DNP 840 Topic 3 Care Delivery or Nursing Model Change

This assignment will give you practice with presentation software along with preparing you to provide specific information for your proposed changes. This is a two-part assignment that will also give you practice in presenting to administrators. There will be times when the doctorally prepared advance practice nurse will need to suggest a nursing model change or a change in care delivery. It will be important for the doctorally prepared advanced practice nurse to have an understanding of how to deliver information and what information should be shared with an audience.

Use the following information to ensure successful completion of the assignment:

Doctoral learners are required to use the APA style for their writing assignments. The APA Style Guide is located in the Student Success Center.
This assignment requires that at least two additional scholarly research sources related to this topic, and at least one in-text citation from each source be included. DNP 840 Topic 3 Care Delivery or Nursing Model Change
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 LopesWrite.
Directions:

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Part One:

Create a 12-15 slide presentation (PowerPoint, include slide notes or voice over; Prezi, include voice over) that presents a proposed care delivery or nursing model change for a department that aligns costs, quality, and health that supports the care of patients across the continuum. Include the following:

Background of issue
The proposed solution
How solution meets need of population (stakeholders, cost, and payer to proposed change)
Proposed change process to implement delivery model
Expected outcomes
Implications that are realistic and aligned with current and future health care financing
Part Two:

Present your presentation to at least one administrator.
Write a brief summary, 100-250 words, of the feedback given to you by the administrator(s).
Portfolio Practice Hours:

Practice immersion assignments are based on your current course objectives and is application based learning using your real-world practice setting. These assignments earn practice immersion hours and are indicated in the syllabus by a Portfolio Practice Hours statement, which reminds you, the learner, to enter in a corresponding case log in Typhon. Actual clock hours are entered, but the average hours associated with each practice immersion assignment is 10. DNP 840 Topic 3 Care Delivery or Nursing Model Change

You are required to complete your assignment using real-world application. Real-world application requires the use of evidence-based data, contemporary theories, and concepts presented in the course. The culmination of your assignment must present a viable application in a current practice setting. For more information on parameters for practice immersion hours, please refer to DNP resources in the DC Network.

To earn portfolio practice hours, enter the following after the references section of your paper: DNP 840 Topic 3 Care Delivery or Nursing Model Change

Practice Hours Completion Statement DNP-840

NURS 6501 Week 1 Discussion – Alterations In Cellular Processes

Module 1: Foundational Concepts of Cellular Pathophysiology

What’s Happening This Module?

This course is composed of eight (8) separate modules. Each module consists of an overarching topic and each week within the module includes specific subtopics for learning. As you work through each module, you will draw upon the knowledge you gain by completing various Knowledge Checks and Case Study Assignments.

Module 1: Foundational Concepts of Cellular Pathophysiology is a 2-week module, Weeks 1 and 2 of the course. In this module, you will examine fundamental concepts of cellular processes and the alterations that lead to various diseases. You will evaluate the genetic environment and its impact on these diseases. You will also evaluate the impact of patient characteristics, including racial and ethnic variables, on physiological functioning. NURS 6501 Week 1 Discussion – Alterations In Cellular Process

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Week 1: Cellular Processes and the Genetic Environment

One of the more common biology analogies refers to cells as the “building blocks” of life. This rightfully places an emphasis on understanding cells, cellular behavior, and the impact of the environment in which they function.

Such an understanding helps explain how healthy cell activity contributes to good health. Just as importantly, it helps explain how breakdowns in cellular behavior and alterations to cells lead to health issues.

This week, you examine cellular processes that are subject to alterations that can lead to disease. You evaluate the genetic environments within which these processes exist as well as the impact these environments have on disease.

Learning Objectives

Students will:

• Evaluate cellular processes and alterations within cellular processes
• Evaluate the impact of the genetic environment on disease

Learning Resources

Required Readings

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

• Chapter 1: Cellular Biology; Summary Review
• Chapter 2: Altered Cellular and Tissue Biology: Environmental Agents (pp. 46-61; begin again with Manifestations of Cellular Injury pp. 83-97); Summary Review
• Chapter 3: The Cellular Environment: Fluids and Electrolytes, Acids, and Bases
• Chapter 4: Genes and Genetic Diseases (stop at Elements of formal genetics); Summary Review
• Chapter 5: Genes, Environment-Lifestyle, and Common Diseases (stop at Genetics of common diseases); Summary Review. NURS 6501 Week 1 Discussion – Alterations In Cellular Processes
• Chapter 7: Innate Immunity: Inflammation and Wound Healing
• Chapter 8: Adaptive Immunity (stop at Generation of clonal diversity); Summary Review
• Chapter 9: Alterations in Immunity and Inflammation (stop at Deficiencies in immunity); Summary Review
• Chapter 10: Infection (pp. 289–303; stop at Infectious parasites and protozoans); (start at HIV); Summary Review
• Chapter 11: Stress and Disease (stop at Stress, illness & coping); Summary Review
• Chapter 12: Cancer Biology (stop at Resistance to destruction); Summary Review
• Chapter 13: Cancer Epidemiology (stop at Environmental-Lifestyle factors); Summary Review

Justiz-Vaillant, A. A., & Zito, P. M. (2019). Immediate hypersensitivity reactions. In StatPearls. Treasure Island, FL: StatPearls Publishing. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/

Credit Line: Immediate Hypersensitivity Reactions – StatPearls – NCBI Bookshelf. (2019, June 18). Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK513315/. Used with permission of Stat Pearls

Required Media

Module 1 Overview with Dr. Tara Harris

Dr. Tara Harris reviews the structure of Module 1 as well as the expectations for the module. Consider how you will manage your time as you review your media and Learning Resources throughout the module to prepare for your Discussion and Assignment. (4m)

Immunity and Inflammation

Khan Academy (2010, February 24). Inflammatory response | Human anatomy and physiology | Health & medicine [Video file]. Retrieved from https://www.youtube.com/watch?v=FXSuEIMrPQk

Note: The approximate length of the media program is 14 minutes.

Soo, P. (2018, July 28). Pathophysiology Ch 10 alterations in immune function [Video file]. Retrieved from https://www.youtube.com/watch?v=Jz0wx1-jTds

Note: The approximate length of the media program is 37 minutes. NURS 6501 Week 1 Discussion – Alterations In Cellular Processes

Acid-Base Balance #1

MedCram. (2012, April 28). Medical acid base balance, disorders & ABGs explained clearly [Video file]. Retrieved from https://www.youtube.com/watch?v=4wMEMhvrQxE

Note: The approximate length of the media program is 13 minutes.

Acid-Base Balance #2

MedCram. (2012, April 29). Medical acid base balance, disorders & ABGs explained clearly | 2 of 8 [Video file]. Retrieved from https://www.youtube.com/watch?v=GmEeKVTpOKI

Note: The approximate length of the media program is 15 minutes.

Hyponatremia

MedCram. (2017, December 23). Hyponatremia explained clearly (remastered) – Electrolyte imbalances [Video file]. Retrieved from https://www.youtube.com/watch?v=bLajK5Vy55M

Note: The approximate length of the media program is 15 minutes.

Online Media from Pathophysiology: The Biologic Basis for Disease in Adults and Children

In addition to this week’s media, it is highly recommended that you access and view the resources included with the course text, Pathophysiology: The Biologic Basis for Disease in Adults and Children. Focus on the videos and animations in Chapters 3, 7, and 8 that relate to alterations in immunity, hyponatremia, and acid/base balance.

Note: To access the online resources included with the text, you need to complete the FREE online registration that is located at https://evolve.elsevier.com/cs/store?role=student

To Register to View the Content

1. Go to https://evolve.elsevier.com/cs/store?role=student
2. Enter the name of the textbook, Pathophysiology: The Biologic Basis for Disease in Adults and Children, or ISBN 9780323654395 (name of text without the edition number) in the Search textbox.
3. Complete the registration process.

To View the Content for This Text

1. Go to https://evolve.elsevier.com/
2. Click on Student Site.
3. Type in your username and password.
4. Click on the Login button.
5. Click on the plus sign icon for Resources on the left side of the screen.
6. Click on the name of the textbook for this course.
7. Expand the menu on the left to locate all the chapters.
8. Navigate to the desired content (checklists, videos, animations, etc.).

Note: Clicking on the URLs in the APA citations for the Resources from the textbook will not link directly to the desired online content. Use the online menu to navigate to the desired content.

Discussion: Alterations in Cellular Processes

At its core, pathology is the study of disease. Diseases occur for many reasons. But some, such as cystic fibrosis and Parkinson’s Disease, occur because of alterations that prevent cells from functioning normally.

Understanding of signals and symptoms of alterations in cellular processes is a critical step in diagnosis and treatment of many diseases. For the Advanced Practice Registered Nurse (APRN), this understanding can also help educate patients and guide them through their treatment plans.

For this Discussion, you examine a case study and explain the disease that is suggested. You examine the symptoms reported and explain the cells that are involved and potential alterations and impacts.

To prepare:

• By Day 1 of this week, you will be assigned to a specific scenario for this Discussion. Please see the “Course Announcements” section of the classroom for your assignment from your Instructor.

By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:

• The role genetics plays in the disease.
• Why the patient is presenting with the specific symptoms described.
• The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
• The cells that are involved in this process.
• How another characteristic (e.g., gender, genetics) would change your response.

Read a selection of your colleagues’ responses.

By Day 6 of Week 1

Respond to at least two of your colleagues on 2 different days and respectfully agree or disagree with your colleague’s assessment and explain your reasoning. In your explanation, include why their explanations make physiological sense or why they do not. NURS 6501 Week 1 Discussion – Alterations In Cellular Processes

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 1 Discussion Rubric

Post by Day 3 of Week 1 and Respond by Day 6 of Week 1

To Participate in this Discussion:

Week 1 Discussion

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Sample Paper – Week 1 Discussion

NURS 6501 Week 1 Discussion – Alterations in Cellular Processes

Alterations in Cellular Processes

Student’s Name:

Institutional Affiliation:

Alterations in Cellular Processes

Considering that the patient was given naloxone in the field and became responsive and has a history of substance abuse, it can be concluded that he has been abusing opioids in large quantities. The patient could also be suffering from rhabdomyolysis. This is a syndrome that is caused by indirect or direct muscle injury. The condition develops when muscle fibers die, and their content gets released into the bloodstream. Traumatic and non-traumatic causes can cause the condition. In this case, the non-traumatic causes that could have led to rhabdomyolysis are substance abuse, which includes the use of illegal drugs and alcohol. The condition can also be caused by antipsychotics, especially when taken in large quantities (Nance & Mammen, 2015). For people who have been diagnosed with this condition, the serum and urine myoglobin levels usually are high. Genetics play a role in the development of this disease. The genetic conditions that normally predispose to this disease include channelopathies, muscular dystrophies, and metabolic myopathies (Nance, & Mammen, 2015). NURS 6501 Week 1 Discussion – Alterations In Cellular Processes

The reason why the patient is experiencing the symptom of burning pain over his left hip and forearm is because of muscle injury that could have occurred in the substance abuse process leading to necrosis, as seen in the ED during the evaluation process (D’Arcy, 2019). The excessive abuse of opioids had caused the symptom of unresponsiveness.

The physiologic response in the scenario is that the patient becomes responsive after receiving naloxone. I think this response occurred because naloxone is a medication that helps in the reversal of opioid overdose. It helps bind opioid receptors, block, and reverse other opioid effects (Rzasa Lynn, & Galinkin, 2018). The medication can help restore respiration to a person whose breathing has been stopped or slowed due to overconsumption of heroin or prescription opioids. The cells that are involved in this process are the μ-opioid receptors. Another characteristic that would change the response is genetics. Some people have an opioid receptor gene with a single building block change that normally protects them against substance dependence. In contrast, the variations in genes for three dopamine receptors are associated with increased risk for opioid addiction (Chiasson-Downs, 2018).

References

Chiasson-Downs, K. (2018, April 24). Why genetics makes some people more vulnerable to opioid addiction – and protects others. Retrieved from https://theconversation.com/why-genetics-makes-some-people-more-vulnerable-to-opioid-addiction-and-protects-others-92000

D’Arcy, M. S. (2019). Cell death: a review of the major forms of apoptosis, necrosis and autophagy. Cell biology international, 43(6), 582-592.

Nance, J. R., & Mammen, A. L. (2015). Diagnostic evaluation of rhabdomyolysis. Muscle & nerve, 51(6), 793-810.

Rzasa Lynn, R., & Galinkin, J. L. (2018). Naloxone dosage for opioid reversal: current evidence and clinical implications. Therapeutic advances in drug safety, 9(1), 63-88.

What’s Coming Up in Week 2?

Next week, you will examine alterations in the immune system and the resultant disease processes. You will also consider patient characteristics, including racial and ethnic variables, that may impact altered physiology. NURS 6501 Week 1 Discussion – Alterations In Cellular Processes