Off Label Drug Use

When treating children, prescribers often adjust dosages approved for adults to accommodate a child’s weight. However, children are not just “smaller” adults. Adults and children process and respond to drugs differently in their absorption, distribution, metabolism, and excretion.

Children even respond differently during stages from infancy to adolescence. This poses potential safety concerns when prescribing drugs to pediatric patients. As an advanced practice nurse, you have to be aware of safety implications of the off-label use of drugs with this patient group.

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To Prepare

• Review the interactive media piece in this week’s Resources and reflect on the types of drugs used to treat pediatric patients with mood disorders.
• Reflect on situations in which children should be prescribed drugs for off-label use.
• Think about strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Consider specific off-label drugs that you think require extra care and attention when used in pediatrics.

By Day 5 of Week 11

Write a 1-page narrative in APA format that addresses the following:

• Explain the circumstances under which children should be prescribed drugs for off-label use. Be specific and provide examples.
• Describe strategies to make the off-label use and dosage of drugs safer for children from infancy to adolescence. Include descriptions and names of off-label drugs that require extra care and attention when used in pediatrics. Off Label Drug Use

The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

Scarcity of Medical Resources

For this assessment, you will continue your survey of ethical principles in health care. Especially in our contemporary world, where needs for health care outstrip available resources, we regularly face decisions about who should get which resources. The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

There is a serious shortage of donor organs. Need vastly outstrips supply, due not only to medical advances related to organ transplantation, but also because not enough people consent to be cadaveric donors (an organ donor who has already died). Munson (2014) points out that in the United States, approximately 10,000 patients die each year because an organ donor was not available, which is three times the number of people killed in the terrorist attacks on 9/11.

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But what is an efficient and morally sound solution to this problem? The policy of presumed consent, where enacted, has scarcely increased supply, and other alternatives, such as allowing donors to sell their organs, raise strong moral objections. In light of this, some have advocated for a policy of conscription of cadaveric organs (Spital & Erin, 2002). This involves removing organs from the recently deceased without first obtaining consent of the donor or his or her family. Proponents of this policy argue that conscription would not only vastly increase the number of available organs, and hence save many lives, but that it is also more efficient and less costly than policies requiring prior consent. Finally, because with a conscription policy allpeople would share the burden of providing organs after death and allwould stand to benefit should the need arise, the policy is fair and just.

Demonstration of Proficiency

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

• Competency 1: Articulate ethical issues in health care.
  • Articulate the moral concerns surrounding a policy of organ conscription.
  • Articulate questions about the fairness and justness of organ conscription policy.
  • Explain the relevance and significance of the concept of consent as it pertains to organ donation.
  • Evaluate alternative policies for increasing available donor organs.
• Competency 5: Communicate in a manner that is scholarly, professional, and respectful of the diversity, dignity, and integrity of others and is consistent with health care professionals.
  • Exhibit proficiency in clear and effective academic writing skills.

References

Munson, R. (2014). Intervention and reflection: Basic issues in bioethics (concise ed.). Boston, MA: Wadsworth.

Spital, A., & Erin, C. (2002). Conscription of cadaveric organs for transplantation: Let’s at least talk about it. American Journal of Kidney Disease, 39(3), 611–615. The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

Instructions

Do you consider the policy of organ conscription to be morally sound?

Write a paper that answers this question, defending that answer with cogent moral reasoning and supporting your view with ethical theories or moral principles you take to be most relevant to the issue. In addition to reviewing the suggested resources, you are encouraged to locate additional resources in the Capella library, your public library, or authoritative online sites to provide additional support for your viewpoint. Be sure to weave and cite the resources throughout your work.

In your paper, address the following:

• On what grounds could one argue that consent is not ethically required for conscription of cadaveric organs? And on what grounds could one argue that consent is required?
• Is the policy truly just and fair, as supporters claim? Explain.
• Do you consider one of the alternative policies for increasing available donor organs that Munson discusses to be preferable to conscription? Explain why or why not.

The Moral And Ethical Considerations Of Organ Conscription Policies And Theories

Evidence-Based Practice Proposal – Section E: Implementation Plan

Evidence-Based Practice Proposal – Section E: Implementation   Plan

In 1,250-1,500 words, provide a description of the methods to be used to implement the proposed solution. Include the following:

1. Describe the setting and access to potential subjects. If there is a need for a consent or approval form, then one must be created. Although you will not be submitting the consent or approval forms in Topic 5 with the narrative, you will include the consent or approval forms in the appendices for the final paper. Evidence-Based Practice Proposal – Section E: Implementation Plan

2. Describe the amount of time needed to complete this project. Create a timeline. Make sure the timeline is general enough that it can be implemented at any date. Although you will not be submitting the timeline in Topic 5 with the narrative, you will include the timeline in the appendices for the final paper.

3. Describe the resources (human, fiscal, and other) or changes needed in the implementation of the solution. Consider the clinical tools or process changes that would need to take place. Provide a resource list. Although you will not be submitting the resource list in Topic 5 with the narrative, you will include the resource list in the appendices for the final paper.

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4. Describe the methods and instruments, such as a questionnaire, scale, or test to be used for monitoring the implementation of the proposed solution. Develop the instruments. Although you will not be submitting the individual instruments in Topic 5 with the narrative, you will include the instruments in the appendices for the final paper.

5. Explain the process for delivering the (intervention) solution and indicate if any training will be needed.

6. Provide an outline of the data collection plan. Describe how data management will be maintained and by whom. Furthermore, provide an explanation of how the data analysis and interpretation process will be conducted. Develop the data collection tools that will be needed. Although you will not be submitting the data collection tools in Topic 5 with the narrative, you will include the data collection tools in the appendices for the final paper.

7. Describe the strategies to deal with the management of any barriers, facilitators, and challenges.

8. Establish the feasibility of the implementation plan. Address the costs for personnel, consumable supplies, equipment (if not provided by the institute), computer-related costs (librarian consultation, database access, etc.), and other costs (travel, presentation development). Make sure to provide a brief rationale for each. Develop a budget plan. Although you will not be submitting the budget plan in Topic 5 with the narrative, you will include the budget plan in the appendices for the final paper.

9. Describe the plans to maintain, extend, revise, and discontinue a proposed solution after implementation.

You are required to cite five to 10 sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and nursing content.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Evidence-Based Practice Proposal – Section E: Implementation Plan

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

All my papers for this class will be based on the below PICOT statement. This is one paper.  Evidence-Based Practice Proposal – Section E: Implementation Plan

PICOT Statement

(P) – Population/ problem:There has been an increase case of death among Asian Americans due to cancer.

(I) – Intervention: Reliable policy, procedure establishment and provision of necessary education to address the problem of cancer are important factors. The government should make sure there are credible institutions to train nursing professionals. The government should also make sure there are adequate public awareness classes given to ensure general population has adequate knowledge about the disease process.

(C) – Americans born and raised in united states.

(O) The above intervention will help to fight against cancer in early detection and curb its spread. Government organizations and non government organizations should work in collaboration with the public and the society to make sure the problem of cancer is addressed and public is educated about the early detection and treatment modalities.

(T) – one year Evidence-Based Practice Proposal – Section E: Implementation Plan

Differential Diagnosis For Skin Conditions

Also, for the skin disorder, you will chose a skin disorder,  You will give CC one sentence.  HPI   example:     A 75 yo woman presents today with itchy red rash.  Give location, description, onset, assorciating or alleviating factors.    You can also use the soap note template that is attached  as guide, PMH, allergies, meds. ROS  ect.    Please let me know if you have any questions or concerns.

• Your soap note template can also be found in the resource under week 4 which is to the right of the page. One can chose which ever picture. Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. Differential Diagnosis For Skin Conditions

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The Lab Assignment

• Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
• Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Also, please access your grading rubric..

By Day 7 of Week 4

soap note template.docx

Properly identifying the cause and type of a patient’s skin condition involves a process of elimination known as differential diagnosis. Using this process, a health professional can take a given set of physical abnormalities, vital signs, health assessment findings, and patient descriptions of symptoms, and incrementally narrow them down until one diagnosis is determined as the most likely cause.

In this Lab Assignment, you will examine several visual representations of various skin conditions, describe your observations, and use the techniques of differential diagnosis to determine the most likely condition.

To Prepare

• Review the Skin Conditions document provided in this week’s Learning Resources, and select one condition to closely examine for this Lab Assignment.
• Consider the abnormal physical characteristics you observe in the graphic you selected. How would you describe the characteristics using clinical terminologies?
• Explore different conditions that could be the cause of the skin abnormalities in the graphics you selected.
• Consider which of the conditions is most likely to be the correct diagnosis, and why.
• Search the Walden library for one evidence-based practice, peer-reviewed article based on the skin condition you chose for this Lab Assignment.
• Review the Comprehensive SOAP Exemplar found in this week’s Learning Resources to guide you as you prepare your SOAP note.
• Download the SOAP Template found in this week’s Learning Resources, and use this template to complete this Lab Assignment. Differential Diagnosis For Skin Conditions

The Lab Assignment

• Choose one skin condition graphic (identify by number in your Chief Complaint) to document your assignment in the SOAP (Subjective, Objective, Assessment, and Plan) note format rather than the traditional narrative style. Refer to Chapter 2 of the Sullivan text and the Comprehensive SOAP Template in this week’s Learning Resources for guidance. Remember that not all comprehensive SOAP data are included in every patient case.
• Use clinical terminologies to explain the physical characteristics featured in the graphic. Formulate a differential diagnosis of three to five possible conditions for the skin graphic that you chose. Determine which is most likely to be the correct diagnosis and explain your reasoning using at least three different references, one reference from current evidence-based literature from your search and two different references from this week’s Learning Resources. Differential Diagnosis For Skin Conditions

 

MN551 Advanced Pathophysiology Across The Lifespan Week 8 Discussion

Case Study: Topic

Case Study Posting Requirements

1. Make sure all of the topics in the case study have been addressed.
2. Cite at least three sources—journal articles, textbooks or evidenced-based websites to support the content.
3. All sources must be within five years.
4. Do not use .com, Wikipedia, or up-to-date, etc., for your sources. MN551 Advanced Pathophysiology Across The Lifespan Week 8 Discussion

Case Study 1

Structure and Function of the Male Genitourinary System

Mario is a 68-year-old male whose wife died of cancer five years ago. Since her death, he began to eat more fast food and stay at home and watch television. Recently, however, Mario’s friend introduced him to a woman whom he became to like very much. After seeing her a few times, Mario became concerned about his health and went to see his doctor. He noticed a change in his sexual performance when he turned 60 and, after seeing so much on television about erectile dysfunction, was concerned he would experience this with his girlfriend.

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1. What factors are present in Mario’s history that predispose him to erectile dysfunction?
2. What condition would you suspect if Mario had a blood test indicating elevated LH and decreased testosterone levels? What effect do low testosterone levels have on the reproductive organs of the male?
3. How do the parasympathetic and sympathetic nervous systems generate erection, emission, and ejaculation?

Case Study 2

Disorders of the Male Genitourinary System

Darius is 63 years old and began to wake up at night to urinate. When he went to the bathroom, he had to strain to initiate the flow, and the stream of urine was weak. Over time, the pattern became more apparent during the day; he often had a sense of urgency and felt he was going to the bathroom frequently. When he did, however, he did not always feel he had emptied his bladder, and he tended to dribble throughout the day. Much to his reluctance, his wife urged him to see a physician. At the doctor’s office, his case history was carefully taken, a digital rectal exam was performed, and lab work was ordered. His blood results were unremarkable, but his urinalysis showed an elevated white blood cell count and bacteria. His physician diagnosed Darius with benign prostatic hyperplasia and urinary tract infection. MN551 Advanced Pathophysiology Across The Lifespan Week 8 Discussion

1. How does BPH contribute to the signs and symptoms of bladder dysfunction, and how was Darius prone to developing a urinary tract infection?
2. What are the static and dynamic components of BPH? Why are α1-adrenergic receptor blockers sometimes used to treat prostatic hyperplasia?
3. How does the prostate feel during a digital rectal exam with benign prostatic hyperplasia, acute bacterial prostatitis, and prostate cancer?
4. Why does the patient with prostate cancer present with symptoms later in the disease?

Case Study 3

Structure and Function of the Female Reproductive System

Janice is 49 years old, is married, and has two teenage children. Over the last year, her periods tended to be irregular and heavier than usual. She also noticed intercourse was becoming more painful for her, and her interest in sex declined. She knew her mother was 51 when she reached menopause, and Janice was concerned about having the mood swings and hot flashes her mother had experienced. She phoned some of her friends to seek their advice. Some said she should try hormone therapy, while others said it was not a good idea at all. Other friends said she should use remedies like red clover tea and soy isoflavone supplements. Janice decided her best bet was to go to the local women’s health care clinic to discuss her options with a nurse.

1. Using the data collected by the Women’s Health Initiative and the Nurses’ Health Study, why are some women at an increased risk for CHD and others are at a decreased risk when hormone therapy is prescribed?
2. Why are alternative methods like red clover and some plant oils being promoted for the menopausal woman? What are the changes that occur in a woman’s reproductive organs when estrogen levels decline?
3. How does estrogen affect bone growth during puberty? Why are postmenopausal women at risk for osteoporosis?

Case Study 4

Disorders of the Female Reproductive System

Tracie is 39 years old and is in a casual relationship with a man. She had her first sexual relationship when she was 13 and prefers to have short-term sexual relationships with men instead of a monogamous, committed partnership. It had been several years since Tracie had a complete physical, so before going on a vacation, she decided to have one done. Tracie’s Pap smear indicated CIN 3 (HSIL) dysplasia. Her physician immediately ordered a colposcopy and LEEP excision, and then asked to see Tracie for a follow-up appointment 6 months later. MN551 Advanced Pathophysiology Across The Lifespan Week 8 Discussion

1. Why is cervical cancer considered a sexually transmitted disease?
2. Explain what the Pap smear entails and why it is an effective tool in the detection of cervical cancer. What does Tracie’s result mean?
3. What is the transformation zone, and why is it vulnerable to the development of cervical cancer?
4. What is the LEEP procedure, and why is it useful for the diagnosis and treatment of cervical dysplasia?

To view the Grading Rubric for this Assignment, please visit the Grading Rubrics section of the Course Home.

MN551 Advanced Pathophysiology Across The Lifespan Week 8 Discussion