FIRST PAPER
IOM Future of Nursing Report and Nursing
Review the IOM report, “The Future of Nursing: Leading Change, Advancing Health,” and explore the “Campaign for Action: State Action Coalition” website. In a 1,000-1,250 word paper, discuss the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development, and how they continue to advance the goals for the nursing profession.
Include the following:
- Describe the work of the Robert Wood Foundation Committee Initiative that led to the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
- Outline the four “Key Messages” that structure the IOM Report recommendations. Explain how these have transformed or influenced nursing practice, nursing education and training, nursing leadership, and nursing workforce development. Provide examples.
- Discuss the role of state-based action coalitions. Explain how these coalitions help advance the goals specified in the IOM report, “Future of Nursing: Leading Change, Advancing Health.”
- Research the initiatives on which your state’s action coalition is working. Summarize two initiatives spearheaded by your state’s action coalition. Discuss the ways these initiatives advance the nursing profession.
- Describe barriers to advancement that currently exist in your state and explain how nursing advocates in your state overcome these barriers.
You are required to cite to a minimum of three sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
SECOND PAPER
Case Study: Mrs. J.
It is necessary for an RN-BSN-prepared nurse to demonstrate an enhanced understanding of the pathophysiological processes of disease, the clinical manifestations and treatment protocols, and how they affect clients across the life span.
Evaluate the Health History and Medical Information for Mrs. J., presented below.
Based on this information, formulate a conclusion based on your evaluation, and complete the Critical Thinking Essay assignment, as instructed below.
Health History and Medical Information
Health History
Mrs. J. is a 63-year-old married woman who has a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). Despite requiring 2L of oxygen/nasal cannula at home during activity, she continues to smoke two packs of cigarettes a day and has done so for 40 years. Three days ago, she had sudden onset of flu-like symptoms including fever, productive cough, nausea, and malaise. Over the past 3 days, she has been unable to perform ADLs and has required assistance in walking short distances. She has not taken her antihypertensive medications or medications to control her heart failure for 3 days. Today, she has been admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD.
Subjective Data
1. Is very anxious and asks whether she is going to die.
2. Denies pain but says she feels like she cannot get enough air.
3. Says her heart feels like it is “running away.”
4. Reports that she is exhausted and cannot eat or drink by herself.
Objective Data
1. Height 175 cm; Weight 95.5kg.
2. Vital signs: T 37.6C, HR 118 and irregular, RR 34, BP 90/58.
3. Cardiovascular: Distant S1, S2, S3 present; PMI at sixth ICS and faint: all peripheral pulses are 1+; bilateral jugular vein distention; initial cardiac monitoring indicates a ventricular rate of 132 and atrial fibrillation.
4. Respiratory: Pulmonary crackles; decreased breath sounds right lower lobe; coughing frothy blood-tinged sputum; SpO2 82%.
5. Gastrointestinal: BS present: hepatomegaly 4cm below costal margin.
Intervention
The following medications administered through drug therapy control her symptoms:
1. IV furosemide (Lasix)
2. Enalapril (Vasotec)
3. Metoprolol (Lopressor)
4. IV morphine sulphate (Morphine)
5. Inhaled short-acting bronchodilator (ProAir HFA)
6. Inhaled corticosteroid (Flovent HFA)
7. Oxygen delivered at 2L/ NC
Critical Thinking Essay
In 750-1,000 words, critically evaluate Mrs. J.’s situation. Include the following:
1. Describe the clinical manifestations present in Mrs. J.
2. Discuss whether the nursing interventions at the time of her admissions were appropriate for Mrs. J. and explain the rationale for each of the medications listed.
3. Describe four cardiovascular conditions that may lead to heart failure and what can be done in the form of medical/nursing interventions to prevent the development of heart failure in each condition.
4. Taking into consideration the fact that most mature adults take at least six prescription medications, discuss four nursing interventions that can help prevent problems caused by multiple drug interactions in older patients. Provide a rationale for each of the interventions you recommend.
5. Provide a health promotion and restoration teaching plan for Mrs. J., including multidisciplinary resources for rehabilitation and any modifications that may be needed. Explain how the rehabilitation resources and modifications will assist the patients’ transition to independence.
6. Describe a method for providing education for Mrs. J. regarding medications that need to be maintained to prevent future hospital admission. Provide rationale.
7. Outline COPD triggers that can increase exacerbation frequency, resulting in return visits. Considering Mrs. J.’s current and long-term tobacco use, discuss what options for smoking cessation should be offered.
You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.
Expert Solution Preview
Introduction:
As a medical professor, it is crucial to provide comprehensive assignments and coursework that enables students to develop their skills, knowledge, and understanding of the medical profession. This paper will answer two separate questions related to nursing practice, education, and workforce development. The first paper will review the IOM report, “The Future of Nursing: Leading Change, Advancing Health,” and explore the “Campaign for Action: State Action Coalition” website. The second paper will critically evaluate a case study of Mrs. J., a patient with a history of chronic illnesses, who is admitted to the ICU for acute decompensated heart failure and acute exacerbation of COPD.
FIRST PAPER
The IOM report and State-Based Action Coalitions’ Influence on Nursing Practice, Education, and Workforce Development:
The Robert Wood Foundation Committee Initiative led to the IOM Report, “Future of Nursing: Leading Change, Advancing Health.” The Committee aimed to identify ways to reform and improve the nursing profession’s education, training, and practice to address the challenges facing the healthcare system. The report emphasizes four “Key Messages” that structure the IOM Report recommendations, namely:
1. Nurses should practice to the full extent of their education and training.
2. Nurses should achieve higher levels of education and training through an improved education system.
3. Nurses should be full partners with physicians and other healthcare professionals in redesigning healthcare in the United States.
4. Effective workforce planning and policymaking require better data collection and improved information infrastructure.
Since the publication of the IOM report, there have been significant changes in nursing practice, education, and workforce development. These changes include teaching nurses to be full partners with physicians, efforts to increase diversity in the nursing profession, and the adoption of new technologies and processes to improve patient care. In addition, the report calls for higher levels of education and training for nurses, which has led to an increase in the number of nurses with advanced degrees, such as nursing practitioners and nurse educators.
State-based action coalitions have played a vital role in advancing the goals specified in the IOM report. These coalitions, made up of nurses, nursing organizations, and other key stakeholders, work to implement the report’s recommendations at the state level. They have been instrumental in developing and implementing programs to increase the number of nurses with advanced degrees, expand scope of practice laws, and advocate for better working conditions for nurses. For instance, the Florida Action Coalition spearheaded two initiatives – Nursing Education Redesign and Nursing Workforce Diversity – aimed at expanding access to nursing education and increasing diversity in the nursing workforce.
However, several barriers to advancement still exist in different states. These barriers include limited funding for nursing education, resistance from physicians and other healthcare professionals, and regulatory barriers to expanding scope of practice. But, through advocacy and collaboration between nursing professionals, these barriers can be broken down.
SECOND PAPER
Mrs. J.’s Case Study:
Clinical Manifestations Present in Mrs. J:
Mrs. J. is a 63-year-old woman with a history of hypertension, chronic heart failure, and chronic obstructive pulmonary disease (COPD). She is admitted to the hospital ICU with acute decompensated heart failure and acute exacerbation of COPD. Clinical manifestations present in Mrs. J. include; anxiety, including asking whether she is going to die, feeling like she cannot get enough air, “running away” heart, and exhaustion.
Appropriateness of Nursing Interventions at the Time of Admission:
The nursing interventions provided to Mrs. J. were appropriate. The medications provided were aimed at managing the symptoms of her conditions. The administration of IV furosemide (Lasix) aimed to reduce the volume overload in her heart and lungs. Enalapril (Vasotec) and Metoprolol (Lopressor) aimed to manage her hypertension, control her heart rate, and improve her heart functioning. IV morphine sulphate (Morphine) was to manage her pain, and inhaled short-acting bronchodilator (ProAir HFA) and inhaled corticosteroid (Flovent HFA) aimed to improve her breathing. She was also provided with oxygen delivered at 2L/NCC to improve oxygen saturation levels.
Four Cardiovascular Conditions that may lead to Heart Failure:
1. Coronary artery disease (CAD): This condition can lead to heart failure by causing damage to the heart’s blood vessels and reducing the oxygen supply to the heart muscle. Medical and nursing interventions, such as lifestyle changes, medication management, and angioplasty, could prevent heart failure.
2. Valvular heart disease: This condition can cause heart failure by reducing the heart’s ability to pump blood. Medical and nursing interventions, such as medication management, surgery, and lifestyle changes, could prevent heart failure.
3. Cardiomyopathy: This condition affects the heart muscle and can lead to heart failure. Medical and nursing interventions such as medication management, lifestyle changes, implantable cardioverter-defibrillator (ICD), and heart transplant could prevent heart failure.
4. Hypertension: This condition can lead to heart failure by causing damage to the heart’s blood vessels and increasing the workload on the heart. Medical and nursing interventions, such as lifestyle changes, medication management, and monitoring of blood pressure, could prevent heart failure.
Nursing Interventions that can prevent problems caused by multiple drug interactions:
1. Assess the patient’s medication history and inform the physician of any possible interactions.
2. Educate patients on the importance of adhering to their medication regimens.
3. Use computerized provider order entry (CPOE) systems to reduce the likelihood of human error and medication interactions.
4. Monitor patients for any signs of adverse reactions and make appropriate changes to the medication regimen.
Health Promotion and Restoration Teaching for Mrs. J:
A health promotion and restoration teaching plan for Mrs. J. should include multidisciplinary resources for rehabilitation and any necessary modifications. The rehabilitation resources available for Mrs. J. should include pulmonary rehabilitation programs and exercises to improve her breathing. Modifications that may be necessary include oxygen therapy, smoking cessation, and dietary modifications. Education methods for providing education to Mrs. J. regarding medications that need to be maintained to prevent future hospital admission could involve a nurse-led medication review program. This program aims to educate patients on their medication regimen, teach them how to manage their symptoms, and help them adhere to their medication schedule.
COPD Triggers that Increase Exacerbation Frequency:
Smoking, pollution, exposure to irritants, changes in weather, respiratory infections, and physical activity are some of the COPD triggers that can increase exacerbation frequency. With Mrs. J.’s current and long-term tobacco use, smoking cessation should be offered as an option for COPD management. Education on the benefits of quitting smoking, nicotine replacement therapy, and counseling support could be provided to assist her in quitting smoking.
Conclusion:
As a medical professor, it is crucial to provide comprehensive assignments and coursework that enables students to develop their skills, knowledge, and understanding of the nursing profession. Through reviewing the IOM report, “The Future of Nursing: Leading Change, Advancing Health,” and exploring the “Campaign for Action: State Action Coalition” website, students can understand the influence the IOM report and state-based action coalitions have had on nursing practice, nursing education, and nursing workforce development. Additionally, by evaluating a case study, such as Mrs. J.’s, students can develop critical thinking skills necessary for their nursing practice.
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