Please read Chapters 9 and 10 of What is Life? A Guide to Biology before beginning this lab.

The purpose of this lab exercise is to demonstrate how a species of animal or plant, alive today,could have small changes over long periods of time and become a totally different species. This is evolution.

For this lab exercise, your group needs to follow the directions below:

1. Select an animal or plant that your group is familiar with that is living now. Describe several characteristics of this present day animal or plant.

2. Take this animal or plant and make small changes over long periods of time in 10 steps – the changes could be caused by factors such as pathogens, environmental, competition, climate, etc. Work as a group. Indicate the factor and what change it caused in the animal or plant at each step. Make small changes.

3. All group members should use the Wiki page and all members should contribute to the changes over time for the selected animal or plant. Remember: Your TA will be checking the Wiki page periodically throughout the semester to ensure group work is being done properly as a group.

4. Clearly describe the changes in the original animal or plant. Remember that small changes are made over time. Show gradual change at each step. Remember to include the cause for the change.

5. This lab exercise is not about the current known fossil history of an animal or plant, such as the evolutionary history of the modern horse. It is about taking the modern horse and changing it into something that has never been seen on earth – or at least we think it has never been seen before.

6. Clearly indicate which group members participated with this group lab exercise. Indicate if a group member had no participation, partial participation (describe partial participation) or full participation. The lab exercise will not be graded if participation is not clearly indicated. Please be honest.

How to submit this exercise: After all discussion, additions and corrections, the group leader should submit this exercise as a Word document, PDF or Powerpoint. Do not submit in any other format or file type This group lab exercise is worth 25 points.. If a group member has no participation, that group member will receive a grade of 0/25. A group member who has participated minimally, but some, will also receive a lower grade on the lab exercise. Check the syllabus for the closing date.

Option 1: Visual or popular culture analytical essay: In an 1800-2000 word essay (6-pages) analyze an object of visual or popular culture from a transnational feminist perspective. You may choose any kind of representation from visual or popular culture, such as, a music video, film, commercial advertising, video game, contemporary art, blog, song, graphic novel, memes, GIFS, etc. You must reference your object of analysis by providing website links to the images and/or copies of the images, or texts you are analyzing in your essay. Directions: Your analytical essay must describe your visual object of analysis and then interpret it from a transnational feminist perspective. Your interpretation of the visual or popular culture object is your thesis that you explore in depth in your essay. The 6-page essay must refer to at least two readings from our textbook and two additional sources that support your argument (e.g., academic articles, monographs, film reviews by established critics, etc.). The point of this exercise is to allow you to conduct an original transnational feminist analysis to some aspect of visual or popular culture of your own choosing. You must make a convincing argument, use your reference materials accurately, and use feminist key terms, concepts and theories properly. You must reread the introduction to “Part III: Representations, Cultures, Media, and Markets,” from the textbook so that you understand the importance of the analysis of visual and popular culture to Women’s Studies. Remember to be as specific as possible about the historical time period, national context and the discipline of the feminist scholars or activists of the readings or case studies you reference. IMPORTANT: Please use a 12 pt. font, double spaced lines, 1-inch margins, and one standard acceptable format for citations for your references and bibliography. Your essay must have a clear thesis statement, logical organization of paragraphs that follow from your thesis statement with clear topic sentences and transition sentences to guide your reader, logical evidence to support your thesis, and an introduction and conclusion that all supports your main argument. You must use proper citations (footnotes and bibliography) in one of the following accepted formats: Turabian, MLA, Chicago or APA. (Sample Chicago Style below). If you do not know how to properly cite a research paper, go to the UH Writing Center for help with this before you turn your paper in. There is a zero tolerance for plagiarism. Papers that include plagiarism will receive 0 points and will be reported in accordance with the University’s policy. You will not be allowed to redo a plagiarized paper. You must use proper citations (Turabian, MLA, Chicago, or APA) to avoid plagiarism. If you paraphrase ideas, you must insert a footnote or endnote and attribute it to the proper source. Every quote of referenced materials must be properly cited as well.

You are a professional nurse caring for Mr. R, a 58-year-old patient who recently underwent surgery for colon cancer that resulted in a temporary colostomy. Select one of the nursing theories from our textbook and address the following:

How you would provide professional nursing care for Mr. R. using the theory you have selected? Be sure to use terminology from the selected nursing theory to explain your interventions.

How can patient-centered care and the patient’s cultural preferences be enhanced by use of this theory?

Relate applications of legal and/or ethical standards to this case study.

TEXT

Hood, L. J. (2018). Leddy and Pepper’s Professional Nursing(9thed.) Wolters Kluwer.

REQUIREMENTS: 150 words min EACH, 1 scholar source (5 or less years) EACH, APA format.

Post 1:

Two drivers of high performance healthcare system that are always required from the organization (hospital) where I work are quality and costs. With this constant demand for high quality of care, nowadays healthcare services are reimbursed based on HCAHPS and patient satisfaction. HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported survey of patients’ perspective of the hospital care that they received (Centers for Medicare and Medicaid Services, September 25, 2014).  Since patient satisfaction is linked to reimbursement, the people in leadership positions are constantly demanding high quality care to be provided to ensure patients are satisfied at the time of the surveys. This can be a problem because there are times we are under staffed which leads to nurse to patient ratio being high. With high nurse to patient ratios the care provided can be affected along with patient satisfaction. Because nurses will not have enough time in a 12 hour shift to tend to every need a patient may have and that will result in the patients becoming upset and dissatisfied. All this will affect the quality driver of high performance in the organization (hospital). Furthermore, there was the introduction of the Deficit Reduction Act of 2005 which created an additional incentive for acute care hospitals to participate in HCAHPS; since July 2007 hospitals subject to the Inpatient Prospective Payment System (IPPS) annual payment update provisions must collect and submit HCAHPS data in order to receive their full IPPS annual payment update (Centers for Medicare and Medicaid Services, September 25, 2014). Therefore, if a hospital receives a low HCAHPS then their reimbursement will be affected. The cost driver can be affected due to the nurses resigning and the expenses involved with training new staff. Nurses are resigning due to the high nurse to patient ratio. In addition, patient dissatisfaction results in low HCAHPS and in turn affects the hospital monetary reimbursement and jeopardizes their attempt to control cost due to nurses leaving the organization looking for a better work ratio.

Post 2:

Access to healthcare is always discussed as one of the top concerns for the overall health of individuals. Millions of people around the world go without appropriate basic healthcare needs or are very limited in access for advanced needs. Cost is very closely in the running for top concerns related to healthcare also. This discussion selects cost and access as the two drivers to apply to my current work situation. Currently I nurse in a rural community emergency room within a critical access hospital which serves many that would normally either remain limited in access for advanced needs or drive extended periods for access elsewhere which inadvertently reduce timely access at the point. There is a presence of concern when legislative efforts aim to increase access and, at the same time, reduce costs! This can easily overburden a rural system which can negatively affect quality. Rural residents, historically, are among America’s most vulnerable populations when it comes to healthcare access (Grant, 2017). About sixty million individuals, within America, live in rural areas, tend to have lower income and have more health problems; this encompasses approximately twenty-three percent of the population (Grant, 2017). Lack of available primary care and specialty services shifts these individuals toward emergency or urgent care facilities for primary care which creates situations where nurses must be able to efficiently adapt to changing patient needs (Pare, Boynton-Sharp, & Peterson, 2017). Nurses in rural settings must be especially adept at continually redirecting their care and skills to adapt to these changing situations and they must do so with minimal support, simply because the support is limited in rural systems (Pare, Boynton-Sharp, & Peterson, 2017).

Critical access hospitals are among some of the most critical access points for our rural residents. Policy changing can easily impact their ability to remain afloat and open for access. They typically maintain thin financial margins and have less ability to shift losses to individuals who are privately insured because the population served is historically uninsured (Grant, 2017). Interestingly, there is a correlation between lack of access and increased overall healthcare costs. As costs for caring for the uninsured and those with less access increases, some of the cost burden is shifted toward increasing costs for those insured (Tongue, 2012). Economic impacts for insurers, employers and individuals increase thus forcing increased cost or reduction of coverage and, ultimately, reports of unmet medical needs by those who are insured (Tongue, 2012). As shifts are made to cover costs it is causing costs to rise and benefits to reduce or cease, exacerbating the uninsured problem and increasing the lack of access. Each of the drivers mentioned in the discussion are almost equally important and as you delve into each it becomes more apparent how our “multifaceted, convoluted and interrelated” (Chamberlain College of Nursing, 2018) healthcare system can easily be impacted by a single policy change affecting all other aspects of the system! It seems almost impossible to develop an approach to solve all issues collectively and concurrently.

Purpose This activity will be a continuation of the Milestone 1: Health History that you submitted in Week 4. In this part of the assignment you will take the information you gathered, analyze the data, and develop a nursing care plan. Course Outcomes This assignment enables the student to meet the following course outcomes: CO #3: Utilize effective communication when performing a health assessment. (PO #3) CO #4: Identify teaching/learning needs from the health history of an individual. (PO #2) CO #5: Explore the professional responsibilities involved in conducting a comprehensive health assessment and providing appropriate documentation. (PO #6) Points This assignment is worth a total of 250 points. Due Date The assignment is to be submitted to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 6.Post questions to the weekly Q & A Forum. Contact your instructor if you need additional assistance.See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time may result in a deduction of points. Directions 1. Download the NR305_Milestone2_Form from Doc Sharing. You will type your answers directly into this Word document. Your paper does NOT need to follow APA formatting; however, you are expected to use correct grammar, spelling, syntax and write in complete sentences. 2. Save the file by clicking “Save as” and adding your last name to the file name, e.g., “NR305_Milestone2_Form_Smith” 3. Submit the completed form to the Dropbox by Sunday, 11:59 p.m. MT at the end of Week 6. Please post questions in the weekly Q & A Forums so the entire class may view the answers. Grading Criteria Category Points % Description ANALYZE THE DATA Areas for focused assessment 30 12 Provide an overview of those areas of strength and weakness noted on the Health Assessment, Health History. Do not go into detail in this section. Client’s strengths 30 12 Expand on areas identified as strengths related to the person’s overall health. Support your conclusions with data from the textbook. Areas of concern 30 12 Expand on areas previously identified as abnormal and those that place the person at health risk. Support your observations with data from the textbook. Health teaching topics 30 12 What health education needs have you identified? Support your statements with facts from the Health History and information from your textbook. NURSING CARE PLAN Diagnosis 30 12 Write one nursing diagnosis that reflects a priority need for this person. Types of diagnoses include an illness, risk for illness or a wellness diagnosis. Plan 30 12 Write one goal and one measurable expected outcome related your nursing diagnosis. Explain why this goal and outcome is a priority. Include cultural consideration of the client. For example, African Americans are at higher risk for hypertension and any prehypertensive blood pressure readings should be addressed. Intervention 30 12 Write as many nursing orders or nursing interventions that you need in order to achieve the outcome. Provide the rationale for each intervention listed Evaluation 30 12 You won’t have an opportunity to carry out your care plan so you cannot evaluate the effectiveness of your nursing orders/interventions. Instead comment on what you would look for in order to evaluate your effectiveness CLARITY OF WRITING 10 4 Use proper grammar, spelling and medical language Total 250 pts 100% A quality paper will meet or exceed all of the above requirements. Grading Rubric Assignment Criteria A Outstanding or highest level of performance B Very good or high level of performance C Competent or satisfactory level of performance F Poor or failing or unsatisfactory level of performance Analyze the Data Areas for focused assessment 30 points Identifies all strengths and weaknesses 27-30 points Overlooks no more than 1 strength and/or 1 weakness 25-26 points Overlooks more than 1 strength and 1 weakness 22-24 points Overlooks more than 2 strengths and 2 weakness areas; item not included 0-21 Client’s strengths 30 points Uses textbook (cites source) to validate all traits identified as strengths 27-30 points Uses textbook (cites source) to validate all but 1 trait identified as a strength 25-26 points Uses source to validate strengths, but not the textbook 22-24 Does not validate identified strengths 0-21 Areas of concern 30 points Uses textbook (cites source) to validate all traits identified as concerns 27-30 points Uses textbook (cites source) to validate all but 1 trait identified as a concern 25-26 points Uses source to validate concerns, but not the textbook 22-24 Does not validate identified concerns 0-21 Health teaching topics 30 points Identifies all areas of knowledge deficit contained in Health History; validates findings using textbook (cites source) 27-30 points Identifies all but 1-2 knowledge deficits contained in Health History; validates findings using textbook (cites source) 25-26 points Fails to identify 3 areas of knowledge deficit contained in Health History; validates findings using textbook (cites source) 22-24 Does not validate findings with textbook 0-21 Nursing Care Plan Diagnosis 30 points Diagnosis properly written in NANDA terms and reflects an illness, risk for illness or a wellness diagnosis. 27-30 points Diagnosis not written in NANDA terms or does not reflect an illness, risk for illness or a wellness diagnosis.25-26 points Diagnosis not written in NANDA terms and does not reflectan illness, risk for illness or wellness diagnosis. 22-24 Diagnosis is not documented 0-21 Plan 30 points Goal realistic; outcome measurable and timed. Cultural considerations are identified and addressed. 27-30 points Goal realistic but outcome not measurable or timed. Cultural considerations are mostly addressed 25-26 points Goal somewhat realistic; outcome not measurable or timed. Cultural considerations are barely addressed. 22-24 Goal is not documented; cultural considerations are not adequately addressed 0-21 Intervention 30 points Interventions will aid in achievement of outcome; sound, rationale provided 27-30 points Interventions will aid in achievement of outcome; rationale provided but not necessarily sound 25-26 points Interventions incomplete and rationale provided but not necessarily sound 22-24 Interventions will not support outcome achievement; no rationale provided 0-21 Evaluation 30 points Criteria listed to thoroughly evaluate effectiveness of health education 27-30 points Criteria listed mostly evaluates effectiveness of health education 25-26 points Criteria listed partially evaluates effectiveness of health education 22-24 No evaluation criteria listed 0-21 CLARITY OF WRITING 10 points No grammar, spelling, or syntax errors. Writes logically in complete sentences. 10 points No more than 2 errors of any type 8-9 points 2-3 errors of any type 6-7 points 3 or more errors of any type 0-5 points Total Points Possible = 250 points Course Project Milestone #2: Nursing Diagnosis and Care Plan Form Your Name: Date: Your Instructor’s Name: Directions: Refer to the Milestone 2: Nursing Diagnosis and Care plan guidelines and grading rubric found in Doc Sharing to complete the information below. This assignment is worth 250 points, with 10 points awarded for clarity of writing, which means the use of proper grammar, spelling and medical language. Type your answers on this form. Click “Save as” and save the file with the assignment name and your last name, e.g., “NR305_Milestone2_Form_Smith” When you are finished, submit the form to the Milestone 2 Dropbox by the deadline indicated in your guidelines. Post questions in the Q&A Forum or contact your instructor if you have questions about this assignment. 1: Analyze Assessment Data: Based on the health history information, identify the following: A. Areas for focused assessment (30 points) Provide a brief overview of those areas of strength and weakness noted from Milestone 1: Health History. B. Client’s strengths (30 points) Expand on areas identified as strengths related to the person’s overall health. Support your conclusions with data from the textbook. C. Areas of concern (30 points) Expand on areas previously identified as abnormal and those that place the person at a health risk. Support your observations with data from the textbook. D. Health teaching topics (30 points) Identify health education needs. Support your statements with facts from the Health History and information from your textbook. 2: Nursing Care Plan Next, plan your care based on your analysis of your assessment data: A. Diagnosis (30 points) Write one nursing diagnosis that reflects a priority need for this person. Remember a wellness diagnosis is a possibility. B. Plan (30 points) Write one goal and one measurable expected outcome related to your nursing diagnosis. Explain why this goal and outcome is a priority. Include cultural considerations for this client. C. Intervention (30 points) Write as many nursing orders or nursing interventions that you need in order to achieve the outcome. Provide the rationale for each intervention listed. D. Evaluation (30 points) You will not carry out your care plan so you cannot evaluate the effectiveness of your nursing interventions. Instead, comment on what you would look for in order to evaluate your effectiveness.