Question Answered step-by-step Scenario: Rita is a moderately obese 48-year-old Hispanic female… Scenario:Rita is a moderately obese 48-year-old Hispanic female client with a BMI of 28. She presents to your community health clinic for a new patient visit after obtaining health insurance a month ago. Rita states she has not seen a healthcare provider for “years” because she couldn’t afford it. The provider has ordered routine labs, including complete blood count (CBC), comprehensive metabolic panel (CMP), an A1c, and a lipid profile. Rita had the labs completed a couple of days before this appointment. These diagnostic tests were within normal limits except for an A1c at 9.2 and a fasting blood glucose at 156 mg/dL. Her vital signs were measured as follows: oral temperature of 37.0°C, BP of 138/68, pulse at 88, SaO2 at 98%, and respiratory rate of 22. She is seeing the nurse practitioner today for a complete physical exam with plans to follow up with the provider in one month. Expected Outcome: Explain how the individual in the scenario might benefit from medication management for their disease.Pharmacotherapeutic Options: Compare the three classes of diabetes medications, oral hypoglycemics, non-insulin injections, and insulin, for management of type 2 diabetes mellitus. Include the following in your response:Pharmacokinetics and pharmacodynamics of each medication classImpact on fasting and postprandial blood sugar levels for the individual in the scenarioRisks, including contraindications and adverse drug reactionsPharmacotherapeutic Recommendation: Evaluate the most likely class of diabetic medication the provider will prescribe for this client. Be sure to include a clinical practice guideline in your response. Consider the following in your response:What are some commonly used medications in this class?Why would this class be preferred over the others?How will this medication complement the management of this disease in the given scenario?Health Promotion: Recommend specific client education and health promotion opportunities for this scenario. Consider the following in your response:What are the expected outcomes of disease management in this scenario?Which health promotion recommendations would you prioritize considering weight management, diet, exercise, and blood glucose monitoring?What should the client know about the chosen medication and its administration? Health Science Science Nursing NURSING C361 Share QuestionEmailCopy link Comments (0)

Question Assessment task Digital Presentation 10 minutes + 500 words… Assessment task Digital Presentation 10 minutes + 500 words Weighting 30% Read the scenario You work in an aged care facility located in a rural township (population 8,000) in NSW. The town is located 50 km from the nearest larger town. The facility provides care for 100 aged residents, many of whom are some distance from their families and friends. The facility is staffed by registered, enrolled nurses and assistants in nursing, kitchen, cleaning and administrative staff. A Director of Nursing, a Deputy Director of nursing and a business manager oversee the operations of the facility. The services of a diversional therapist, a physiotherapist, a pharmacist and several doctors from the local general practice are also employed by the facility. In response to facility accreditation, the Director of Nursing at the facility you work at is compelled to upgrade the facility’s documentation practices. The accreditation team found that entries in each resident’s record were infrequent and contained minimal information. Moreover, each resident’s record was divided between six different folders: a medication folder, a wound care folder, a nursing notes folder, a medical notes folder, an allied health folder and a care plan folder. The lack of integration was identified as creating a risk to the safety and quality of resident care as a holistic and up to date picture of each resident’s health status was impossible to ascertain. Visiting providers often had no knowledge of the residents’ health status or responses to treatment and depended on verbal recounts provided by staff. The Director of Nursing decided to ask one of the senior registered nurses, Sam, to lead the practice changes required to address the issue. Sam consulted with a friend at another Aged care facility, who gave advice on what to do. Sam decided to merge all of the folders, with the exception of the medication charts, together for each resident (100 folders), which she completed over a weekend. On Monday when staff came to work, they were presented with a memo advising them of the change, specific times for records to be updated, and a sample of the appropriate structure to use when writing a resident’s report. During that week, episodes of confusion occurred as staff could not access the record when required. Doctors were angry that their own notes were not immediately available and mixed in with others. Nurses were angry that were not getting off work on time as they had to wait until others had finished with the record before they could make their own entries. Some nurses didn’t bother waiting and went home leaving the care undocumented, and were reprimanded by Sam when they returned. The Director of Nursing ordered an audit in response to complaints and found that the notes were more out of date than before, and that the lack of consistency between the sections of the record remained an issue. Furthermore, staff were angry stressed and negative about the change and their lack of involvement. The Director of Nursing regretted not providing more support to Sam with the change project and resolved to renew the approach she had taken. Sam was happy for someone else to lead the project and reflected on the importance of applying change theory and principles of leadership for future change projects. Task The Director of Nursing has asked you to develop and present a plan to lead the practice changes required to address the issue for review. Using Lewin’s Change Theory (Unfreezing, Movement, Refreezing) present how you will successfully implement change, maintain change and avoid resistance to change. Refer to the following principles of leadership to support your plan. • developing teams • nurturing positive workplace cultures • motivating team members • empowering team members • developing emotional intelligence • enabling effective change Remember the focus is on leadership and not on the nuances of clinical practice. Relevance Leading and participation in change in clinical practice is fundamental to nursing work. This activity presents an opportunity for students to use a theory of change management and gain knowledge of core leadership principles. It is expected that this activity will foster deeper understanding of change leadership in nursing contexts.  Suggested lay out:Introduction (2 slides)What you propose will occur during the Unfreezing stage with implementation of relevant leadership principles (2 slides)What you propose will occur during the Changing stage with implementation of relevant leadership principles   (2slides)What you propose will occur during the refreezing stage with implementation of relevant leadership principles  (2slides) Conclusion—in this instance a very short recap and thank you for listening type slide (1slide) Health Science Science Nursing NUR MISC Share QuestionEmailCopy link Comments (0)