Adult Health Case study Hypertension

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Adult Health Case study Hypertension

HPI:

E.W.  is a 40-year old African American male, who has had difficulty controlling his HTN lately. He is visiting his primary care provider for a thorough physical examination and to renew a prescription to continue his blood pressure medication.

 

PMH:

 

  • Chronic sinus infections
  • Hypertension for approximately 11 years
  • Pneumonia 6 years ago that resolved with antibiotic therapy
  • One major episode of major depressive illness caused by the suicide of his wife of 15 years, 5 years ago.
  • No surgeries
  • Allergies to Penicillin (Rash)

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FH:

 

  • Father died at age 49 from AMI; had HTN
  • Mother has DM and HTN
  • Brother died at age 20 from complication of CF
  • Two younger sisters are A & W

SH:

 

The patient is a widower and lives alone. He has a 15-year-old son who lives with a maternal aunt. He has not spoken with his son for four years. The patient is an air traffic controller at the local airport. He smoked cigarettes for approximately 10 years but stopped smoking when he was diagnosed with HTN.  He drinks “several beers every evening to relax” and does not pay particular attention to the sodium, fat or carbohydrate content of the foods that he eats. He admits to “salting almost everything he eats, sometimes even before tasting it.” He denies ever having dieted. He takes an occasional walk but has no regular daily exercise program.

 

Meds:

  • Hydrochlorothiazide 50 mg PO QD
  • Pseudoephedrine hydrochloride 60 mg PO Q6hr prn
  • Beclomethasone dipropionate 1 spray into each nostril Q6 hr prn

 

Review of Systems:

 

  • States that his overall health has been fair to good during the past 12 months
  • Weight has increased by approximately 20 pounds during the last year
  • Denies chest pain, shortness of breath at rest, headaches, nocturia, nosebleeds, and hemoptysis
  • Reports some shortness of breath with activity, especially when climbing stairs, and that breathing difficulties are getting worse
  • Denies any nausea, vomiting, diarrhea, or blood in the stool
  • Self-treats occasional right knee pain with OTC extra-strength acetaminophen
  • Denies any genitourinary symptoms

 

Physical Exam and Lab tests

 

General:

The patient is an obese black man in no apparent distress. He appears to be his stated age.

 

Vital Signs:

BP: 155/96 sitting

HR: 73, regular

RR: 15, unlabored

Temp: 98.8 degrees F

Height: 5’11”

Weight: 221 lb

BMI: 31.

 

HEENT:

 

  • Tympanic membrane intact and clear throughout
  • No nasal drainage
  • No exudates or erythema in oropharynx
  • PERRLA, pupil diameter 3. mm bilaterally
  • Sclera without icterus
  • EOMI
  • Fundoscopy reveals mild arteriolar narrowing with no nicking, hemorrhages, exudates, or papilledema.

Supple without masses or bruits

Thyroid normal

Negative lymphadenopathy

 

Lungs:

Mild basilar crackles bilaterally

No wheezes

 

Heart:

RRR

Prominent S3 sound

No murmurs or rubs

 

ABD:

 

Soft and nondistended

Non tender with no guarding or rebound

No masses, bruits, or organomegaly

Normal bowel sounds

 

Rectal/GU

 

Normal size prostate without nodules or asymmetry

Heme negative stool

Normal penis and testes

 

Ext:

No CCE

Limited ROM right knee

 

Neuro

 

No sensory or motor abnormalities

CNs II-XII intact

Negative Babinski

DTRs=2+

Muscle tone = 5/5 throughout

 

Laboratory tests

Na                      139meq/L RBC                    5.9mil/mm33 Mg                           2.4mg/dL
K                          3.9meq/L WBC                   7,100/mm3 P04                          3.9mg/dL
Cl                        102meq/L AST                   29 IU/L Uric acid                 7.3mg/dL
HCO3                  27 meq/L ALT                   43 IU/L Glu, fasting            110mg/dL
BUN                     17mg/dL ALK phos       123 IU/L T. Chol                 275mg/dL
Cr                          1.0mg/dL GGT               119 IU/L HDL                      31mg/dL
HgB                      16.9g/dL T. Bilirubin      0.9mg/dL LDL                     179mg/dL
Hct                         48% T. protein      6.0g/dL Trig                      290mg/dL
Plt                   235,000/mm3 Ca                  9.3mg/dL PSA                    1.3ng/mL

 

Urinalysis results:

Appearance- clear, amber in color

Specific gravity- 1.017

Ph- 5.3

Protein- negative

 

RBC- 0

WBC- 0

Bacteria- negative

 

ECG:

Increased QRS voltage suggestive of LVH

 

ECHO:

Moderate LVH with EF = 46%

 

Wk 4 Bayonnes Organizational Performance Analysis Paper

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Wk 4 Bayonnes Organizational Performance Analysis Paper

Wk 4 Bayonnes Organizational Performance Analysis

I’m working on a management writing question and need an explanation to help me understand better.

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  • Using a formal systems diagramming approach, analyze Bayonne’s organizational performance and develop a robust effect-cause-effect tree diagram using the 5-Whys tool, as done previously in the course.
  • Create a robust causal loop diagram that incorporates appropriate causal loop logic in the analysis, and which also identifies common system archetype patterns within the diagram. This diagram should describe fundamental system behaviors and outcomes. The diagram itself should be one page and can be hand-drawn or drawn with software. Tables are not appropriate; it must be in the form of a diagram.
  • Write a summary description, including specific recommendations, that links directly to both your 5-why and associated CLD analysis (which includes embedded archetype relationships) for improving the packaging company’s operations and the organization as a whole. (1-2 single spaced pages). Wk 4 Bayonnes Organizational Performance Analysis Paper

Interdisciplinary Plan Proposal

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Interdisciplinary Plan Proposal

Interdisciplinary Plan Proposal

            Write a brief introduction (2 to 3 sentences) to your proposal that outlines the issue you are attempting to solve, the part of the organization in which the plan would be carried out, and the desired outcome. This will set the stage for the sections below.

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Objective

Describe what your plan will do and what you hope it will accomplish in one or two succinct sentences. Also, comment on how the objective, if achieved, will improve organizational or patient outcomes. For example:

Test a double-loop feedback model for evaluating new product risk with a small group of project managers with the goal of reducing the number of new products that fail to launch. This objective is aligned to the broader organizational goal of becoming more efficient taking products to market and, if successful, should improve outcomes by reducing waste.

Questions and Predictions

For this section ask yourself 3 to 5 questions about your objective and your overall plan. Make a prediction for each question by answering the question you posed. This helps you to define the important aspects of your plan as well as limit the scope and check its ability to be implemented.

For example:

  1. How much time will using a double-loop feedback model add to a project manager’s workload?
    1. At first, it will likely increase their workloads by 5 to 10 percent. However, as the process is refined and project managers become more familiar and efficient, that percentage will decrease.

Change Theories and Leadership Strategies

For this section, you may wish to draw upon the research you did regarding change theories and leadership for the Interview and Interdisciplinary Issue Identification assessment. The focus of this section is how those best practices will create buy-in for the project from an interdisciplinary team, improve their collaboration, and/or foster the team’s ability to implement the plan. Be sure that you are including at least one change theory and at least one leadership strategy in your explanation. Always remember to cite your sources; direct quotes require quotation marks and a page or paragraph number to be included in the citation.

Another way to approach your explanations in this section is to think through the following:

  • What is the theory or strategy?
  • How will it likely help an interdisciplinary team to collaborate, implement, and/or buy in to the project plan?
    • Make sure to frame this explanation within the organizational context of the proposed plan, that is, your interviewee’s organization.

Team Collaboration Strategy

In this section, begin by further defining the responsibilities and actions that represent the implementation of the plan. One strategy to defining this is to take a “who, what, where, and when” approach for each team member.

For example:

  • Project Manager A will apply the double-loop feedback model on one new product project for a single quarter.
  • Project Manager B will apply the double-loop feedback model on all new product projects for a quarter.

Vice President A will review the workloads of project managers using the double-loop feedback model every Thursday for one quarter.

After you have roughly outlined the roles and responsibilities of team members, you will explain one or more collaborative approaches that will enable the team to work efficiently to achieve the plan’s objective. As with the change theories and leadership strategies, you may draw on the research you conducted for the Interview and Interdisciplinary Issue Identification assessment. However, you are being asked to give a more in-depth explanation of the collaboration approaches and look at how they will help the theoretical interdisciplinary team in your plan proposal.

Another way to approach your explanations in this section is to think through the following:

  • What is the collaboration approach?
  • What types of collaboration and teamwork will best help the interdisciplinary team be successful?
  • How is the collaboration approach relevant to the team’s needs and will it help drive success?
    • Make sure to frame this explanation in terms of the subject of the plan proposal; that is, your interviewee’s organization.

Required Organizational Resources

For this section, you will be making rough estimates of the resources needed for your plan proposal to be successful. This section does not have to be exact but the estimates should be realistic for the chosen organization.

Items you should include or address in this section:

  • What are the staffing needs for your plan proposal?
  • What equipment or supplies are needed for your plan proposal?
    • Does the organization already have these?
      • If so, what is the cost associated with using these resources?
      • If not, what is the cost of acquiring these resources?
    • What access (to patients, departments, and so forth) is needed?
      • Are there any costs associated with these?
    • What is the overall financial budget request for the plan proposal?
      • Staff time, resource use, resource acquisition, and access charged?
        • Remember to include a specific dollar amount in your request.

After you have detailed your budget, make sure that you explain any impacts on organizational resources that could happen if your plan is not undertaken and successful. In other words, if the issue you are try to solve through your plan proposal persists or gets worse, what will be the potential costs to the organization?

 

 

References

Roles and competencies of the advanced practice nurse (APN)

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Roles and competencies of the advanced practice nurse (APN)

The purpose of this assignment is to provide the student an opportunity to explore the roles and competencies of the advanced practice nurse (APN). 

Activity Learning Outcomes 

Through this assignment, the student will demonstrate the ability to: 

  1. Examine roles and competencies of advanced practice nurses essential to performing as leaders and advocates of holistic, safe, and quality care. (CO1) 
  2. Explore the process of scholarship engagement to improve health and healthcare outcomes in various settings. (CO4)

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Due Date

Assignment should be submitted to the Week 2 Roles in Advanced Practice Nursing dropbox by Sunday 11:59 p.m. MST at the end of Week 2. When the assignment is placed in the dropbox, it will automatically be submitted to Turnitin. You may submit the assignment one additional time before the due date to lower the Turnitin score. If you choose to resubmit, the second submission will be considered final and subject to grading.  Once the due date for the assignment passes, you may not resubmit to lower a Turnitin score. 

This assignment will follow the late assignment policy specified in the course syllabus. 

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. 

In the event of a situation that prevents timely submission of an assignment, students may petition their instructor for a waiver of the late submission grade reduction. The instructor will review the student’s rationale for the request and make a determination based on the merits of the student’s appeal. Consideration of the student’s total course performance to date will be a contributing factor in the determination. Students should continue to attend class, actively participate, and complete other assignments while the appeal is pending. 

Total Points Possible:  150 

Requirements

  1. A Week 2 Paper Template (Links to an external site.) to be used for your assignment is required for this assignment. 
  2. The Roles in Advanced Nursing Practice paper is worth 150 points and will be graded on the quality of the content, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric. 
  3. Submit the paper as a Microsoft Word Document, which is the required format at Chamberlain University. You are encouraged to use the APA Academic Writer and Grammarly tools when creating your assignment. 
  4. Follow the directions below and the grading criteria located in the rubric closely. Any questions about this paper may be posted under the Q & A Forum or emailed to your faculty. 
  5. The length of the paper should be 3-6 pages, excluding title page and reference page(s). 
  6. Support ideas with a minimum of 2 scholarly resources. Scholarly resources do not include your textbook. You may need to use more than 2 scholarly resources to fully support your ideas. 
  7. You may use first person voice when describing your rationale for choosing the CNP role and your plans for clinical practice.  
  8. Current APA format is required with both a title page and reference page(s). Use the following as Level 1 headings to denote the sections of your paper (Level 1 headings use upper- and lower-case letters and are bold and centered): 
    • Roles in Advanced Practice Nursing (This is the paper introduction. In APA format, a restatement of the paper title, centered and bolded serves as the heading of the introduction section) 
    • Four APN Roles 
    • Rationale for Choosing CNP Role 
    • Plans for Clinical Practice 
    • Role Transition 
    • Conclusion 

Directions

  1. Introduction: Provide an overview of what will be covered in the paper. Introduction should include general statements on advanced practice nursing roles, general statements on the role transition from RN to APN, and identification of the purpose of the paper. 
  2. Four APN Roles: Describe the role, educational preparation, and work environment for the four APN roles (CNP, CNS, CRNA & CNM). Provide support from at least one scholarly source. 
  3. Rationale for Choosing CNP Role: Describe your rationale for choosing the CNP advanced practice role versus one of the other roles. 
  4. Plans for Clinical Practice: Discuss your plans for clinical practice after graduation. Explain how your understanding of NP practice has changed after researching the four ANP roles. 
  5. Role Transition: Discuss your transition from the RN role to the NP role. Describe two factors that may impact your transition. Discuss two strategies you will use to support a successful transition from the RN to your NP role. Provide reference support from at least one scholarly source. The textbook is not a scholarly source. 
  6. Conclusion: Provide a conclusion, including a brief summary of what you discussed in the paper. 
ASSIGNMENT CONTENT 
Category  Points  %  Description 
Introduction  12  8%  Provides an overview of what will be covered in the paper. Introduction should include:  

  1. general statements on advanced practice nursing roles 
  2. general statements on the role transition from RN to APN 
  3. identification of the purpose of the paper. 
Four APN Roles  40  27%  Describes the role, educational preparation, and work environment for the four APN roles  

  1. CNP 
  2. CNS 
  3. CRNA 
  4. CNM 

Provides support from at least one scholarly source. 
Rationale for Choosing CNP Role  15  10%  Describes the student’s rationale for choosing the CNP advanced practice role versus one of the other roles. 
Plans for Clinical Practice  15  10%  Discusses the student’s plans for clinical practice after graduation. Explains how student’s understanding of NP practice has changed after researching ANP roles. 

 
Role Transition  40  27%  Discusses the student’s transition from the RN role to the NP role.  

  1. Describes two factors that may impact the transition.  
  2. Discusses two strategies student will use to support a successful transition from the RN to your NP role.  

Provides reference support from at least one scholarly source. The textbook is not a scholarly source. 
Conclusion  12  8%  Provides a conclusion, including a brief summary of what was discussed in the paper. 
  134  90%  Total CONTENT Points= 134 points 
ASSIGNMENT FORMAT 
Category  Points  %  Description 
APA Formatting  8  5%  Formatting follows APA Manual (current edition) guidelines for  

  1. title page 
  2. body of paper (including citations and headings) 
  3. reference page 
Writing Mechanics  8  5%  Writing mechanics Follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual. The length of the paper is at least 3 pages but no more than 6 pages. 
  16  10%  Total FORMAT Points= 16 points 
  150  90%  ASSIGNMENT TOTAL=150 points 

 

 

Rubric

NR500NP_Week 2_ Roles in APN_Sept 19

NR500NP_Week 2_ Roles in APN_Sept 19
Criteria Ratings Pts
This criterion is linked to a Learning OutcomeIntroduction

Provides an overview of what will be covered in the paper. Introduction should include 1) general statements on advanced practice nursing roles; 2) general statements on the role transition from RN to APN; and 3) identification of the purpose of the paper.
12 pts

Excellent

Presentation of information is comprehensive and includes all three requirements.

 11 pts

V. Good

Presentation of information is superficial and includes all three requirements.

 10 pts

Satisfactory

Presentation of information includes two requirements.

 6 pts

Needs Improvement

Presentation of information includes one requirement.

 0 pts

Unsatisfactory

No introduction provided or introduction does not address any of the requirements.
12 pts
This criterion is linked to a Learning OutcomeFour APN Roles

Describes the role, educational preparation, and work environment for the four APN roles
1) CNP
2) CNS
3) CRNA
4) CNM
Provides support from at least one scholarly source.
40 pts

Excellent

Presentation of information is comprehensive, includes all four roles, AND provides support from at least one scholarly source.

 36 pts

V. Good

Presentation of information is superficial in places, includes some description of all four roles AND provides support from at least one scholarly source.

 33 pts

Satisfactory

Presentation of information includes description of three roles AND Provides support from at least one scholarly source.

 20 pts

Needs Improvement

Presentation of information includes description of three roles but does not provide support from at least one scholarly source.

 0 pts

Unsatisfactory

Presentation of information includes description of two or fewer roles, with or without support from a scholarly source.
40 pts
This criterion is linked to a Learning OutcomeRationale for Choosing CNP Role

Describes the student’s rationale for choosing the CNP advanced practice role versus one of the other roles.
15 pts

Excellent

Presentation of information is comprehensive

 14 pts

V. Good

Presentation of information is satisfactory.

 12 pts

Satisfactory

Presentation of information is superficial.

 8 pts

Needs Improvement

Presentation of information is minimal.

 0 pts

Unsatisfactory

Does not provide rationale for choosing CNP role.
15 pts
This criterion is linked to a Learning OutcomePlans for Clinical Practice

1) Discusses the student’s plans for clinical practice after graduation.
2) Explains how student’s understanding of NP practice has changed after researching ANP roles.
15 pts

Excellent

Presentation of information is comprehensive and includes both requirements.

 14 pts

V. Good

Presentation of information is superficial and includes both requirements.

 12 pts

Satisfactory

Presentation of information is minimal and includes both requirements.

 8 pts

Needs Improvement

Presentation of information is missing one requirement.

 0 pts

Unsatisfactory

Does not provide plans for clinical practice.
15 pts
This criterion is linked to a Learning OutcomeRole Transition

Discusses the student’s transition from the RN role to the NP role.
1) Describes two factors that may impact the student’s transition.
2) Discusses two strategies student will use to support a successful transition from the RN to your NP role.
Provides reference support from at least one scholarly source.
40 pts

Excellent

Presentation of information is comprehensive, includes both requirements, AND provides support from at least one scholarly source.

 36 pts

V. Good

Presentation of information is superficial in places, includes both requirements AND provides support from at least one scholarly source.

 33 pts

Satisfactory

Presentation of information is minimal, includes both requirements, AND provides support from at least one scholarly source.

 20 pts

Needs Improvement

Presentation of information includes only one of the requirements OR does not provide support from a scholarly source.

 0 pts

Unsatisfactory

Presentation of information does not address role transition.
40 pts
This criterion is linked to a Learning OutcomeConclusion

Provides a conclusion, including a brief summary of what was discussed in the paper.
12 pts

Excellent

Provides a conclusion, including a brief summary of what was discussed in the paper.

 11 pts

V. Good

Conclusion superficial in places, provides a brief summary of what was discussed in the paper.

 10 pts

Satisfactory

Conclusion provides a partial summary of what was discussed in the paper.

 6 pts

Needs Improvement

Conclusion minimal, does not provide a summary of what was discussed in the paper.

 0 pts

Unsatisfactory

No Conclusion provided.
12 pts
This criterion is linked to a Learning OutcomeAPA Formatting

Formatting follows current edition APA Manual guidelines for
• title page
• body of paper (including citations and headings)
• reference page
One deduction for each type of APA format error.
8 pts

Excellent

0 to 1 APA error is present

 7 pts

V. Good

2–3 APA errors are present

 6 pts

Satisfactory

4–5 APA errors are present

 4 pts

Needs Improvement

6–7 APA errors are present

 0 pts

Unsatisfactory

8 or more APA errors are present
8 pts
This criterion is linked to a Learning OutcomeWriting Mechanics

Writing mechanics Follow the rules of grammar, spelling, word usage, punctuation, and other aspects of formal written work as found in the current edition of the APA manual
8 pts

Excellent

1–2 errors or exceptions

 7 pts

V. Good

3–4 errors or exceptions

 6 pts

Satisfactory

5–6 errors or exceptions OR the paper is less than 3 pages or greater than 6 pages

 4 pts

Needs Improvement

7–8 errors or exceptions

 0 pts

Unsatisfactory

9 or more errors or exceptions
8 pts
This criterion is linked to a Learning OutcomeLate penalty deductions

Students are expected to submit assignments by the time they are due. Assignments submitted after the due date and time will receive a deduction of 10% of the total points possible for that assignment for each day the assignment is late. Assignments will be accepted, with penalty as described, up to a maximum of three days late, after which point a zero will be recorded for the assignment. Quizzes and discussions are not considered assignments and are not part of the late assignment policy.
0 pts

Manual Deductions

 0 pts

Manual Deductions
0 pts
Total Points: 150

 

Connection Between Our Culture and the News Media

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Connection Between Our Culture and the News Media

Week 2 Discussion: Connection Between Our Culture and the News Media

44 unread replies.44 replies.

Required Resources
Read/review the following resources for this activity:

  • Textbook: Chapter 5, 6
  • Lesson: Read this Week’s Lesson which is located in the Modules tab
  • Initial Post: minimum of 2 scholarly sources (must include your textbook for one of the sources). Follow-Up Post: minimum of 1 scholarly source for your Follow-Up Post.

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Initial Post Instructions

For the initial post, respond to one of the following options, and label the beginning of your post indicating either Option 1 or Option 2:

Option 1: The framers of the Constitution were concerned that everyday citizens would not be able to understand or comprehend the makings of our government. They felt that everyday citizens were uninformed and did not care what was going on in our government. Even today we see where citizens are interested in government affairs seemingly only if our country is in turmoil such as unemployment, recessions, civil unrest, etc. Do you agree with this assessment? Are we uninformed? Do we wait till a crisis happens to voice our opinions?

Option 2: Many experts see the media as biased and more like infotainment. In fact, many people have turned to social networks as an outlet for news instead of CBS, NBC, FOX, CNN and other news stations. Do you see this as an issue? Do you see the news as biased or unbiased? Should there be more restrictions on the news stations?

Be sure to make connections between your ideas and conclusions and the research, concepts, terms, and theory we are discussing this week.

 

 

 

 

 

 

 

 

 

 Student Example

Option 2

As we learned in week two’s lesson, news media has a “huge impact of public opinion and political behavior” (Chamberlain, 2022). I do agree with the experts and feel that the news can be biased. This is an issue because the people deserve to get the story without things being left out or without options. When the news does this it is called sharing politics. They leave out parts or explain something in a way that leans towards their political side.  Everyone had their own options and working at a certain station could have their own politics involved as to what view they want to have on a piece of news. Mastrine gives a great example, “Our team noted that NPR does not give lots of coverage to current hot-button issues frequently seen in coverage on the Right — such as free speech, abortion, or the Second Amendment — and in that same vein, does not give lots of coverage to hot-button issues often covered by the Left — economic inequality, climate change, or social justice initiatives” (year page). This example is what I feel we all already know. Different media outlets have different approaches and views on how they feel about things. I think the news should be given with as many facts as possible leaving out opinions or have two opposing views review the same story. A lot of times when I am interested in a story, I go to different news outlets to hear different views on the same topic. I do not know about the restrictions that can be enforced with news, but I think people generally know which station has what political view, so they listen or watch the stations they agree with more. To have a well-rounded knowledge base when something interests me, I look at the story from as many different sources that I can find to help get a rounded view. I am then able to decipher through the opinions and facts to have my own view. It would be nice to have a news station that reports the same story with different views back-to-back so you do not have to rewatch the same news story just to try and figure out fact verse opinion and make sure nothing was left out of one news story compared to the other.

References

Chamberlain University (2022). POLI330 Political Science: Week 2 lesson. Downers Grove, IL: Online Publication.

Mastrine, J. (2019). Taking a Closer Look at the NPR News Media Bias Rating. AllSides Perspectives Blog. https://chamberlainuniversity.idm.oclc.org/login?qurl=https%3A%2F%2Fwww.proquest.com%2Fblogs-podcasts-websites%2Ftaking-closer-look-at-npr-news-media-bias-rating%2Fdocview%2F2260147142%2Fse-2%3Faccountid%3D147674

 

 

The Affordable Care Act and Beyond

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The Affordable Care Act and Beyond

 

 

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The Affordable Care Act and Beyond

 

Your Name

School of Business, Technology, and Health Care Administration, Capella University

BHA-FPX4003: Present and Future State Developments within the United States Health Care System

Faculty

Date, Year

 

Template Instructions (delete this page after reading)

  • Review the assessment scoring guide before you complete this template so that you understand the difference between “Distinguished,” “Proficient,” “Basic,” and “Non-Performance” grading levels.
  • The headings in the template below are designed to correspond to the scoring criteria. Please maintain these headings.
  • For this assessment, you will analyze the impacts of the Affordable Care Act on the healthcare ecosystem we inhabit today. As part of this analysis, you will also discuss the related significance of one other health care initiative enacted since 2010 selected from the following:
    • The Hospital Quality Initiative (2012)
    • The Medicare Access and CHIP Reauthorization Act (MACRA) (2015)
    • The Merit-Based Incentive Payment System (MIPS) (2015)
    • The American Rescue Plan Act (2021)
  • Please delete these instructions and all other instructions [contained in brackets] throughout the template prior to submitting this document for grading.

 

 

 

 

 

 

 

Introduction

[Provide a brief introduction to the main themes of your paper here.]

Sources Addressing the Affordable Care Act

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000

            Follow your citation [on a new line] with your information about the source. Tab to move the first line over so the annotation falls in line with the hanging indent. This could be a summary or a critical analysis for why this would be useful in addressing the topic of your paper. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.

Author’s last name, First name initial. Middle initial. (Year of publication). Title of the book in italics. Publishing company. DOI or URL if available

            Follow your citation [on a new line] with your information about the source. Tab to move the first line over so the annotation falls in line with the hanging indent. This could be a summary or a critical analysis for why this would be useful in addressing the topic of your paper. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.

Author’s last name, First name initial. Middle initial. (Year of publication). Title of the article.  Title of the Journal in Italics, volume number(Issue number), pages used. DOI number

Follow your citation [on a new line] with your information about the source. Tab to move the first line over so the annotation falls in line with the hanging indent. This could be a summary or a critical analysis for why this would be useful in addressing the topic of your paper. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.      

Sources Addressing [enter here the health care initiative after the ACA that you selected]

American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000

            Follow your citation [on a new line] with your information about the source. Tab to move the first line over so the annotation falls in line with the hanging indent. This could be a summary or a critical analysis for why this would be useful in addressing the topic of your paper. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.

Author’s last name, First name initial. Middle initial. (Year of publication). Title of the book in italics. Publishing company. DOI or URL if available

            Follow your citation [on a new line] with your information about the source. Tab to move the first line over so the annotation falls in line with the hanging indent. This could be a summary or a critical analysis for why this would be useful in addressing the topic of your paper. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.

Author’s last name, First name initial. Middle initial. (Year of publication). Title of the article.  Title of the Journal in Italics, volume number(Issue number), pages used. DOI number

Follow your citation [on a new line] with your information about the source. Tab to move the first line over so the annotation falls in line with the hanging indent. This could be a summary or a critical analysis for why this would be useful in addressing the topic of your paper. The entire page is double-spaced with no extra space after the paragraph. Your references will be in APA7 format with the hanging indent and in alphabetical order.      

Impacts of the ACA and [enter here initiative you chose]
on the U.S. Health Care Ecosystem

Affordable Care Act Overview

            [Explain the history, structure, and purpose of the Affordable Care Act.]

[Enter here the initiative you chose] Overview

            [Explain the history, structure, and purpose of the (enter your selected initiative here).]

Impact on the U.S. Health Care Ecosystem

  • [Explain the relationship between the ACA and your chosen initiative.]
    • [What groundwork did the ACA create to make your chosen initiative possible?]
  • [Explain the present and future impacts of the ACA and your chosen initiative on the U.S. health care system.]
    • [What groundwork does your chosen initiative create that could be expanded or extrapolated in future initiatives?]
    • [Cite at least one scholarly/professional source to support your prediction(s).]

Conclusion

[Based the sources and analysis you included in this paper, answer the following question in one paragraph: “Does the future of U.S. health care appear to improve or decline?”]

References

[Lastname, C. (2018). Title of the source without caps except Proper Nouns or: First word after colon. The Journal or Publication Italicized and Capped, Vol#(Issue#), Page numbers.]

[Lastname, O. (2019).  Online journal using DOI or digital object identifier. Main Online Journal Name, Vol#(Issue#), 159–192. doi: 10.1000/182]

[Lastname, W. (2021). If there is no DOI use the URL of the main website referenced. Article Without DOI Reference, Vol#(Issue#), 166–212. http://www.mainwebsite.org]

 

[NOTE: The above references are SAMPLES ONLY. For more information and example related to references, visit Capella’s Writing Center. You are responsible for submitting appropriate in-text and reference page citations.] 

NRNP – 6665 Week 8: Neurodevelopmental Disorders Assignment

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NRNP – 6665 Week 8: Neurodevelopmental Disorders Assignment

NRNP – 6665 Week 8: Neurodevelopmental Disorders

I can’t believe I am sitting here talking to this lady. Mom thinks I am nuts just because I will not do what she asks. She doesn’t care about me. She only cares about my little brother and that man that keeps coming around. I don’t care about her. That is why I throw things and won’t do what she asks. I don’t care about anyone. Those kids at school who used to be my friends don’t know anything. I am so much smarter than they are. NRNP – 6665 Week 8: Neurodevelopmental Disorders Assignment

—Jacob, age 11

There are many mental disorders that occur early in the life course. The DSM-5 describes neurodevelopmental disorders such as intellectual disability and delay, autism spectrum disorder, language and speech disorders, ADHD and specific learning disorder (e.g., dyslexia, difficulty mastering mathematical reasoning). Diagnosis of these various conditions can rarely be made in a single office visit and often requires a comprehensive approach involving multiple stakeholders, including the child, his or her parents, teachers, other significant figures in the child’s life, and medical and mental health professionals, such as psychologists who can conduct comprehensive neuropsychological testing.

The PMHNP must coordinate and integrate several sources of information to arrive at an accurate diagnosis of these disorders. Early and accurate diagnosis is essential to developing an effective treatment plan, which will have the potential to minimize the impact of these disorders on the child’s developmental trajectory. When one considers appropriate diagnosis from this perspective, the importance of diagnostic accuracy becomes quite apparent.

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This week, you begin exploring disorders that occur early in the life course and use this knowledge to create a study guide for a neurodevelopmental disorder.

Learning Objectives

Students will:

  • Analyze signs and symptoms of neurodevelopmental disorders
  • Analyze the pathophysiology of neurodevelopmental disorders
  • Analyze diagnosis and treatment methods for neurodevelopmental disorders
  • Summarize legal, ethical, and patient education factors related to neurodevelopmental disorders. NRNP – 6665 Week 8: Neurodevelopmental Disorders Assignment

Learning Resources

Required Readings (click to expand/reduce)

 

Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health. American Psychiatric Association Publishing.

  •  Chapter 12, “Developmental Milestones”

 

Thapar, A., Pine, D. S., Leckman, J. F., Scott, S., Snowling, M. J., & Taylor, E. A. (2015). Rutter’s child and adolescent psychiatry (6th ed.). Wiley Blackwell.

  • Chapter 51, “Autism Spectrum Disorder”
  • Chapter 55, “ADHD and Hyperkinetic Disorder”

Utah State University. (n.d.). Creating study guides. https://www.usu.edu/academic-support/test/creating_study_guides

Walden University. (2020). Success strategies: Self-paced interactive tutorials. https://academicguides.waldenu.edu/academic-skills-center/skills/tutorials/success-strategies

 

Zakhari, R. (2020). The psychiatric-mental health nurse practitioner certification review manual. Springer.

  • Chapter 13, “Child/Adolescent Neurodevelopmental Disorders”

Required Media (click to expand/reduce)

 

Dillon, K. (2019, March 23). DSM-5 neurodevelopmental disorders. [Video]. YouTube. https://www.youtube.com/watch?v=Ydr9s_UwACo

The National Center for Learning Disabilities. (2013, February 20). What is ADHD? [Video]. YouTube. https://youtu.be/0Wz7LdLFJVM

Osmosis. (2017, October 17). Autism – causes, symptoms, diagnosis, treatment, pathology [Video]. YouTube. https://youtu.be/x2hWVgZ8J4A

 

Medication Review

Irritability in autism Attention-deficit/hyperactivity disorder
aripiprazole
risperidone		 amphetamine IR, XR, and ER
dextroamphetamine
atomoxetineclonidine hydrocholoride ER
Dexmethylphenidate IR and XR
guanfacine hydrocholride ER
lisdexamfetamine
methylphenidate
methylphenidate hydrocholoride IR and ER, transdermal

Assignment: Study Guide Forum

Abnormal brain development or damage at an early age can lead to neurodevelopmental disorders. Within this group of disorders, some are resolvable with appropriate and timely interventions, either pharmacological or nonpharmacological, while other disorders are chronic and need to be managed throughout the lifespan.

For this Assignment, you will develop a study guide for an assigned disorder and share it with your colleagues. In sum, these study guides will be a powerful tool in preparing for your certification exam.

Photo Credit: Getty Images/iStockphoto

To Prepare

  • Your Instructor will assign you to a specific neurodevelopmental disorder from the DSM-5.
  • Research your assigned disorder using the Walden Library. Then, develop an organizational scheme for the important information about the disorder.

The Assignment

Create a study guide for your assigned disorder. Your study guide should be in the form of an outline with references, and you should incorporate visual elements such as concept maps, charts, diagrams, images, color coding, mnemonics, and/or flashcards. Be creative! It should not be in the format of an APA paper. Your guide should be informed by the DSM-5 but also supported by at least three other scholarly resources. NRNP – 6665 Week 8: Neurodevelopmental Disorders Assignment

Areas of importance you should address, but are not limited to, are:

  • Signs and symptoms according to the DSM-5
  • Differential diagnoses
  • Incidence
  • Development and course
  • Prognosis
  • Considerations related to culture, gender, age
  • Pharmacological treatments, including any side effects
  • Nonpharmacological treatments
  • Diagnostics and labs
  • Comorbidities
  • Legal and ethical considerations
  • Pertinent patient education considerations

By Day 7 of Week 8

Submit your Assignment to the forum as an attachment. Although no responses are required, collegial discussion is welcome. You are encouraged to utilize your peers’ submitted guides on their assigned neurodevelopmental disorders for study.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Assignment Rubric

 

Post by Day 7 of Week 8

To Participate in this Assignment:

Week 8 Assignment

Week 1 Discussion: Determining Democracy

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Week 1 Discussion: Determining Democracy

Week 1 Discussion: Determining Democracy

1717 unread replies.1919 replies.

Required Resources
Read/review the following resources for this activity:

  • Textbook: Chapter 1 ,2, 3
  • Lesson: Read this Week’s Lesson which is located in the Modules tab
  • Initial Post: minimum of 2 scholarly sources (must include your textbook for one of the sources). Follow-Up Post: minimum of 1 scholarly source for your Follow-Up Post.

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Initial Post Instructions

For the initial post, respond to one of the following options, and label the beginning of your post indicating either Option 1 or Option 2:

  • Option 1:Does democracy require equality of income or wealth? Discuss why democracy might make a country more or less egalitarian?
  • Option 2: Political scientist Larry Sabato has proposed a new constitutional convention(Links to an external site.). Select any one of his proposed ideas and write a short list of pros and cons for this idea and support your reasoning. 

Be sure to make connections between your ideas and conclusions and the research, concepts, terms, and theory we are discussing this week.

Follow-Up Post Instructions

Respond to at least one peer. Further the dialogue by providing more information and clarification. Minimum of 1 scholarly source which can include your textbook or assigned readings or may be from your additional scholarly research.

 

 

 

 

 

 

 

 

 

 

 Student Example

Option 1

A democracy is a type of government in which the people have political power, the head of state’s power is limited, the separation of powers between governmental bodies is ensured, and natural rights and civil freedoms are protected (Achen et al., 2017). The term democracy is derived from the Greek terms “people” (dmos) and “rule” (rule). However, developing and maintaining a people-centered government—a “popular” government—is significantly more complex than the concept’s semantic simplicity suggests.

Economic development and affluence do not always imply democracy. However, higher wealth levels and the presence of a solid middle class can prevent a return to authoritarianism after democracy develops (Lawson-Remer, 2013). It expounds on the study of some researchers who suggest that high GDP does not accelerate democratic changes but rather forecasts whether democracy, however it emerged, would be sustained. It is not to say that democracy needs a particular level of economic prosperity before seeking political liberty. Even if greater wealth levels aid the sustainability of democracy, democracy in low-income nations is possible. Indeed, various researchers have recently argued that democracy may lead to the fulfillment of other developmental areas, such as economic progress. Nevertheless, the more nations can promote equitable economic growth and develop a large middle class, the greater their chances of maintaining democratic gains (Lawson-Remer, 2013). Considerably under the best of circumstances, this is a challenging assignment; it is made even more difficult by the transitional nations are experiencing.

Those interested in fostering democracy across the world should keep in mind that, while economic growth only is insufficient to provide political freedom, the existence of an extensive and thriving middle class significantly improves the possibilities of successful democratization.

References

Achen, C., Bartels, L., Achen, C. H., & Bartels, L. M. (2017). Democracy for realists. In Democracy for Realists. Princeton University Press.

Lawson-Remer, T., (2013). New Insights on the Relationship Between Democracy and Wealth. https://www.cfr.org/blog/new-insights-relationship-between-democracy-and-wealth

 

 

CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

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CONTROVERSY ASSOCIATED WITH DISSOCIATIVE DISORDERS

 

WK 11 PRAC 6665

Assignment: Journal Entry

Photo Credit: Image by Free-Photos from Pixabay

Critical reflection of your growth and development during your practicum experience in a clinical setting has the benefit of helping you to identify opportunities for improvement in your clinical skills, while also recognizing your strengths and successes.

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Use this Journal to reflect on your clinical strengths and opportunities for improvement, the progress you made, and what insights you will carry forward into your next practicum. 

To Prepare

  • Refer to the “Population-Focused Nurse Practitioner Competencies” found in the Week 1 Learning Resources, and consider the quality measures or indicators advanced nursing practice nurses must possess in your specialty of interest.
  • Refer to your Clinical Skills Self-Assessment Form you submitted in Week 1, and consider your strengths and opportunities for improvement.
  • Refer to your Patient Log in Meditrek, and consider the patient activities you have experienced in your practicum experience and reflect on your observations and experiences.

Journal Entry (450–500 words)

Learning From Experiences

  • Revisit the goals and objectives from your Practicum Experience Plan. Explain the degree to which you achieved each during the practicum experience.
  • Reflect on the three (3) most challenging patients you encountered during the practicum experience. What was most challenging about each?
  • What did you learn from this experience?
  • What resources were available?
  • What evidence-based practice did you use for the patients?
  • What would you do differently?
  • How are you managing patient flow and volume?
  • How can you apply your growing skillset to be a social change agent within your community?

Communicating and Feedback

  • Reflect on how you might improve your skills and knowledge, and communicate those efforts to your Preceptor.
  • Answer the questions: How am I doing? What is missing?
  • Reflect on the formal and informal feedback you received from your Preceptor.

 

 

Rubric Detail

 

Select Grid View or List View to change the rubric’s layout.

Name: PRAC_6665_Week11_Assignment_Rubric

  • Grid View
  • List View

 Show Descriptions

Assimilation and Synthesis: Content Reflection–

Excellent 45 (45%) – 50 (50%)

Good 40 (40%) – 44 (44%)

Fair 35 (35%) – 39 (39%)

Poor 0 (0%) – 34 (34%)

Assimilation and Synthesis: Personal Growth–

Excellent 27 (27%) – 30 (30%)

Good 24 (24%) – 26 (26%)

Fair 21 (21%) – 23 (23%)

Poor 0 (0%) – 20 (20%)

Written Expression and Formatting–

Excellent 14 (14%) – 15 (15%)

Good 12 (12%) – 13 (13%)

Fair 11 (11%) – 11 (11%)

Poor 0 (0%) – 10 (10%)

APA–

Excellent 5 (5%) – 5 (5%)

Good 4 (4%) – 4 (4%)

Fair 3.5 (3.5%) – 3.5 (3.5%)

Poor 0 (0%) – 3 (3%)

Total Points: 100

Name: PRAC_6665_Week11_Assignment_Rubric

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Pakistani Female With Delusional Thought Processes

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Pakistani Female With Delusional Thought Processes

Pakistani Female With Delusional Thought Processes

BACKGROUND

The client is a 34-year-old Pakistani female who moved to the United States in her late teens/early 20s. She is currently in an “arranged” marriage (her husband was selected for her when she was 9 years old). She presents following a 21-day hospitalization for what was diagnosed as “brief psychotic disorder.” She was given this diagnosis as her symptoms have persisted for less than 1 month. Pakistani Female With Delusional Thought Processes

Prior to admission, she was reporting visions of Allah, and over the course of a week, she believed that she was the prophet Mohammad. She believed that she would deliver the world from sin. Her husband became concerned about her behavior to the point that he was afraid of leaving their 4 children with her. One evening, she was “out of control,” which resulted in his calling the police and her subsequent admission to an inpatient psych unit.

During today’s assessment, she appears quite calm and insists that the entire incident was “blown out of proportion.” She denies that she believed herself to be the prophet Mohammad and states that her husband was just out to get her because he never loved her and wanted an “American wife” instead of her. She says she knows this because the television is telling her so. Pakistani Female With Delusional Thought Processes

She currently weighs 140 lbs., and she is 5’ 5.

SUBJECTIVE

Client reports that her mood i s “good.” She denies auditory/visual hallucinations but believes that the television talks to her. She believes that Allah sends her messages through the TV. At times throughout the clinical interview, she becomes hostile towards you but then calms down.

A review of her hospital records shows that she received a medical workup from physician, who reported her to be in overall good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week after she got out of the hospital because she thinks her husband is going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM

The client is alert and oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. She demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is slow and, at times, interrupted by periods of silence. Self-reported mood is euthymic. Affect is constricted. Although the client denies visual or auditory hallucinations, she appears to be “listening” to something. Delusional and paranoid thought processes as described above. Insight and judgment are impaired. She is currently denying suicidal or homicidal ideation.

You administer the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis: Schizophrenia, paranoid type

RESOURCES

PANSS Scale. Available at: http://egret.psychol.cam.ac.uk/medicine/scales/PANSS

§ Kay, S. R., Fiszbein, A., & Opler, L. A. (1987). The Positive and Negative Syndrome Scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13(2), 261–276. doi:10.1093/schbul/13.2.261

https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

§ Clozapine REMS Program. (n.d.). Clozapine REMS: A guide for healthcare providers. Retrieved September 7, 2016, from https://www.clozapinerems.com/CpmgClozapineUI/rems/pdf/resources/Clozapine_REMS_A_Guide_for_Healthcare_Providers.pdf

http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf

§ Paz, Z., Nalls, M., and Ziv, E. (2011). The genetics of benign neutropenia. Israel Medical Association Journal, 13(10), 625–629. Retrieved from http://www.ima.org.il/FilesUpload/IMAJ/0/40/20149.pdf Pakistani Female With Delusional Thought Processes

Decision Point One

Select what you should do:
Start Zyprexa (olanzapine) 10 mg orally at BEDTIME
Start Invega Sustenna 234 mg IM X1 followed by 156 mg IM on day 4 and monthly thereafter
Start Abilify (aripiprazole) 10 mg orally at BEDTIME

Assignment: Assessing and Treating Patients With Psychosis and Schizophrenia

Psychosis and schizophrenia greatly impact the brain’s normal processes, which interfere with the ability to think clearly. When symptoms of these disorders are uncontrolled, patients may struggle to function in daily life. However, patients often thrive when properly diagnosed and treated under the close supervision of a psychiatric mental health practitioner. For this Assignment, as you examine the patient case study in this week’s Learning Resources, consider how you might assess and treat patients presenting with psychosis and schizophrenia.

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To prepare for this Assignment:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with schizophrenia-related psychoses.

The Assignment: 5 pages

Examine Case Study: Pakistani Woman With Delusional Thought Processes. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

At each decision point, you should evaluate all options before selecting your decision and moving throughout the exercise. Before you make your decision, make sure that you have researched each option and that you evaluate the decision that you will select. Be sure to research each option using the primary literature.

Introduction to the case (1 page)

  • Briefly explain and summarize the case for this Assignment. Be sure to include the specific patient factors that may impact your decision making when prescribing medication for this patient. Pakistani Female With Delusional Thought Processes

Decision #1 (1 page)

  • Which decision did you select?
  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #2 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples.

Decision #3 (1 page)

  • Why did you select this decision? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • Why did you not select the other two options provided in the exercise? Be specific and support your response with clinically relevant and patient-specific resources, including the primary literature.
  • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources (including the primary literature).
  • Explain how ethical considerations may impact your treatment plan and communication with patients. Be specific and provide examples. Pakistani Female With Delusional Thought Processes

Conclusion (1 page)

  • Summarize your recommendations on the treatment options you selected for this patient. Be sure to justify your recommendations and support your response with clinically relevant and patient-specific resources, including the primary literature. Pakistani Female With Delusional Thought Processes

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature.

Reminder : The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at https://academicguides.waldenu.edu/writingcenter/templates/general#s-lg-box-20293632). All papers submitted must use this formatting. Pakistani Female With Delusional Thought Processes