Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives

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Discuss the access, cost, and quality of quality environments, as well as recent quality initiatives (See Chapter 24 and Table 24.1). Student is to reflect on the relationship between quality measures and evaluation and role development. In addition, describe this relationship and note how the role of the APN might change without effective quality measures.ExpectationsLength: 1500 words, double-spaced, excluding title and reference pages (required)Format:  APA 7th Edition

Discussion replies

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Read other students’ posts and respond to at least two of them. In addition to other comments you may have, address the following questions in your response posts:Do you believe the presentation of each perspective is well-disciplined? Why or why not?How does one’s discipline influence your interpretation of an argument?Use any personal experience if appropriate to help support or debate other students’ posts. If differences of opinion occur, debate the issues professionally and provide examples to support your opinions.

NU500-8B-Unit 4 Assignment Theory Evaluation Paper

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InstructionsThe purpose of the Theory Evaluation Paper is to help you critically evaluate a middle-range nursing theory. This assignment will be completed using the three stages of the theory evaluation process:  Theory Description, Theory Analysis, and Theory Evaluation.Select a Middle-Range Nursing Theory- Select one specific middle-range nursing theory from your textbook that best suits your area of practice. (Ex. Pender’s Health Promotion Model, Kolcaba’s Comfort Theory, Beck’s Postpartum Depression Theory, etc.)APA Student Title Page- (No Abstract Needed)Include the following information on the Student title page in 7th APA format:Assignment name in Bold Font: (Ex. Theory Evaluation Paper: Swanson’s Theory of Caring)Skip a LineYour NameName of UniversityCourse Number and NameInstructor’s NameDate of Submission (Month, Day, Year)Introductory paragraph Capture the reader’s attention (ex. Grabbing statistics) and discuss the rationale for selecting the specific nursing theory for your area of nursing over other nursing theories (Do not write in first person; Include a purpose/thesis statement of what you will describe in the paper as the last sentence of the introductory paragraph.) Next, begin the Body of Paper.Theory Description (Level 1 Header)Purpose (Level 2 Header); (Designate as Descriptive, Explanatory, Predictive, or Prescriptive;  Include Scope-middle-range)Concepts (Level 2 Header); (Introduce and list main concepts)Definitions (Level 2 Header); (Define concepts and other important aspects)Relationship (Level 2 Header); (Describe relationship among concepts)Structure (Level 2 Header); (Describe; Is there a diagram of structure?)Assumptions (Level 2 Header); (beliefs, propositions of the theory)5.  Theory Analysis (Level 1 Header)Theory’s Origin (Level 2 Header); (historical creation and evolution of theory)Unique Focus (Level 2 Header); (distinctive views)Content (Level 2 Header); (include definitions of metaparadigm concepts of person, environment, health, and nursing)6.  Theory Evaluation (Level 1 Header)Significance (Level 2 Header); (usefulness, social significance, cultural significance)Comprehensiveness (Level 2 Header); (of the content, thoroughness, utility)Logical Congruence (Level 2 Header); (consistency and clarity of theory; consistent use of concepts throughout the literature)Credibility (Level 2 Header); (legitimacy, empirical support through research)Contribution to Nursing (Level 2 Header); (usefulness to nursing practice, education, and research)7.  Conclusion (Level 1 Header) Conclusion paragraph with concluding statements to summarize the content and re-state or re-phrase the purpose/thesis statement.8.  APA Reference Page- Please be sure to support your paper with in-text citations. Please use 5 peer-reviewed resources.Additional Instructions: Your assignment should be typed into a Word or other word processing document, formatted in APA style. Paper should be a minimum of 4-5 pages in length, excluding the title and references pages.  You may increase the number of pages of the body of the paper up to 7-8 pages if needed.  This is a scholarly paper and should not be written in first person.  Paragraphs should have a minimum of 3 sentences.  Paraphrasing should be done using in-text citations.  Direct quotes should be rare and used only when the content can be said in no other way. If using direct quotes, you must include page or paragraph number.Unit 4 Required ResourcesMcEwen, M. & Wills, E. (2019). Theoretical basis for nursing (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. ISBN 9781496351203.Chapters 17 and 21Chinn, P. & Kramer, M. (2018) Knowledge development in nursing: Theory and process (10th ed.). St. Louis, MO:  Elsevier. ISBN 9780323530613Chapter 8Toolshero. (2019).Authentic leadership (Links to an external site.). [Website]. Retrieved from https://www.toolshero.com/leadership/authentic-leadership/Toolshero. (2019).Leadership (Links to an external site.). [Website]. Retrieved from https://www.toolshero.com/leadership/Clavelle, J.T., DNP, RN, NEA-BC, FACHE, & Prado-Inzerillo, M., DNP, RN, NEA-BC. (2018, November).Inspire others through transformational leadership (Links to an external site.).  American Nurse Today, 13(11).  [Website]. Retrieved from https://www.americannursetoday.com/inspire-transformational-leadership/Greenleaf Center for Servant Leadership.  (2016).What is servant leadership (Links to an external site.)?  [Website]. Retrieved from https://www.greenleaf.org/what-is-servant-leadership/American Psychological Association. (2020). Publication manual of the American Psychological Association (7th ed.). https://doi.org/10.1037/0000165-000PresentationsPlease view the following two videos or powerpoint presentations.  They are offered in two formats for your viewing preference.Leadership Theoriesdownload[Powerpoint presentation]Module 4.1 Notes Leadership Theorydownload[Narrative Script Word Doc]Leadership Theories in Practicedownload[Powerpoint presentation]Module 4.2 Notes In Practicedownload[Narrative Script Word Doc]WebsitesAONL (Formerly AONE). (2019).Certified in Executive Nursing Practice Certification (Links to an external site.). [Website]. Retrieved from https://www.aonl.org/initiatives/cenpANCC (NL). (n.d.).Nurse Executive Certification (NE-BC) (Links to an external site.). [Website]. Retrieved from https://www.nursingworld.org/our-certifications/nurse-executive/

Discussion: Decision Making When Treating Psychological Disorders.

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PLEASE FOLLOW THE INSTRUCTIONS AS INDICATED BELOW:1). ZERO (0) PLAGIARISM2). ATLEAST 5 REFERENCES, NO MORE THAN 5 YEARS3).  PLEASE SEE THE ATTACHMENT FOR RUBRIC DETAILS.4). Please review and follow the grading rubric details well, and include each component in the assignment as required. Also, follow the APA writing rules and stylePsychological disorders, such as depression, bipolar, and anxiety disorders can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.  For this Discussion, you will select an interactive media piece to practice decision-making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology.To PrepareReview this week’s interactive media pieces and select one to focus on for this Discussion.Reflect on the decision steps in the interactive media pieces, and consider the potential impacts from the administration of the associated pharmacotherapeutics on the patient’s pathophysiology.Post a brief explanation of the psychological disorder presented and the decision steps you applied in completing the interactive media piece for the psychological disorder you selected. Then, explain how the administration of the associated pharmacotherapeutics you recommended may impact the patient’s pathophysiology. How might these potential impacts inform how you would suggest treatment plans for this patient? Be specific and provide examples.Adult/Geriatric DepressionHispanic Male With MDDBACKGROUND INFORMATIONThe client is a 70 year-old Hispanic American male who came to the United States when he was in high school with his father. His mother died back in Mexico when he was in school. He presents today to your office for an initial appointment for complaints of depression. The client was referred by his PCP after “routine” medical work-up to rule out an organic basis for his depression. He has no other health issues with the exception of some occasional back pain and “stiff” shoulders which he attributes to his current work as a laborer in a warehouse.SUBJECTIVEDuring today’s clinical interview, client reports that he always felt like an outsider as he was “teased” a lot for being “black” in high school. States that he had few friends, and basically kept to himself. He describes his home life as “good.” Stating “Dad did what he could for us, there were 8 of us.” He also reports a remarkably diminished interest in engaging in usual activities, states that he has gained 15 pounds in the last 2 months. He is also troubled with insomnia which began about 6 months ago, but have been progressively getting worse. He does report poor concentration which he reports is getting in “trouble” at work.MENTAL STATUS EXAMThe client is alert, oriented to person, place, time, and event. He is casually dressed. Speech is clear, but soft. He does not readily make eye contact, but when he does, it is only for a few moments. He is endorsing feelings of depression. Affect is somewhat constricted, but improves as the clinical interview progresses. He denies visual or auditory hallucinations, no overt delusional or paranoid thought processes readily apparent. Judgment and insight appear grossly intact. He is currently denying suicidal or homicidal ideation. You administer the “Montgomery- Asberg Depression Rating Scale (MADRS)” and obtained a score of 51 (indicating severe depression).RESOURCES§ Montgomery, S. A., & Asberg, M. (1979). A new depression scale designed to be sensitive to change. British Journal of Psychiatry, 134, 382-389.Decision Point OneDecision Point OneSelect what you should do:Begin zoloft 25 mg orally dailyRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksReports a 25% decrease in symptomsClient is concerned over the new onset of erectile dysfunctionDecision Point OneBegin Effexor XR 37.5 mg orally dailyRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksClient reports that there is no change in depressive symptoms at allDecision Point OneBegin Phenelzine 15 mg orally TIDRESULTS OF DECISION POINT ONEClient returns to clinic in four weeksClient reports that he was rushed to the Emergency Room 2 weeks ago after collapsing at the warehouse where he works. He was taken by ambulance to the local community hospital. He was diagnosed with postural hypotensionClient was treated with fluid bolus and told to stop taking his phenelzine and to follow up with his primary care provider within one week, and you within that same time frame.Decision Point TwoSelect what you should do next:Decision Point TwoRestart Phenelzine and counsel client on dietary choices and importance of hydrationRESULTS OF DECISION POINT TWOClient reports that although he had no more episodes of passing out, he has been dizzy when he gets up at night to use the bathroomClient also reports that at various times throughout the day when he goes from a sitting to a standing position, he feels light-headedDecision Point TwoPhenelzine is not reinitiated. Instead, we began therapy with Lexapro 20 mg orally daily after an appropriate “wash out” period (5 half-lives).RESULTS OF DECISION POINT TWOClient returns to clinic in four weeksClient had no more syncopal episodes or episodes of orthostatic hypotensionClient reports a decrease in depressive symptoms by approximately 25 percent on the MADR scaleDecision Point TwoRe-start Phenelzine 7.5 mg orally TIDRESULTS OF DECISION POINT TWOClient returns to clinic in four weeksClient reported that he still has a little dizzinessClient also reports that that his depression has improved greatly (a 35% decrease in MADR scale from 51 to 33)Decision Point ThreeSelect what you should do next:Decision Point ThreeContinue current drug dose and counsel client on dietary modifications and orthostatic hypotension safetyGuidance to StudentThe initiation of an SSRI or SNRI should not begin until an adequate “wash out” period of MAOI- this is generally defined as the time it takes for 5 half-lives of the drug to be metabolized. Co-administration of SSRI, SNRI, or TCA with MAOI is contraindicated as it can cause serotonin syndrome and can actually be fatal. You can continue the current dose and counsel client as to dietary modifications as well as orthostatic hypotension safety, however, it should be remembered that he works in a warehouse and may be at risk for falls/injury due to orthostatic hypotension. A “watch and wait” approach may be appropriate if the client has failed all other antidepressants. Increasing the dose back to 15 mg orally TID is not indicated as his orthostatic hypotension will likely worsen.

NR283 Pathophysiology

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Week 3: Discussion: Skin and Respiratory System DisordersThe initial post must include responses to all the questions in this discussion.Ebook: Gould’s Pathophysiology for the Health Professions, 6e 6th EditionMr. J, age 42, is a construction worker in Las Vegas who lives with his daughter and grandson, Sammy. He recently noticed that a mole on his face seemed to be getting larger and darker. At first, he did not worry because he was in the sun a lot and assumed the change may have been caused by sunburn. After a month, not only was the mole larger and darker, but it appeared to be “bumpy.” His doctor diagnosed a malignant melanoma skin cancer following a biopsy of the nevus. Mr. J reports pain in his right shin that does not go away when he puts his feet up or sleeps.Discussion QuestionsRelate Mr. J’s skin changes to the warning signs for malignant melanoma.Discuss the normal progression of this malignancy. What is the significance of the bone pain that Mr. J is experiencing?Discuss the treatment available for this patient and the prognosis for recovery.Discussion QuestionsMr. J is babysitting his grandson Sammy, age 3 years, who ate his dinner and then said his tummy hurt. Mr. J suggested he lie down in the adjacent room while his parents finished dinner. A few minutes later, Mr. J heard Sammy vomiting. He rushed in to lift Sammy up. When vomiting ceased, he noticed Sammy continued to cough and seemed to be choking. He was struggling to breathe, and a wheezing sound was obvious. It appeared that he had aspirated some vomitus. Mr. J drove him to a nearby hospital for examination.Discuss the specific effects of aspirating vomitus on Sammy, including the probable effects on his bronchi and lungs. Why might one lung be affected more than the other?Discuss the pathophysiologic changes causing the signs and symptoms and any tests required to clarify the effects on Sammy.Suggest some reasons for Sammy’s difficulty breathing and wheezing.Discuss the potential complications of aspiration of vomitus.GUIDELINESWeekly OutcomesArticulate alterations in structure and function of the respiratory and integumentary systems. (CO 1)Trace the impact that alterations in the respiratory and integumentary systems have on the body. (CO 2)Summarize the impact of alterations in the respiratory and integumentary systems on homeostasis. (CO 3)Main Topics and ConceptsAlterations in the respiratory system: OxygenationPathological processes in structures and functionsCancers of the respiratory systemPathophysiologic respiratory system response to agingGenetic influences on respiratory system pathology2. Alterations in the integumentary system (skin disorders)Pathological processes of the integumentary systemCancers of the integumentary systemGenetic influences on the integumentary systemWeekly ObjectivesUnderstand normal respiratory and integumentary system disorders.Compare and contrast common respiratory and integumentary disorders: causes, clinical manifestations, diagnostic tests, and treatments.Apply understanding of alterations in respiratory and integumentary systems across the lifespan to formulate care priorities.Examine responses to aging and its impact on pathophysiologic changes in the respiratory and integumentary systems.Describe how heredity and genetics influence pathophysiological alterations in the cardiovascular and integumentary systems.Examine factors leading to cancers of the respiratory and integumentary systems.Sub-Concepts with ExemplarOxygenation: Upper (Infectious Rhinitis) respiratory condition; Lower respiratory conditions (Pneumonias); atelectasis; pneumothoraxGenetics: Cystic fibrosis and congenital heart defects/anomaliesAcid-Base Imbalance: Arterial blood gasesAcute versus Chronic conditions: Infant Respiratory Distress Syndrome (IRDS), Adult Respiratory Distress Syndrome (ARDS), and Asthma (single episode), Chronic Obstructive Pulmonary Disease (COPD)Cellular adaptation: Lung cancerImmunity: Inflammatory skin disordersInfection: wounds; abscess; viral and fungal rashesInflammation: skin infection; skin irritationAPA format (6th ed.) and is free of errorsGrammar and mechanics are free of errors free of PlagiarismReferences: Use your book, the outside source must be within the last 5 yrs, Scholarly Articles,s or Nurse journals within the last 5 yrs.

MN552 SOAP Note: Advanced practice nursing assessment

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No plagiarism please.  I have half the work completed, I will attach what I’ve done to serve as reference.Comprehensive SOAP NoteThis Assignment will help develop skills to perform an integrated history and physical examination for individuals across the lifespan.Considerations of lifestyle practices, cultural/ethnic differences, and developmental variations will be incorporated into the plan of care.Use critical thinking and diagnostic reasoning skills to formulate differential diagnoses, medical diagnoses, and an evidence-based action plan.Include sections 1 and 2 of the SOAP note with recommendations (incorrect or omitted data) based on feedback provided for the previous sections of the SOAP note.Click here for the written guide for the Comprehensive SOAP Note.

Mother and daughther: a cultural tale

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Mother and daughther: a cultural tale

End of life care discussion board

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Share with your classmates a time when you cared for a patient at the end of their life.

Future Considerations for the APN Role

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Please see attachment for Instructions

WK3 NRNP 6645

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USE 5 RESOURCES