NR601 week 6 discussion part 2

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NR601 week 6 discussion part 2

Discussion Part Two (graded)

Physical Exam:

Discussion Part Two (graded)

Vital signs: blood pressure 145/90, heart rate 100, respirations 20

height 5’1”; weight 210 pounds

Labwork:

CBC: normal

UA: 2+ glucose; 1+ protein; negative for ketones

CMP: BUN/Creat. elevated; Glucose is 300 mg/dL

Hemoglobin A1c: 12%

Thyroid panel: normal

LFTs: normal

Cholesterol: total cholesterol (206), LDL elevated; HDL is low

EKG: normal

General: obese female in not acute distress

HEENT: unremarkable

CV: S1 and S2 RRR without murmurs or rubs

Lungs: Clear to auscultation

Abdomen- soft, round, nontender with positive bowel sounds present; no organomegaly; no abdominal bruits

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Discussion Questions Part Two

• For the primary diagnosis, what non-pharmacological and pharmacological strategies would be appropriate?

• Include the following: lab work and screenings to be completed.

• Describe patient education strategies.

• Describe follow-up and any referrals that may be necessary. NR601 week 6 discussion part 2

Assessing Musculoskeletal Pain

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PLEASE PAY ATTENTION TO THE CASE STUDY,ZERO PLAGIARISMFIVE REFERENCESCase 2: Ankle PainPhoto Credit: University of Virginia. (n.d.). Lateral view of ankle showing Boehler’s angle [Photograph]. Retrieved from http://www.med-ed.virginia.edu/courses/rad/ext/8ankle/01anatomy.html. Used with permission of University of Virginia.A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

Assessing Musculoskeletal Pain

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PLEASE PAY ATTENTION TO THE CASE STUDY,ZERO PLAGIARISMFIVE REFERENCESCase 2: Ankle PainPhoto Credit: University of Virginia. (n.d.). Lateral view of ankle showing Boehler’s angle [Photograph]. Retrieved from http://www.med-ed.virginia.edu/courses/rad/ext/8ankle/01anatomy.html. Used with permission of University of Virginia.A 46-year-old female reports pain in both of her ankles, but she is more concerned about her right ankle. She was playing soccer over the weekend and heard a “pop.” She is able to bear weight, but it is uncomfortable. In determining the cause of the ankle pain, based on your knowledge of anatomy, what foot structures are likely involved? What other symptoms need to be explored? What are your differential diagnoses for ankle pain? What physical examination will you perform? What special maneuvers will you perform? Should you apply the Ottawa ankle rules to determine if you need additional testing?

NR601 week 7 discussion part 1

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NR601 week 7 discussion part 1

Discussion Part One (graded)

C.G. is a 69-year-old male with a history of right head and neck cancer that you have been following for one year. The carcinoma was initially localized to the head and neck-specifically at the left lingual tonsil region and went on to complete a total of 6 weeks of radiation and chemotherapy. Recently, the last PET scan indicated some metabolic activity in the left lymph node area along with other regions of abnormal metabolic activity in the body-particularly the liver and the lungs indicating metastasis. C.G. indicates that he is tired of the effects of chemotherapy and radiation and does not want to pursue any more treatment for cancer. NR601 week 7 discussion part 1

Background:

Right head and neck cancer with metastasis to liver and lungs; patient is refusing further treatment.

PMH:

Hypertension

Hyperlipidemia

Stomatitis

Anemia

Neutropenia

Current medications:

Carvedilol 12.5 mg po 1 daily

Furosemide 40 mg po daily

Surgeries:

2012: right radical neck dissection

Allergies:

None

Vaccination History:

Influenza vaccine last received 1 year ago

Received pneumovax at age 65

Received Tdap 5 years ago

Has not had the herpes zoster vaccine

Social history and Risk Factors:

Former smoker-stopped smoking at the time his cancer was diagnosed-2 years ago

Negative for alcohol intake or drug use

Patient does not have an advanced directive or living will. He is refusing further treatment for his cancer and his wife and children are in disagreement with him. The patient wants to know what his options are for the remainder of his life. NR601 week 7 discussion part 1

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Family history:

Negative

Discussion Part One:

Provide differential diagnoses (DD) with rationale.

Further ROS questions needed to develop DD.

Identify the legal/ethical issues involved with the patient and describe your approach to addressing end-of-life care for this patient. NR601 week 7 discussion part 1

NR601 week 7 discussion part 2

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NR601 week 7 discussion part 2

Discussion Part Two (graded)

Physical examination:

Vital Signs: Height: 6’0 Weight: 140 pounds; BMI: 19.0 BP: 156/84 P: 84 regular R: 20

HEENT: normocephalic, symmetric PERRLA, EOMI; poor dentition

NECK: left neck supple; non-palpable lymph nodes; no carotid bruits. Limited ROM

LUNGS: rhonchi in anterior chest bilaterally. NR601 week 7 discussion part 2

HEART: S1 and S2 audible; regular rate and rhythm

ABDOMEN: active bowel sounds all 4 quadrants; Normal contour; RUQ tenderness; liver palpable

NEUROLOGIC: negative

GENITOURINARY: negative

MUSCULOSKELETAL: negative

PSYCH: PHQ-9 is 15

SKIN: oral mucosa irritated-stomatitis

Discussion Part Two:

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Summarize the history and results of the physical exam. Discuss the differential diagnosis and rationale for choosing the primary diagnosis. Include one evidence-based journal article that supports your rationale and include a complete treatment plan that includes medications, possible referrals, patient education, ICD 10 Codes, and plan for follow up. NR601 week 7 discussion part 2

nr508 Week 6 discussion 1

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nr508 Week 6 discussion 1

Jonathon is a 56 year-old retired automobile mechanic who has not been to the doctor in approximately 6-7 years. He presents to your office complaining that 3 weeks ago he was awoken with severe pain and inflammation in his knee, which has been consistent since that initial night. Upon physical examination of his knee, it appears swollen and erythematous with periarticular involvement.  nr508 Week 6 discussion 1.pon physical examination and laboratory results you notice the following:

 

Physical examination:

GEN: well nourished, obese male (310 pounds)

VS: BP 191/112 HR 75 RR 15 T 98.6, HT 5’8”

EXT: Knee joint inflammation

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Laboratory (fasting):

Na 139 mEq/L

K 3.8 mEq/L

Ca 9.1 mg/dL

CL 102 mmol/L

HCO3 22 mEq/L

BUN 10 mg/dL

SCr 0.9 mg/dL

Serum Uric Acid 6.5 mg/dL

Alb 4.1 g/dL

Cholesterol 300 mg/dL

UA: pH 6.8, uric acid 250 mg/24h

 

 

What problems can be identified in this patient? Please provide a list of differential diagnoses, as well as indication of your primary diagnosis.What is your pharmacological plan for your primary diagnosis including the medication, dose, and mechanism of action? nr508 Week 6 discussion 1

Influence of Diversity and Inclusion on Organizational Culture

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Define      “diversity” and “inclusion” as applied to your presentation that will      compare two healthcare organizations. Describe the two healthcare      organizations you are comparing, including type and degree of diversity      and inclusion, as well as organization type, size, location, and other      distinguishing factors. Include supporting sources.Analyze      the culture of the two healthcare organizations and how each is influenced      by diversity and inclusion.Compare      the cultures of the two healthcare organizations based on the role of      diversity and inclusion in each, and strengths and weaknesses that relate      to or derive from the degree of diversity and inclusion.Summarize      your conclusions on the impact of diversity and inclusion on      organizational culture in healthcare settings based on your comparison.Apply      leadership strategies for a nurse executive to promote greater diversity,      retain diverse staff members, and build cohesive teams and work groups.

nr506-Evaluation of Epidemiological

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nr506-Evaluation of Epidemiological

Evaluation of Epidemiological Problem

Guidelines& Grading Rubric

PURPOSE

The purpose of this assignment is to

• Provide learners with the opportunity to integrate knowledge and skills learned throughout this course

• Directly apply principles and knowledge learned in the course to problem solving of population health problems in their own geographic areas.

COURSE OUTCOMES

This assignment enables the student to meet the following course outcomes:

1. Define key terms in epidemiology, community health, and population-based research.

2. Compare study designs used for obtaining population health information from surveillance, observation, community, and control trial based research. nr506-Evaluation of Epidemiological

3. Identify appropriate outcome measures and study designs applicable to epidemiological subfields such as infectious disease, chronic disease, environmental exposures, reproductive health, and genetics.

4. Apply commonly used measures of health risk.

5. Examine current ethical/legal issues in epidemiology.

6. Identify important sources of epidemiological data.

7. Evaluate a public health problem in terms of magnitude, person, time, and place.

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TOTAL POINTS POSSIBLE: 200

 

REQUIREMENTS

This paper should clearly and comprehensively identify the disease or population health problem chosen. The problem must be an issue in your geographic area and a concern for the population you will serve upon graduation with your degree. The paper should be organized into the following sections:

1. Introduction with a clear presentation of the problem as well as significance and a scholarly overview of the paper. nr506-Evaluation of Epidemiological

2. Background of the disease including definition, description, signs and symptoms, and current incidence and/or prevalence statistics current state, local, and national statistics pertaining to the disease. (Include a table of incidence or prevalence rates by your geographic county, state, and national statistics.)

3. A review of current surveillance methods and any mandated reporting or methods for reporting the disease for providers.

4. Conduct descriptive epidemiology analysis of the disease including who is more frequently affected and characteristics of the population that might help in creating a prevention plan. Include costs (both financial and social) associated with the disease or problem.

5. Review how the disease is diagnosed, current national standards for screening or prevention, and pick one screening test and review its sensitivity, specificity, positive predictive value, cost and any current national guidelines for conducting which patients to conduct this test on.

6. Provide a brief plan of how you will address this epidemiological disease in your practice once you are finished with school. Provide three actions you will take along with how you will measure outcomes of your actions.

7. Conclude in a clear manner with a brief overview of key points of the entire disease,

PREPARING THE PAPER

• Page length: 7-10 pages, excluding title/cover page

• APA format 6th edition

• Include references when necessary.

• Include at least one table to present information somewhere in the paper. nr506-Evaluation of Epidemiological

 

DIRECTIONS AND GRADING CRITERIA

 

Category Points

Possible Points Earned Comments

Scholarly Introduction (clear presentation of problem) 20

Background and significance of the disease (includes incidence or prevalence statistics) 30

Current surveillance methods 30

Descriptive epidemiological analysis (includes characteristics of the at-risk population and/or those affected by the disease and costs of the disease) 30

Screening and diagnosis (includes review of current guidelines for screening and diagnosis of the disease. In-depth review of statistics one screening or diagnostic test provided) 30

Plan of action (includes at least three evidenced based actions, supported by literature, that the student will take in their own practice and how outcomes will be measured) 30

Conclusion 20

Mechanics of writing, APA 10

Total 200 Total Points earned =

A quality paper will meet or exceed all of the criteria requirements. nr506-Evaluation of Epidemiological

 

GRADING RUBRIC

Assignment Criteria Exceptional

Outstanding or highest level of performance Exceeds

Very good or high level of performance Meets

Competent or satisfactory level of performance Needs Improvement

Poor or failing level of performance Developing

Unsatisfactory level of performance

Identification of the problem/concern 20 Points 18 Points 16 Points 8 Points 0 Points

Comprehensively identifies the problem/concern Adequately identifies the problem/concern Identification of problem/concern is limited Identification of problem/concern is unclear. Identification of problem/concern is absent

Background and significance of the disease (includes incidence or prevalence statistics) 30 Points 26 Points 24 Points 11 Points 0 Points

Background is complete, presents risks, disease impact and includes a review of incidence and prevalence of the disease within the student’s local area, state, and nationally. Evidence supports background. Background is complete, presents risk, disease impact and at least one set of incidence and prevalence statistics are presented and supported by evidence. Background missing one or more key points and at least one set of incidence and prevalence statistics are presented. Lack of evidence or limited presentation of the background. Background missing more than one key point and at least one set of incidence and prevalence statistics are presented, or there is no supported evidence. Unclear conclusions or presentation. Background and significance of the disease is not provided. nr506-Evaluation of Epidemiological

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Current surveillance methods 30 Points 26 Points 24 Points 11 Points 0 Points

Current local, state, and national disease surveillance methods are reviewed, currently gathered types of statistics, and information on whether the disease is mandated for reporting, supported by evidence More than one local, state, and national disease surveillance methods are reviewed, currently gathered types of statistics, and information on whether the disease is mandated for reporting, supported by evidence One of either local, state, and national disease surveillance methods are reviewed, currently gathered types of statistics, and information on whether the disease is mandated for reporting, supported by evidence One of either local, state, and national disease surveillance methods are reviewed, currently gathered types of statistics, or only information on whether the disease is mandated for reporting, or evidence is lacking to support this area. Unclear conclusions or presentation. Local, state, and national disease surveillance methods were not discussed.

Descriptive epidemiological analysis (includes characteristics of the at-risk population and/or those affected by the disease and costs of the disease) 30 Points 26 Points 24 Points 11 Points 0 Points

Comprehensive review and analysis of descriptive epidemiological points of the identified disease and population most at risk, supported by scholarly evidence. Adequate review with some analysis of descriptive epidemiological points of the identified disease and population most at risk supported by scholarly evidence. Limited review and analysis of key descriptive epidemiological points of the identified disease and at-risk population. Minimal analysis of key descriptive epidemiological points of the identified disease and at-risk population. No analysis of key descriptive epidemiological points of the identified disease and at-risk population is provided.

Screening and diagnosis (includes review of current guidelines for screening and diagnosis of the disease. In-depth review of statistics one screening or diagnostic test provided) 30 Points 26 Points 24 Points 11 Points 0 Points

Comprehensive review of current guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests is presented. Adequate review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests is presented. Limited review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. Minimal or unclear review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests. Review of guidelines for screening, diagnosis, and statistics related to validity, predictive value, and reliability of screening tests not provided. nr506-Evaluation of Epidemiological

 

Plan of action (includes at least three evidenced based actions, supported by literature, that the student will take in their own practice and how outcomes will be measured) 30 Points 26 Points 24 Points 11 Points 0 Points

A comprehensive plan of action specific to the student’s interests, the problem, and the geographic area is presented with 3 evidenced based actions that will be taken to address the impact, outcomes, or prevalence of the disease. An adequate, but not fully comprehensive, plan of action specific to the student’s interests, the problem, and the geographic area is presented with 3 evidenced based actions that will be taken to address the impact, outcomes, or prevalence of the disease. A limited plan of action specific to the student’s interests, the problem, and the geographic area is, outcomes, or prevalence of the disease. Three actions are presented with limited or little evidence. Actions are minimal or unclear, or lack specificity to geographic area, are not supported directly by evidence or are not direct actions the student can take in practice. Plan of action not provided.

Conclusion 20 Points 18 Points 16 Points 8 Points 0 Points

The conclusion thoroughly, clearly, succinctly, and logically presents major points of the paper with clear direction for action. The conclusion adequately and logically presents major points of the paper with clear direction for action, but lacks one major point or is not succinct. The conclusion is a limited review of key points of the paper, is not succinct, or lacks one or more major points of the paper or clear direction for action. Conclusion is unclear or significantly limited in overview of the paper. Conclusion not provided.

Grammar, Spelling, APA 10 Points 9 Points 8 Points 4 Points 0 Points

APA format, grammar, spelling, and/or punctuation are accurate, or with zero to one errors. Two to four errors in APA format, grammar, spelling, and syntax noted. Five to seven errors in APA format, grammar, spelling, and syntax noted. Eight to nine errors in APA format, grammar, spelling, and syntax noted. Post contains greater than ten errors in APA format, grammar, spelling, and/or punctuation or repeatedly makes the same errors after faculty feedback. nr506-Evaluation of Epidemiological

Total Points Possible = 200 points

week7 6050 discussion moledule4

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Discussion 1: Evidence Base in DesignWhen politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.To Prepare:Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.Review the health policy you identified and reflect on the background and development of this health policy.By Day 3 of Week 7Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.Learning ResourcesNote: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.Required ReadingsMilstead, J. A., & Short, N. M. (2019). Health policy and politics: A nurse’s guide (6th ed.). Burlington, MA: Jones & Bartlett Learning.Chapter 5, “Public Policy Design” (pp. 87–95 only)Chapter 8, “The Impact of EHRs, Big Data, and Evidence-Informed Practice” (pp. 137–146)Chapter 9, “Interprofessional Practice” (pp. 152–160 only)Chapter 10, “Overview: The Economics and Finance of Health Care” (pp. 183–191 only)American Nurses Association (ANA). (n.d.). Advocacy. Retrieved September 20, 2018, from https://www.nursingworld.org/practice-policy/advocacy/Centers for Disease Control and Prevention (CDC). (n.d.). Step by step: Evaluating violence and injury prevention policies: Brief 4: Evaluating policy implementation. Retrieved from https://www.cdc.gov/injury/pdfs/policy/Brief%204-a.pdfCongress.gov. (n.d.). Retrieved September 20, 2018, from https://www.congress.gov/Klein, K. J., & Sorra, J. S. (1996). The challenge of innovation implementation. Academy of Management Review, 21(4), 1055–1080. doi:10.5465/AMR.1996.9704071863Note: You will access this article from the Walden Library databases.Sacristán, J., & Dilla, T. D. (2015). No big data without small data: Learning health care systems begin and end with the individual patient. Journal of Evaluation in Clinical Practice, 21(6), 1014–1017. doi:10.1111/jep.12350Note: You will access this article from the Walden Library databases.Tummers, L., & Bekkers, V. (2014). Policy implementation, street level bureaucracy, and the importance of discretion. Public Management Review, 16(4), 527–547. doi:10.1080/14719037.2013.841978.Note: You will access this article from the Walden Library databases.Required MediaLaureate Education (Producer). (2018). Getting your Program Designed and Implemented [Video file]. Baltimore, MD: Author.Accessible player –Downloads–Download Video w/CCDownload AudioDownload TranscriptLaureate Education (Producer). (2018). Health policy and politics [Video file]. Baltimore, MD: Author.three sources for the discussion

Neurological Functional Pathways Assignment

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Neurological Functional Pathways Assignment

Neurological functional pathways

Prior to beginning work on this discussion, read Chapters 5 and 8 in your course textbook, and view the Sleep Disorders video. These required materials examine topics on neurotransmitter and receptor systems, anatomical structures, neurological functional pathways, and their role in control of movement, consciousness and sleep, and how they correlate to selected related disorders.

Please choose either Option A or Option B for your discussion posting:  Neurological Functional Pathways Assignment

Option A

Complete the following:

· Evaluate one of the disorders of consciousness covered this week.

· Explain theories of etiology (causation), including the neuroanatomical structures, neurotransmitter/receptor systems, and the functional nervous system (neural) pathways involved.

o Include an analysis of the contribution of genetics, the environment, and lifestyle to the development and natural history of the condition.

o Provide information regarding diagnostic criteria, and evaluate options for care interventions (both pharmacological and nonpharmacological).

o Be sure to identify the neuroanatomical structures and any neurotransmitter/receptor systems involved.

· Also in your discussion, imagine you are in a career position that utilizes a degree in psychology, including, but not limited to, that of a social worker, teacher or teacher’s aide, child care worker, psychiatric technician or other behavioral health staff, peer support specialist, social service specialist, probation or parole officer, case manager, or counselor.

o How would your knowledge of the neurobiology of sleep disorders or disorders of consciousness help you in your professional life? Neurological Functional Pathways Assignment

o Would you be able to better assist your clients, students, or patients with this knowledge?

You must use a minimum of one peer-reviewed and/or scholarly source that was published within the last five years, documented in APA style, as outlined in the Ashford Writing Center. Your post should be a minimum of 250 words. You may cite and reference your textbook, required or recommended reading, or multimedia, but these will not fulfill the source requirement.

Make sure to use terminology from the DSM-5 for psychological/behavioral health conditions and current terminology from professional sources for neurological conditions. Please be sure to access the DSM-5 directly in our library. For further information view The DSM-5: Accessing and Using the DSM-5 in the Ashford University Library (Links to an external site.) screencast on how to access and use this resource, and how to cite and reference the DSM-5.

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Option B

Complete the following:

· Evaluate one of the sleep disorders covered this week.

· Explain theories of etiology (causation), including the neuroanatomical structures, neurotransmitter/receptor systems, and the functional nervous system (neural) pathways involved.

o Include an analysis of the contribution of genetics, environment, and lifestyle to the development and natural history of the condition.

o Provide information regarding diagnostic criteria and evaluate options for care interventions (both pharmacological and nonpharmacological).

o Be sure to identify the neuroanatomical structures and any neurotransmitter/receptor systems involved. Neurological Functional Pathways Assignment

· Also in your discussion, imagine you are in a career position that utilizes a degree in psychology, including but not limited to that of a social worker, teacher or teacher’s aide, child care worker, psychiatric technician or other behavioral health staff, peer support specialist, social service specialist, probation or parole officer, case manager, or counselor.

o How would your knowledge of the neurobiology of sleep disorders or disorders of consciousness help you in your professional life?

o Would you be able to better assist your clients, students, or patients with this knowledge?

You must use a minimum of one peer-reviewed and/or scholarly source that was published within the last five years, documented in APA style, as outlined in the Ashford Writing Center. Your post should be a minimum of 250 words. You may cite and reference your textbook, required or recommended reading, or multimedia, but these will not fulfill the source requirement.

Make sure to use terminology from the DSM-5 for psychological/behavioral health conditions and current terminology from professional sources for neurological conditions. Please be sure to access the DSM-5 directly in our library. For further information view The DSM-5: Accessing and Using the DSM-5 in the Ashford University Library (Links to an external site.) screencast on how to access and use this resource, and how to cite and reference the DSM-5.

Guided Response: Respond substantively to a minimum of two of your classmate’s original posts, preferably those who discussed different disorders than you. Address the disorder, neurotransmitter and receptor systems, or neuroanatomical structures involved in the disorder, and the research analysis of your classmate. In addition, please observe the following guidelines for all responses:

· Provide a courteous and interactive learning environment.

· Continue to monitor the discussion board throughout the active learning week and reply to anyone (instructor or classmate) who has chosen to respond to your original post.

· Your responses should address (at minimum) the disorder, neurotransmitter/receptor systems and/or/ neuroanatomical structures involved in the disorder, care interventions, and the research analysis of your classmate.

· Each response should demonstrate that you have read the existing replies on the board (in your response, mention information and viewpoints already expressed by existing responses to the same post). Neurological Functional Pathways Assignment