To the untrained ear, most coughs sound the same. However, as you might recall from past clinical experiences, a simple cough can lead to a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive pulmonary disease (COPD). Although it can sometimes be challenging to diagnose a patient based on common respiratory symptoms such as congestion, coughing, and wheezing, it is important to be able to distinguish minor differences as even mild symptoms might require intervention with drug treatments. When recommending potential treatment options, advanced practice nurses must consider how individual patient factors might impact the effects of prescribed drugs.

To prepare:

-Review Chapter 26 and Chapter 27 of the Arcangelo and Peterson text.

-Select and research one of the following respiratory disorders: the common cold, pneumonia, or a chronic obstructive —-pulmonary disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

-Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

THE DISCUSSION IS IN APA, MINIMUM 3 REFERENCES NOT OLDER THAN 2013 AND CITATION.

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 18, “Otitis Media and Otitis Externa” (pp. 243-252)

This chapter compares the causes and pathophysiology of two common ear infections—otitis media and otitis externa. It also identifies types of drugs used to treat these ear infections.

Chapter 24, “Upper Respiratory Infections” (pp. 259-374)

This chapter explores the causes, pathophysiology, and diagnostic criteria of two upper respiratory infections—the common cold and sinusitis—as well as drug therapy for both infections. It also covers monitoring patient response and patient education of drug therapy for these infections.

Chapter 25, “Asthma” (pp. 377-392)

This chapter examines the causes, pathophysiology, pharmacogenomics, and diagnostic criteria of asthma. It also outlines suggested drug therapy plans for asthmatic patients.

Chapter 26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)

This chapter explains the causes and pathophysiology of chronic obstructive pulmonary disease (COPD). It also examines the process of selecting, administering, and managing drug therapy for COPD patients.

Chapter 27, “Bronchitis and Pneumonia” (pp. 407-424)

This chapter begins by examining the causes, pathophysiology, and diagnostic criteria of acute bronchitis, chronic bronchitis, and community-acquired pneumonia. It then explores the process of selecting, administering, and managing drug therapy for patients with bronchitis and pneumonia.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This website presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.

Discussion: Pharmacotherapy for Respiratory DisordersTo the untrained ear, most coughs sound the same. However, as you might recall from past clinical experiences, a simple cough can lead to a patient diagnosis of a common cold, pneumonia, or even a chronic obstructive pulmonary disease (COPD). Although it can sometimes be challenging to diagnose a patient based on common respiratory symptoms such as congestion, coughing, and wheezing, it is important to be able to distinguish minor differences as even mild symptoms might require intervention with drug treatments. When recommending potential treatment options, advanced practice nurses must consider how individual patient factors might impact the effects of prescribed drugs.

To prepare:

Review Chapter 26 and Chapter 27 of the Arcangelo and Peterson text.

Select and research one of the following respiratory disorders: the common cold, pneumonia, or a chronic obstructive pulmonary disease (COPD) such as emphysema or chronic bronchitis. Consider types of drugs that would be prescribed to patients to treat symptoms associated with this disorder.

Select one of the following factors: genetics, gender, ethnicity, age, or behavior. Reflect on how this factor might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

With these thoughts in mind:

By Day 3

Post a description of the respiratory disorder you selected including types of drugs that would be prescribed to patients to treat associated symptoms. Then, explain how the factor you selected might impact effects of prescribed drugs, as well as any measures you might take to help reduce negative side effects.

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 18, “Otitis Media and Otitis Externa” (pp. 243-252)

This chapter compares the causes and pathophysiology of two common ear infections—otitis media and otitis externa. It also identifies types of drugs used to treat these ear infections.

Chapter 24, “Upper Respiratory Infections” (pp. 259-374)

This chapter explores the causes, pathophysiology, and diagnostic criteria of two upper respiratory infections—the common cold and sinusitis—as well as drug therapy for both infections. It also covers monitoring patient response and patient education of drug therapy for these infections.

Chapter 25, “Asthma” (pp. 377-392)

This chapter examines the causes, pathophysiology, pharmacogenomics, and diagnostic criteria of asthma. It also outlines suggested drug therapy plans for asthmatic patients.

Chapter 26, “Chronic Obstructive Pulmonary Disease” (pp. 395-406)

This chapter explains the causes and pathophysiology of chronic obstructive pulmonary disease (COPD). It also examines the process of selecting, administering, and managing drug therapy for COPD patients.

Chapter 27, “Bronchitis and Pneumonia” (pp. 407-424)

This chapter begins by examining the causes, pathophysiology, and diagnostic criteria of acute bronchitis, chronic bronchitis, and community-acquired pneumonia. It then explores the process of selecting, administering, and managing drug therapy for patients with bronchitis and pneumonia.

Drugs.com. (2012). Retrieved from http://www.drugs.com/

This website presents a comprehensive review of prescription and over-the-counter drugs including information on common uses and potential side effects. It also provides updates relating to new drugs on the market, support from health professionals, and a drug-drug interactions checker.

National Heart Lung and Blood Institute. (2007). Expert panel report 3 (EPR3): Guidelines for the diagnosis and management of asthma. Retrieved from http://www.nhlbi.nih.gov/guidelines/asthma/asthgdln.htm

This website presents guidelines for diagnosing and managing asthma and outlines treatment recommendations for specific age groups.

NR 504 Week 2 Assignment: Role of Ethics within Leadership

The purpose of this assignment is to apply ethical principles to current leadership practices within healthcare by a) explaining two ethical principles, b) applying selected ethical principles to leadership, c) identifying how selected ethical principles can prevent or resolve leadership concerns, d) discussing how selected ethical principles will be incorporated into own leadership practices, and e) communicate ideas in a clear, succinct and scholarly manner.

NR 504 Week 2 Discussion Question/Answer Leadership Whirlwind

Step into a Leadership Whirlwind by clicking on the icon below. After listening to the “Whirlwind” identify two issues and develop a specific plan that would facilitate improvement for C.J. Your plan requires scholarly support for the actions as well as providing C.J. information useful for improvement.

Peer response: For the peer response, you assume the role of C.J.’s immediate supervisor……………… different technique/action to improve the identified plan.

The first step of the EBP process is to develop a question from the nursing practice problem of interest.

Select a practice problem of interest to use as the focus of your research.

Start with the patient and identify the clinical problems or issues that arise from clinical care.

Following the PICOT format, write a PICOT statement in your selected practice problem area of interest, which is applicable to your proposed capstone project.

The PICOT statement will provide a framework for your capstone project (the project students must complete during their final course in the RN-BSN program of study).

Conduct a literature search to locate research articles focused on your selected practice problem of interest. This literature search should include both quantitative and qualitative peer-reviewed research articles to support your practice problem.

Select six peer-reviewed research articles which will be utilized through the next 5 weeks as reference sources. Be sure that some of the articles use qualitative research and that some use quantitative research. Create a reference list in which the six articles are listed. Beneath each reference include the article’s abstract. The completed assignment should have a title page and a reference list with abstracts.

Suggestions for locating qualitative and quantitative research articles from credible sources:

Use a library database such as CINAHL Complete for your search.

Using the advanced search page check the box beside “Research Article” in the “Limit Your Results” section.

When setting up the search you can type your topic in the top box, then add quantitative or qualitative as a search term in one of the lower boxes. Research articles often are described as qualitative or quantitative.

To narrow/broaden your search, remove the words qualitative and quantitative and include words that narrow or broaden your main topic. For example: Diabetes and pediatric and dialysis. To determine what research design was used, review the abstract and the methods section of the article. The author will provide a description of data collection using qualitative or quantitative methods.

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

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

You are not required to submit this assignment to Turnitin.

Addressing the knowledge you have gained, and building on that knowledge to add your evaluation of the role that the managed care organization (MCO) plays in today’s health care environment, develop a 500 word reflection to incorporate the following:

What is a health care organization’s administrative role regarding oversight of risk management policies and ensuring compliance with managed care organization (MCOs) standards?

What is your assessment of the value provided to an organization that stems from the regulatory statutes of a typical MCO? Consider the establishment of conflict resolution and risk management strategies within the health care organization from the employer/employee perspective as well as in regards to patient conflict circumstances.

What MCO responsibilities pertain to the Patient Protection and Affordable Care Act (PPACA) and Center for Medicare and Medicaid Services (CMS) focus on fraud, waste, and abuse laws?

Prepare this assignment according to the guidelines found in the APA Style Guide.

CHECK PLAGIARISM, MINIMUM OF 3 REFERENCES

Assignment 1: Assessing the Genitalia and Rectum

Patients are frequently uncomfortable discussing with health care professional’s issues that involve the genitalia and rectum; however, gathering an adequate history and properly conducting a physical exam are vital. Examining case studies of genital and rectal abnormalities can help prepare advanced practice nurses to accurately assess patients with problems in these areas.

In this assignment, you will consider case studies that describe abnormal findings in patients seen in a clinical setting.

In this assignment, you will analyze a SOAP note case study that describes abnormal findings in patients seen in a clinical setting. You will consider what history should be collected from the patients, as well as which physical exams and diagnostic tests should be conducted. You will also formulate a differential diagnosis with several possible conditions.

GENITALIA ASSESSMENT

Subjective:

· CC: “I have bumps on my bottom that I want to have checked out.”

· HPI: AB, a 21-year-old WF college student reports to your clinic with external bumps on her genital area. She states the bumps are painless and feel rough. She states she is sexually active and has had more than one partner over the past year. Her initial sexual contact occurred at age 18. She reports no abnormal vaginal discharge. She is unsure how long the bumps have been there but noticed them about a week ago. Her last Pap smear exam was 3 years ago, and no dysplasia was found; the exam results were normal. She reports one sexually transmitted infection (chlamydia) about 2 years ago. She completed the treatment for chlamydia as prescribed.

· PMH: Asthma

· Medications: Symbicort 160/4.5mcg

· Allergies: NKDA

· FH: No hx of breast or cervical cancer, Father hx HTN, Mother hx HTN, GERD

· Social: Denies tobacco use; occasional etoh, married, 3 children (1 girl, 2 boys)

Objective:

· VS: Temp 98.6; BP 120/86; RR 16; P 92; HT 5’10”; WT 169lbs

· Heart: RRR, no murmurs

· Lungs: CTA, chest wall symmetrical

· Genital: Normal female hair pattern distribution; no masses or swelling. Urethral meatus intact without erythema or discharge. Perineum intact with a healed episiotomy scar present. Vaginal mucosa pink and moist with rugae present, pos for firm, round, small, painless ulcer noted on external labia

· Abd: soft, normoactive bowel sounds, neg rebound, neg murphy’s, neg McBurney

· Diagnostics: HSV specimen obtained

Assessment:

· Chancre

· PLAN: This section is not required for the assignments in this course (NURS 6512) but will be required for future courses.

To prepare:

With regard to the SOAP note case study provided:

· Review this week’s Learning Resources, and consider the insights they provide about the case study.

· Consider what history would be necessary to collect from the patient in the case study.

· Consider what physical exams and diagnostic tests would be appropriate to gather more information about the patient’s condition. How would the results be used to make a diagnosis?

· Identify at least five possible conditions that may be considered in a differential diagnosis for the patient.

To complete:

Refer to Chapter 5 of the Sullivan text. Analyze the SOAP note case study. Using evidence based resources, answer the following questions and support your answers using current evidence from the literature.

· Analyze the subjective portion of the note. List additional information that should be included in the documentation.

· Analyze the objective portion of the note. List additional information that should be included in the documentation.

· Is the assessment supported by the subjective and objective information? Why or Why not?

· Would diagnostics be appropriate for this case and how would the results be used to make a diagnosis?

· Would you reject/accept the current diagnosis? Why or why not? Identify three possible conditions that may be considered as a differential diagnosis for this patient. Explain your reasoning using at least 3 different references from current evidence based literature.