Disc wk 2/50/woman.

Britt/classmate ;post/needs to be respond a comment…..

A 50-year-old woman is admitted with chief complaints of headache and decreased range of motion in her neck. She also complains of vertigo, hearing loss in one ear, profuse sweating, and uncontrollable eye movements. Her past medical history indicates that she was in a motor vehicle accident three day before her admission.

What specific diagnostic examinations would you recommend? Why?

What conditions should be ruled out? Why?

How would you distinguish between these conditions? What are the possible causes of these symptoms?

       With chief complaints of headache and neck stiffness post MVA, I would first order a CT of the brain and cervical spine. This imaging would be pertinent to rule out possible CVA, brain injury, and neck fracture. There is also a strong chance that the patient has whiplash or a concussion. More information would have to be given to determine if the patient actually hit her head, or if she was rear-ended, to direct plan of care.


       The patient does exhibit some symptoms of a concussion, so this must be ruled out. “The signs of a concussion may include: memory problems, confusion, drowsiness or feeling sluggish, dizziness, double vision or blurred vision, abnormal eye movement, headache, nausea or vomiting, sensitivity to light or noise, balance problems, slowed reaction to stimuli, post traumatic vertigo, or dizziness that lasts up to several months” (Healthline Media Editorial Team, 2017). A traumatic brain injury must be ruled out as well especially since the patient exhibits with the symptom of profuse sweating. “Sweating disorders after traumatic brain injury are common with multifactorial causes including injuries, tumors, infarcts, or hemorrhages of the brain or medulla” (Garg, A. Malhotra, R., 2016). Whiplash would also be a possible diagnosis and is very common after MVAs. This would be the less severe diagnoses. “About 80% of the cases of whiplash injuries recover within a few months. However, about 15-20% (about 40,000 cases per year) develop “late whiplash injury syndrome”. This syndrome involves complaints including neck pain, headache, vertigo, hearing loss and tinnitus. Hearing loss, tinnitus and dizziness are the main ontological symptoms of whiplash” (Arches Natural Products, 2018).


       Along with imaging, it would be priority to conduct a thorough neuro exam and assess cranial nerves. I would ask if the patient is on any anticoagulants and have basic blood work drawn. Once this data is gathered, the physician should be able to narrow it down and form an accurate diagnosis to treat the patient.

What type of drug should you prescribe based on your patient’s diagnosis? How much of the drug should the patient receive? How often should the drug be administered? When should the drug not be prescribed? Are there individual patient factors that could create complications when taking the drug? Should you be prescribing drugs to this patient?

These are some of the questions you might consider when selecting a treatment plan for a patient. As an advanced practice nurse prescribing drugs, you are held accountable for people’s lives on a daily basis. Patients and their families will often place trust in you because of your position. With this trust comes power and responsibility, as well as an ethical and legal obligation to “do no harm.” It is important that you are aware of current professional, legal, and ethical standards for advanced practice nurses with prescriptive authority. In this Discussion, you explore ethical and legal implications of scenarios and consider how to appropriately respond.

Scenario 1:

As a nurse practitioner, you prescribe medications for your patients. You make an error when prescribing medication to a 5-year-old patient. Rather than dosing him appropriately, you prescribe a dose suitable for an adult.

Scenario 2:

A friend calls and asks you to prescribe a medication for her. You have this autonomy, but you don’t have your friend’s medical history. You write the prescription anyway.

Scenario 3:

You see another nurse practitioner writing a prescription for her husband who is not a patient of the nurse practitioner. The prescription is for a narcotic. You can’t decide whether or not to report the incident.

Scenario 4:

During your lunch break at the hospital, you read a journal article on pharmacoeconomics. You think of a couple of patients who have recently mentioned their financial difficulties. You wonder if some of the expensive drugs you have prescribed are sufficiently managing the patients’ health conditions and improving their quality of life.

To prepare:

• Review Chapter 1 of the Arcangelo and Peterson text, as well as articles from the American Nurses Association, Anderson and Townsend, the Drug Enforcement Administration, and Philipsend and Soeken.
• Select one of the four scenarios listed above.
• Consider the ethical and legal implications of the scenario for all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family.
• Think about two strategies that you, as an advanced practice nurse, would use to guide your ethically and legally responsible decision-making in this scenario.

With these thoughts in mind:

Post an explanation of the ethical and legal implications of the scenario you selected on all stakeholders involved such as the prescriber, pharmacist, patient, and the patient’s family. Describe two strategies that you, as an advanced practice nurse, would use to guide your decision making in this scenario.

• This work should have Introduction and conclusion
• This work should have at 3 to 5current references (Year 2012 and up)
• Use at least 2 references from class Learning Resources

The following Resources are not acceptable:

1. Wikipedia
2. Cdc.gov- nonhealthcare professionals section
3. Webmd.com
4. Mayoclinic.com

Required Readings

**Arcangelo, V. P., Peterson, A. M., Wilbur, V., & Reinhold, J. A. (Eds.). (2017). Pharmacotherapeutics for advanced practice: A practical approach (4th ed.). Ambler, PA: Lippincott Williams & Wilkins.

Chapter 1, “Issues for the Practitioner in Drug Therapy” (pp. 3–14)

 This chapter introduces issues relating to drug therapy such as adverse      drug events and medication adherence. It also explores drug safety, the      practitioner’s role and responsibilities in prescribing, and prescription      writing.

Chapter 59, “The Economics of Pharmacotherapeutics” (pp. 1009-1018)

 This chapter analyzes the costs of drug therapy to health care systems and      society and explores practice guideline compliance and current issues in      medical care.

Chapter 60, “Integrative Approaches to Pharmacotherapy—A Look at Complex Cases” (pp. 1021-1036)

 This chapter examines issues in individual patient cases. It explores      concepts relating to evaluation, drug selection, patient education, and      alternative treatment options.

**Crigger, N., & Holcomb, L. (2008). Improving nurse practitioner practice through rational prescribing. The Journal for Nurse Practitioners, 4(2), 120–125.

Note: Retrieved from the Walden Library databases.

This article explores issues relating to prescription drugs, specifically the frequency in which drugs are prescribed to patients. It also examines factors to consider before beginning drug therapy plans with patients.

**Philipsen, N. C., & Soeken, D. (2011). Preparing to blow the whistle: A survival guide for nurses. The Journal for Nurse Practitioners, 7(9), 740–746.

Note: Retrieved from the Walden Library databases.

This article examines issues that nurses encounter when reporting errors in medical settings. It also outlines the role of ethics and the responsibility of nurses to notify all individuals who are impacted by a medical error.

Write 3–4 pages describing the effective use of patient-care technologies, communication systems, and information systems across the care continuum of a health care system of your choice. Add a one-page executive summary your organization could use to disseminate these ideas.

Because a lack of knowledge when using technology can lead to errors in patient care, effective use of technology in health care is paramount to providing a safe health care delivery environment.

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

Competency 3: Explain the use of information management tools and technologies to monitor and improve health care delivery and patient outcomes.

Describe effective use of technology across the care continuum in a health care setting.

Describe how to manage change and technology to improve positive outcomes.

Support description of effective patient care with current nursing and informatics theoretical ideas.

Competency 4: Communicate in a manner that is consistent with expectations of a nursing professional.

Write coherently to support a central idea in appropriate format with correct grammar, usage, and mechanics.

To deepen your understanding, you are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of the business community.

How might standardized nursing language (SNL), interprofessional communication, information system support, staff and patient education, organizational culture, and state and national regulations influence technology use?

What are the complexities in using technology across a continuum of care?

What are the opportunities?

What are the barriers?

How can we manage change and technology use to develop improved patient outcomes?

Assessment Instructions

In the role of a nurse leader, describe the effective use of patient-care technologies across the care continuum in a chosen health care system.

Preparation

Choose any type of health care system, for example, acute, ambulatory, or home health or telehealth.

Directions

Submit the following for this assessment:

Technology Across the Care Continuum

Include the following in your 3–4-page description:

A brief overview of the care continuum in your selected health care system.

Describe the types of patient-care technologies and how they are used across the care continuum in your system. Be sure to include communication and information systems.

Identify strengths and weaknesses in the systems and describe how to manage change and technology to improve patient outcomes.

Support your description of effective patient care with current nursing and informatics theoretical ideas.

Executive Summary

Based on the description above, add a 1-page executive summary that captures the following points:

Current state of technology across the care continuum in your system.

Proposed improvements.

Risks of making or not making changes or improvements.

Recommended next steps.

Additional Requirements

Written communication: Ensure written communication is free of errors that detract from the overall message.

APA formatting: Format resources and citations according to current APA style and formatting guidelines.

Number of resources: Cite a minimum of four peer-reviewed resources.

Length: Submit 4–5 typed, double-spaced pages.

Font and font size: Use Times New Roman, 12 point. 

PURPOSE

The purpose of this assignment is to allow the learner to demonstrate good organization, appropriate resources, and correct APA formatting for preparing a scholarly paper.

COURSE OUTCOMES

This assignment enables the student to meet the following Course Outcomes (COs).

· CO3: Demonstrate effective verbal, written, and technological communication using legal and ethical standards for transferring knowledge using success resources provided to Chamberlain students. (PO3)

· CO4: Integrate critical thinking and judgment in professional decision-making in collaboration with faculty and peers. (PO4)

· CO5: Apply concepts of professionalism when planning for personal, intellectual, and professional development. (PO5)

· CO9: Demonstrate accountability for personal and professional development by assessing information and technology competence, implementing plans for upgrading technology skills, and using effective strategies for online student success using resources provided to Chamberlain students. (PO5)

DUE DATE

Submit the assignment by Sunday end of Week 6, 11:59 p.m. MT.

POINTS

This assignment is worth a total of 225 points.

PREPARING THE SCHOLARLY PAPER PHASE 2

1. Carefully read these instructions and the Rubric.
2. Download the Week 6 Scholarly Paper Phase 2 Template (Links to an external site.)Links to an external site.. Use of the assigned template is required. Rename that document as Your Last Name Scholarly Paper Phase 1.docx, for example Smith Scholarly Paper Phase 2. Save it to your own computer or drive in a location where you will be able to retrieve it later.
3. Type your assignment directly on the saved template using Microsoft Word. The document must be saved as a .docx. Save frequently to prevent loss of your work.

The only resource for your paper is the following assigned article: https://www.americannursetoday.com/wp-content/uploads/2018/09/ant9-Resiliency-831.pdf

Note: Logging in to the Chamberlain Library is needed to access this article. Use of the assigned article is required.

1. Follow the instructions and specifics on the assigned required template and the rubric. You will demonstrate your scholarly writing abilities as well as APA abilities in references, citations, quotations, and paraphrasing.
2. See rubric for length limitations for each section and other criteria.
3. For the Introduction section (see rubric for details),

a. introduce the assigned paper topic;

b. explain that the purpose of this paper is to provide a summary of the assigned article;

c. explain that that the impact of the article contents on your own future practice will be included; and

d. length must be 50–75 words.

1. For the Article Summary section (see rubric for details),

a. clearly summarize the major content of the assigned article using 175–200 words;

b. content must include main ideas from across the entire article;

c. specifics should be excellent;

d. content must be attributed to the correct source; and

e. instructor feedback from Week 4 Scholarly Paper Phase 1 must be used to revise and improve this section.

1. For the Impact section,

a. clearly state how learning from the assigned article will impact your future practice;

b. length must be 125–150 words;

c. writing must be concise and clearly relate the assigned article contents to practice;

d. use first person in this section; and

e. instructor feedback from Week 4 Scholarly Paper Phase 1 must be used to revise and improve this section.

1. For the Conclusion,

a. write a concise summary of main points of the paper;

b. provide a concluding statement; and

c. length must be 75–100 words.

1. Double check your work with the rubric prior to submission.
2. Note: Assigned Template must be used for this assignment. The Assigned Template has been specially prepared to help you do well on this assignment. See #2 above.
3. Note: Assigned Article must be used for this assignment. Failure to do so may result in loss of points and/or Academic Integrity violation investigation.

Academic Integrity Reminder

Chamberlain College of Nursing values honesty and integrity. All students should be aware of the Academic Integrity policy and follow it in all discussions and assignments.

By submitting this assignment, I pledge on my honor that all content contained is my own original work except as quoted and cited appropriately. I have not received any unauthorized assistance on this assignment.

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