NUR4153CBE Section 01 Deliverable 1 – How is Clinical Decision Making Influenced?

/in /by

NUR4153CBE Section 01 Deliverable 1 – How is Clinical Decision Making Influenced?

NUR4153CBE Section 01CBE Clinical Reasoning and Clinical Judgement (6 Months) – CBE – 2020 Winter Six Month 2

Deliverable 1 – How is Clinical Decision Making Influenced?

Evaluate factors integral to clinical reasoning

Scenario You are working as a charge nurse on a medical-surgical unit in an acute healthcare facility. One of the staff nurses who recently from bereavement leave has been assigned to care for an elderly client, newly diagnosed with stage IV pancreatic cancer. While you are visiting with the client, the nurse is completing her assessment. The client requests assistance to set up hospice care, complete an advanced directive, and reach out to his estranged daughter. The nurse stated, “I can get you the paperwork for the advance directive, but I can’t call your child for you, I am not a social worker.” The nurse leaves the room and asks to speak with you stating, “I can’t care for this client, I need my client assignment changed now or else I will go home.” As the charge nurse, you step in and change the nurse’s client assignment and offer to assist the client with his requests. Later, you have the opportunity to debrief with the nurse regarding her reaction and decisions regarding the client’s requests and make some recommendations on how the nurse could have responded differently. You write up a summary of the events and include the follow-up conversation with the nurse. NUR4153CBE Section 01 Deliverable 1 – How is Clinical Decision Making Influenced?

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Instructions Compose a written memo of the situation and debrief for the employee’s personnel file. Include the following in the summary:

Analysis of the internal and external cues impacting the responses of the staff nurse and the charge nurse.

Describe how these factors influenced the clinical decision making of both nurses.

Emotional intelligence action plan for the nurse based on interactions observed with the client and the charge nurse.

· Include self-compassion and compassion toward others.

· Include an alternative response from the staff nurse and charge nurse.

Deliverable 2 – The Impact of Relational Inquiry

Explain the impact of relational inquiry when recognizing and analyzing cues to action in the process of clinical reasoning.

Scenario

You are a nursing student in a BSN Program, currently enrolled in a Leadership course. As part of your current immersion experience, you are working with the charge nurse in the operating room. In pre-op on the first day of this clinical experience, you observe an upset client refusing to sign a surgery consent unless a small religious object could accompany him and stay attached to his body. This object is a key component of his cultural beliefs, and he will cancel the surgery if he is unable to keep the religious object attached to his body. The charge nurse states, “Let me check and see what we can do, I will need a bit of time to collaborate with others and see if we can identify a solution.” You observe the charge nurse gather a team of nurses in the pre-op area and begin reviewing the policy and procedure manuals for the facility to determine if a solution can be identified to allow the object to be taken into the operating room. While the healthcare team was looking for a solution, someone recommended that the object is wrapped in non-conductive material, and applied to the client under a sterile dressing. According to policy, this would work with Surgeon approval. NUR4153CBE Section 01 Deliverable 1 – How is Clinical Decision Making Influenced?

Instructions

In post-conference, you debrief with a faculty member and discuss this powerful example of healthcare team members working together to support and respect a client’s unique cultural needs and belief system. The clinical faculty tells you to complete a clinical journal entry which describes the process involved in this example of professional practice. Include the following in your journal entry:

· Explain how relational inquiry was applied in this situation to promote the process of clinical reasoning.

· From context and culture

· Optimization of health and well-being

· Collaborating across differences

· Do you believe this action was appropriate, and why or why not?

· Provide a supporting argument to defend choice for appropriate or non-appropriate response by the nurse and include personal biases.

Deliverable 3 – Clinical Reasoning Appropriate for the Situation

Integrate modes of inquiry to generate and evaluate hypotheses in the context of clinical reasoning.

Scenario

You recently finished new graduate orientation in the emergency room (ER) of a rural, 60-bed hospital, and tonight is the first shift you have worked independently. The Intensive Care Unit of the hospital has only four beds and usually sends the sickest clients in need of complex care to a regional medical facility located 50 miles from your location. During orientation, you were told repeatedly the purpose of treatment in this ER is triage, stabilize, and send home or send to a larger network facility.

Tonight your first client is an 82-year-old female named Ruth. Ruth was dropped off at the ER by a neighbor who said that she had nausea and vomiting for a week. Her husband was recently admitted to an Alzheimer’s Unit at a local Long-Term Care facility, and the neighbor thought stress was making it hard for Ruth to eat, but tonight she vomited up fresh blood and appeared dizzy. The neighbor also brought in a bag of medication she found in the home but was unsure which medication belonged to Ruth or her husband. NUR4153CBE Section 01 Deliverable 1 – How is Clinical Decision Making Influenced?

When you enter the room to begin the assessment, you find a frail woman sitting in a wheelchair with apparent labored breathing. She appears dirty with matted hair clothed in a bathrobe with numerous food stains and has a heavy smell of cigarette smoke. You notice the chart has a highlighted area noting the client has only Medicaid for insurance. You ask her if she understands why she is in the ER and she asks, “Where is my husband? He is usually home by now.”

Past medical history:

· Two pack per day smoker for 58 years

· Type I Diabetic

Assessment data:

· Blood pressure: 178/98

· Heart rate: 84 beats per minute

· Oxygen saturation: 84

· Temperature: 101.8 degrees Fahrenheit

· Hyperactive bowel sounds in all 4 quadrants

· An open wound on the bottom of right foot

Instructions

You are feeling overwhelmed with your first client but remember first you need to evaluate internal and external cues to develop a priority hypothesis to guide clinical reasoning. Create notes for this client’s plan of care including:

· Design a hypothesis for each of the four modes of inquiry: empirical, ethical, aesthetic and sociopolitical. NUR4153CBE Section 01 Deliverable 1 – How is Clinical Decision Making Influenced?

Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley

/in /by

Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley

Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley
By Day 7
Focus on the identified client within your chosen case.
Analyze the case using a systems approach, taking into consideration both family and community systems.
Complete and submit the “Dissecting a Theory and Its Application to a Case Study” worksheet based on your analysis. Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Tiffani Bradley Case
Identifying Data: Tiffani Bradley is a 16-year-old Caucasian female. She was raised in a Christian family in Philadelphia, PA. She is of German descent. Tiffani’s family consists of her father, Robert, 38 years old; her mother, Shondra, 33 years old, and her sister, Diana, 13 years old. Tiffani currently resides in a group home, Teens First, a brand new, court-mandated teen counseling program for adolescent victims of sexual exploitation and human trafficking. Tiffani has been provided room and board in the residential treatment facility for the past 3 months. Tiffani describes herself as heterosexual. Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley
Presenting Problem: Tiffani has a history of running away. She has been arrested on three occasions for prostitution in the last 2 years. Tiffani has recently been court ordered to reside in a group home with counseling. She has a continued desire to be reunited with her pimp, Donald. After 3 months at Teens First, Tiffani said that she had a strong desire to see her sister and her mother. She had not seen either of them in over 2 years and missed them very much. Tiffani is confused about the path to follow. She is not sure if she wants to return to her family and sibling or go back to Donald. Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley.
Family Dynamics: Tiffani indicates that her family worked well together until 8 years ago. She reports that around the age of 8, she remembered being awakened by music and laughter in the early hours of the morning. When she went downstairs to investigate, she saw her parents and her Uncle Nate passing a pipe back and forth between them. She remembered asking them what they were doing and her mother saying, “adult things” and putting her back in bed. Tiffani remembers this happening on several occasions. Tiffani also recalls significant changes in the home’s appearance. The home, which was never fancy, was always neat and tidy. During this time, however, dust would gather around the house, dishes would pile up in the sink, dirt would remain on the floor, and clothes would go for long periods of time without being washed. Tiffani began cleaning her own clothes and making meals for herself and her sister. Often there was not enough food to feed everyone, and Tiffani and her sister would go to bed hungry. Tiffani believed she was responsible for helping her mom so that her mom did not get so overwhelmed. She thought that if she took care of the home and her sister, maybe that would help mom return to the person she was before.
Sometimes Tiffani and her sister would come downstairs in the morning to find empty beer cans and liquor bottles on the kitchen table along with a crack pipe. Her parents would be in the bedroom, and Tiffani and her sister would leave the house and go to school by themselves. The music and noise downstairs continued for the next 6 years, which escalated to screams and shouting and sounds of people fighting. Tiffani remembers her mom one morning yelling at her dad to “get up and go to work.” Tiffani and Diana saw their dad come out of the bedroom and slap their mom so hard she was knocked down. Dad then went back into the bedroom. Tiffani remembers thinking that her mom was not doing what she was supposed to do in the house, which is what probably angered her dad.
Shondra and Robert have been separated for a little over a year and have started dating other people. Diana currently resides with her mother and Anthony, 31 years old, who is her mother’s new boyfriend.
Educational History: Tiffani attends school at the group home, taking general education classes for her general education development (GED) credential. Diana attends Town Middle School and is in the 8th grade. Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley. Assignment: Application of Systems Theory to a Case Study – Tiffani Bradley
Employment History: Tiffani reports that her father was employed as a welding apprentice and was waiting for the opportunity to join the union. Eight years ago, he was laid off due to financial constraints at the company. He would pick up odd jobs for the next 8 years but never had steady work after that. Her mother works as a home health aide. Her work is part-time, and she has been unable to secure full-time work.
Social History: Over the past 2 years, Tiffani has had limited contact with her family members and has not been attending school. Tiffani did contact her sister Diana a few times over the 2-year period and stated that she missed her very much. Tiffani views Donald as her “husband” (although they were never married) and her only friend. Previously, Donald sold Tiffani to a pimp, “John T.” Tiffani reports that she was very upset Donald did this and that she wants to be reunited with him, missing him very much. Tiffani indicates that she knows she can be a better “wife” to him. She has tried to make contact with him by sending messages through other people, as John T. did not allow her access to a phone. It appears that over the last 2 years, Tiffani has had neither outside support nor interactions with anyone beyond Donald, John T., and some other young women who were prostituting.
Mental Health History: On many occasions Tiffani recalls that when her mother was not around, Uncle Nate would ask her to sit on his lap. Her father would sometimes ask her to show them the dance that she had learned at school. When she danced, her father and Nate would laugh and offer her pocket change. Sometimes, their friend J

NSG 4067 Week 4 Project – Analysis of an Age Related Topic

/in /by

NSG 4067 Week 4 Project – Analysis of an Age Related Topic

NSG 4067 Week 4 Project – Analysis of an Age Related Topic
By the due date assigned, submit your assignment to the Submissions Area.
Conduct in-depth analysis of a pertinent topic related to aging. Define the problem, specific population affected, cultural implications, and financial/legal/ethical implications. What interventions can be used to improve the problem? What resources are available? What are the associated costs? Is this idea sustainable?
Submit your paper in a 6–7-page Microsoft Word document.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Support your responses with examples.
On a separate references page, cite all sources using APA format.
Use this APA Citation Helper as a convenient reference for properly citing resources.
This handout will provide you the details of formatting your essay using APA style.
You may create your essay in this APA-formatted template.
References must be within 3 years. NSG 4067 Week 4 Project – Analysis of an Age Related Topic
Submission Details
Name your document SU_NSG4067_W4_A2_LastName_FirstInitial.doc.
Submit your document to the Submissions Area by the due date assigned.
KINDLY ORDER NOW FOR A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER
NSG 4067 Week 4 Project – Analysis of an Age Related Topic
NSG 4067 Week 4 Project – Analysis of an Age Related Topic
NSG 4067 Week 4 Project – Analysis of an Age Related Topic
NSG 4067 Week 4 Project – Analysis of an Age Related Topic
Week 5 Quiz
Question 1 (5 points)
An 88-year-old, being admitted to rule out lung cancer, is assessed using the short form of the Geriatric Depression Scale tool. When it is determines that the earned score is 9, the nurse initially:
Question 1 options:
Asks if they have any thoughts of committing suicide.
Recognizes that this score is not indicative of depression.
Knows it is not unusual for clients this age to earn such a score.
Notifies the client’s healthcare provider immediately.
Question 2 (5 points)
A widowed grandmother is about to assume the role of custodial parent for her 6-year-old grandchild. Which intervention has priority when preparing the grandmother for long-term success in this new role?
Question 2 options:
Reviewing the developmental milestones of childhood.
Identifying local sources of child counseling services.
Discussing the common challenges of parenting a 6 year old.
Teaching stress management and relaxation techniques.
S

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Question 3 (5 points)
The client is diagnosed with dyslipidemia. This diagnosis is supported when the client’s lipid panel indicates a: Select all that apply.
Question 3 options:
Triglyceride level of triglyceride levels (>2000 mg/dL).
Low Density Lipids (LDL) level of 120 mg/dL.
Total Cholesterol level of 260 mg/dL.
High Density Lipids (HDL) level of 70 mg/dL.
Glucose level of 230 mg/dL. NSG 4067 Week 4 Project – Analysis of an Age Related Topic
Question 4 (5 points)
Which factor is the greatest barrier to an older adult living independently?
NSG 4067 Full Course latest
Question 4 options:
Deficits in vision and/or hearing resulting in safety issues.
Limited finances that prevent upkeep and maintenance of a residence.
Depression that occurs after the death of a spouse or significant other occurs.
The manifestation of cognitive impairment resulting from dementia or Alzheimer’s.
Question 5 (5 points) Question 5 Unsaved
Compared with acute pain, persistent pain requires the nurse to:
Question 5 options:
Monitor vital signs more frequently.
Document the character of the pain as burning.
Administer analgesics at least every 4 hours.
Educate the client to the benefit of specific lifestyle changes.
Question 6 Unsaved
When diagnosed with diverticulosis, a client asks how this problem occurred. Which assessment data identifies a risk factor for diverticulosis?
Question 6 options:
Drinks a quart of whole milk daily.
Takes an over the counter laxative twice weekly.
History of a Helicobacter pylori infection.
Maintains a diet low in fiber.
Question 7 (5 points) Question 7 Unsaved
When focusing best on the goal of enhancing the health and well-being of the older residents of extended care living facility, the nurse:
Question 7 options:
Assures that they all receive their medications and treatments on time.
Assesses each new resident to determine their food and beverage preferences.
Asks the nursing assistant to “allow the residents to dress themselves but to check that they are dressed appropriately.”
Documents that “the residents appeared to enjoy the opportunity to socialize at the weekly Sunday brunch.”
Question 8 (5 points) Question 8 Unsaved
The nurse best addresses the spirit of the Healthy People 2020 project regarding the older adult when:
Question 8 options:
Providing information regarding where free flu vaccinations are being given to those over 65 years of age.
Facilitating a “Walking for your Health” program for residents of a senior living apartment complex.
Arranging for a registered nutritionist to hold a “Grandparents and their Grandchildren Cooking Together” class.
Encouraging their utilization of government sponsored health and wellness programs that target the senior citizen.
Q. NSG 4067 Week 4 Project – Analysis of an Age Related Topic

Benchmark – community teaching plan: community teaching work plan

/in /by

Benchmark – community teaching plan: community teaching work plan

The benchmark assesses the following competency:

4.2 Communicate therapeutically with patients.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

  1. Primary Prevention/Health Promotion
  2. Secondary Prevention/Screenings for a Vulnerable Population
  3. Bioterrorism/Disaster
  4. Environmental Issues

    ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment. Benchmark – community teaching plan: community teaching work plan

  1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
  2. Request feedback (strengths and opportunities for improvement) from the provider.
  3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Rubic_Print_Format

Course Code Class Code Assignment Title Total Points
NRS-428VN NRS-428VN-O504 Benchmark – Community Teaching Plan: Community Teaching Work Plan Proposal 100.0
Criteria Percentage Unsatisfactory (0.00%) Less Than Satisfactory (80.00%) Satisfactory (88.00%) Good (92.00%) Excellent (100.00%) Comments Points Earned
Content 80.0%
Planning and Topic 30.0% The chosen topic is not one of four approved topics. The epidemiologic rationale is omitted. The teaching plan is based on an approved topic. The epidemiological rational contains significant inaccuracies. The teaching plan is based on an approved topic. The epidemiological rational is unclear. There are some inaccuracies. The teaching plan is based on an approved topic. The epidemiological rational needs some detail for accuracy or clarity. The teaching plan is based on an approved topic. The epidemiological rational is well-supported and relevance to the topic is demonstrated.
Effectiveness of Teaching Plan Criteria 40.0% Two or more of the assignment criteria are omitted. More than one of the assignment criteria are omitted. Overall, the teaching plan is vague. Significant information is needed. One of the assignment criteria is omitted or, multiple criteria are incomplete. The teaching plan can be effective, but more information or rational is needed. All assignment criteria are adequately completed. Some rational is needed for support or clarity. Overall, the teaching plan is effective. All assignment criteria are thoroughly completed. Rational and detail is provided throughout.
Therapeutic Communication (C 4.2 Communicate therapeutically with patients.) 10.0% Therapeutic communication approach is omitted. Therapeutic approach is not demonstrated. The teaching plan attempts to communicate with an activity; the activity is not appropriate for the teaching plan. It is unclear if active listening techniques were used to connect with the audience. A partial summary of how the interaction of the audience is presented.It is unclear if nonverbal techniques were employed. More information is needed. The teaching plan is communicated with an activity that generally uses active listening techniques to connect with the audience. A summary of how the attention of the audience was captured and how the presentation was concluded is presented. The teaching plan indicates that some nonverbal techniques were employed. The teaching plan is communicated with an activity that uses active listening techniques to connect with the audience. How the attention of the audience was captured and how the presentation was concluded is presented. The teaching plan indicates that the use of nonverbal techniques was employed. The teaching plan is communicated with an activity that uses clear active listening techniques to connect with the audience. A clear description of how the attention of the audience was captured and how the presentation was concluded is presented. The teaching plan thoroughly describes nonverbal techniques that were employed, such as eye contact, appropriate dress for the setting, facial expressions, and voice intonation. Benchmark – community teaching plan: community teaching work plan
Organization and Effectiveness 15.0%
Organization of Proposal, Paragraph Development, and Transitions 10.0% Organization of proposal is disjointed. Paragraphs and transitions consistently lack unity and coherence. There are no apparent connections between ideas. Transitions are inappropriate or lacking. Some degree of organization is evident. Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, or cohesiveness. Paragraphs are generally competent, but ideas may show some inconsistency in organization or in their relationships to each other. A logical progression of ideas between paragraphs is apparent. Paragraphs exhibit a unity, coherence, and cohesiveness. Proposal is well-organized and logical. Ideas progress and relate to each other. Paragraph and transition construction guide the reader.
Criteria 2Mechanics of Writing (includes spelling, punctuation, grammar, language use) 5.0% Surface errors are pervasive enough that they impede communication of meaning. Inappropriate word choice or sentence construction is used. Some degree of organization is evident. Some paragraphs and transitions may lack logical progression of ideas, unity, coherence, or cohesiveness. Frequent and repetitive mechanical errors distract the reader. Inconsistencies in language choice (register), sentence structure, or word choice are present. Some mechanical errors or typos are present, but they are not overly distracting to the reader. Correct sentence structure and audience-appropriate language are used. Prose is largely free of mechanical errors, although a few may be present. A variety of sentence structures and effective figures of speech are used. Writer is clearly in command of standard, written, academic English.
Format 5.0%
Paper Format (use of appropriate style for the major and assignment) 2.0% Template is not used appropriately or documentation format is rarely followed correctly. Template is used, but some elements are missing or mistaken; lack of control with formatting is apparent. Template is used, and formatting is correct, although some minor errors may be present. Template is fully used; There are virtually no errors in formatting style. All format elements are correct.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style) 3.0% Sources are not documented. Documentation of sources is inconsistent or incorrect, as appropriate to assignment and style, with numerous formatting errors. Sources are documented, as appropriate to assignment and style, although some formatting errors may be present. Sources are documented, as appropriate to assignment and style, and format is mostly correct. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Total Weightage 100%

 

 

Community Teaching Work Plan Proposal

Planning and Topic

Directions: Develop an educational series proposal for your community using one of the following four topics:

1. Bioterrorism/Disaster

2. Environmental Issues

3. Primary Prevention/Health Promotion

4. Secondary Prevention/Screenings for a Vulnerable Population

Planning Before Teaching:

Name and Credentials of Teacher:

 
Estimated Time Teaching Will Last: Location of Teaching:

 
Supplies, Material, Equipment Needed: Estimated Cost:

 
Community and Target Aggregate:

 
Topic:

 

Identification of Focus for Community Teaching (Topic Selection):

 

Epidemiological Rationale for Topic (Statistics Related to Topic):

 


Teaching Plan Criteria

 

Your teaching plan will be graded based on its effectiveness and relevance to the population selected. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

Nursing Diagnosis:

 

 

 

Readiness for Learning: Identify the factors that would indicate the readiness to learn for the target aggregate. Include emotional and experiential readiness to learn.

 

 

 

Learning Theory to Be Utilized: Explain how the theory will be applied.

 

Goal: Healthy People 2020 (HP2020) objective(s) utilized as the goal for the teaching. Include the appropriate objective number and rationale for using the selected HP2020 objective (use at least one objective from one of the 24 focus areas). If an HP2020 objective does not support your teaching, explain how your teaching applies to one of the two overarching HP2020 goals.  Benchmark – community teaching plan: community teaching work plan

 

How Does This HP2020 Objective Relate to Alma Ata’s Health for All Global Initiatives

Develop Behavioral Objectives (Including Domains), Content, and Strategies/Methods:

Behavioral Objective
and Domain

Example – Third-grade students will name one healthy food choice in each of the five food groups by the end of the presentation. (Cognitive Domain)

 Content
(be specific)

Example – The Food Pyramid has five food groups which are….

Healthy foods from each group are….
Unhealthy foods containing a lot of sugar or fat are….

 Strategies/Methods

(label and describe)

Example – Interactive poster presentation of the Food Pyramid. After an explanation of the poster and each food category, allow students to place pictures of foods on the correct spot on the pyramid. Also, have the class analyze what a child had for lunch by putting names of foods on the poster and discussing what food group still needs to be eaten throughout day.
1.

 

 

 1. 1.
2.

 

 

 2. 2.
3.

 

 

 3. 3.
4.

 

 

 4. 4.

 

Creativity: How was creativity applied in the teaching methods/strategies?

 

Planned Evaluation of Objectives (Outcome Evaluation): Describe what you will measure for each objective and how.

1.

 

 

2.

 

 

3.

 

4.

 

 

Planned Evaluation of Goal: Describe how and when you could evaluate the overall effectiveness of your teaching plan.

 

 

Planned Evaluation of Lesson and Teacher (Process Evaluation):

 

 

Barriers: What are potential barriers that may arise during teaching and how will those be handled?

 

 

Therapeutic Communication

4.2 Communicate therapeutically with patients.

 

How will you begin your presentation and capture the interest of your audience? Describe the type of activity will you use with your audience to exhibit active listening? Describe how you applied active listening in tailoring your presentation to your audience? How will you conclude your presentation? What nonverbal communication techniques will you employ? Benchmark – community teaching plan: community teaching work plan

Assignment: How is the EHR changing the roles of the HIM staff?

/in /by

Assignment: How is the EHR changing the roles of the HIM staff?

Assignment: How is the EHR changing the roles of the HIM staff?
How is the EHR changing the roles of the HIM staff? Do you feel these are positive or negative changes? Why or why not?
What changes would you expect from the centralization of HIM functions and why?
What is your view of the HIM profession as a whole? Why?
Expert Answer
Ans: The health information management (HIM) profession is changing rapidly alongside the evolving needs of healthcare organizations concerned about the quality of their EHR data – and their ability to safeguard that data with an appropriate level of”¦
ORDER CUSTOMIZED SOLUTIONS @ 5% DISCOUNT
Health Data Content HITT-1301, Chapter-1

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Terms in this set (28)

How is the EHR changing the roles of the HIM staff?

There are a number of answers. For example, you could have written about how the HIM staff is analyzing and using the information from the EHR rather than filing loose sheets of paper into the record. Another example is computer-assisted coding. Students may focus on ability to work at home or how a centralized HIM department impacts the HIM professional. Assignment: How is the EHR changing the roles of the HIM staff?

What changes would you expect from the centralization of HIM functions?

Answers will vary but should include topics such as reallocation of space, ability to work remotely, and the ability to work with physicians and facility staff.

What is your view of the HIM profession?

HIM profession is a connection between doctors, patients, insurance providers and other service providers within the health care system. HIM professionals work in a variety of settings and job titles, and assists the health system in managing health-related information to ensure that it meets relevant medical, administrative, and legal requirements.

The first professional association for health information managers was established in what year?
a. 1900
b. 1905
c. 1928
d. 1970

c.1928

The hospital standardization program was started by __________.
a. American Health Information Management. Assignment: How is the EHR changing the roles of the HIM staff?

Discussion: How geopolitical and phenomenological place influence the context of a population

/in /by

Discussion: How geopolitical and phenomenological place influence the context of a population

Topic 1 DQ 2
Geopolitical and phenomenological place influence the context of a population or community assessment and intervention in various ways. A community could be defined by one of two designations, phenomenological (relational) or geological (spatial). A geographic community is a community within defined jurisdictional boundaries. These communities could include city communities, rural municipalities or towns. Phenomenological communities, on the other hand, define a group of people with shared or similar-minded relationships, beliefs, goals, and interests (Leipert, 1996). They might not necessarily share the same geographical boundaries as geographical communities. These communities could include social groups or religious groups. Discussion: How geopolitical and phenomenological place influence the context of a population. These people mostly come together to achieve the feeling of belonging in their relational designations. These people may have a group perspective that differentiates them from other groups on matters including culture, values, beliefs, characteristics, and goals.
Everyone lives in a geographic community and many people are also part of a phenomenological group. These groupings present various challenges for public health nurses. The main challenge is the issue of cultural and language barriers. Some of the practices that can help overcome these challenges include reflective practice and obtaining knowledge of different cultures and practices. Nurses should also self-evaluate and ensure that their personal beliefs do not interfere with the nursing process.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

The nursing process is utilized to assist in identifying health issues because it involves the appropriate application of a systematic series of actions that aim at ensuring that individuals achieve their optimal level of health. The main steps in the nursing processes include assessment, diagnosis, planning, implementation, and evaluation. Assessment refers to the collection and evaluation of information regarding the status of health in the community (Rector, 2013). It aids in discovering potential or existing needs and assets as a basis for any future action plans or interventions.
Using 200-300 words APA format with references to support the discussion.
Discuss how geopolitical and phenomenological place influence the context of a population or community assessment and intervention. Describe how the nursing process is utilized to assist in identifying health issues (local or global in nature) and in creating an appropriate intervention, including screenings and referrals, for the community or population. Discussion: How geopolitical and phenomenological place influence the context of a population

NSG 6330 Week 4 Discussion: iHuman Case Study – Rachael Hardy

/in /by

NSG 6330 Week 4 Discussion: iHuman Case Study – Rachael Hardy

NSG 6330 Week 4 Discussion: iHuman Case Study – Rachael Hardy
This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .
Start reviewing and responding to the postings of your classmates as early in the week as possible . Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week .
For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .
The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam . NSG 6330 Week 4 Discussion: iHuman Case Study – Rachael Hardy
Click here for information on how to access and navigate iHuman .
This week, complete the iHuman case titled “Rachael Hardy” .
After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:
Discuss the questions that would be important to include when interviewing a patient with this issue .
Describe the clinical findings that may be present in a patient with this issue .
Are there any diagnostic studies that should be ordered on this patient? Why?
List the primary diagnosis and three differential diagnoses for this patient .Explain your reasoning for each .
Discuss your management plan for this patient, including pharmacologic therapies, tests, patient education, referrals, and follow-ups.
KINDLY ORDER NOW FOR A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER
NSG 6330 Week 5 Discussion: iHuman Case Study – Pamela Flowers
This discussion assignment provides a forum for discussing relevant topics for this week based on the course competencies covered .For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned .
To support your work, use your course textbook readings and the South University Online Library .As in all assignments, cite your sources in your work and provide references for the citations in APA format .
Start reviewing and responding to the postings of your classmates as early in the week as possible . Respond to at least two of your classmates’ initial postings .Participate in the discussion by asking a question, providing a statement of clarification, providing a point of view with a rationale, challenging an aspect of the discussion, or indicating a relationship between two or more lines of reasoning in the discussion .Cite resources in your responses to other classmates .Complete your participation for this assignment by the end of the week . NSG 6330 Week 4 Discussion: iHuman Case Study – Rachael Hardy
For this assignment, you will complete an iHuman case study based on the course objectives and weekly content .The iHuman cases emphasize core learning objectives for an evidence-based primary care curriculum .Throughout your nurse practitioner program, you will use the iHuman case studies to promote the development of clinical reasoning through the use of ongoing assessments and diagnostic skills, and to develop patient care plans that are grounded in the latest clinical guidelines and evidence-based practice .
The iHuman assignments are highly interactive and a dynamic way to enhance your learning .Material from the iHuman cases may be present in the quizzes, the midterm exam, and the final exam .
Click here for information on how to access and navigate iHuman .
This week, complete the iHuman case titled “Pamela Flowers” .
After completing your iHuman Case Study, answer the following questions using the latest evidenced based guidelines:
Discuss the questions that would be important to include when interviewing a patient with this issue .
Describe the clinical findings that may be present in a patient with this issue .
Are there any diagnostic studies that should be ordered on this patient? Why?
List the primary diagnosis and three differential diagnoses for this patient . NSG 6330 Week 4 Discussion: iHuman Case Study – Rachael Hardy

Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders

/in /by

Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders

Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders
Psychotic disorders change ones sense of reality and cause abnormal thinking and perception. Patients presenting with psychotic disorders may suffer from delusions or hallucinations or may display negative symptoms such as lack of emotion or withdraw from social situations or relationships. Symptoms of medication-induced movement disorders can be mild or lethal and can include, for example, tremors, dystonic reactions, or serotonin syndrome.
For this Assignment, you will complete a focused SOAP note for a patient in a case study who has either a schizophrenia spectrum, other psychotic, or medication-induced movement disorder.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

To Prepare
Review this weeks Learning Resources. Consider the insights they provide about assessing, diagnosing, and treating schizophrenia spectrum, other psychotic, and medication-induced movement disorders.
Photo Credit: Getty Images/Wavebreak Media
Review the Focused SOAP Note template, which you will use to complete this Assignment. There is also a Focused SOAP Note Exemplar provided as a guide for Assignment expectations.
Review the video, Case Study: Sherman Tremaine. You will use this case as the basis of this Assignment. In this video, a Walden faculty member is assessing a mock patient. The patient will be represented onscreen as an avatar.
Consider what history would be necessary to collect from this patient.
Consider what interview questions you would need to ask this patient. Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders
The Assignment
Develop a focused SOAP note, including your differential diagnosis and critical-thinking process to formulate a primary diagnosis. Incorporate the following into your responses in the template:
Subjective: What details did the patient provide regarding their chief complaint and symptomology to derive your differential diagnosis? What is the duration and severity of their symptoms? How are their symptoms impacting their functioning in life?
Objective: What observations did you make during the psychiatric assessment?¯
Assessment: Discuss the patients mental status examination results. What were your differential diagnoses? Provide a minimum of three possible diagnoses with supporting evidence, and list them in order from highest priority to lowest priority. Compare the DSM-5 diagnostic criteria for each differential diagnosis and explain what DSM-5 criteria rules out the differential diagnosis to find an accurate diagnosis. Explain the critical-thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
Plan: What is your plan for psychotherapy? What is your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters, as well as a rationale for this treatment and management plan. Also incorporate one health promotion activity and one patient education strategy. Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders
Reflection notes: What would you do differently with this patient if you could conduct the session again? Discuss what your next intervention would be if you were able to follow up with this patient.¯Also include in your reflection a discussion related to legal/ethical considerations (demonstrate critical thinking beyond confidentiality and consent for treatment!), health promotion, and disease prevention, taking into consideration patient factors (such as age, ethnic group, etc.), PMH, and other risk factors (e.g., socioeconomic, cultural background, etc.).
Provide at least three evidence-based, peer-reviewed journal articles or evidenced-based guidelines that relate to this case to support your diagnostics and differential diagnoses. Be sure they are current (no more than 5 years old).

Five Reference of not more than 5 years.
Medication Review
Review the FDA-approved use of the following medicines related to treating schizophrenia-spectrum and other psychotic disorders:

Psychosis

Schizoaffective    disorder

alprazolam (adjunct)
amisulpride
aripiprazole
asenapine
blonanserin
carbamazepine (adjunct)
chlorpromazine
clonazepam (adjunct)
clozapine
cyamemazine
flupenthixol
fluphenazine
haloperidol
iloperidone
lamotrigine (adjunct)
lorazepam (adjunct)
loxapine
lurasidone

mesoridazine
molindone
olanzapine
paliperidone
perospirone
perphenazine
pimozide
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol

amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone

perospirone
perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct)
ziprasidone
zotepine
zuclopenthixol

Schizophrenia

Cataplexy syndrome

Catatonia

Extrapyramidal side    effects

amisulpride
aripiprazole
asenapine
carbamazepine (adjunct)
chlorpromazine
clozapine
cyamemazine
flupenthixol
haloperidol
iloperidone
lamotrigine (adjunct)
l-methylfolate (adjunct)
loxapine
lurasidone
mesoridazine
molindone
olanzapine
paliperidone
perospirone

perphenazine
pipothiazine
quetiapine
risperidone
sertindole
sulpiride
thioridazine
thiothixene
trifluoperazine
valproate (divalproex) (adjunct) Assignment: Focused SOAP Note for Schizophrenia Spectrum, Other Psychotic, and Medication-Induced Movement Disorders
ziprasidone
zotepine
zuclopenthixol
Seasonal affective disorder
bupropion
Sedation-induction
hydroxyzine
midazolam

clomipramine
imipramine
sodium oxybate

alprazolam
chlordiazepoxide
clonazepam
clorazepate
diazepam
estazolam
flunitrazepam
flurazepam
loflazepate
lorazepam
midazolam
oxazepam
quazepam
temazepam
triazolam

benztropine
diphenhydramine
trihexyphenidyl

Week 1 Research Assignment: The Effects of Drugs on a Man’s Reproductive System

/in /by

Week 1 Research Assignment: The Effects of Drugs on a Man’s Reproductive System

Week 1 Research Assignment

Assignment Click for more options

Your Journal research assignments are worth 15% of your grade. Please complete them by the end of the week.

You will submit your Research Assignment by clicking on title “Week 1 Research Assignment” above, then creating your document and saving to your computer. This document will then be uploaded by clicking on “Browse my Computer”.

The Effects of Drugs on a Man’s Reproductive System

There has been a lot of research on how teratogens cause genetic and congenital birth defects in babies. What are Teratogens? They are anything that will interfere with the growth or development of a fetus. You will find article after article about the effects of women smoking, taking drugs, and drinking alcohol on developing babies. But what happens if a man smokes, takes drugs, or drinks alcohol? Can this harm a developing fetus? Week 1 Research Assignment: The Effects of Drugs on a Man’s Reproductive System

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Directions:

1. Write at least 200 words on this topic.

2. Save and name your assignment “Week 1 Research Assignment”, then save on your computer. This document will then be uploaded by clicking on “Browse my Computer”.

3. Make sure to cite your sources in your assignment.

Tips:

1. Read pages 59- 64 from Chapter 2.

2. Check out these websites:

1. http://www.come-over.to/FAS/mentoo.htm

1. http://www.sfgate.com/cgi-bin/article.cgi?file=/chronicle/archive/1998/10/02/MN77373.DTL

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3901885/

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

/in /by

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

Advanced practice nurses will be working with a multitude of individuals and it is important for an advance practice nurse to know and understand pharmacokinetics and pharmacodynamics of the different medications that they will be prescribing throughout their career.  According to Rosenthal and Burchum (2018), pharmacokinetics is the study of drug movement throughout the body and pharmacodynamics is the study of the biochemical and physiologic effects of drugs on the body and the molecular mechanisms by which those effects are produced.  Pharmacokinetics involves four basic processes which includes absorption, distribution, metabolism, and excretion (Rosenthal & Burchum, 2018). NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

A 68-year old female comes to the hospital because she is feeling flushed and just not feeling like herself.  Upon examination the patient is hypertensive and slightly tachycardic.  The patient does not have any complaints of pain.  The patient has a health history of anxiety, depression, COPD, hypertension, and chronic kidney disease.  The patient is being admitted for hypertensive crisis.  The patient takes a serotonin reuptake inhibitor for her depression, an ace inhibitor for her hypertension.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

One factor to consider while treating this patient is their chronic kidney disease.  The chronic kidney disease could be one reason that the patient is having uncontrolled hypertension and will also need to be considered when treating this patient with new medications. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics  A second factor could be the patient’s compliance with medication regimen at home.  A third reason could be environmental exposure.

One of the first things that would need to be done would be to ask the patient about her compliance with her home medication regimen.  It would be important to obtain a renal function panel to determine if the patient was in acute renal failure.  After this information is obtained a better plan of care could be made for the patient’s long-term treatment.

If a patient is having acute kidney failure or injury the alterations of drug responses are attributed to pharmacokinetics and that at least 50% of all essential medications are influenced by kidney dysfunction (Keller & Hann, 2018).  The four basic processes of pharmacokinetics play a major role in renally compromised patients NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.  All four phases involve movement and if one phase is compromised it can cause a disruption in the effectiveness of the medication.

Environmental exposures can also be taken into consideration when considering the pharmacokinetics and pharmacodynamics of the effectiveness of a medication.  In a recent study it was shown that environmental pollutants such as pesticides can alter drug-metabolizing enzymes, as well as pharmacokinetics of drug metabolism (Banerjee, 2020).

In conclusion, having the full details of this patient’s case would be beneficial in determining a full treatment plan.  After the hypertensive crisis was under control then I would continue with the patient’s home dose and continue to monitor the patient.  The patient may need to have an increase in their medication, or they may need to add in a secondary medication for hypertension NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

 

References

Banerjee, et al.  (01/17/2020).  Effect of environmental exposure and pharmacogenomics of drug metabolism. 

DOI: https://doi.org/10.2174/1389200221666200110153304

Keller, F., & Hann, A.  (2018).  Principles of drug response and alterations in kidney disease.  CJASN September 2018, 13 (9) 1413-1420; DOI: https://doi.org/10.2215/CJN.10960917

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

Discussion: Pharmacokinetics and Pharmacodynamics

As an advanced practice nurse assisting physicians in the diagnosis and treatment of disorders, it is important to not only understand the impact of disorders on the body, but also the impact of drug treatments on the body. The relationships between drugs and the body can be described by pharmacokinetics and pharmacodynamics.

Pharmacokinetics describes what the body does to the drug through absorption, distribution, metabolism, and excretion, whereas pharmacodynamics describes what the drug does to the body NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

When selecting drugs and determining dosages for patients, it is essential to consider individual patient factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes. These patient factors include genetics, gender, ethnicity, age, behavior (i.e., diet, nutrition, smoking, alcohol, illicit drug abuse), and/or pathophysiological changes due to disease.

For this Discussion, you reflect on a case from your past clinical experiences and consider how a patient’s pharmacokinetic and pharmacodynamic processes may alter his or her response to a drug.

To Prepare
  • Review the Resources for this module and consider the principles of pharmacokinetics and pharmacodynamics.
  • Reflect on your experiences, observations, and/or clinical practices from the last 5 years and think about how pharmacokinetic and pharmacodynamic factors altered his or her anticipated response to a drug.
  • Consider factors that might have influenced the patient’s pharmacokinetic and pharmacodynamic processes, such as genetics (including pharmacogenetics), gender, ethnicity, age, behavior, and/or possible pathophysiological changes due to disease.
  • Think about a personalized plan of care based on these influencing factors and patient history in your case study.
By Day 3 of Week 1

Post a description of the patient case from your experiences, observations, and/or clinical practice from the last 5 years. Then, describe factors that might have influenced pharmacokinetic and pharmacodynamic processes of the patient you identified. Finally, explain details of the personalized plan of care that you would develop based on influencing factors and patient history in your case. Be specific and provide examples. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

By Day 6 of Week 1

Read a selection of your colleagues’ responses and respond to at least two of your colleagues on two different days by suggesting additional patient factors that might have interfered with the pharmacokinetic and pharmacodynamic processes of the patients they described. In addition, suggest how the personalized plan of care might change if the age of the patient were different and/or if the patient had a comorbid condition, such as renal failure, heart failure, or liver failure.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link, and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit! NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

 

NURS_6521_Week1_Discussion_Rubric

Excellent Good Fair Poor
Main Posting
Points Range: 45 (45%) – 50 (50%)

Answers all parts of the discussion question(s) expectations with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources.

Supported by at least three current, credible sources.

Written clearly and concisely with no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 40 (40%) – 44 (44%)

Responds to the discussion question(s) and is reflective with critical analysis and synthesis of knowledge gained from the course readings for the module.

At least 75% of post has exceptional depth and breadth.

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

Supported by at least three credible sources.

Written clearly and concisely with one or no grammatical or spelling errors and fully adheres to current APA manual writing rules and style.
Points Range: 35 (35%) – 39 (39%)

Responds to some of the discussion question(s). NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

One or two criteria are not addressed or are superficially addressed.

Is somewhat lacking reflection and critical analysis and synthesis.

Somewhat represents knowledge gained from the course readings for the module.

Post is cited with two credible sources.

Written somewhat concisely; may contain more than two spelling or grammatical errors.

Contains some APA formatting errors.
Points Range: 0 (0%) – 34 (34%)

Does not respond to the discussion question(s) adequately.

Lacks depth or superficially addresses criteria.

Lacks reflection and critical analysis and synthesis.

Does not represent knowledge gained from the course readings for the module.

Contains only one or no credible sources.

Not written clearly or concisely.

Contains more than two spelling or grammatical errors. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness
Points Range: 10 (10%) – 10 (10%)
Posts main post by day 3
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%) NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics
Points Range: 0 (0%) – 0 (0%)
Does not post by day 3
First Response
Points Range: 17 (17%) – 18 (18%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
Points Range: 15 (15%) – 16 (16%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics
Points Range: 13 (13%) – 14 (14%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed.

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 12 (12%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics
Second Response
Points Range: 16 (16%) – 17 (17%)

Response exhibits synthesis, critical thinking, and application to practice settings.

Responds fully to questions posed by faculty.

Provides clear, concise opinions and ideas that are supported by at least two scholarly sources.

Demonstrates synthesis and understanding of learning objectives.

Communication is professional and respectful to colleagues. .

Responses to faculty questions are fully answered, if posed.

Response is effectively written in standard, edited English.
Points Range: 14 (14%) – 15 (15%)

Response exhibits critical thinking and application to practice settings.

Communication is professional and respectful to colleagues.

Responses to faculty questions are answered, if posed.

Provides clear, concise opinions and ideas that are supported by two or more credible sources.

Response is effectively written in standard, edited English.
Points Range: 12 (12%) – 13 (13%)

Response is on topic and may have some depth.

Responses posted in the discussion may lack effective professional communication.

Responses to faculty questions are somewhat answered, if posed. .

Response may lack clear, concise opinions and ideas, and a few or no credible sources are cited.
Points Range: 0 (0%) – 11 (11%)

Response may not be on topic and lacks depth.

Responses posted in the discussion lack effective professional communication.

Responses to faculty questions are missing.

No credible sources are cited.

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics
Participation
Points Range: 5 (5%) – 5 (5%)
Meets requirements for participation by posting on three different days.
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Points Range: 0 (0%) – 0 (0%)
Does not meet requirements for participation by posting on 3 different days
Total Points: 100

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics Example

As an Intensive Care Unit (ICU) nurse of 10 years, I have taken care of a variety of different people with a broad spectrum of illnesses and problems. Pharmacokinetics, or how the body processes a drug, must be carefully considered for the best treatment options (Rosenthal & Burchum, 2018). A typical patient diagnosis that can be particularly difficult to manage medically is drug and alcohol abusers. Their drug tolerances and organ impairment related to damage from abuse can make it especially challenging to treat their conditions.

I vividly remember taking care of a patient in their early 30s who was admitted to the medical intensive care unit that I worked in for alcohol withdrawal. He had no past medical history except for alcohol and benzodiazepine abuse. He was found by a family member in alcohol withdrawal and was immediately brought to the hospital. The clinical institute withdrawal assessment for alcohol scale (CIWA), was used to determine the severity of withdrawal. This scale views different symptoms of withdrawal such as nausea/vomiting, tremors, sweats, anxiety, agitation, visual and auditory disturbances, headache, and orientation (MERCK Manual Professional Version, 2020). His CIWA score was extremely high, which showed severe withdrawal.

Typical treatment for alcohol withdrawal includes the administration of benzodiazepines in order to get through the detox process. This drug helps lessen the withdrawal symptoms. When giving this patient a standard dose of benzodiazepines such as Ativan or Valium, there was no decrease in clinical symptoms. This was because of his history of benzodiazepine abuse and increased tolerance. Increased drug administration and frequency were ordered until the patient’s withdrawal symptoms were under control. However, the patient also had liver damage from alcoholic cirrhosis. Benzodiazepines are drugs that are metabolized by the liver (Brett & Murnion, 2015).  Since the liver was not functioning correctly, the medications administered to control alcohol withdrawal were not processed appropriately by the liver, causing a buildup of the drugs (Louvet & Mathurin, 2015). The patient became unresponsive, and an advanced airway was placed for airway protection. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

I feel that this patient’s care could have been handled differently. Due to this patient’s history, a different plan of treatment should have been initiated. I feel that by following the standard protocol for alcohol withdrawal treatment, the outcome of this patient getting intubated was inevitable. However, the patient will remain unresponsive until his body cleared all of the benzodiazepine drugs. This could be a lengthy process and delay his care further. I would have suggested intubation and mechanical ventilation from admission, and to use sedation safe for the liver. By doing this, the patient would be able to overcome his detox safely and have his breathing tube removed sooner. This would decrease any other risks associated with prolonged mechanical ventilation NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

 

References

Brett, J., & Murnion, B. (2015, October). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152-155. http://dx.doi.org/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4657308/

Louvet, A., & Mathurin, P. (2015, March 15). Alcoholic liver disease: mechanisms of injury and targeted treatment. Nature Reviews Gastroenterology, 12, 231-242. Retrieved from https://www.nature.com/articles/nrgastro.2015.35

MERCK Manual Professional Version. (2020). CIWA. Retrieved February 27, 2020, from https://www.merckmanuals.com/professional/multimedia/clinical-calculator/CIWA%20Ar%20Clinical%20Institute%20Withdrawal%20Assessment%20for%20Alcohol%20Scale

Rosenthal, L. D., & Burchum, J. R. (2018). Lehne’s pharmacotherapeutics for advanced practice providers. St. Louis, MO: Elsevier. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

 

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics Example

Pharmacokinetics refers to the processes that the body subjects a drug to once administered. These processes include absorption, distribution, metabolism, and excretion. Contrarily, pharmacodynamics describes the effects that a drug has on the body, such as changes in the physiological processes and the side effects. The two processes are affected by different patient characteristics, such as age and gender. I have worked with the pediatric patient population and observed the two concepts in these patients. Lu and Rosenbaum (2014) define the pediatric population as consisting of neonates, infants, developing children, and adolescents. Their age affects pharmacokinetics and pharmacodynamics in various ways.

I have learned a lot from my experience with pediatric patient populations. First, the effective administration of drugs is tremendously challenging. This is because the rapid developments taking place inside the body have profound effects on pharmacokinetics and pharmacodynamics. For example, the gastric PH of a pediatric patient changes rapidly from birth through to childhood, which affects the efficiency of orally administered drugs. In addition, their physical size and physiological factors such, as membrane permeability, vary as the individual matures. In one instance, medicine administered to two children with similar conditions, and with an age differential of two months, had different results due to fast growth rate. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

ORDER NOW FOR CUSTOMIZED SOLUTION PAPERS

Administering drugs to pediatric patient population requires careful consideration of their unique physical and physiological characteristics. For example, the difference in the physical size between neonates and infants require that they are given different dosage sizes. Growth occurs very fast when the child is young, and it is critical to have the exact age and weight to administer the correct dosage. Another essential factor to consider in administering drugs is the PH of the gut. At birth, for example, gastric PH is neutral. Administering drugs to neonates should then consider the chemical composition of drugs administered orally to ensure they are effective (van den Anker et al., 2018). Every child should be treated uniquely as the rate of growth, and bodily changes vary. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

References

Lu, H., & Rosenbaum, S. (2014). Developmental pharmacokinetics in pediatric populations. The Journal of Pediatric Pharmacology and Therapeutics, 19(4), 262-276.

van den Anker, J., Reed, M. D., Allegaert, K., & Kearns, G. L. (2018). Developmental changes in pharmacokinetics and pharmacodynamics. The Journal of Clinical Pharmacology, 58(10), S10-S25 NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

 

NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics Response

Great job on explaining how medication administration can be influenced on patient factors such that of a pediatric patient. I work on the opposite end of the spectrum-gerontology patients so reading your discussion post was interesting and educational. I did some additional research on how medication administration and prescribing is different upon the pediatric population. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics

In review of literature one potential restraint that providers have when it comes to the pediatric patients is considering the likelihood that oral medications may be rejected due to the taste and texture that they are available in. It is essential for providers to understand the developmental pathway that occurs in terms of pediatric patients. According to Eidelman & Abdel-Rahman (2016), “the capacity to discriminate sweet and umami is present in utero, followed by texture, temperature and piquancy at 1–2 years of age and finally bitter, salty and sour around the age of 2 years. Olfactory senses do not appear to fully mature until children are 5–7 years of age. Other adaptive behaviors, which typically manifest by 2–5 years of age, influence a child’s willingness to accept novel foods, and by extension, medicines” (Eidelman & Abdel-Rahman, 2016, p.70). It is essential that providers are aware of all of the available forms and flavors that medications come in to ensure that medication is not rejected by the pediatric patient to ensure that the medication is effective. I found this factor interesting as it is not something that I would have considered or thought to consider prior to reviewing the content that is covered in this week’s material NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics.

Cultural differences that may exist between the prescribing provider and the patient and their families should also be taken into consideration when prescribing medications. Many different cultures will often use traditional and herbal medications in addition to mainstream medications so having a clear understanding of these cultural differences and being able to ask appropriate questions to identify other health practices is essential as traditional and herbal medications can influence the effectiveness and interactions between the two treatment options (World Health Organization, 2007, p.10).

 

Eidelman, C. &.-R. (2016). Pharmacokinetic considerations when prescribing in children. International Journal of Pharmacokinetics, 69-80.

Organization, W. H. (2007). Promoting Safety of Medicines for Children. Geneva: WHO Press. NURS 6521 week 1 Discussion: Pharmacokinetics and Pharmacodynamics