholesome development.
Integration of Children’s Culture:
Building Trust and Respect: In interaction with children, educators are expected to foster healthy and positive interpersonal relationships that count for multiculturalism. This is, the acknowledgement and appreciation of each child’s cultural background as well as including this in operation and everyday transactions.
Supportive Environment: Culture foster children’s social and emotional development: staff supporting several cultural children to explain their cultural views. Teachers should encourage children to embrace their cultural background and try to target their classroom in a manner that the children feel comfortable explaining their ethnicity and their stories to the others.
Personalized Interactions: Teacher to child or any interaction with children should release an element of cultural relevancy and sensitivity. Teachers should be able to observe cultural differences; and modify the way they communicate as well as the ways through which they teach the young children.
Family Involvement: It is at this level that communicating with families is a powerful tool to promoting understanding of culture with a view of fostering its recognition within an ECEC setting. The state recommends that teachers engage the family in the learning process and ask them how they wish to be supported regarding the cultural heritage of child.
Summary
Quality Area 1 has a responsibility for organisational cultural competence whereby, cultural diverse backgrounds of children are considered in the curriculum that is offered for learning. Quality Area 5 has to do with promoting cultural competence with the children and valuing the cultural backgrounds of the learners. Altogether, those quality areas constitute a well-coordinated framework for embracing children’s culture in ECEC settings for the purpose of enhancing the notion that all children are accepted in the society.
Identify five impacts of the stolen generations for Aboriginal and Torres Strait Islander communities.
The Stolen generations, comprising of Aboriginal and Torres strait Islander children who were stripped of their natural families from around the early 1800s to 1970s by the Australian federal and state governments, incurred many and lasting impacts. Here are five key impacts:Here are five of the main effects:
Cultural Disconnection:
Loss of Cultural Identity: A number of children became isolated from their families and they lost their cultural heritage, language among other aspects. It led to the decline of culture and culture practices of the people within the affected regions, among them being;
Generational Trauma: The loss of culture was also a reason of intergenerational trauma which claims that all the negative implications of separation and interruption are inherited.
Family Disruption:
Breakdown of Family Units: This lead to great loses and displacements of families that had children being evacuated for safety. Nuclear families were separated, which meant disruption of the supportive networks and prosaic of a generation.
Impact on Parenting: People who decided to become parents and grandparents suffered trauma and it was revealed that such role models were not positive and able to shape a secure environment or the next generations, so the cycle of interrupted childhood went on.
Socioeconomic Disadvantages:
Educational and Economic Gaps: For generations, most families in the so called stolen generations were not allowed to go to school and were forced into ugly low wage earning industries. Lack of education left them crippled as they could not only fail to secure employment, but also employment that was well paid and sustainable to boot.
Health Disparities: The socioeconomic has remained the same to today; thus, aggravating the health inequalities including reduced life expectancy and increased incidences of chronic diseases among the aboriginal and Torres Strait Islander groups.
Psychological and Emotional Effects:
Mental Health Issues: Majority of the Stolen Generations had major psychological issues ranging from depression, anxiety as well as PTSD. This was so because the victims developed mental health problems such as depression due to the breakdown of family and cultural relations.
Identity Struggles: The emotion that was pushing for the uprooting and the consequent cultural severance led to problems of identity: self and cultural identity including elements of self-esteem.
Social Disintegration:
Erosion of Social Structures: The forced removals unbundled all the primary social structures in as much as communal solidarity was concerned. It was the cost of this demarginalisation that the mechanisms supporting social relations, community and leadership and the more general social capital and cohesiveness were eroded.
Increased Vulnerability: Social structures became disintegrated; individuals and society was left more open to social ill, like substance abuse, acts of violence and crime.
These impacts are present up to the present time in the lives of the Aboriginal and Torres Strait Islanders because more efforts are still required to begin addressing the harm that was initiated by the Stolen Generations policies.
1. During morning rounds, your patient states, ""I will never get better, I can't get any sleep in this place...can you help me?""
What are some independent nursing interventions you could implement to assist this patient?""
3. As a nurse, how would you respond if you were caring for a patient with a terminal illness who said to you, ""I am in such pain and I can't take it anymore, please help me die now.""
4. A patient is stressed about an upcoming surgery and asks you to pray with her. Would you? Is this the role of the RN? How could you facilitate prayer with the patient?"
1. Independent Nursing Interventions for Insomnia:Independent Nursing Interventions for Insomnia:
When a patient expresses difficulty sleeping and a lack of hope, there are several independent nursing interventions you can implement:When a patient expresses difficulty sleeping and a lack of hope, there are several independent nursing interventions you can implement:
Assess Sleep Environment: Promote patient environment in that it be favorable for sleep. These are noise, light and room temperature checks. Make changes to the environment that it becomes more enjoyable.
Promote Relaxation Techniques: Instruct the patient on other stress management strategies as relaxation techniques that would help cope with stress including deep breathing, progressive muscle relaxation, and guided imagery that would assist in assure better sleep.
Establish a Routine: Assist the patient begin consistent sleep-wake pattern. Go to bed at the same time every night and wake up at the same time each morning, and have some wind-down time before the bedtime, for example, reading a book or listening to the relaxing music.
Monitor and Address Pain or Discomfort: If the patient is complaining of pain or any discomfort that may hinder him/her from sleeping, check his/her pain and consult with the rest of the healthcare crew to address the issue.
Provide Emotional Support: Please be prepared to listen and offer Emotional Support in any way, shape or form. Ensure the patient has no concerns or anxiety and rebut them if they exist, so you can comfort the patient.
Educational Support: Instruct the patient on sleep hygiene habits that include of limiting on caffeine intake and eating large meals at night, doing extensive exercises in the daytime.
2. Responding to a Request for Assisted Suicide:Responding to a Request for Assisted Suicide:
If a patient with a terminal illness expresses a desire for help to end their life, it is crucial to handle the situation with sensitivity and adhere to legal and ethical guidelines:If a patient with a terminal illness expresses a desire for help to end their life, it is crucial to handle the situation with sensitivity and adhere to legal and ethical guidelines:
Listen and Validate: Show concern while listening and assure the patient that there emotions are understood. Show them that you understand it is painful and distressing and that all such feelings are valid.
Assess Pain and Symptom Management: Each patient to observe that their pain and other ailments’ management are being attended to adequately. Involve the other healthcare givers and focus on the patient’s symptom management and reviewing the other services readily available in the field of palliative care.
Discuss Alternatives: List down the different available choices for comfort care and care support. Describe how lung cancer patient’s quality of life can be impacted positively by the intervention of palliative care as well as issues of suffering.
Document and Report: The conversation should be documented as well as the patient’s request for a knee replacement surgery carefully documented. Intervene, and report the observed situation, together with an account of the incident, to the members of the healthcare team such as the physician and the social worker.
Provide Emotional Support: Printer emotions and psychological support. Discuss with the patient about self help or join any support group if required.
One should never engage in assisted suicide since it is against the law and institutions in many parts of the world.
3. Facilitating Prayer with the Patient:Facilitating Prayer with the Patient:
Facilitating prayer with a patient can be part of providing holistic care, addressing their spiritual needs:Facilitating prayer with a patient can be part of providing holistic care, addressing their spiritual needs:
Respect the Patient’s Wishes: The time when the patient wishes to pray, it is desirably acceptable to pray with the patient, provided that the act is not uncomfortable to the partner.
Offer to Facilitate: If you are not comfortable saying prayers, offer to make arrangements for the patient to get a visit from a chaplain /spiritual counselor.
Supportive Presence: Paying attention to the preferences of the patient when praying is crucial especially if one is the one conducting the prayers.
Encourage Spiritual Practices: If the patient agrees you may facilitate spiritual resources or spiritual support of the patients’ faith, like reading material, prayer alliance or spiritual care.
Role of the RN: Reducing spiritual distress by praying for patient can be part of spiritual care for a patient with cancer, which is included to the frame of medical treatment. But the key thing that needs to be understood is that it is crucial not to mix personal and professional interactions while extending these kinds of supports. If not certain, getting advice from a chaplain or a spiritual care giver is recommended.
Part 1: You are a surgical nurse at Memorial Hospital
At 4:00 PM, you receive a patient from the recovery room who has had a total hip replacement. You note that the hip dressings are saturated with blood but are aware that total hip replacements frequently have some postoperative oozing from the wound. There is an order on the chart to reinforce the dressing as needed, and you do so. When you next check the dressing at 6:00 PM, you find the reinforcements saturated and drainage on the bed linen. You call the physician and tell her that you believe the patient is bleeding too heavily. The physician reassures you that the amount of bleeding you have described is not excessive but encourages you to continue to monitor the patient closely. You recheck the patient's dressings at 7:00 and 8:00 PM. You again call the physician and tell her that the bleeding still looks too heavy. She again reassures you and tells you to continue to watch the patient closely. At 10:00 PM, the patient's blood pressure becomes non-palpable, and she goes into shock. You summon the doctor, and she comes immediately.
Question 1:
What are the legal ramifications of this case?
Question 2:
Using the components of professional negligence outlined in Table 5.3 of your book, determine who in this case is guilty of malpractice. Justify your answer.
Question 3:
At what point in the scenario should each character have altered his or her actions to reduce the probability of a negative outcome?"
1. Legal Ramifications
Legal Ramifications:
Potential for Malpractice Claim: In view of this development, the defendant and other concerned practitioners might have committed malpractice by failing to adequately treat the patient’s condition, leading to the manifestation of shock and subsequently, fear owing to excessive bleeding. The claim could be made on what may have been done to stop the bleeding that was uncontrollable in a timely manner.
Duty of Care: Since the surgical nurse and the physician are jointly responsible for the client, they have the client’s best interest at heart with regards to the postoperative complications. Any failure or delay in relation to such matters as excessive bleeding is likely to be deemed a breach of this duty.
Documentation and Communication: The specific documentation of the observations made by the nurse and the communication with the physician shall be very vital in legal cases. Documentation is vital since it shows if there was an assessment failure or if the patient’s state was not effectively managed.
Informed Consent: If the surgery was associated with the high risk of heavy blood loss then it is supposed to be stated in the consent form together with measures that can be taken in order to minimize this risk and manage it.
2. Professional Negligence and Malpractice
Components of Professional Negligence:
Duty of Care: Both the nurse and the physician had a responsibility of performing their duties with professionalism when handling the patient.
Breach of Duty:
Nurse: The nurse could have been in violations of the duty of care if one failed to report or go further to ensure that bleeding was well controlled once he or she observed that the patient was bleeding profusely or after the dressings were just re-emphasized.
Physician: The physician may have been negligent if the nurse’s complaints of heavy bleeding were not believed or if the nurse was not offered or given other options to have heavy bleeding looked at despite reporting it severally.
Causation: The hemorrhage which occurred fascinated the patient to shock, thereby strongly suggesting that had there been no inadequate intervention, then definitely the poor outcome would not have prevailed.
Damages: Patients lost a lot of blood and shocked hence being consider and treated as a harm patient.
Guilty of Malpractice:
Physician: Probably even more to blame in this case, as the physician was in a position of being able to and of responsibility to manage the bleeding. Even though, the nurse conveyed her concerns on several occasions, the physician did not implement additional actions or conduct systematic review of the patient’s status comprehensively.
Nurse: Perhaps less legally responsible if they performed their jobs as instructed and auditory and otherwise properly reported violations to the extent feasible. Nonetheless, the failure to go further up the ladder or to take other steps might well be a breach of duty.
3. Suggestions for the Change of Behaviors
Nurse's Actions:
4:00 PM: I recalled that the dressings were soaked, then obeyed the order to restock. This was appropriate initially.
6:00 PM & 7:00 PM: The nurse should have recorded the level of bleeding more accurately and perhaps, the nurse could have sought a more aggressive action/ or another assessment instead of re–emphasizing the dressings.
8:00 PM: When bleeding persisted the nurse should have thought of taking this problem to another level, may be consult another doctor the patient or seek for an urgent surgical intervention.
Physician's Actions:
Initial Response (4:00 PM): Simply said, provided a level of support to the nurse, without gathering more information or executing extra actions. The physician should have obtained additional elaborated information and/or considered additional diagnostic or clinical action.
6:00 PM & 8:00 PM: The physician should have re-examined the situation of the patient or requested other diagnostic imagines to determine the cause of bleeding. It is at this time that a consultation with a surgeon or further diagnostic procedures should have been done.
General Recommendations:
Increased Monitoring and Documentation: The nurse and the physician should take extra precautions and record often of the state of the patient.
Intervention and Escalation: Thus, when bleeding was abnormal more vigorous treatment and increase in functioning level should have been practiced.
Effective Communication: Reoccurrence of concern should lead to effective communication between the nurse and the physician since they belong to different functional roles.
What-does-a-sexual-assault-medical-examination-prove?
Beyond identifying, defining a sexual assault medical examination, also called a forensic examination or rape kit, has several functions. It is conducted to:
1. Collect Physical Evidence:
Biological Evidence: The examination can retrieve the evidence like semen, saliva, blood, or skin cells that can be the perpetrator’s. It can also be vital in leading to the arrestation of the perpetrator besides fixing him to the crime.
Trace Evidence: The exam may also pick fibers, hair, or any material that may implicate the suspect with the victim or the scene of the crime.
Injuries: The examination reflects any external trauma (n. e. , contusions, abrasions) incurred by the victim’s physique, including the genital area, which contributes to the narration of rape.
2. Document the Assault:
Medical Findings: It records the state of physical injuries and their absent; and obtains records of medical history related to the attack on the victim.
Legal Record: The findings made during the examination consist of documentation that can back the victim and aid in a prosecution in the case of a trial.
3. Assess and Provide Medical Care:Assess and Provide Medical Care:
Treatment of Injuries: All the first-response physical injuries are managed and the patient is offered medical attention to any physical abuse that the victim has suffered.
Preventative Treatment: In most cases the victim is advised and prescribed with STI prophylaxis and emergency contraception.
4. Provide Psychological Support:
Emotional and Psychological Care: The examination involves referral to psychological or counselling services as part of examining the psychological effects of the assault.
What the Examination Does Not Prove:What the Examination Does Not Prove:
Consent: The exam does not record the existence of consent or the lack of it. It can merely describe actions and take note of signs; issues to do with consent are generally handled during the probe and the trial.
Assailant's Identity (Directly): Even though DNA evidence lets you compare the suspect with the criminal, the exam in question cannot determine the criminal by itself.
Summary:
A sexual assault medical examination’s primary function is to look for evidential material that may help in the legal proceedings and as well tend to the needs of a survivor, and last but not least to assess the condition of a victim. The information gathered can be useful in trial but it does not define whether an assault happened or there was consent – those conclusions are legal.
You are a staff nurse in a surgical unit.
Shortly after reporting for duty, you make rounds on all your patients. Mrs. Jones is a 36-year-old woman scheduled for a bilateral salpingo-oophorectomy and hysterectomy. In the course of conversation, Mrs. Jones comments that she is glad she will not be undergoing menopause as a result of this surgery. She elaborates by stating that one of her friends had surgery that resulted in ""surgical menopause"" and that it was devastating to her. You return to the chart and check the surgical permit and doctor's progress notes. The operating room permit reads ""bilateral salpingo-oophorectomy and hysterectomy,"" which does lead to menopause, and it is signed by Mrs. Jones. The physician has noted ""discussed surgery with patient"" in the progress notes. You return to Mrs. Jones's room and ask her what type of surgery she is having. She states, ""I'm having my uterus removed."" You phone the physician and relate your information to the surgeon who says, ""Mrs. Jones knows that I will take out her ovaries if necessary; I've discussed it with her. She signed the permit. Now, please get her ready for surgery�she is the next case.""
ASSIGNMENT: Discuss what you should do at this point. Why did you select this course of action? What issues are involved here? Be sure to discuss legal ramifications of this case."\
Course of Action:
Clarify Patient Understanding:
Immediate Action: Back to Mrs. Jones and check on her understanding of the surgery. Politely let her tell you all that she thinks will happen when she is being operated on, including have her ovaries removed and whether she expects to go through menopause.
Why: This makes sure that the civil liberty of patient consent does mean that he or she has full understanding of the nature and ramifications of surgery.
Re-Evaluate Informed Consent:
Action: If Mrs. Jones does not understand fully that the surgery is a bilateral salpingo-oophorectomy that will cause the surgical menopause then she cannot be considered to have informed consent. This means the surgery should not go on until she has received all the information an is agreeing to the surgery again.
Why: Both legal and ethical, informed consent is mandatory. The patient serving as a receptor of the procedure must understand the process, probability for risk factors, and implication of the action before agreeing.
Contact the Surgeon:
Action: It is suggested that Mrs. Jones remains rather naive as for the consequences of the operation, thus, it is crucial to inform the surgeon about it. Also, ask that the said surgeon explain the procedure details and the effects to her in person.
Why: The burden of the duty lies on the side of the surgeon to make sure that the patient in question understands all that is being done to him or her. Consequently, as a nurse, your duty is also to stand for the patient autonomy right to be or not knowledgeable.
Document the Interaction:
Action: Jot down all discussions with Mrs. Jones and the surgeon and all the instructions that the surgeon has provided.
Why: Documentation is vital especially for legal purposes and where the task involved is done to leave a trace on what was done.
Delay Surgery if Necessary:
Action: Depending on the surgeon’s explanation to Mrs. Jones or if Mrs. Jones is still not clear about the surgery, the patients’ best interest should be channeled to a stop on the surgery until informed consent is witnessed.
Why: Surgical operation done without the patients’ consent could result in cases with the patient filing a case of negligence or battery.
Issues Involved:
Informed Consent:
The main problem is whether or not Mrs. Jones has consented to have the surgery done willingly. Informed consent presupposes full disclosure of the information concerning the particular procedure, possible risks, and chances for the given patient. The omission of the fact that Mrs. Jones has no idea that her ovaries are to be removed and that this will lead to menopause speaks volume of informed consent.
Patient Autonomy:
Mrs. Jones has access to information about own health and thus has rights to make decisions regarding own health care. This autonomy is violated if she has limited understanding of the consequences of her surgery.
Legal Ramifications:
Negligence: Using informed consent in surgeons can be seen as negligence since it does not measure up to the standard of care to practice surgery without it.
Battery: That is why operation without the patient’s consent could be regarded as battery, as it is an unlawful touching of the patient’s body.
Documentation: Documentation must be done and proper so that it can be used in legal cases and to show that everything done was done right and for the benefit of the patient.
Ethical Considerations:
Non-maleficence: The core of the issue at stake is the medical codification of the principle of ‘do no harm’. Continuing without the candor that is expected in informed consent is likely to cause increase psychological harm to Mrs. Jones, if only she realizes that she underwent a procedure she did not fully understand.
Beneficence: Explain to Mrs. Jones what her surgery entails is not only the right step to follow as a healthcare provider but also meets the legal right of the patient.
Conclusion:
The proper thing to do is to make certain that Mrs. Jones has made an ‘informed consent’ for her surgery. This consists of explain the situation to her, calling the surgeon, and maybe postposing the surgery. The questions of patient’s self-determination, the concept of informed consent, one’s legal and moral responsibilities are at the heart of this case.
Assignment 1: Foundation to Clinical Scenario:
Robert is a 51 year elderly person who lives with his significant other in provincial Victoria. He has been conceded to your ward from the Intensive Care Unit (ICU), where he had a multi day stay for an intense compounding of COPD, brought about by local area procured pneumonia. He required a few days of non-obtrusive ventilation while in ICU. Robert discloses to you his better half (Jill) was extremely terrified when he was conceded to ICU, and he doesn't have any desire 'to get her through that any longer'. He might want some assistance to comprehend and deal with his COPD. Robert said he was determined to have COPD around year and a half back by his GP, yet concedes he was debilitated for 'some time' before that. He is a current smoker, and has smoked for around 40 years. He has ineffectively endeavored to stop on in excess of 5 events. Robert worked for a long time on his chicken ranch, yet now discovers he becomes short of breath effectively and Robert and Jill have needed to enlist a homestead assistant. Robert's prescriptions include:
Salbutamol 2 - 4 puffs PRN
Budesonide/Efomoterol fumarate dry out 2 puffs day by day
Metoprolol 25mg every day
Ibuprofen SR 100 mg every day
Pathophysiology.
1: Describe the pathophysiology of COPD. Remember for your answer the two sickness measures contained in the umbrella term ' COPD' and how they create.
Robert has been determined to have an extreme intensification of COPD, brought about by Community-Acquired Pneumonia.
2 Explain the term 'intense intensification of COPD'. What variables put patients like Robert at high danger for intensifications of COPD? What else may add to a compounding of COPD?
Question 3
Discuss widely the effects of Pediatric transfers that help kids live more, more typical lives?
Question 4
Question
Foundation to Clinical Scenario:Robert is a 51 year elderly person who lives with his better half in territorial Victoria. He has been conceded to your ward from the Intensive Care Unit (ICU), where he had a multi day stay for an intense worsening of COPD, brought about by local area gained pneumonia. He required a few days of non-obtrusive ventilation while in ICU. Robert reveals to you his better half (Jill) was exceptionally terrified when he was conceded to ICU, and he doesn't have any desire 'to get her through that any longer'. He might want some assistance to comprehend and deal with his COPD. Robert said he was determined to have COPD around year and a half prior by his GP, yet concedes he was debilitated for 'some time' before that. He is a current smoker, and has smoked for around 40 years. He has ineffectively endeavored to stop on in excess of 5 events. Robert worked for a long time on his chicken ranch, yet now discovers he becomes short of breath effectively and Robert and Jill have needed to recruit a homestead assistant. Robert's drugs include:
Salbutamol 2 - 4 puffs PRN
Budesonide/Efomoterol fumarate get dried out 2 puffs day by day
Metoprolol 25mg day by day
Anti-inflamatory medicine SR 100 mg day by day
Pathophysiology
1. Describe the pathophysiology of COPD. Remember for your answer the two illness measures contained in the umbrella term 'COPD' and how they create.
Robert has been determined to have a serious fuel of COPD, brought about by Community Acquired Pneumonia.
2. Explain the term 'intense fuel of COPD'. What variables put patients like Robert at high danger for intensifications of COPD? What else may add to a compounding of COPD?
3. Describe the pathophysiology of pneumonia. Remember for your answer the contrasts between Community Acquired, Hospital Acquired and Health Care Associated Pneumonia.
Pharmacology
The Respiratory Physician who explored Robert in ICU proposed a few changes to his present inhaler system. The doctor recommended that Robert stop his Budesonide/Efomoterol fumarate dry out, and start on Tiotropium 2 puffs every day.
4. For every one of the three inhalers (Salbutamol, Budesonide/Efomoterol fumarate get dried out and Tiotropium), depict the
Component of activity in COPD
Contraindications and Adverse Reactions
Nursing Considerations and Patient Education Points
Remember for your answer why the respiratory doctor may have changed Robert's medicine system.
Robert was determined to have Community Acquired Pneumonia, and Streptococcus pneumoniae was refined from his sputum.
5. Identify three anti-toxins that could be utilized to treat Streptococcus pneumoniae for Robert's situation. For every anti-infection, portray the
Instrument of activity
Contraindications and Adverse Reactions
Nursing Considerations and Patient Education Points
Psychosocial issues
6. Discuss three proof based intercessions to assist Robert with dealing with his COPD."
Pathophysiology
Pathophysiology of COPD:
Chronic Obstructive Pulmonary Disease (COPD) is an umbrella term that encompasses two main conditions: Which are chronic bronchitis and emphysema.
Chronic bronchitis results in the inflammation of the bronchial tubes, and the consequent production of more mucus, coughing and constriction or narrowing of the velocity of air being transported into the lungs.
Emphysema is characterized by the destruction of The alveoli, thus destroy the area that is used to exchange gases and the inability to expel air, in essence blowing up the lungs.
The two lead to airflow obstruction which is chronic, partly reversible and is associated with breathlessness, recurrent periods of chest infection, and low oxygen saturation.
Acute Exacerbation of COPD:
Acute exacerbation of COPD therefore , means a worsening of the condition to a worse state than normal fluctuations that patients experience on a daily basis, which might be characterized by shortness of breath, cough and increased production of sputum.
The triggers that are known to cause worsening of chronic obstructive pulmonary disease symptoms include smoking especially tobacco use, respiratory infections including influenza, air pollution, and other chronic diseases such as heart failure.
Poor medication adherence and exposure to environmental irritants and untreated comorbid conditions are other causes of COPD exacerbations.
Pathophysiology of Pneumonia:
Pneumonia is an inflammation of the lung tissue characterised by the presence of alveolar exudate, which interferes with the exchange of gases.
CAP is acquired in a non-hospital setting and S. pneumoniae is one of the sources that lead to it.
HAP is a pneumonia that occurs 48 hours after admission to a healthcare facility and the etiologic agents are usually more resistant.
HCAP is pneumonias in patients with history of exposure to healthcare facilities within the preceding 90 days and may involve MDR coccal pathogens.
Pharmacology
Inhalers in COPD Management:
Salbutamol:
Mechanism of Action: An SABer that is quick-acting selective agonist of the beta-2 receptors, helps in the relaxation of the bronchial smooth muscle.
Contraindications & Adverse Reactions: Should not be administered for patients with allergy to salbutamol; side effects include increased heart rate, muscle shaking, and racing heart.
Nursing Considerations: Look for features suggesting overuse, teach the correct way of using the inhaler, and check for improvement of symptoms.
Budesonide/Formoterol:
Mechanism of Action: Budesonide is an inhaled corticosteroid that inhibits the release of inflammatory mediators and ‘formoterol slow-release’ is an inhaled LABA that brings down smooth muscle tone in the airways.
Contraindications & Adverse Reactions: Should not be given during an acute asthma attack or wind; known side effects are oral candidiasis, hoarseness, and potential system effects such as suppression of the adrenal axis.
Nursing Considerations: Mind the client about the importance of rinsing the mouth after using the mouthwash to reduce the occurrence of oral thrush, check up on him/her for side effects, and remind him/her to stick to the prescribed regimen.
Tiotropium:
Mechanism of Action: An anticholinergic of long-acting stern, which prevents muscarinic receptor and as a result, leads to bronchodilation, and decreased mucus production.
Contraindications & Adverse Reactions: Should not be used in patients with hypersensitivity to tiotropium or other anticholinergic agents; side effects associated with this drug are dry mouth, constipation and urinary retention.
Nursing Considerations: Teach client/patient about the correct technique of using the inhaler, observe for side effects of anticholinergic agents and evaluate level of breathing.
Rationale for Medication Change: It is viable to assume that because Formoterol is combined with Budesonide there is a need of a long acting bronchodilator with practically no systemic corticosteroid side effects for the long term treatment.
Antibiotics for Streptococcus pneumoniae:
Amoxicillin:
Mechanism of Action: An antibiotic belonging to the group of beta-lactam which actually interferes with the synthesis of bacterial cell wall thus causing cell disruption and death.
Contraindications & Adverse Reactions: Coadministration with erythromycin is reported to cause QT prolongation; other side effects include nausea, vomiting, diarrhoea and rash.
Nursing Considerations: Safeguard nonadherence to the total course, supervise for allergy, and warn for side effects.
Clarithromycin:
Mechanism of Action: An erythromycin derived macrolide with bacteriostatic activity that works by binding to the 50S subunit of the bacterial ribosome.
Contraindications & Adverse Reactions: Is contraindicated in sevelamer thus should not be used in patients with hypersensitivity to macrolides; the side effects include gastrointestinal disturbances, prolongation of the QT interval and there may be potential interactions with other drugs.
Nursing Considerations: Watch and await for drug interactions, teach the patient, the effects of which are reduced with food intake, and consider the effectiveness of the medication.
Ceftriaxone:
Mechanism of Action: A third generation cephalosporin antibiotic that is bactericidal by blocking bacterial cell wall synthesis and triggering cell wall enlargement and ultimately cell autolysis.
Contraindications & Adverse Reactions: Clinical use contraindicated for patients allergic to cephalosporin; side effects are gastrointestinal disturbances, allergy and phlebitis at the site of injection.
Nursing Considerations: For the group that received an allergy shot / injection: observe for reactions and instruct on completion of the full course, and injection technique.
Psychosocial Issues
Evidence-Based Interventions for COPD Management:Evidence-Based Interventions for COPD Management:
Smoking Cessation Support: Give advice and support to patients for smoking cessation which may involve counseling, use of nicotine replacement products or varenicline. Controlling the dependency on nicotine is a viable way of attenuating the diseases’ advancement.
Pulmonary Rehabilitation: It is recommended that Robert attend pulmonary rehabilitation that involves exercise training, teaching as well as behavior modification aimed at enhancing physical fitness, lessening the ability of breathing difficulties and thereby improving the quality of life.
Psychosocial Support: Provide counsel for psychological disorder like anxiety, depression, and fear that result from COPD. The who propositions, such as Jill, should be considered in the care plan to assist with coping with the affective stressors of chronic illness.
What are some of the ""Ptsd"" symptoms a rape victim may experience?"
A rape victim might experience several symptoms of PTSD, as the disorder manifests, in distinct manners. Some of the common symptoms include:
1. Re-experiencing Symptoms:
Intrusive Memories: Intrusive, physically unbidden memories of the assault.
Flashbacks: Recurringly acting as if the movie has not yet come to an end and is in the process of being replayed.
Nightmares: Night mares of the rape.
Intense Emotional Distress: Severe anxiety, panic attacks, crying and other kinds of strong emotional response when the person is reminded of the trauma.
2. Avoidance Symptoms:
Avoiding Reminders: Avoidance behaviors in relationship to ideas, emotions, or other communication about the assault. The avoidance may be directed to persons, places, objects or situations that can be associated with the trauma.
Emotional Numbing: Apathy, isolation, or anhedonia, in other words, feeling disconnected from other people or being unable to derive pleasure from activities.
3. Negative Changes in Thoughts and Mood:Negative Changes in Thoughts and Mood:
Guilt or Shame: To feel guilty over the sexual assault or feel extremely embarrassed were also put forward.
Negative Beliefs: Pattern of negative cognition which consists in negative evaluation of oneself, others or the environment, for example, “I am worthless,” or “Everybody is against me,” or “The world is an unsafe place. ”
Distorted Feelings: Experiences of perceived security disruption, threat, or punishment, discontent, anxiety or despair.
Memory Problems: Forgetting some essential constants of the assault.
4. Arousal and Reactivity Symptoms:
Hypervigilance: Being constantly alert, being prepared to be aware of all what is going around.
Irritability or Anger Outbursts: Sudden temper or rage outbursts that don’t match the occasion.
Difficulty Sleeping: This is particularly expressed in cases of difficulty to fall or to remain asleep due to anxiety or nightmares.
Concentration Problems: Poor concentration, meaning the ability to to pay attention to all activities and tasks undertaken.
Exaggerated Startle Response: Sudden movements which could be caused by the ability to be easily woken up or startled.
5. Physical Symptoms:
Somatic Complaints: Heartburn, headaches, migraines, stomach aches, joint pains, neck pains or any other chronic pain without known physical etiology.
I need the introduction for my case presentation i need the objectives, this is the diagnosis of my patient:
: corona virus disease 19, clinically improved, bilateral pneumonia, acute respiratory disease syndrome, sepsis."
Introduction
Patient presentation We report a case of a 57 years old man who was diagnosed with severe COVID-19 infection with bilateral pneumonic infiltrates, acute lung injury/ARDS, and sepsis on admission. Such conditions gives a real meaning to COVID-19 especially on the respiratory system especially with the inflammatory response that the respiratory system can affect other systems in the body of an infected individual hence, the fatal outcomes as seen in patients with COVID-19. The presentation will also present the continuum of the disease of the patient, management and continuity, as well as the team work and clinical management for enhancement of the clinical status of the patient.
Objectives
To present the patient's clinical background: Explain to the patient concerning matters about the coronavirus, disease progression, first manifestations, and preliminary diagnosis of bilateral pneumonia, ARDS, sepsis.
To explore the clinical progression of COVID: Get to know how this virus called SARS-CoV-2 causes respiratory tract illness including pneumonia and ARDS; how it spreads its misery to other systems of the body to result into sepsis.
To analyze the management strategies: Enumerate the kind of respiratory support, medication, and infection prevention control measures, which were applied in the care of the patient to end up with improvement of the clinical status.
To evaluate the outcomes and prognosis: Determine the stage of restoration and estimate the factors viewed as beneficial for the even better clinical status improvement, as well as analyze potential future scenarios.
To discuss the implications for nursing practice: Identify and define the acutely required and critical care components of nursing management in COVID-19 particularly in patients with severe manifestations as in ARDS , sepsis etc.
Define and give an example for each type (either in the clinical area or in the academe
1Autocratic leader 2Democratic leader( participative, consultative) 3 laissez-faire( nondirective, permissive)leader 4 bureaucratic leader 5 situational leader 6 charismatic leader 7 transactional leader
1. Autocratic Leader
Definition: An autocratic leader makes decisions and assumes authority without consulting the views of others not being concerned with the feelings of others. It is also known by decision making and it is the type of leadership in which managers make decisions and dictate the course that should be followed.
Example: A clinical dictatorship such as clinical leadership style may seem as a highly qualified surgeon who alone determines how a certain surgery should be conducted or other members can or cannot. The surgeon acts very quickly especially if he is working at an emergency spot and at the same time, overseeing that all members are working as per protocol.
2. Democratic Leader (Participative, Consultative)
Definition: A democratic leader seek to involve the team members with the intention to boost the feeling of participation in the making of the decisions. Another aspect of this leader is that he or she also listens from the other members and is willing to collaborate with the team.
Example: Taking the academic setting, a good example of a democratic leader is a dean who invites members of the faculty to a meeting with an aim of changing some aspects of curriculum and allowing anyone to speak about the matter at hand before arriving at any decision.
3. Laissez-Faire Leader (Nondirective, Permissive)
Definition: This is a very autocratic management style which often, does not involve employees and expects a final product from them with little or no suggestion or proposal being made by the traditional autocratic leader. This style works well when the members of the team are trained to execute the tasks and have the drive towards the achievement of the tasks.
Example: Of course, there is always a nursing supervisor who behaves more or less as a laissez-faire leader and simply allows the nursing staff to work for months and years without digging in and picking a fight only to intercede when the going gets tough.
4. Bureaucratic Leader
Definition: A bureaucratic leader works under regulation and legislations, polices and procedures of a given organization. This form of leadership concentration on obeying the laws and is prevalent in bureaucracies.
Example: In a hospital for example, a bureaucratic leader could be the hospital administrator who ensures that every practice in the healthcare facility is formally legal in accordance to the provisions of the government laws, a feat, which the official will perform to the letter.
5. Situational Leader
Definition: Situational leader are those that alter their style of leadership over the activities on the ground and the competency and the level of commitment from the people. This approach is very flexible one and depends on the circumstances may take any of the following forms.
Example: For example in an emergency room of a hospital, a situational leader will exhibit different behavior in that he may be assertive when the need arises such as during the crises, yet when recruiting new staff he will be an encouragement.
6. Charismatic Leader
Definition: Charisma is thus defined as someone or a person, who has the capacity to mobilise people and energise them to be charged up by the leader’s energy, self-confidence and magnetism. They have often a clear vision and they are able to mobilise the people.
Example: On the theoretical plane it can be the charismatic of a teacher motivating the learners towards the mastery of the subject and toward further research.
7. Transactional Leader
Definition: A transactional leader strives at creating clear set of tasks, and rewards or sanctions regarding the groups. The study shows that this leadership style follows in an organization to maintain the hierarchy and to attain stated and measurable and short-term goals.
Example: In clinical setting an example of a transactional leader could be a nurse manager who will have particular performance requires from the staff and who will promise a reward to the members of a group that has met the expectations for the day and punishment to the members of the group who has not met the expectations of the day.
