NR631 Q-2 PICOT

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PurposeClear identification of the problem or opportunity is the first step in evidence-based nursing. In a previous course, you identified a practice problem of interest and developed a PICOT question. This assignment is a review of PICOT with the opportunity to revise or refine it. You will post your PICOT in the Week 1 Discussion for your classmates to review and provide feedback.Due date: Sunday at 11:59 PM MT at the end of Week 1Students are given the opportunity to request an extension on assignments for emergent situations. Supporting documentation must be submitted to the assigned faculty. If the student’s request is not approved, the assignment is graded and a late penalty is applied as follows:Monday = 10% of total possible point reductionTuesday = 20% of total possible point reductionWednesday = 30% of total possible point reductionIf the student’s request is approved, the student will be informed of the revised due date. Should the student fail to meet the revised due date, the assignment is graded and a late penalty is applied as follows:Monday = 10% of total possible point reductionTuesday = 20% of total possible point reductionWednesday = 30% of total possible point reductionCourse OutcomesThis assignment enables the student to meet the following Course Outcome (CO):CO 2: Using current knowledge, standards of practice, and research from evidence-based literature, synthesize a foundation for the nurse executive role. (PO 3,4)Total Points Possible: 50RequirementsDescription of the AssignmentUse the PICOT worksheet found above to complete the Week 1 Assignment PICOT Worksheet.Step 1: State your PICOT question. This should be the PICOT question that you previously developed in NR505 and which you should have continued to build upon in the Nurse Executive track courses. If your PICOT question has changed since NR505, please note the changes in this section so it’s clear to the instructor what was original and what has been updated.Step 2: Clearly define your PICOT question. List each element: P (problem, population, or problem), I (intervention), C (comparison with other treatment or current practice), O (desired outcome), and T (time frame). Is the potential solution something for which you (as nurse or student) can find a solution through evidence research? Look in your book for guidelines to developing your PICOT question and also read the required articles.Step 3: Describe the issue or problem that will be the focus of your CGE evidence-based practice change project. What have you noticed in your work or school environment that isn’t achieving the desired patient or learning outcomes? What needs to change in nursing, what can you change with the support of evidence in the literature?Step 4: How was the practice issue identified? How did you come to know this was a problem in your clinical practice? Review the listed concerns and check all that apply.Step 5: What terms did you use in order to make sure your search is wide enough to obtain required information but narrow enough to keep it focused? How will you narrow your search if needed?Criteria for ContentAccess the PICOT worksheet found above.Follow the instructions on the PICOT worksheet and complete the form.Submit the completed PICOT worksheet form.Example 1What is the PICO(T) question?Will influenza immunization compliancy rates increase if flu clinics are provided in flu PODS and immunization clinics at convenient times that cover all shifts?Define each element of the question below.P (patient, population, or problem): Require hospital employees and volunteers to have the influenza immunization annually.I (intervention): Offer multiple flu PODS and immunization clinics to hospital employees and volunteers, making it convenient to receive the required immunization. Offer these at a variety of times, available to all shifts.C (comparison with other treatment or current practice): Compare analytics showing employees and volunteers who received flu shots prior to 2016, when flu PODS and immunization clinics were not offered, to 2016, when flu PODS and immunization clinics are offered to accommodate shifts. Track the number of employees or volunteers coming at each time frame.O (desired outcome): The desired outcome is increased employees and volunteer compliance with the flu shot policy.Example 2What is the PICO(T) question?For nondiabetic patients on corticosteroid therapy, does monitoring for headache, fatigue, nausea, vomiting, and blurred vision hourly versus not observing for signs of hyperglycemia promote improvement of pulmonary complications?Define each element of the question below.P (patient, population, or problem): nondiabetic patients on corticosteroid therapyI (intervention): monitoring for headache, fatigue, nausea, vomiting, and blurred visionC (comparison with other treatment or current practice): no observations for signs of hyperglycemiaO (Desired outcome): improvement of pulmonary complicationsT (time): 90 days

Case Study Putting it all Together

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InstructionsAfter having read Chapters 1-3 and reviewed the learning materials for this week, please complete the following case study. Remember that your answers may be combined with medical terminology, but they must be defined and explained in physiological terminology.Mrs. K.B. is age 64 and has been a patient of yours for many years. You are calling her today to tell her the results of her Pap test which was done last week during her routine annual checkup in your office. The test showed marked dysplasia of cervical cells but no sign of infection. Unfortunately, when you call, there is no answer.Since you saw Mrs. K.B. last week she has had gastritis with severe vomiting for 3 days. She has a history of heart problems and is presently feeling dizzy and lethargic. Her eyes appear sunken, her mouth is dry, she walks unsteadily, and she complains of muscle aching, particularly in the abdomen, and she is concerned about her chronic back pain as well and how she is going to handle her pain if she can’t keep her medication down. She is thirsty but is unable to retain food or fluid. A neighbor has brought Mrs. K.B. to the hospital, where examination shows that her blood pressure is low, and her pulse and respirations are rapid. Laboratory tests demonstrate elevated hematocrit, hypernatremia, decreased serum bicarbonate, serum pH 7.35, and urine of high specific gravity. This case study illustrates a combination of fluid, electrolyte, and acid-base imbalances. Specific laboratory values are not given to focus on the basic concepts. For clarity, this case study is discussed in multiple parts. Further information about the specific problems involved is given in each part and is followed by a series of questions.Part 1Later in the afternoon, you receive a phone call from Mrs. K.B.’s daughter Sara who tells you that she has been admitted to the hospital with vomiting. Sara is asking about her mother’s test results. Please answer the following questions regarding your conversation with Sara.Sara is requesting her Mother’s test results and she seems to know that her Mom had a Pap test last week. Sara is really concerned because her Mom had an abnormal Pap test a few years ago and her sister also has a history of Ovarian Cancer. How do you handle this conversation with Sara?In thinking about how you might discuss these results with Mrs. K.B. or Sara, explain how each of these terms might apply to this scenario: prognosis, latent stage, remission, exacerbations, and predisposing factors.Explain cellular adaptations and in particular, dysplasia and how testing and or additional testing is done regarding this condition.Part 2: Day 1Initially, Mrs. K.B. lost water, sodium in the mucus content, and hydrogen and chloride ions in the hydrochloric acid portion of the gastric secretions.Alkalosis develops for two reasons, the first being the direct loss of _______________ ions, and the second being the effects of chloride ion loss. When chloride ions are lost in the gastric secretions, it is replaced by chloride from the serum (See Fig. 2.9 in Chapter 2 of your Gould text). To maintain equal numbers of cations and ____________ in the serum, chloride ions, and bicarbonate ions can exchange places when needed. Therefore, more bicarbonate ions shift into the serum from storages sites in the _______________ to replace the lost chloride ions. More bicarbonate ions in the serum raise serum pH, and the result is hypochloremic alkalosis.Which compartments are likely to be affected in this case by early fluid-loss?Explain how a loss of sodium ions contributes to dehydration.Describe the early signs of dehydration in Mrs. K.B.Describe the compensations for the losses of fluid and electrolytes that should be occurring in Mrs. K.B.Explain why Mrs. K.B. may not be able to compensate for losses as well as a younger adult.Part 3: Days 2-3As Mrs. K.B. continues to vomit and is still unable to eat or drink any significant amounts, loss of the duodenal contents, which include intestinal, pancreatic, and biliary secretions, occurs. No digestion and absorption of any nutrients occurs.Losses at this stage include water, sodium ions, potassium ions, and bicarbonate ions. Also, intake of glucose and other nutrients is minimal. Mrs. K.B. shows elevated serum sodium levels.Sara has been at the hospital all morning waiting for the provider to come by with an update. Sara is rubbing her Mom’s back and she continues to complain back pain.Explain why serum sodium levels appear to be in high in this caseExplain how high serum sodium levels might affect the intracellular fluidUsing your knowledge of normal physiology, explain how continued fluid loss is likely to affect the following:Blood volumeCell functionKidney functionGiven Mrs. K.B.’s history, why might a potassium imbalance have more serious effects on her?As the provider, when you enter the room, you find Sara rubbing her Mom’s back – you introduce yourself and what is the first thing that you would then need to do?In regard to Mrs. K.B.’s back pain, what type of questions or history would you like to obtain?Mrs. K.B. reports using herbal compresses at home to help her back pain and that she usually takes two “extra-strong” Acetaminophen tablets every 4 hours and a Tylenol #3 whenever the pain is severe. Sara states that she has tried to get her Mom to use “more natural” treatments for her back but she “loves her Tylenol.”When considering sources for Herbal and Natural Remedies there are many to choose from but not all are FDA approved, and who has time to vet every website. Take a look atNatural Medicines, which is in the Research Guides at the Regis Library. What type of Natural Medicine treatment would you recommend for Mrs. K.B. knowing that her back pain is due to arthritis that was diagnosed 10 years prior, that could offer her relief from her back pain?What should Mrs. K.B. and Sara understand about the dosage of acetaminophen that she is taking?Finally, Sara commented that her Mom seems to be suffering more frequently from insomnia but claims that her medication controls her back pain. Could the Tylenol #3 tablets be interring with her sleep and if so how is this occurring?Part 4: Day 3Mrs. K.B. has spent the night in the ED due to a bed shortage and she is finally admitted to Med-Surg.After a prolonged period of vomiting, metabolic acidosis develops. This change results from several factors.Loss of bicarbonate ions in duodenal secretionsLack of nutrients leading to ______________ of stored fats and protein with production of excessive amounts of ketoacidsDehydration and decreased blood volume leading to decreased excretion of acids by the __________________Decreased blood volume leading to decreased tissue perfusion, less oxygen to cells, and increased _________________ metabolism with increased lactic acid.Increased muscle activity and stress leading to increased metabolic acid production.These factors lead to an increased amount of acids in the blood, which bind with bicarbonate buffer and result in decreased serum bicarbonate and decreased serum pH or metabolic _________________.List several reasons why Mrs. K.B. is lethargic and weak.Predict the serum level of carbon dioxide, lactic acid, pH, pO2, K+, Na+, LFTs—note you should indicate low, normal or high and explain why in a brief sentence to indicate you understand the pathophysiology of the process.If Mrs. K.B. continues to lose body fluid, why might serum pH decrease below 7.35?If serum pH drops below 7.35 what signs would be observed in Mrs. K.B.Describe the effect of acidosis on serum potassium levels.Mrs. K.B. will be given replacement fluid therapy. Why is it important that sodium and potassium be given as well as water?Case Study RubricNote: Scholarly resources are defined as evidence-based practice, peer-reviewed journals; textbook (do not rely solely on your textbook as a reference); and National Standard Guidelines. Review assignment instructions, as this will provide any additional requirements that are not specifically listed on the rubric.Case Study Rubric – 100 PointsCriteriaExemplaryExceeds ExpectationsAdvancedMeets ExpectationsIntermediateNeeds ImprovementNoviceInadequateTotal PointsContent of Case StudyThe writer demonstrates a well-articulated understanding of the case study subject matter in a clear, complex, and informative manner. The case study content and theories are well developed and linked to the course content, assignment requirements, and practical experience. The case study includes relevant material that fulfills all objectives of the assignment.Cites three or more references, using at least one new scholarly resource that was not provided in the course materials.30 pointsThe writer demonstrates an understanding of the subject matter, and the components of the case study are accurately represented with evidence-based practice, ethics, theory, and/or role content. Course materials and scholarly resources are present to support required concepts. The paper includes relevant material that fulfills all objectives of the case study.Cites two references.26 pointsThe writer demonstrates a moderate understanding of the subject matter, as evidenced by components of the case study and use of evidence-based practice, theory, or role-development. Course content is present but missing depth and/or development.Cites only one reference.23 pointsAbsent application to evidence-based practice, theory, or role development.Demonstrates incomplete understanding of content and/or inadequate preparation.Significant content of case study is vague, inaccurately portrayed, or missing.No references cited.Submits assignment late.20 points30Analysis and Synthesis of Case Study Content and MeaningThrough critical analysis, the submitted case study provides an accurate, clear, concise, and complete summary of the scenario.Information from scholarly resources is synthesized, providing new information or insight related to the context of the assignment by providing both supportive and alternative information or viewpoints.All instruction requirements noted.30 pointsCase study is complete, providing evidence of further synthesis of course content via scholarly resources.Information is synthesized to help fulfill the case study requirements. The content supports at least one viewpoint.Submission provides clarification of the assignment by correctly answering all posed questions within the instructions.All instruction requirements noted.26 pointsLacks clarification or new information. Scholarly reference supports the content without adding any new information or insight. Case study content may be confusing or unclear, and the summary may be incomplete.Most instruction requirements are noted.23 pointsSubmission is primarily a summation of the assignment without further synthesis of course content or analysis of the scenario.Demonstrates incomplete understanding of content and/or inadequate preparation.Missing some instruction requirements.Submits assignment late.20 points30Application of KnowledgeThe summary of the case study provides information validated via scholarly resources that offer a multidisciplinary approach to the scenario provided.The student’s application in practice is accurate and plausible, and additional scholarly resource(s) supporting the application are provided.All questions posed within the assignment are answered correctly in a well-developed manner, applying knowledge with citations for validation.All instruction requirements noted.30 pointsA summary of the study, findings, and knowledge gained from the assignment is presented.Student indicates how the information will be used within their professional practice.All questions posed within the assignment are answered within the case study. The answer to one question may be vague and/or limited in development, but as a whole all answers are correct.All instruction requirements noted.26 pointsObjective criteria are not clearly used, allowing for a more superficial application of knowledge between the assignment and the broader course content.One question is answered incorrectly and/or two case study answers are vague or limited in development but remain correct.Student’s indication of how they will apply this new knowledge to their clinical practice is vague.Most instruction requirements are noted.23 pointsThe application of knowledge is significantly lacking.Demonstrates incomplete understanding of content and/or inadequate preparation.Student’s indication of how they will apply this new knowledge to their clinical practice is not practical or feasible.Application of knowledge is incorrect and/or student fails to explain how the information will be used within their personal practice.Multiple questions are not answered or are answered incorrectly (e.g., two questions answered incorrectly, or three case study answers are vague or limited in development but remain correct).Missing some instruction requirements.Submits assignment late.20 points30OrganizationWell-organized content with a clear and complex purpose statement and content argument. Writing is concise with a logical flow of ideas.5 pointsOrganized content with an informative purpose statement, supportive content, and summary statement. Argument content is developed with minimal issues in content flow.4 pointsPoor organization and flow of ideas distract from content. Narrative is difficult to follow and frequently causes reader to reread work. Purpose statement is noted.3 pointsIllogical flow of ideas. Prose rambles. Purpose statement is unclear or missing.Demonstrates incomplete understanding of content and/or inadequate preparation.No purpose statement.Submits assignment late.2 points5APA, Grammar, and SpellingCorrect APA formatting with no errors.The writer correctly identifies reading audience, as demonstrated by appropriate language (avoids jargon and simplifies complex concepts appropriately).Writing is concise, in active voice, and avoids awkward transitions and overuse of conjunctions.There are no spelling, punctuation, or word-usage errors.5 pointsCorrect and consistent APA formatting of references, and cites all references used. No more than two unique APA errors.The writer demonstrates correct usage of formal English language in sentence construction. Variation in sentence structure and word usage promotes readability.There are minimal to no grammar, punctuation, or word-usage errors.4 pointsThree to four unique APA formatting errors.The writer occasionally uses awkward sentence construction or overuses/inappropriately uses complex sentence structure. Problems with word usage (evidence of incorrect use of thesaurus) and punctuation persist, often causing some difficulties with grammar. Some words, transitional phrases, and conjunctions are overused.Multiple grammar, punctuation, or word usage errors.3 pointsFive or more unique formatting errors, or no attempt to format in APA.The writer demonstrates limited understanding of formal written language use; writing is colloquial (conforms to spoken language).The writer struggles with limited vocabulary and has difficulty conveying meaning such that only the broadest, most general messages are presented.Grammar and punctuation are consistently incorrect. Spelling errors are numerous.Submits assignment late.2 points5Total Points100

Critical Reflection Paper

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Critical Reflection Paper: Chapter 9Objective: To critically replicate you’re thoughtful of the readings and your competence to rub on them to your Health care ethics.ASSIGNMENT GUIDELINES (10%):Students will judgmentally appraise the readings from Chapter 9 on your textbook. This assignment is intended to help you assessment, examination, and spread over the readings to your healthcare ethics as well as become the foundation for all of your remaining assignments.You need to read the article (in the additional weekly reading resources localize in the Syllabus and also in the Lectures link) assigned for week 1 and develop a 2-3-page paper reflecting your appreciative and ability to apply the readings to your ethics. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA format 7th Edition, when referring to the selected articles and include a reference page.EACH PAPER SHOULD INCLUDE THE   FOLLOWING:1.Introduction (25%)Provide a short-lived summary of the undertone (not a description) of each Chapter and articles you read, in your own words.2.Your Critique (50%)*What is your response to the content of Chapter 9?*What did you absorb about Ethics and Safe patient handling? Mention and explain two examples where you can apply them.* What are the ethics arguments for advocacy on SPHM programs and behaviors?*For the Professional role you have right now: what are the implications of this chapter for you?3.Conclusion (15%)Fleetingly recapitulate your thoughts & postulation to your analysis of the articles and Chapter you read. How did these articles and Chapters impact your thoughts about the principles of ethics?Evaluation will be based on how clearly you respond to the above, in particular:a) The clarity with which you critique the articles;b) The depth, scope, and association of your paper; and,c) Your conclusions, including a description of the impact of these articles and Chapters on any Health Care Setting.

Discuss how the levels of prevention help determine educational needs for a patient.

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Compare and contrast the three different levels of health promotion (primary, secondary, tertiary). Discuss how the levels of prevention help determine educational needs for a patient.

SCHOLARLY PAPER: Dorothy Johnson’s Behavioral System Model (24 Hours)

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1) Minimum 5 full pages (No words)2)¨******APA norms (Mandatory)All paragraphs must be narrative and cited in the text- each paragraphsBulleted responses are not acceptedDont write in the first personDont copy and pase the questions.Answer the question objectively, do not make introductions to your answers, answer it when you start the paragraph3) It will be verified by Turnitin and SafeAssign4) Minimum  6 references not older than 5 years5)***************Identify your answer with the numbers, according to the question.Example:Q 1. Nursing is XXXXXa) Accordinto XXXXQ 2. Health is XXXXa)  These are the issues that arise_____________________________________________________________Dorothy Johnson’s Behavioral System Model1)Introduction (1/2 page)a) Identification of theorist including a brief background of the theorist (accomplishments, career, accolades, research efforts)2)Analysis of basic components/concepts and major relationships in the theory (Minimum 2 pages)a) Briefly discuss the theory’s core conceptsb) Use asecondary sourcethat covers the selected nursing theory, you must have a minimum of 3 references from nursing literature (only one from a non-article source like a secondary source/text) to support your discussion in this section.3)Relevance (Minimum 2 pages)a)  Personal relevance if any of the authors described (connect the theorist to the theory)b) Relevance to healthcare and the client discussed (connect the theory to healthcare today)c) Application to research and/or practice provided (connect the theory to current research/practice)d) Use at least two peer-reviewed/research articles that detail the nursing theory being applied in clinicale) Practice/research, and summarize key findings of both articles including results and implications for future practice4)  Summary (1/ 2 page)Include theory strengths and limitation in the summar

Week 7: Signature Assignment – Theory of Human Caring on APN Role Student Presentation

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Assignment PromptExplore the influence of Jean Watson’s Theory of Human Caring on your future role as an APN. The student will explore the concepts and caritas processes from the Theory of Human Caring and present how these concepts may impact their future APN role.Directions:The student will create a PowerPoint and includespeaker notesthat may be added to the speaker note section on each slide.The presentation should be limited to no more than 10 slides. See suggested slides below.If you are unfamiliar with Dr. Watson’s theory see this overview.A suggested outline for the presentation may include the following slides:Slide 1 – Introduction to yourself and future planned APN role and practiceSlide 2 – Previous experience with Watson’s Theory of Human CaringSlide 3 – Core Concepts of the Theory Applicable to the APN roleSlide 4 – Core Concepts of the Theory Applicable to the APN role (as needed)Slide 5 – Five Carative Factors or Caritas Processes You Plan to Use in the APN RoleSlide 6 – Five Carative Factors or Caritas Processes You Plan to Use in the APN Role (as needed)Slide 7 – What Does the Theory of Human Caring Mean to YouSlide 8 – APN Implications of Theory of Human CaringSlide 9 – Summary/Main PointsSlide 10 – ReferenceExpectationsDue: Monday, 11:59 pm PTFormat: PPT Presentation with Speaker NotesLength: 10 Slides, maximumSave the file with Student First Name_Last Name_Watson_PresentationSee USU NUR Presentation Rubric for additional details and point weighting.

Assignment: Legislation Comparison Grid and Testimony/Advocacy Statement

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As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.To Prepare:Select a bill that has been proposed (not one that has been enacted) using the congressional websites provided in the Learning Resources.The Assignment: (1- to 2-page Comparison Grid; 1-page Legislation Testimony/Advocacy Statement)Part 1: Legislation Comparison GridBased on the health-related bill (proposed, not enacted) you selected, complete the Legislation Comparison Grid Template. Be sure to address the following:Determine the legislative intent of the bill you have reviewed.Identify the proponents/opponents of the bill.Identify the target populations addressed by the bill.Where in the process is the bill currently? Is it in hearings or committees?Part 2: Legislation Testimony/Advocacy StatementBased on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:Advocate a position for the bill you selected and write testimony in support of your position.Describe how you would address the opponent to your position. Be specific and provide examples.

Overview of Quality in Health Care

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The purpose of this assignment is to apply the concepts you have  learned in this course to a situation you have encountered. Choose one  quality or patient safety concern with which you are familiar and that  you have not yet discussed in this course. In a 1,250-1,500 word essay,  reflect on what you have learned in this course by applying the concepts  to the quality or patient safety concern you have selected. Include the  following in your essay:Briefly describe the issue and associated challenges.Explain how EBP, research, and PI would be utilized to address the issue.Explain the PI or QI process you would apply and discuss why you chose it.Describe your data sources, including outcome and process data.Explain how the data will be captured and disseminated.Discuss which organizational culture considerations will be essential to the success of your work.This assignment uses a rubric.This  assignment uses a rubric. Please review the rubric prior to beginning  the assignment to become familiar with the expectations for successful  completion.

Patricia Brenner theory

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1. Discuss the clinical narrative provided here using the unfolding case study format to promote situated learning of clinical reasoning (Benner, Hooper-Kyriakidis, & Stannard, 2011).2. Regarding the various aspects of the case as they unfold over time, consider questions that encourage thinking, increase understanding, and promote dialogue, such as: What are your concerns in this situation? What aspects stand out as salient? What would you say to the family at given points in time? How would you respond to your nursing colleagues who may question your inclusion of the family in care?3. Using Benner’s approach, describe the five levels of competency and identify the characteristic intentions and meanings inherent at each level of practice.

Pharmacology week 1 discussion

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For these questions, please read the following case study and then respond to the questions noted below.Ms. BD is a 33-year-old G2P1 African-American female who presents to your clinic today complaining of unusual fatigue, nausea, and vomiting for the last five days. She has a medical history of chronic hypertension (HTN) that was diagnosed shortly after her first pregnancy two years ago and GERD. MS. BD’s blood pressure is controlled on Lisinopril-Hydrochlorothiazide 20/12.5mg by mouth twice a day, and GERD controlled on Bismuth Subsalicylate 262mg by mouth every 6 hours as needed. During the interview, you learn that she is single, sexually active, has one partner and that her menses is ten days late. She performed a home pregnancy the three days after missing her menstrual cycle, and the results were inconclusive. She states she feels terrible and needs relief. She has no other medical problems, symptoms, or concerns.Assessment: Physical examination is unremarkable. BP128/68, HR is 74, Urine human chorionic gonadotropin (HCG) positive, beta HCG sent, potassium 4.2, bloodurea nitrogen (BUN) 14, creatinine is 0.6, Alanine aminotransferase (ALT) 29, White blood cells (WBCs) 6.5, hemoglobin (Hgb) 12.8, hematocrit (Hct) 39, and platelets 330,000.List the additional questions you would need to ask this patient. Explain.What is the safety profile of Lisinopril-hydrochlorothiazide and bismuth subsalicylate in pregnant women? What are the possible complications to the pregnant woman and her fetus?What is the importance of assessing laboratory values when prescribing medications? How might the laboratory values, in this case, impact your treatment plan?Would you make any changes to Ms. BD’s blood pressure and GERD medications? Explain. If yes, what would you prescribe? Discuss the medications safety in pregnancy, mechanism of action, route, the half-life; how it is metabolized in and eliminated from the body; and contraindications and black box warnings.How does ethnopharmacology apply to this patient if she were NOT pregnant? Explain.What health maintenance or preventive education do you provide in this client case based on your choice of medications/treatment?Would you treat this patient or refer her? Explain. If you refer, where would you refer this patient?