To do a comment to the post below in APA style with citation, needs 2 credible reference from 2013 and above.Episodic/Focused SOAP Note TemplatePatient Information:J, 11, Male, XX (Race) S.CC: “Mil

To do a comment to the post below in APA style with citation, needs 2 credible reference from 2013 and above.

Episodic/Focused SOAP Note Template

Patient Information:

J, 11, Male, XX (Race) 

S.

CC: “Mild ear ache”

HPI: The patient is 11 year old XX male who presented himself with a mild right ear ache, which started two days ago. Associated symptom include possible fever, right ear pain, difficulty hearing from the right ear. Associated symptom are exacerbated with sleep. 

Current Medications: Inquire if patient is currently taking any medications, rule out earring loss related to medication toxicity. 

Allergies: Inquire about allergies. 

PMH: Inquire if patient has a history of acute otitis media or underlying hearing loss. Inquire if patient has had tonsillectomy or an adenoidectomy in the past. SH: Spends time in pool during summer. 

FH: Inquire if family members have history of hearing loss. 

ROS:

• GENERAL: Possible fever. Inquire about patient’s swimming habits and ask if ear plugs used. Determine method of cleaning ear. 
• HEENT: Right ear pain. Inquire if patient has tinnitus, discharge from ear, vertigo, or itchiness. Inquire if patient has a history of acute otitis media, hearing loss, vertigo, tinnitus, discharge from ear canal.
• RESPIRATORY: Inquire if patient has had post nasal discharge or sputum production and ask about color of mucous. 
• ALLERGIES:  Unknown 

O.

Physical exam:

• HEENT— Assess outer ear and note surrounding tissue, shape, color, and any lesions. Assess the external ear for discharge or any odor. Assess for the placement of a foreign object in ear. Assess for tenderness on the outer ear near the auricle and mastoid. Tenderness could indicate a possible infection. Use otoscope to assess external and middle ear. At this time, assess for erythema, lesions, and discharge. Inspect tympanic membrane for perforations. Assess the frontal and maxillary sinuses for swelling. No tenderness or swelling over the soft tissue should be present. Assess tonsils and inside of mouth for lesions, erythema, and swelling. 
• RESPIRATORY: Determine if upper respiratory infection is present, assess for clear lungs. 

Diagnostic results: 

• Whispered Voice- Determines if patient is able to hear whispering. If they do not pass this test, hearing loss could be assumed. (Ball, Dains, Flynn, Solomon, Stewart, et al., 2015, p. 241). 
• Weber Test- Determines unilateral hearing loss (Ball et al., 2015, p. 241). 
• Rinne Test- Determines if the patient conducts sound better through bone or air. The patient should hear the sound conducted through the air twice as long (Ball et al., 2015, p. 241)
• Culture of ear fluid (Attlmayr, 2015). 

Differential Diagnoses

• Otitis externa 
  • Often seen with individuals that swim. This infection is located on the outer ear. Pain is worse when an otoscope is inserted because sensitivity is on the outer ear. The outer portion of the ear is often inlamted and tender to touch. When inspecting the ear, the ear canal would appear narrow. Because of the narrowing, fluid is unable to drain from the ear (Rosenfeld et al., 2014). 
• Otitis media
  • Otitis media is a middle ear infection that usually presents unilaterally, hearing loss is present, and tympanic membrane is pink. Pus often forms inside the ear, which could cause perforation of the tympanic membrane. Ear pain, fever, difficulty hearing, irritability, and lethargy can also accompany this diagnosis. While examining the ear with the otoscope, erythema, dullness, decrease light reflex, and bulging of the tympanic membrane (Nash, 2013). 
• Eustachian catarrh 
  • Often results after an upper respiratory infection. It would be essential to determine if the patient has has a recent upper respiratory tract infection. Fluid collects in the eustachian tube, which causes pain and trouble hearing (Nash, 2013). 
• Cholesteatoma 
  • The growth of a skin tag inside the ear, behind the ear drum. The patient could be born with it or it can develop after several ear infections. It would be essential to determine if the patient has had frequent ear infections in the past (Chawla, Ezhil Bosco, Lim, Shenoy, & Krishnan, 2015). 
• Mastoiditis
  • Mastoiditis is a common complication of acute otitis media. Pain, erythema, and tenderness are typically present alone the mastoid process (Attlmayr, 2015). 

P.  NA

Reference

Attlmayr, B., Zaman, S., Scott, J., Derbyshire, S. G., Clarke, R. W., & De, S. (2015). 

Paediatric acute mastoiditis, then and   now: Is it more of a problem now?. The Journal 

Of Laryngology And Otology, 129(10), 955-959. doi:10.1017/S0022215115002078

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S.,   Stewart, R. W. (2015). Seidel’s guide to physical 

examination (8th ed.). St. Louis, MO: Elsevier Mosby.

Chawla, A., Ezhil Bosco, J. I., Lim, T. C., Shenoy, J. N., & Krishnan, V. (2015). Computed tomography 

features of external auditory canal cholesteatoma: A pictorial review. Current Problems In 

Diagnostic Radiology, 44(6), 511-516. doi:10.1067/j.cpradiol.2015.05.001

Nash, L. (2013). A case study on prescribing for an acute ear infection in a child. Nurse Prescribing, 

11(4), 179-184.

Rosenfeld, R. M., Schwartz, S. R., Cannon, C. R., Roland, P. S., Simon, G. R., Kumar, K. A., & … 

Robertson, P. J. (2014). Clinical practice guideline: Acute otitis externa. Otolaryngology-Head & 

Neck Surgery, 150S1-S24. doi:10.1177/0194599813517083

Use selected health policy issue as the basis for completing this assignment.Policy issued selected: (Prescription drug abuse)Research a professional organization with influence over the health policy

Use selected health policy issue as the basis for completing this assignment.Policy issued selected: (Prescription drug abuse)

Research a professional organization with influence over the health policy issue.

Locate at least one academic article focusing on the professional organization’s efforts to effect change on the health policy issue.

Contact the organization and ask at least two specific questions regarding the health policy issue that neither their website nor the article answered.

Prepare a marketable visual presentation (i.e., flyer, pamphlet, poster, etc.) on the organization. Include the following in your presentation:

1.The role and mission of the organization

2.The benefits of the organization to its members and the APRN community as a whole.

3. How will networking with this organization and with others in the industry help drive change in the area of your selected health policy issue?

4. Based on the article you selected and your research on the organization, how can the organization be used as a guiding coalition to address your health policy issue.

Other instructions: Please read carefully instructions above. US based.  I don’t need a paper. What i need is find a  professional organization with influence over Prescription drug abuse health policy. Then Locate at least one academic article focusing on the professional organization’s efforts to effect change on the health policy issue. then Contact the organization and ask at least two specific questions regarding the health policy issue that neither their website nor the article answered. Then lastly Prepare a marketable visual presentation (i.e., flyer, pamphlet, poster, etc.) on the organization. In the marketable visual presentation should include: 

1. The role and mission of the organization

2.The benefits of the organization to its members and the APRN community as a whole.

3. How will networking with this organization and with others in the industry help drive change in the area of your selected health policy issue?

4. Based on the article you selected and your research on the organization, how can the organization be used as a guiding coalition to address your health policy issue.

As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others w

As a nurse, you can have a great impact on the success or failure of the adoption of EHRs. It is important for nurses to understand their role as change agents and the ways they can influence others when addressing the challenges of changing to a drastically different way of doing things.

Everett Rogers, a pioneer in the field of the diffusion of innovations, identified five qualities that determine individual attitudes towards adopting new technology (2003). He theorized that individuals are concerned with:

· Relative advantage: The individual adopting the new innovation must see how it will be an improvement over the old way of doing things.

· Compatibility with existing values and practices: The adopter must understand how the new innovation aligns with current practices.

· Simplicity: The adopter must believe he or she can easily master the new technology; the more difficult learning the new system appears, the greater the resistance that will occur.

· Trialability: The adopter should have the opportunity to “play around’ with the new technology and explore its capabilities.

· Observable results: The adopter must have evidence that the proposed innovation has been successful in other situations.

Note: You are not required to purchase Rogers’ book or pursue further information regarding his list of five qualities. The information provided here is sufficient to complete this Assignment. The full reference for Rogers’ work is provided below the due date on this page.

For this Assignment, you assume the role of a nurse facilitator in a small hospital in upstate New York. You have been part of a team preparing for the implementation of a new electronic health records system. Decisions as to the program that will be used have been finalized, and you are now tasked with preparing the nurses for the new system. There has been an undercurrent of resistance expressed by nurses, and you must respond to their concerns. You have a meeting scheduled with the nurses 1 week prior to the training on the new EHR system. Consider how you can use the five qualities outlined by Rogers (2003) to assist in preparing the nurses for the upcoming implementation.

To prepare

· Review the Learning Resources this week about successful implementations of EHRs.

· Consider how you would present the new EHR system to the nurses to win their approval.

· Reflect on the five qualities outlined by Rogers. How would addressing each of those areas improve the likelihood of success? 

Write a 3- to 5-page paper which includes the following:

· Using Rogers’ (2003) theory as a foundation, outline how you would approach the meeting with the nurses. Be specific as to the types of information or activities you could provide to address each area and include how you would respond to resistance.

· Analyze the role of nurses as change agents in facilitating the adoption of new technology.

Nutrition/ Core Nutritional Science Assignment/no plagiarism/deadline closePLS CHECK ATTACHMENTDNT 200 — NUTRITION FOR HEALTH SCIENCES STUDY GUIDE 6: ENERGY METABOLISM AND WEIGHT CONTROLDirectio

  Nutrition/ Core Nutritional Science Assignment/no plagiarism/deadline close

PLS CHECK ATTACHMENT

DNT 200 — NUTRITION FOR HEALTH SCIENCES 

STUDY GUIDE 6: ENERGY METABOLISM AND WEIGHT CONTROL

Directions. Using Chapters 7, 8, and 9 of your textbook as a reference, answer the following questions. Please include the questions with your answers. Be sure to put your name on your document. Your answers should be thoughtful, complete, and in Standard English. Credit will not be given for answers copied from online sources.

1. Define the following

Acetyl CoA 

Adaptive Thermogenesis 

Aerobic 

Amenorrhea 

Anabolism 

Anaerobic 

Anorexia nervosa 

Appetite 

ATP (adenosine triphosphate) 

Bariatric 

Basal Metabolic Rate (BMR) 

Basal metabolism 

Behavior Modification  

Binge eating disorder 

Body composition 

Body Mass Index 

Bomb Calorimeter 

Brite adipocytes 

Brown Adipose Tissue 

Bulimia nervosa 

Catabolism 

Cathartic 

Central Obesity 

Clinically severe obesity

CoA 

Coenzymes 

Cori cycle 

Coupled reactions 

Disordered eating 

Eating disorders 

Ectopic fat 

Electron transport chain 

Emetic 

Endoscopic procedures 

Energy balance 

Enzymes 

Fad Diets 

Female athlete triad 

Fuel 

Gastric aspiration 

Gene pool 

Ghrelin 

Gluconeogenisis 

Glycolysis 

Hunger 

Hyperplastic Obesity 

Hypertrophic Obesity 

Hypothesis 

Inflammation 

Insulin Resistance 

Intragastric balloon 

Ketoacid 

Ketone bodies 

Lactate (in the context of energy metabolism) 

Lean Body Mass 

Leptin 

Leptin resistance 

Lipoprotein lipase (LPL) 

Metabolic syndrome 

Metabolism 

Mitochondria 

Muscle dysmorphia 

Neuropeptide Y 

Normal-weight obesity syndrome 

Obese 

Obesogenic environment 

Orthorexia nervosa 

Overweight 

Photosynthesis 

Physiological fuel value 

Pyruvate 

Relative energy deficiency in sport (RED-S) 

Resting Metabolic Rate (RMR) 

Satiating 

Satiation 

Satiety 

Set Point 

Stress fractures 

Subcutaneous Fat  

Successful weight-loss maintenance 

TCA cycle 

Thermic Effect of food (TEF) 

Thermogenesis 

Underweight 

Visceral Fat 

Waist circumference 

Weight cycling 

Weight management 

2. Your friend Tiffany is taking a nutrition course at another local community college. She is having difficulty understanding the unit about the energy yielding pathways of carbohydrate, protein, and fat. Help her by discussing how the basic units of carbohydrate, protein, and fat are utilized in energy pathways to produce energy. Be thorough. Include their differences and similarities? 

3. Tina W. is a 44 year old white female who has tried a number of weight-loss programs to include very strict diets. She has never exercised in her previous weight loss attempts. She takes several cardiac medications, none of which she can remember. She is 5’9” and weighs 195 pounds. Her lowest body weight was 135 pounds, when she was 30 years old. (She was able to maintain that weight for two years.) Her blood pressure is high, at 160/90. Tina mentioned that she tried numerous diets as a teenager when she weighed 170 pounds for 3 years. 

a. Using the formulae  in your text book, calculate Tina’s:

1. BMR (Hint: Be sure to read note b in the BMR column of Table 8-1). What is the meaning of your calculation?

2. Estimated Energy Requirements. Assume a sedentary activity level. What is the meaning of your calculation?

Show your work for both questions. 

b. What types of exercise would you be likely to discuss with Tina? 

c. What would be the goals of her treatment? 

4. Determine your BMI. Is your BMI in a healthy range? If not, why not? Do you believe that measuring body fat percentage may more accurately reflect your body composition? Briefly discuss each body composition measure (e.g. skinfold calipers, bioelectrical impedance analysis, etc.) and discuss why measuring body fat is important in assessing a client’s overall health status. 

5. Select one fad diet from any popular publication or online source. Using the ‘How To H9-1’ Box for Identifying a Fad Diet or Other Weight-Loss Scam (Highlight 9, page 291) of your textbook, evaluate the diet. 

6. List and briefly explain the four main components of energy expenditure?

7. Kristin B. , like many Americans is overweight. Kristin is 43-year-old and a mother of two. She has gained 40 pounds since the birth of her youngest child five years ago. She is 64 inches tall and weighs 170 pounds with a BMI of 29.2. Her waist circumference is 37 inches. Kristin can’t figure out why it is so hard to lose weight and keep it off. 

Kristin decides something must be wrong with her to be such a dieting failure. Maybe she just doesn’t have sufficient willpower or maybe she has abnormal metabolism. She feels tired most of the time and has very little energy. She is very busy with her children and has a demanding job as a middle school teacher. Kristin tries to cook healthy meals for her family but is often too tired or stressed to bother, so she stops to get some fast food on her way home. To make matters worse, her seven year-old son recently came home from school and said the kids were teasing him for being fat.

Kristin’s father recently died from complications of type 2 diabetes. At her last medical checkup, her blood pressure was mildly elevated but all of her laboratory blood tests were normal.

Kristin decides it is time to make some changes for her entire family but she doesn’t know quite where to start. She hopes she can help her son by finding a diet that works for him. Complicating the problem is the fact that Kristin’s husband doesn’t have a weight problem. Knowing that you are studying nutrition, Kristin decides to ask you for advice.

a. Based on her health history and physical measurements, describe how you would determine the seriousness of Kristin’s weight gain in relation to her health. 

b. Using the information in chapter 9, what would you estimate to be a reasonable amount of weight for Kristin to lose over the next six months? 

c. What are some advantages for Kristin of keeping a food and exercise record? What other habits besides food intake and physical activity may be especially useful for Kristin to record?  

d. You advise Kristin to limit her daily caloric intake to 1,400 kcalories. Use Table 9-3 to plan one day of meals and snacks to meet her nutritional needs within this calorie level. Use the chart below (one row is already completed): 

Pattern (e.g.    fruit, vegetables, grain, etc.) – from Table 9-2

check attachment for table

Write a formal paper of 750-1,000 words that addresses the following:Discuss the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level

Write a formal paper of 750-1,000 words that addresses the following:

1. Discuss the differences in competencies between nurses prepared at the associate-degree level versus the baccalaureate-degree level.
2. Identify a patient care situation in which you describe how nursing care or approaches to decision-making may differ based upon the educational preparation of the nurse (BSN versus a diploma or ADN degree).

For additional help finding research on this topic, refer to the GCU Library tutorial located at in the Student Success Center.

Refer to the “American Association of Colleges of Nursing (AACN) Fact Sheet: Creating a More Highly Qualified Nursing Workforce” as a resource.

Refer to the assigned readings for concepts that help support your main points.

Refer to “Grand Canyon University College of Nursing Philosophy.” This is an informational resource to assist in completing the assignment.

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. Students should review the rubric prior to beginning the assignment to become familiar with the criteria and expectations for successful completion.

You are required to submit this assignment to Turnitin. Please refer to the directions in the Student Success Center.