2 discussions for academic essays(Nursing classes) 2 pages each

NURS6521 week 11 Discussion: Off-Label Drug Use in Pediatrics

The unapproved use of approved drugs, also called off-label use, with children is quite common. This is because pediatric dosage guidelines are typically unavailable since very few drugs have been specifically researched and tested with children.

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.

To prepare:

• Review the Bazzano et al. and Mayhew articles in the Learning Resources. 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.

With these thoughts in mind:

By Day 3

Post an explanation of circumstances under which children should be prescribed drugs for off-label use. Then, 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.

By Day 6

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days who provided a different rationale than you did, in one or more of the following ways:

• Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.
• Validate an idea with your own experience and additional research.

NURS6501 week 11 Discussion: Disorders of the Reproductive Systems

While the male and female reproductive systems are unique to each sex, they share a common function—reproduction. Disorders of this system range from delayed development to structural and functional abnormalities. Since many reproductive disorders not only result in physiological consequences but also psychological consequences such as embarrassment, guilt, or profound disappointment, patients are often hesitant to seek treatment. Advanced practice nurses need to educate patients on disorders and help relieve associated stigmas. During patient evaluations, patients must feel comfortable answering questions so that you, as a key health care provider, will be able to diagnose and recommend treatment options. As you begin this Discussion, consider reproductive disorders that you would commonly see in the clinical setting.

To Prepare

• Review Chapter 22 and Chapter 23 in the McPhee and Hammer text, as well as Chapter 32 in the Huether and McCance text.
• Select two disorders of the male and/or female reproductive systems that interest you. Consider the similarities and differences between the disorders.
• Select one of the following factors: genetics, ethnicity, age, or behavior. Think about how the factor you selected might impact the diagnosis of and treatment for the reproductive disorders. 

By Day 3

Post a description of the two reproductive disorders you selected, including their similarities and differences. Then explain how the factor you selected might impact the diagnosis of treatment for the reproductive disorders. 

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days who selected different disorders or factors than you, in one or more of the following ways:

• Share insights on how the factor you selected impacts the pathophysiology of the disorder your colleague selected.
• Offer alternative diagnoses and prescription of treatment options for the disorder your colleague selected.
• Validate an idea with your own experience and additional research.

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theo

Nursing theories are tested and systematic ways to implement nursing practice. Select a nursing theory and its conceptual model. Prepare a 10-15 slide PowerPoint in which you describe the nursing theory and its conceptual model and demonstrate its application in nursing practice. Include the following:

1. Present an overview of the nursing theory. Provide evidence that demonstrates support for the model’s efficacy in nursing practice. Explain how the theory proves the conceptual model.
2. Explain how the nursing theory incorporates the four metaparadigm concepts.
3. Provide three evidence-based examples that demonstrate how the nursing theory supports nursing practice. Provide support and rationale for each.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style.

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

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 required to submit this assignment to LopesWrite. Please refer to the directions in the Student Success Center.

Advanced Medical Surgical Nursing Week 3 Quiz ( Chapters 33-40)

Question

Question 1

A nursing student wants to know why clients with chronic obstructive pulmonary disease tend to be polycythemic. What response by the nurse instructor is best?

a. It is due to side effects of medications for bronchodilation.

b. It is from overactive bone marrow in response to chronic disease.

c. It combats the anemia caused by an increased metabolic rate.

d. It compensates for tissue hypoxia caused by lung disease.

Question 2

A nurse assesses a client who had a myocardial infarction and is hypotensive. Which additional assessment finding should the nurse expect?

a. Heart rate of 120 beats/min

b. Cool, clammy skin

c. Oxygen saturation of 90%

d. Respiratory rate of 8 breaths/min

Question 3

A nurse assesses a client in an outpatient clinic. Which statement alerts the nurse to the possibility of left-sided heart failure?

a.“I have been drinking more water than usual.”

b.“I am awakened by the need to urinate at night.”

c.“I must stop halfway up the stairs to catch my breath.”

d.“I have experienced blurred vision on several occasions.”

Question 4

A nurse assesses clients on a cardiac unit. Which client should the nurse identify as being at greatest risk for the development of left-sided heart failure?

a. A 36-year-old woman with aortic stenosis

b. A 42-year-old man with pulmonary hypertension

c. A 59-year-old woman who smokes cigarettes daily

d. A 70-year-old man who had a cerebral vascular accident

Question 5

A client is receiving rivaroxaban (Xarelto) and asks the nurse to explain how it works. What response by the nurse is best?

a. “It inhibits thrombin.”

b. “It inhibits fibrinogen.”

c. “It thins your blood.”

d. “It works against vitamin K.”

Question 6

A client undergoing hemodynamic monitoring after a myocardial infarction has a right atrial pressure of 0.5 mm Hg. What action by the nurse is most appropriate?

a. Level the transducer at the phlebostatic axis.

b. Lay the client in the supine position.

c. Prepare to administer diuretics.

d. Prepare to administer a fluid bolus.

Question 7

A nurse assesses a client with atrial fibrillation. Which manifestation should alert the nurse to the possibility of a serious complication from this condition?

a. Sinus tachycardia

b. Speech alterations

c. Fatigue

d. Dyspnea with activity

Question 8

A client has been diagnosed with hypertension but does not take the antihypertensive medications because of a lack of symptoms. What response by the nurse is best?

a.“Do you have trouble affording your medications?”

b.“Most people with hypertension do not have symptoms.”

c.“You are lucky; most people get severe morning headaches.”

d.“You need to take your medicine or you will get kidney failure.”

Question 9

A client received tissue plasminogen activator (t-PA) after a myocardial infarction and now is on an intravenous infusion of heparin. The client’s spouse asks why the client needs this medication. What response by the nurse is best?

a.“The t-PA didn’t dissolve the entire coronary clot.”

b.“The heparin keeps that artery from getting blocked again.”

c.“Heparin keeps the blood as thin as possible for a longer time.”

d.“The heparin prevents a stroke from occurring as the t-PA wears off.”

Question 10

The nurse is reviewing the lipid panel of a male client who has atherosclerosis. Which finding is most concerning?

a. Cholesterol: 126 mg/dL

b. High-density lipoprotein cholesterol (HDL-C): 48 mg/dL

c. Low-density lipoprotein cholesterol (LDL-C): 122 mg/dL

d. Triglycerides: 198 mg/dL

Question 11

A hospitalized client has a platelet count of 58,000/mm3. What action by the nurse is best?

a. Encourage high-protein foods.

b. Institute neutropenic precautions.

c. Limit visitors to healthy adults.

d. Place the client on safety precautions.

Question 12

A client is in the hospital after suffering a myocardial infarction and has bathroom privileges. The nurse assists the client to the bathroom and notes the client’s O2 saturation to be 95%, pulse 88 beats/min, and respiratory rate 16 breaths/min after returning to bed. What action by the nurse is best?

a. Administer oxygen at 2 L/min.

b. Allow continued bathroom privileges.

c. Obtain a bedside commode.

d. Suggest the client use a bedpan

Question 13

A nurse is working with a client who takes atorvastatin (Lipitor). The client’s recent laboratory results include a blood urea nitrogen (BUN) of 33 mg/dL and creatinine of 2.8 mg/dL. What action by the nurse is best?

a. Ask if the client eats grapefruit.

b. Assess the client for dehydration.

c. Facilitate admission to the hospital.

d. Obtain a random urinalysis.

Question 14

While assessing a client on a cardiac unit, a nurse identifies the presence of an S3 gallop. Which action should the nurse take next?

a. Assess for symptoms of left-sided heart failure.

b. Document this as a normal finding.

c. Call the health care provider immediately.

d. Transfer the client to the intensive care unit.

Question 15

The nurse is evaluating a 3-day diet history with a client who has an elevated lipid panel. What meal selection indicates the client is managing this condition well with diet?

a. A 4-ounce steak, French fries, iceberg lettuce

b. Baked chicken breast, broccoli, tomatoes

c. Fried catfish, cornbread, peas

d. Spaghetti with meat sauce, garlic bread

Question 16

A client is in shock and the nurse prepares to administer insulin for a blood glucose reading of 208 mg/dL. The spouse asks why the client needs insulin as the client is not a diabetic. What response by the nurse is best?

a. “High glucose is common in shock and needs to be treated.”

b. “Some of the medications we are giving are to raise blood sugar.”

c. “The IV solution has lots of glucose, which raises blood sugar.”

d. “The stress of this illness has made your spouse a diabetic.”

Question 17

The nurse gets the hand-off report on four clients. Which client should the nurse assess first?

a. Client with a blood pressure change of 128/74 to 110/88 mm Hg

b. Client with oxygen saturation unchanged at 94%

c. Client with a pulse change of 100 to 88 beats/min

d. Client with urine output of 40 mL/hr for the last 2 hours

Question 18

A nurse cares for a client with right-sided heart failure. The client asks, “Why do I need to weigh myself every day?” How should the nurse respond?

a. “Weight is the best indication that you are gaining or losing fluid.”

b. “Daily weights will help us make sure that you’re eating properly.”

c. “The hospital requires that all inpatients be weighed daily.”

d. “You need to lose weight to decrease the incidence of heart failure.”

Question 19

A nurse cares for a client who has a heart rate averaging 56 beats/min with no adverse symptoms. Which activity modification should the nurse suggest to avoid further slowing of the heart rate?

a. “Make certain that your bath water is warm.”

b.“Avoid straining while having a bowel movement.”

c.“Limit your intake of caffeinated drinks to one a day.”

d.“Avoid strenuous exercise such as running.”

Question 20

A nurse is caring for a client after surgery. The client’s respiratory rate has increased from 12 to 18 breaths/min and the pulse rate increased from 86 to 98 beats/min since they were last assessed 4 hours ago. What action by the nurse is best?

a. Ask if the client needs pain medication.

b. Assess the client’s tissue perfusion further.

c. Document the findings in the client’s chart.

d. Increase the rate of the client’s IV infusion.

Question 21

An emergency room nurse obtains the health history of a client. Which statement by the client should alert the nurse to the occurrence of heart failure?

a. “I get short of breath when I climb stairs.”

b. “I see halos floating around my head.”

c. “I have trouble remembering things.”

d. “I have lost weight over the past month.”

Question 22

The health care provider tells the nurse that a client is to be started on a platelet inhibitor. About what drug does the nurse plan to teach the client?

a. Clopidogrel (Plavix)

b. Enoxaparin (Lovenox)

c. Reteplase (Retavase)

d. Warfarin (Coumadin)

Question 23

A nurse assesses a client’s electrocardiograph tracing and observes that not all QRS complexes are preceded by a P wave. How should the nurse interpret this observation?

a. The client has hyperkalemia causing irregular QRS complexes.

b. Ventricular tachycardia is overriding the normal atrial rhythm.

c. The client’s chest leads are not making sufficient contact with the skin.

d. Ventricular and atrial depolarizations are initiated from different sites.

Question 24

A nurse caring for a client with sickle cell disease (SCD) reviews the client’s laboratory work. Which finding should the nurse report to the provider?

a. Creatinine: 2.9 mg/dL

b. Hematocrit: 30%

c. Sodium: 147 mEq/L

d. White blood cell count: 12,000/mm3

Question 25

A nurse assesses clients on a medical-surgical unit. Which client should the nurse identify as having the greatest risk for cardiovascular disease?

a. An 86-year-old man with a history of asthma

b. A 32-year-old Asian-American man with colorectal cancer

c. A 45-year-old American Indian woman with diabetes mellitus

d. A 53-year-old postmenopausal woman who is on hormone therapy

Question 26

A student nurse is assessing the peripheral vascular system of an older adult. What action by the student would cause the faculty member to intervene?

a. Assessing blood pressure in both upper extremities

b. Auscultating the carotid arteries for any bruits

c. Classifying capillary refill of 4 seconds as normal

d. Palpating both carotid arteries at the same time

Question 27

A nurse assesses a client after administering a prescribed beta blocker. Which assessment should the nurse expect to find?

a. Blood pressure increased from 98/42 mm Hg to 132/60 mm Hg

b. Respiratory rate decreased from 25 breaths/min to 14 breaths/min

c. Oxygen saturation increased from 88% to 96%

d. Pulse decreased from 100 beats/min to 80 beats/min

Question 28

A nurse evaluates prescriptions for a client with chronic atrial fibrillation. Which medication should the nurse expect to find on this client’s medication administration record to prevent a common complication of this condition?

a. Sotalol (Betapace)

b. Warfarin (Coumadin)

c. Atropine (Sal-Tropine)

d. Lidocaine (Xylocaine)

Question 29

A nurse assesses an older adult client who has multiple chronic diseases. The client’s heart rate is 48 beats/min. Which action should the nurse take first?

a. Document the finding in the chart.

b. Initiate external pacing.

c. Assess the client’s medications.

d. Administer 1 mg of atropine.

Question 30

A client presents to the emergency department in sickle cell crisis. What intervention by the nurse takes priority?

a. Administer oxygen.

b. Apply an oximetry probe.

c. Give pain medication.

d. Start an IV line.

Question 31

A nurse assesses a client admitted to the cardiac unit. Which statement by the client alerts the nurse to the possibility of right-sided heart failure?

a.“I sleep with four pillows at night.”

b.“My shoes fit really tight lately.”

c.“I wake up coughing every night.”

d.“I have trouble catching my breath.”

Question 32

A nursing student is caring for a client who had a myocardial infarction. The student is confused because the client states nothing is wrong and yet listens attentively while the student provides education on lifestyle changes and healthy menu choices. What response by the faculty member is best?

a.“Continue to educate the client on possible healthy changes.”

b.“Emphasize complications that can occur with noncompliance.”

c.“Tell the client that denial is normal and will soon go away.”

d.“You need to make sure the client understands this illness.”

Question 33

A client is receiving an infusion of tissue plasminogen activator (t-PA). The nurse assesses the client to be disoriented to person, place, and time. What action by the nurse is best?

a. Assess the client’s pupillary responses.

b. Request a neurologic consultation.

c. Stop the infusion and call the provider.

d. Take and document a full set of vital signs.

Question 34

A client in sickle cell crisis is dehydrated and in the emergency department. The nurse plans to start an IV. Which fluid choice is best?

a.0.45% normal saline

b.0.9% normal saline

c. Dextrose 50% (D50)

d. Lactated Ringer’s solution

Question 35

A student is caring for a client who suffered massive blood loss after trauma. How does the student correlate the blood loss with the client’s mean arterial pressure (MAP)?

a. It causes vasoconstriction and increased MAP.

b. Lower blood volume lowers MAP.

c. There is no direct correlation to MAP.

d. It raises cardiac output and MAP.

Question 36

A client has a serum ferritin level of 8 ng/mL and microcytic red blood cells. What action by the nurse is best?

a. Encourage high-protein Foods.

b. Perform a Hemoccult test on the client’s stools.

c. Offer Frequent oral care.

d. Prepare to administer cobalamin (vitamin B12).

Question 37

A nurse is assessing clients on a medical-surgical unit. Which client should the nurse identify as being at greatest risk for atrial fibrillation?

a. A 45-year-old who takes an aspirin daily

b. A 50-year-old who is post coronary artery bypass graft surgery

c. A 78-year-old who had a carotid endarterectomy

d. An 80-year-old with chronic obstructive pulmonary disease

Question 38

A client hospitalized with sickle cell crisis frequently asks for opioid pain medications, often shortly after receiving a dose. The nurses on the unit believe the client is drug seeking. When the client requests pain medication, what action by the nurse is best?

a. Give the client pain medication if it is time for another dose.

b. Instruct the client not to request pain medication too early.

c. Request the provider leave a prescription for a placebo.

d. Tell the client it is too early to have more pain medication.

Question 39

A nurse is caring for a client after surgery who is restless and apprehensive. The unlicensed assistive personnel (UAP) reports the vital signs and the nurse sees they are only slightly different from previous readings. What action does the nurse delegate next to the UAP?

a. Assess the client for pain or discomfort.

b. Measure urine output from the catheter.

c. Reposition the client to the unaffected side.

d. Stay with the client and reassure him or her.

Question 40

A nurse is assessing a dark-skinned client for pallor. What action is best?

a. Assess the conjunctiva of the eye.

b. Have the client open the hand widely.

c. Look at the roof of the client’s mouth.

d. Palpate for areas of mild swelling.

Nursing philosophy APA format ,word ,6-7 pages ,references

This written assignment will allow you to reflect on your beliefs about nursing. Writing your philosophy of nursing will reveal your professional and personal growth over time as you compare previous versions of your philosophy.

Think about the following before you start writing your paper.

You have learned about various theoretical works in nursing including Nightingale’s Environmental Theory, and Jean Watson Philosophy and Science of Caring, Orem’s Self-Care Deficit Theory of Nursing among others. Which nursing theory most closely matches your beliefs? Why are philosophies of nursing, conceptual models, grand theories, and middle-range theories important to nursing? Why did you choose nursing as your profession? What do you believe is the core of nursing? What is the focus of nursing? To live out your philosophy, what should you keep in mind about your patients, families, environment?

Instructions:

This paper reflects your own values and world view, therefore there are no right or wrong answers.

Paper must be written in APA style.

Paper should be between 5-7 pages excluding cover page and references.

Address the following topics in your paper

• Your educational and professional background, reasons for returning to school, current practice specialty, and professional goals.
• Individuals who have influenced your views about nursing
• Your philosophy of nursing
• Nursing metaparadigm: your definition of nursing, human beings, the environment, and health
• Your beliefs: Is healthcare a right or privilege? What are the roles of the nurse? What are your thoughts about nursing education?
• Trends and current issues affecting nursing
• Where is nursing going? What can you do to advance nursing?

Rubric

Some Rubric

Some RubricCriteriaRatingsPts

This criterion is linked to a Learning OutcomeIntroduction

view longer description

Oustanding10.0 pts

Acceptable6.0 pts

Unacceptable0.0 pts

10.0 pts

This criterion is linked to a Learning OutcomePersonal philosophy of nursing, nursing metaparadigm (nursing, human being, environment, health)

view longer description

Outstanding20.0 pts

Acceptable6.0 pts

Unacceptable0.0 pts

20.0 pts

This criterion is linked to a Learning OutcomeTrends affecting nursing

Outstanding20.0 pts

Acceptable10.0 pts

Unacceptable0.0 pts

20.0 pts

This criterion is linked to a Learning OutcomeYour beliefs: is healthcare a right or privilege? roles of the nurse? education?

Outstanding20.0 pts

Acceptable10.0 pts

Unacceptable0.0 pts

20.0 pts

This criterion is linked to a Learning OutcomeFuture of nursing

Outstanding20.0 pts

Acceptable10.0 pts

Unacceptable0.0 pts

20.0 pts

This criterion is linked to a Learning OutcomeAPA, grammar, spelling, and punctuation

Outstanding5.0 pts

Acceptable3.0 pts

Unacceptable0.0 pts

5.0 pts

This criterion is linked to a Learning OutcomeLogical presentation of ideas

Outstanding5.0 pts

Acceptable3.0 pts

Unacceptable0.0 pts

5.0 pts

Total Points: 100.0

NR 361 Week 6 Assignment Interview with Nursing Information Expert

This file of NR 361 Week 6 Assignment Interview with Nursing Information Expert comprises:

The purpose of this assignment is toCommunicate your understanding of the importance of quality information in everyday nursing practice,Discuss the roles and responsibilities of a Nursing Information Expert, andArticulate how the professional nurse uses information or data in everyday practice to improve outcomes.Course OutcomesThis assignment enables the student to meet the following course outcomes.CO #1: Describe patient-care technologies as appropriate to address the needs of a diverse patient population. (PO #1)CO #4: Investigate safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers. (PO #4)CO #8: Discuss the value of best evidence as a driving force to institute change in delivery of nursing care. (PO #8)PointsThis assignment is worth a total of 250 points.Due DateThis assignment, Interview with a Nursing Information Expert, is due at the end of Week 6. Submit your completed Interview, using the Interview Form, to the basket in the Dropbox by Sunday, 11:59 p.m. mountain time. Post questions to the weekly Q A Forum. Contact your instructor if you need additional assistance.See the Course Policies regarding late assignments. Failure to submit your paper to the Dropbox on time will result in a deduction of points.Directions1. Download the NR361 Interview Form from Doc Sharing. It is found under the Week 6 Interview link.2. Select your interviewee and schedule an interview. This individual must be a registered nurse. Job titles of RNs who may be considered include but, are not limited to, Nursing Clinical Information Manager, Super User, Director/Manger Clinical Education, Chief Information Officer, Quality Assurance or Performance Improvement Nurse, Nurse Informaticist, Telenursing Specialist, Nurse Abstractor, Case Manager, Compliance Nurse. If you have any concerns about whether the RN is suitable for this assignment, contact your instructor BEFORE you schedule the interview.3. Review all questions (areas of inquiry) on the Interview Form located in Doc Sharing PRIOR to conducting the interview. You may print the form and take it with you to the interview.4. Note that there are five (5) Required Questions to ask the RN.5. Note that there are four (4) Optional Questions. You need to select only ONE of them to ask the RN.6. Note that there are two (2) Follow-Up Questions that must be answered by YOU.Prior to conducting your interview, review two scholarly resources. These resources should guide your understanding of the RNs role and responsibilities or make you more knowledgeable about GIGO, interprofessional communication, or other key concepts in the questions that you may not fully understand. For example, if your interviewee is a Telenurse, you would want to review information on this specialty. If you do not know what GIGO means, look it up.7. Conduct your interview. The length of your interview will vary but should not exceed one hour.8. Submit the form to the Dropbox prior to the deadline outlined above.