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 a 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 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 a 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 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. 

For this week’s Assignment you will be creating a hypothetical case assessment in your area of interest involving a client presenting with an issue that merits an adult (18 years – 70 years) personality assessment.

Write a minimum 10-page essay incorporating the following elements:

• Include the following demographic and personal information: fictional name, age, marital status, number of children, educational level, income level, and relevant medical history. Describe clearly the nature of the client’s presenting problem (e.g., consideration of inpatient substance abuse treatment, a candidate for successful completion of a behavior analysis/application program, or a patient with a psychiatric diagnosis, etc.).
• Explain the initial problem in sufficient detail to make clear your decisions regarding assessment.

Based on the above, answer the following questions in essay format:

1. What would be the most appropriate instrument in personality assessment for evaluating the primary presenting problem?
2. What are the strengths regarding what this instrument can tell us about the client?
3. Why is this the most appropriate instrument? (Be sure to include appropriate reference to source materials.)
4. What are the limitations of what this instrument can tell us about the client?
5. Discuss some of the concerns or issues that might arise in a workplace setting with an individual that has this personality disorder. Elaborate on how this disorder could affect the workplace culture/climate in regards to behavior, interpersonal and group interactions, and productivity.
6. In your discussion of the assessment process, including administration and interpretation, consider professional competencies that reflect the professional characteristics, culture of a given work setting and how these practices are essential to an effective multicultural competency environment.

Select an adult personality test – (four) websites for psychological test databases are provided on page 30 of your textbook. Discuss what type of data the test provides and how you might use this particular test to assess a client.

Along with the text, and the four articles listed below, locate an additional two peer reviewed journal articles. (7 total references)

Note: Find a test measuring a construct in your area of interest; do not purchase a review of any test. You will use the websites to look up the name and brief description of a test and then conduct further research on your own about this test.

Read the following articles which are accessible through the following Library links:

Fine, S. (2013). Practical guidelines for implementing preemployment integrity tests. Public Personnel Management, 42(2), 281-292. Retrieved from http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=bth&AN=88923808&site=eds-live

Discuss the following in essay format: Address the purpose of preemployment integrity testing.

1. Describe the primary purpose many organizations include integrity testing during the hiring process of new employees.
2. Describe the differences between overt integrity tests and personality-based integrity tests, including when an organization would choose one over the other type.
3. Discuss the guidance the author provides in regards to fairness and adverse impact from integrity tests.

Meyer, G. J., & Kurtz, J. E. (2006). Advancing personality assessment terminology: Time to retire objective and projective as personality test descriptors. Journal of Personality Assessment, 87(3), 223-225. Retrieved  from 
http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=mdc&AN=17134328&site=eds-live

Discuss the following in essay format:  Address the historical use of the terms objective and projective to classify a personality test, as well as problems with such classification.

Naugle, K. (2009). Counseling and testing: What counselors need to know about state laws on assessment and testing. Measurement & Evaluation In Counseling & Development, 42(1), 31-45. Retrieved  from
http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=tfh&AN=43205692&site=eds-live

Discuss the following in essay format: Review the local laws on assessment and testing, using a comparison between licensed and nonlicensed professionals.

1. Discuss how psychological test publishing companies monitor the competencies of those who purchase and utilize assessment instruments they sell.
2. Using Table 2 – Assessment Legislation via a State-by-State Basis (pgs. 38-39), look up your home state and describe what types of assessment activities the legislation allows a counselor to engage in.
3. Describe why the authors contend that professionals who possess the appropriate coursework, experience and supervision, but are not licensed psychiatrists or psychologists, are being discriminated against when it comes to laws regarding psychological testing.

Scroggins, W., Thomas, S., & Morris, J. (2008). Psychological testing in personnel selection, part I: A century of psychological testing. Public Personnel Management, 37(1), 99-109. Retrieved from 
http://search.ebscohost.com.libauth.purdueglobal.edu/login.aspx?direct=true&db=bth&AN=31579029&site=eds-live

Discuss the following in essay format: Review prior and local hiring practices and the challenges with using personality testing.

1. Why had many industrial psychologists traditionally rejected the use of personality testing while many human resources manager maintain an optimistic and enduring faith in the ability of them to discriminate between good and poor job candidates?
2. Discuss how military psychology and the role of psychological services were considered essential to the nation’s defense efforts during World War II?
3. Describe three ways in which the use of personality tests in employment selection is considered controversial?

The assignment should:

• Follow assignment directions (review grading rubric for best results).
• Use correct APA formatting per the APA Publication Manual, 6th Edition.
• Demonstrate college-level communication through the composition of original materials in Standard American English.
• Be written in Standard American English and be clear, specific, and error-free. If needed, be sure to use the Writing Center for help.
• Be a minimum of 10 pages (not including Title Page and Reference List).

Given the current trend of massive flow of data and the sensitivity of the Personal Health Information (PHI),

discuss the four (4) common strategies of achieving data privacy in Healthcare Industry. Support each suggestion with scholarly citation and references – APA formatting.

Textbook:

EMC Education Service (Eds). (2015) Data Science and Big Data Analytics: Discovering, Analyzing, Visualizing, and Presenting Data, Indianapolis, IN: John Wiley & Sons, Inc

Read the following scenario about Kaiser Permanente’s Innovations Consultancy section from Ch. 12, “The Effective Change Manager: What Does It Take?,” of Managing Organizational Change: A Multiple Perspectives Approach:

Scenario: Kaiser Permanente’s Innovations Consultancy

Lew McCreary (2010) describes how Kaiser Permanente, a managed care consortium based in Oakland, California, has developed a novel approach to innovation and improvement. The company set up its own internal Innovation Consultancy unit. This unit employs change experts to observe people, ask them how they feel about their work, take notes and photographs, make drawings, and identify better ways of doing things. This involves, McCreary (p. 92) suggests, “a combination of anthropology, journalism, and empathy,” exploring how staff and patients live, work, think, and feel before trying to solve a problem.

A key part of the approach involves “uncovering the untold story”—finding out “what is really going on here?” For example, to prevent nurses being interrupted during medication rounds, and thus to reduce errors, a “deep dive” event was held, including nurses, doctors, pharmacists, and patients. The event generated around 400 ideas, some straightforward and some “outlandish.” This led to the design of a smock that said “leave me alone” on it (known as “no-interruption wear”) and a five-step process for ensuring the correct dispensing of medication.

Another example concerned the exchange of patient information between nursing shifts. This used to take 45 minutes, and delayed the next shift’s contact with patients. In addition, nurses would compile and exchange information in idiosyncratic ways, potentially missing important details. The revised Nurse Knowledge Exchange is faster and more reliable, with new software and with information presented in standard formats.

Members of the Information Consultancy unit do not dictate the changes that are to be made, but work with staff as “co-designers” on change projects. This approach allows Kaiser Permanente to achieve the aim of implementing innovation and change quickly and economically.

Write a 525- to 700-word paper in which you:

• Identify processes, work units, interdepartmental committees, etc., within an organizational structure that are being evaluated by the Consultancy in order to promote a proactive approach toward change.
• Discuss what barriers you perceive existed within the segments of the consortium that hindered change prior to the innovative and improvement approach that waslaunched.
• Incorporate the underlying skill sets discussed in the case study. Draw upon your readings in Ch.12, “The Effective Change Manager: What Does It Take?”

Format your paper consistent with APA guidelines.

– Title: The relevance of the Professional Code of Ethics 

For this assignment you are to introduce the introduce Professional Codes of Ethics in general. Then you will pick the ACM or IEEE Code of Ethics and briefly describe it. You will then pick up to two related items and expand on those to support the notion that Code of Ethics are necessary, useful and important. If you decide that that Code of Ethics are not necessary or useful, that will necessitate a more comprehensive discussion of codes of ethics, or specifically that of ACM or IEEE, to arrive at a logical conclusion. The paper must consist of the following sections. 

-The section titles must be present: 

• Title page: Title: Information Privacy and Surveillance, Course number, Paper 1, Name, Date Due: November 18, 2019 

• Introduction (Introduce the general issues on the subject of privacy and surveillance.) 

• Definition: Define the specific issue that you will be addressing • Background and Discussion (of the specific issue, recommendation) 

• Conclusion (Recommendation, how it will improve things.) 

• References (Between 6-8, maximum 3 online references.) 

-Requirements

 • Throughout the paper you must give credit to the ideas and words of others. Failure to give credit may be considered plagiarism, which may result from 15 to 100 points off depending on the severity. Please read the syllabus and CSUSB Bulletin for policies on plagiarism and cheating. 

• There must be no more than a total of 400 words of direct quotes. Beware of paraphrasing and plagiarism. Please read and follow the guidelines here: http://libguides.csusb.edu/plagiarism2 

• Must be free of grammatical and spelling errors. 

• The voice throughout the paper must be consistent. 

• The citation style of the references must be in IEEE format: https://ieee-dataport.org/ sites/default/files/analysis/27/IEEE%20Citation%20Guidelines.pdf • Length: Overall the paper must between 1,200 to 1,400 words. Use 1.5 spacing instead of double spacing. 

What should a company do to meet an employees needs for (a) survival, (b) security, (c) belonging, (d) respect, and (e) fulfillment. What policies and practices would you recommend?

Answer EACH question with 300 words and 2 references EACH. 

I am providing some sites for research. Please utilize these and other scholarly references. 

1. What is the relationship between motivation and self-efficacy related to adult students? How does this affect teacher performance? ( 300 words and at least 2 scholarly references)

2. How can the instructional coach diagnose areas of improvement in teachers without the use of an evaluation? Share two examples of how you might execute this. ( 300 words and at least 2 scholarly references)

These links may help in answering these questions:

Read “Why Kansas is Developing Standards for its Adult Education Leaders,” by Zacharakis and Glass, from Adult Basic Education & Literacy Journal (2010). 

URL:

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=58843008&site=ehost-live&scope=site

Read “Meeting the Challenge: Teaching Strategies for Adult Learners,” by Goddu, from Kappa Delta Pi Record (2012).

URL:

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=83629863&site=ehost-live&scope=site

Read “Forms of Educational Activities that Enhance Self-Directed Learning of Adults,” by Kvedaraite, Jasnauskaite, Geležiniene, and Strazdiene, from Problems of Education in the 21st Century (2013).

URL:

http://www.scientiasocialis.lt/pec/files/pdf/vol56/74-85.Kvedaraite_Vol.56.pdf

Read “A Case Study of Constructivist Instructional Strategies for Adult Online Learning,” by Ruey, from British Journal of Educational Technology (2010).

URL:

https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=ehh&AN=52904286&site=ehost-live&scope=site