No Plegarism please, will be checked with Turnitin.

Will need minimum of 300 words, APA Style, double spaced, times new romans, font 12, and and (3 references with intext citations )

Case and Discussion

A 21-year-old women comes to your office with a 2 day history of right ear pain. She reports that the ear pain began shortly after taking scuba diving lessons. She describes the pain as “a pressure” and also notes “crackling” in the right ear and periodically feeling dizzy.

Please answer questions below in discussion board response.

What other associated symptoms should you ask about?

How does the time course help to distinguish among different causes of ear pain?

How does the age of the patient help with narrowing the diagnostic possibilities?

What diagnostic tests do you want to include to help you with your diagnosis?

Create a differential diagnosis flowsheet for this patient and include the diagnostics as well as the pharmacological management and rationale related to the differentials.

Case Study

Read the following case study:

A small community hospital in the Midwest has used a homegrown information system for years. The system began in the early 1970s with a financial module. Over time, additional modules were added. A limited number of departments selected a commercial system and interfaces were used to integrate these into the overall functionality of the hospital information system. Except for physicians, most in-house clinical or care-related documentation is online. However, about 15% to 20% of this documentation is done by free text and is not effectively searchable. In addition, the screens, including the drop-down and default values, were built using terms selected by the in-house development team in consultation with clinical staff; thus there is no data dictionary or specific standard language. In the last few years, the hospital has purchased two outpatient clinics (obstetrics and mental health) and a number of local doctor practices. The clinics and doctors’ offices are now being converted to the hospital administrative systems. A few of the clinical applications that are tied directly to the administrative systems such as order entry and results reporting are also being installed.

A major change is being planned. A new chief information officer (CIO) was hired last year and she has appointed a chief medical information officer (CMIO) and a chief nursing information officer (CNIO). No other significant staff changes were made. With her team in place, one of the CIO’s first activities was to complete an inventory of all applications. Rather than continue to build, a decision was made to switch to a commercial vendor and the hospital selected a commercial system.

As a member of the clinical staff with informatics education, the CIO has requested that you develop a training and information presentation for the clinical staff that will:

1· Identify two or more issues with the existing system

2· Provide staff with appropriate “work-around” for using the existing system

3· Provide an overview of two of the standard languages used within the new system including discipline or specialty, updating frequency, and available cross-maps

• One standard language should pertain only to nursing
• One standard language should be multidisciplinary.

4· Obtain clinical staff input, using a five-question survey, of specific methods to support transition to the new system; questions should be open-ended.

PowerPoint Presentation

Directions:

1. Review the case study.
2. Download the provided PowerPoint template to create a presentation that includes:

· Your name on the title slide of the presentation

· Identification of two or more issues with existing system

· Identification of “work-a-round” solutions when using existing system

· Overview of standard language used only in nursing

· Overview of multidisciplinary standard language

· Set of five (5) open-ended survey questions for staff input on transitioning to the new system

Presentation is free of spelling and grammar errors.

In a reflection of 450-600 words, explain how you see yourself fitting into the following IOM Future of Nursing recommendations:

Recommendation 4: Increase the proportion of nurses with a baccalaureate degree to 80% by 2020.

Recommendation 5: Double the number of nurses with a doctorate by 2020.

Recommendation 6: Ensure that nurses engage in lifelong learning.

Identify your options in the job market based on your educational level.

How will increasing your level of education affect how you compete in the current job market?

How will increasing your level of education affect your role in the future of nursing?

While APA format is not required for the body of this assignment, solid academic writing is expected and in-text citations and references should be presented using APA documentation guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

You are required to submit this assignment to Turnitin

Try out recording your final presentation. First, create a few PowerPoint slides to be used for the presentation. Next, record a draft version. Discuss your experience .

What has worked for you? What are you struggling with?

Reply to at least two peers providing support and recommendations.

Your initial posting should be at least 400 words in length. Please reply to at least two

classmates. Replies to classmates should be at least 200 words in length.

NOTE: Start working on your final PPT now as you will need to share this with your classmates for the final Module 8 Initial Discussion. Directions for the Signature Assignment are in Module 8.

Part two:

Start by reading and following these instructions:

Quickly skim the questions or assignment below and the assignment rubric to help you focus.

Read the required chapter(s) of the textbook and any additional recommended resources. Some answers may require you to do additional research on the Internet or in other reference sources. Choose your sources carefully.

Consider the course discussions so far and any insights gained from it.

Create your Assignment submission and be sure to cite your sources if needed, use APA style as required, and check your spelling.

Assignment:

Implementation of New Systems

Recorded presentation between 7 and 12 minutes in length. The presentation should include a PowerPoint and oral presentation of the slides. There is no slide number requirement. Answer all questions thoroughly with the allotted time. Be sure to include a title slide, objective slide, content slides, reference slide in APA format. Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly citations to support your claims. This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level. Save your assignment as an MP4 document (.mp4) or link.

You are a project manager assigned to implementing a new computer system in an organization:

Why is it important to understand usability, configurability, and interoperability? Should these concepts outweigh the underlining cost of the new system? Which system do you recommend and why?

During phase one, you are selecting a team. What characteristics are important to consider when selecting a team?

During phase two the following principle was discussed, “lead with culture, determining where the resistance is,” and then, engage all levels of employees (Sipes, 2019, p. 161). What does this principle mean to you and how can you implement this principle?

How will you handle physician and other key professionals’ resistance to change and using the new system?

Discuss possible pitfalls during the implementation phase and how you can avoid them?

Describe your personal experience with automation and new information systems.

Assignment Expectations:

Length: Recorded presentation between 7 and 12 minutes in length. The presentation should include a Power Point and oral presentation of the slides. There is no slide number requirement. Answer all questions thoroughly with the allotted time.

Structure: Include a title slide, objective slide, content slides, reference slide in APA format.

References: Use the appropriate APA style in-text citations and references for all resources utilized to answer the questions. Include at least three (3) scholarly sources to support your claims.

Rubric: This assignment uses a rubric for scoring. Please review it as part of your assignment preparation and again prior to submission to ensure you have addressed its criteria at the highest level.

Format: Save your assignment as an MP4 document (.mp4) or link

File name: Name your saved file according to your first initial, last name, and the module number (for example, “RHall Module 1.mp4”)

Presentation: Use a presentation software (PowerPoint, Google Slides) to create a visual presentation. Then use screencast-o-matic or other screen recording program to record an mp4 presentation between 7 and 12 minutes in length. Please do not record as voice-over PowerPoint because this cannot be saved in mp4 format. If you submit your assignment as a powerpoint with voice over recording you will not receive credit for your assignment (or partial credit as you did not meet the full requirements of the assignment.)

So you can record the audio and type it up and send it to me and i will do the same. I know this assignment requires a lot

Week 1 Quiz

Question 1 A patient has a blood serum drug level of 50 units/mL. The drug’s half-life is 1 hour. If concentrations above 25 units/mL are toxic and no more of the drug is given, how long will it take for the blood level to reach the nontoxic range?

Question 2 During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives

Question 3 Which of the following affects drug distribution throughout the body?

Question 4 An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?

Question 5 An older adult patient with a history of Alzheimer’s disease and numerous chronic health problems has been prescribed several medications during his current admission to hospital and recent declines in the patient’s cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient?

Question 6 A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to

Question 7 A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?

Question 8 A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction?

Question 9 The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?

Question 10 A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to

Question 11 A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient’s compromised renal function will likely

Question 12 A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient’s care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?

Question 13 A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)

Question 14 The nurse’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?

Question 15 A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?

Question 16 On the 1 a.m. rounds, the nurse finds a patient awake and frustrated that she cannot go to sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later, the nurse finds the patient out of bed, full of energy and cleaning her room. The nurse evaluates the patient’s response to the hypnotic as

Question 17 Which of the following statements best defines how a chemical becomes termed a drug?

Question 18 In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?

Question 19 In which of the following patients would a nurse expect to experience alterations in drug metabolism?

Question 20 30 ml = _______________tbsp

Question 21 Tylenol 325 mg/tablet, patient needs 650 mg; how many tables should patient take?

Question 22 A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patient’s stay in the hospital?

Question 23 A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the

Question 24 A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

Question 25 A patient has been prescribed 1 mg lorazepam (Ativan) sublingual prior to the scheduled insertion of a peripherally inserted central (PIC) line. How should the nurse direct the patient when administering this medication?

Question 26 A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is

Question 27 Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?

Question 28 A nurse is caring for an 81-year-old patient in a long-term care facility who takes nine different medications each day. The patient has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the patient is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to

Question 29 A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 p.m. The nurse finds the patient drowsy and confused at 10 a.m. the next day. The nurse is aware that this behavior is most likely due to

Question 30 An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that

Question 31 A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to

Question 32 An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize that this change in the resident’s medication regimen make create a risk for

Question 33 A 77-year-old man with a long history of absence seizures has been treated with ethosuximide for many years. The man is now in the process of moving to a long-term care facility and a nurse is creating a plan of care. The nurse understands the potential adverse effects of this drug and would consequently prioritize which of the following nursing diagnoses?

Question 34 A 70-year-old woman with a history of a trial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse’s admission assessment, the nurse realizes that the patient has been taking ginkgo biloba supplements in addition to her prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this patient’s care?

Question 35 A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness of the patient’s drug therapy?

Question 36 Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should

Question 37 Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient’s age will have what effect on her use of nitroglycerin?

Question 38 A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs?

Question 39 A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral ant platelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse’s advice?

Question 40 A home health nurse is performing a home visit to an elderly client who has early-stage dementia. The nurse observes that some of the client’s pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the nurse prioritize when planning this client’s care?