NRNP 6540 Week1 Discussion

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NRNP 6540 Week1 Discussion

To prepare:

 

Review this week’s Learning Resources, considering how assessment tools are used to evaluate patients.

Your Instructor will assign a case study to use for this Discussion. Review the case study and, based on the provided information, think about a possible patient evaluation plan. As part of your evaluation planning, consider where the evaluation would take place, whether any other professionals or family members should be present, appropriate assessment tools and guidelines, and any other relevant information you may wish to address.

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Consider whether the assessment tool you identified was validated for use with this specific patient population and if this poses issues. Think about additional factors that might present issues when performing assessments such as language, education, prosthetics, missing limbs, etc. NRNP 6540 Week1 Discussion

Consider immunization requirements that may be needed for this patient.

 

Case Study 1:

Mr. Perkins, age 81, reports for an annual physical examination. He says he is doing well. His only known problem is osteoarthritis. He also requests a flu shot. He takes no medications other than Tylenol for arthritis pain. When he walks into the exam room, you notice that he is using a straight cane in his right hand. When you ask about the cane, he says he began using the cane because the pain in his right hip had increased significantly over the past 6 months.

Solution:
The case study assigned involves Mr. Perkins, age 81 who presents for her annual physical examination. His key health problem is osteoarthritis. Current medications include Tylenol for managing arthritis pain. The patient also complains of pain at his right hip. Given that osteoarthritis is among the key cause of hip pain in older adults, it would be important to carry out the assessment. NRNP 6540 Week1 Discussion

NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

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NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

Focused SOAP Note Template

Patient Information:

Initials, Age, Sex, Race

S (subjective)

CC (chief complaint): a BRIEF statement identifying why the patient is here, stated in the patient’s own words (for instance “headache,” NOT “bad headache for 3 days”).

HPI (history of present illness): This is the symptom analysis section of your note. Thorough documentation in this section is essential for patient care, coding, and billing analysis. Paint a picture of what is wrong with the patient. Use LOCATES Mnemonic to complete your HPI. You need to start EVERY HPI with age, race, and gender (e.g., 34-year-old AA male). You must include the seven attributes of each principal symptom in paragraph form not a list. If the CC was “headache”, the LOCATES for the HPI might look like the following example:

  • Location: Head
  • Onset: 3 days ago
  • Character: Pounding, pressure around the eyes and temples
  • Associated signs and symptoms: Nausea, vomiting, photophobia, phonophobia
  • Timing: After being on the computer all day at work
  • Exacerbating/relieving factors: Light bothers eyes; Aleve makes it tolerable but not completely better
  • Severity: 7/10 pain scale

Current Medications: Include dosage, frequency, length of time used, and reason for use; also include over the counter (OTC) or homeopathic products.

Allergies: Include medication, food, and environmental allergies separately, including a description of what the allergy is (i.e., angioedema, anaphylaxis, etc.). This will help determine a true reaction versus intolerance.

PMHx: Include immunization status (note date of last tetanus for all adults), past major illnesses, and surgeries. Depending on the CC, more info is sometimes needed. NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

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Soc and Substance Hx: Include occupation and major hobbies, family status, tobacco and alcohol use (previous and current use), and any other pertinent data. Always add some health promo question here, such as whether they use seat belts all the time or whether they have working smoke detectors in the house, living environment, text/cell phone use while driving, and support system.

Fam Hx: Illnesses with possible genetic predisposition, contagious, or chronic illnesses. Reason for death of any deceased first-degree relatives should be included. Include parents, grandparents, siblings, and children. Include grandchildren if pertinent.

Surgical Hx: Prior surgical procedures.

Mental Hx: Diagnosis and treatment. Current concerns (anxiety and/or depression). History of self-harm practices and/or suicidal or homicidal ideation.

Violence Hx: Concern or issues about safety (personal, home, community, sexual (current and historical).

Reproductive Hx: Menstrual history (date of LMP), Pregnant (yes or no), Nursing/lactating (yes or no), contraceptive use (method used), types of intercourse (oral, anal, vaginal, other, any sexual concerns).

ROS (review of symptoms): Cover all body systems that may help you include or rule out a differential diagnosis You should list each system as follows:

  • General:
  • Head:
  • EENT (eyes, ears, nose, and throat):
  • :

Note: You should list these in bullet format, and document the systems in order from head to toe.

Example of Complete ROS:

GENERAL: No weight loss, fever, chills, weakness, or fatigue.

HEENT:

  • Eyes: No visual loss, blurred vision, double vision or yellow sclerae.
  • Ears, Nose, Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat.

SKIN: No rash or itching.

CARDIOVASCULAR: No chest pain, chest pressure or chest discomfort. No palpitations or edema.

RESPIRATORY: No shortness of breath, cough or sputum.

GASTROINTESTINAL: No anorexia, nausea, vomiting or diarrhea. No abdominal pain or blood.

GENITOURINARY: Burning on urination. Last menstrual period (LMP), MM/DD/YYYY.

NEUROLOGICAL: No headache, dizziness, syncope, paralysis, ataxia, numbness or tingling in the extremities. No change in bowel or bladder control.

MUSCULOSKELETAL: No muscle, back pain, joint pain or stiffness.

HEMATOLOGIC: No anemia, bleeding or bruising. NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

LYMPHATICS: No enlarged nodes. No history of splenectomy.

PSYCHIATRIC: No history of depression or anxiety.

ENDOCRINOLOGIC: No reports of sweating, cold or heat intolerance. No polyuria or polydipsia.

REPRODUCTIVE: Not pregnant and no recent pregnancy. No reports of vaginal or penile discharge. Not sexually active.

ALLERGIES: No history of asthma, hives, eczema or rhinitis.

O (objective)

Physical exam: From head-to-toe, include what you see, hear, and feel when doing your physical exam. You only need to examine the systems that are pertinent to the CC, HPI, and History. Do not use “WNL” or “normal.” You must describe what you see. Always document in head to toe format (i.e., General: Head: EENT: etc.).

Diagnostic results: Include any labs, x-rays, or other diagnostics that are needed to develop the differential diagnoses (support with evidenced and guidelines).

A (assessment)

Differential diagnoses: List a minimum of three differential diagnoses. Your primary or presumptive diagnosis should be at the top of the list. For each diagnosis, provide supportive documentation with evidence-based guidelines.

P (plan)

Includes documentation of diagnostic studies that will be obtained, referrals to other health-care providers, therapeutic interventions, education, disposition of the patient, and any planned follow up visits. Each diagnosis or condition documented in the assessment should be addressed in the plan. The details of the plan should follow an orderly manner.

Also included in this section is the reflection. Reflect on this case, and discuss what you learned, including any “aha” moments or connections you made.

Also include in your reflection, a discussion related to health promotion and disease prevention taking into consideration patient factors (such as, age, ethnic group, etc.), PMH, and other risk factors (e.g., socio-economic, cultural background, etc.).

References

You are required to include at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure to use correct APA 7th edition formatting.

Week 2: Psychosocial Disorders

In so many countries, to be old is shameful; to be mentally ill as well as old is doubly shameful. In so many countries, people with elderly relatives who are also mentally ill are ashamed and try to hide what they see as a disgrace on the family.

—Dr. Nori Graham, Psychiatrist and Honorary Vice President of Alzheimer’s Disease International

In this quote, Dr. Graham is expressing her observations and experiences in her work with numerous international organizations. Many patients and their families experience feelings of anxiety and shame upon receiving a diagnosis of dementia, delirium, or depression. Among caregivers, 36% report having tried to hide the dementia diagnosis of their family member (Alzheimer’s Disease International, 2019). As an advanced practice nurse providing care to patients presenting with dementia, delirium, and depression, it is critically important to consider the impact of these disorders on patients, caregivers, and their families. A thorough understanding of the health implications of these disorders, as well as each patient’s personal concerns, will aid you in making effective treatment and management decisions. NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

This week, you explore geriatric patient presentations of dementia, delirium, and depression. You also examine assessment, diagnosis, and treatment for these disorders and complete a SOAP (subjective, objective, assessment, and plan) note.

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Reference:
Alzheimer’s Disease International. (2019). World Alzheimer report 2019: Attitudes to dementia. Author. https://www.alz.co.uk/research/world-report-2019

Learning Objectives

Students will:

  • Evaluate patients presenting with symptoms of dementia, delirium, or depression
  • Develop differential diagnoses for patients with psychosocial disorders
  • Develop appropriate treatment plans, including diagnostics and laboratory orders, for patients with psychosocial disorders

 

Assignment: Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression

Photo Credit: Getty Images

With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders. While many symptoms of dementia, delirium, and depression are similar, it is important that you are able to identify those that are different and properly diagnose patients. A diagnosis of one of these disorders is often difficult for patients and their families. In your role as an advanced practice nurse, you must help patients and their families manage the disorder by facilitating necessary treatments, assessments, and follow-up care.

To prepare:

  • Review the case study provided by your Instructor. Reflect on the way the patient presented in the case, including whether the patient might be presenting with dementia, delirium, or depression.
  • Reflect on the patient’s symptoms and aspects of disorders that may be present. What distinct symptoms or factors would lead you to a diagnosis of dementia, delirium, or depression?
  • Consider how you might assess, perform diagnostic tests, and recommend medications to treat patients presenting with the symptoms in the case.
  • Access the Focused SOAP Note Template in this week’s Resources.

The Assignment:

Complete the Focused SOAP Note Template provided for the patient in the case study. Be sure to address the following:

  • Subjective: What was the patient’s subjective complaint? What details did the patient provide regarding their history of present illness and personal and medical history? Include a list of prescription and over-the-counter drugs the patient is currently taking. Compare this list to the American Geriatrics Society Beers Criteria®, and consider alternative drugs if appropriate. Provide a review of systems.
  • Objective: What observations did you note from the physical assessment? What were the lab, imaging, or functional assessments results? How would you interpret and address the results of the Mini-Mental State Examination (MMSE)?
  • Assessment: Provide a minimum of three differential diagnoses. List them from top priority to least priority. Compare the diagnostic criteria for each, and explain what rules each differential in or out. Explain you critical thinking process that led you to the primary diagnosis you selected. Include pertinent positives and pertinent negatives for the specific patient case.
  • Plan: Provide a detailed treatment plan for the patient that addresses each diagnosis, as applicable. Include documentation of diagnostic studies that will be obtained, referrals to other healthcare providers, therapeutic interventions, education, disposition of the patient, caregiver support, and any planned follow-up visits. Provide a discussion of health promotion and disease prevention for the patient, taking into consideration patient factors, past medical history (PMH), and other risk factors. Finally, include a reflection statement on the case that describes insights or lessons learned. NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study
  • Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines, which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. Follow APA 7th edition formatting.

Reminder: The College of Nursing requires that all papers submitted include a title page, introduction, summary, and references. The Sample Paper provided at the Walden Writing Center provides an example of those required elements (available at http://writingcenter.waldenu.edu/57.htm). All papers submitted must use this formatting.

 

By Day 7

 

 

Rubric Detail Tutor needs to FOLLOW

 

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

Name: NRNP_6540_Week2_Assignment_Rubric

 

  Excellent Fair Poor
Create documentation in the Focused SOAP Note Template about the patient in the case study to which you were assigned.

In the Subjective section, provide:
• Chief complaint
• History of present illness (HPI)
• Current medications, checked against Beers Criteria
• Allergies
• Patient medical history (PMHx)
• Review of systems

 9 (9%) – 10 (10%)

The response throughly and accurately describes the patient’s subjective complaint, history of present illness, current medications, allergies, medical history, and review of all systems that would inform a differential diagnosis. A thorough cross-check of medications against the Beers Criteria has been completed and appropriate alternative drugs recommended if applicable. NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

 7 (7%) – 7 (7%)

The response describes the patient’s subjective complaint, history of present illness, current medications, allergies, medical history, and review of all systems that would inform a differential diagnosis, but is somewhat vague or contains minor innacuracies. A cross-check of medications against the Beers Criteria has been completed but alternatives may be missing.

 0 (0%) – 6 (6%)

The response provides an incomplete or inaccurate description of the patient’s subjective complaint, history of present illness, current medications, allergies, medical history, and review of all systems that would inform a differential diagnosis. A cross-check of medications against the Beers Criteria has not been completed. Or, subjective documentation is missing.
In the Objective section, provide:
• Physical exam documentation of systems pertinent to the chief complaint, HPI, and history
• Diagnostic results, including any labs, imaging, or other assessments needed to develop the differential diagnoses		 9 (9%) – 10 (10%)

The response thoroughly and accurately documents the patient’s physical exam for pertinent systems. Diagnostic tests and their results are thoroughly and accurately documented.

 7 (7%) – 7 (7%)

Documentation of the patient’s physical exam is somewhat vague or contains minor innacuracies. Diagnostic tests and their results are documented but contain minor innacuracies.

 0 (0%) – 6 (6%)

The response provides incomplete or inaccurate documentation of the patient’s physical exam. Systems may have been unnecessarily reviewed, or, objective documentation is missing.
In the Assessment section, provide:
• At least three (3) differentials with supporting evidence. Explain what rules each differential in or out, and justify your primary diagnosis selection. Include pertinent positives and pertinent negatives for the specific patient case.		 23 (23%) – 25 (25%)

The response lists in order of priority at least three distinctly different and detailed possible conditions for a differential diagnosis of the patient in the assigned case study, and provides a thorough, accurate, and detailed justification for each of the conditions selected.

 18 (18%) – 19 (19%)

The response lists three possible conditions for a differential diagnosis of the patient in the assigned case study, with some vagueness and/or inaccuracy in the conditions and/or justification for each.

 0 (0%) – 17 (17%)

The response lists two or fewer, or is missing, possible conditions for a differential diagnosis of the patient in the assigned case study, with inaccurate or missing justification for each condition selected.
In the Plan section, provide:
• A detailed treatment plan for the patient that addresses each diagnosis, as applicable. Includes documentation of diagnostic studies that will be obtained, referrals to other health-care providers, therapeutic interventions, education, disposition of the patient, and any planned follow up visits.
• A discussion related to health promotion and disease prevention taking into consideration patient factors, PMH, and other risk factors.
• Reflections on the case describing insights or lessons learned.		 27 (27%) – 30 (30%)

The response thoroughly and accurately outlines a treatment plan for the patient that addresses each diagnosis and includes diagnostic studies neeed, referrals, therapeutic interventions, patient education and disposition, and planned follow-up visits. A thorough and accurate discussion of health promotion and disease prevention related to the case is provided. Reflections on the case demonstrate strong critical thinking and synthesis of ideas.

 21 (21%) – 23 (23%)

The response somewhat vaguely or inaccurately outlines a treatment plan for the patient. The discussion on health promotion and disease prevention related to the case is somewhat vague or contains innaccuracies. Reflections on the case demonstrate adequate understanding of course topics.

 0 (0%) – 20 (20%)

The response does not address all diagnoses or is missing elements of the treatment plan. The discussion on health promotion and disease prevention related to the case is vague, innaccurate, or missing. Reflections on the case are vague or missing.
Provide at least three evidence-based peer-reviewed journal articles or evidenced-based guidelines which relate to this case to support your diagnostics and differentials diagnoses. Be sure they are current (no more than 5 years old) and support the treatment plan in following current standards of care. 9 (9%) – 10 (10%)

The response provides at least three current, evidence-based resources from the literature to support the treatment plan for the patient in the assigned case study. Each resource represents the latest in standards of care and provides strong justification for treatment decisions.

 . 7 (7%) – 7 (7%)

Three evidence-based resources are provided to support treatment decisions, but may not represent the latest in standards of care or may only provide vague or weak justification for the treatment plan.

 0 (0%) – 6 (6%)

Two or fewer resources are provided to support treatment decisions. The resources may not be current or evidence-based, or do not support the treatment plan.
Written Expression and Formatting—Paragraph Development and Organization:
Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused–neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction are provided that delineate all required criteria.		 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineate all required criteria. NRNP 6540 WU The Signs of The Disease Anxiety and Restlessness Case Study

 3 (3%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment is vague or off topic.

 0 (0%) – 2 (2%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.
Written Expression and Formatting—English writing standards:
Correct grammar, mechanics, and proper punctuation		 5 (5%) – 5 (5%)

Uses correct grammar, spelling, and punctuation with no errors.

 3 (3%) – 3 (3%)

Contains several (three or four) grammar, spelling, and punctuation errors.

 0 (0%) – 2 (2%)

Contains many (≥ five) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, running heads, parenthetical/in-text citations, and reference list. 5 (5%) – 5 (5%)

Uses correct APA format with no errors.

 3 (3%) – 3 (3%)

Contains several (three or four) APA format errors.

 0 (0%) – 2 (2%)

Contains many (≥ five) APA format errors.
Total Points: 100  

Name: NRNP_6540_Week2_Assignment_Rubric

 

Week 2: Psychosocial CASE SCENARIO

Week 2 Case 1: Dementia

HPI: Ms. Peters is a 70-year-old female who is brought to your office by her son with reports of acute confusion (more than usual) and some agitation and restlessness. She has a known history of dementia, managed with Aricept 10 mg. daily. Her son, Jared, reports that 2 days ago she began to become more confused than usual and very easily agitated. He reports that yesterday, she couldn’t remember where she was in her own home. She had a doctor’s appointment 3 days ago and her HCTZ (hydrochlorothiazide) was increased to 50 mg. due to increased bp’s.

Ms. Peter’s last Mini-Mental State Exam (MMSE) score was 18/30. The assessment was repeated, and the score remained unchanged.

Ms. Peters and her son denies her having any falls or contributing traumas recently. She denies any changes in diet or routine regimens. No reported dysuria, no fever, nausea, or vomiting.

Note: Be sure to review the MMSE and how to interpret results (Mental State Assessment Tests). Make sure you document the patient’s score in your SOAP note document. Also review the Geriatric Depression Assessment (Geriatric Depression Scale [GDS]).

Ms. Peters is a 70-year-old female who is alert but easily distracted, at times, during today’s clinical interview. Her eye contact is fair. Speech is clear and coherent but tangential at times. She makes no unusual motor movements and demonstrates no tics. She denies any visual or auditory hallucinations. She denies any suicidal thoughts or ideations. She is alert but disoriented to place and time. She denies any falls, denies any pain. Her son does say she has had some “stumbling” and balance issues but no reported falls.

All other Review of System and Physical Exam findings are negative other than stated.

Vital Signs: 98.1 120/64 HR-72 20

PMH: Hypertension, Diabetes, Osteoporosis, Chronic Allergic Rhinitis

Allergies: Atorvastatin

Medications:

  • Multivitamin daily
  • Losartan 50mg daily
  • HCTZ 50mg daily
  • Fish Oil 1 tablet daily
  • Glyburide 5mg daily
  • Metformin 500mg BID
  • Donepezil 10mg daily
  • Alendronate 70mg orally once a week

Social History: As stated in Case Study

ROS: As stated in Case study

Diagnostics/Assessments done:

  1. CXR—no cardiopulmonary findings. WNL
  2. CT head—diffuse Cerebral Atrophy
  3. MMSE—Ms. Peters scored 18 out of 30 with primary deficits in orientation, registration, attention and calculation, and recall at a previous visit. At today’s visit, there is no change. The score suggests moderate dementia.
  4. Hemoglobin A1C7.2%
  5. Basic Metabolic Panel as shown below
TEST RESULT REFERENCE RANGE
GLUCOSE 90 65–99
SODIUM 130 135–146
POTASSIUM 3.4 3.5–5.3
CHLORIDE 104 98–110
CARBON DIOXIDE 29 19–30
CALCIUM 9.0 8.6–10.3
BUN 20 7–25
CREATININE 1.00 0.70–1.25
GLOMERULAR FILTRATION RATE (eGFR) 77 >or=60 mL/min/1.73m2

 

NURS 6630 Walden Psychopharmacological Approaches to Treat Psychopathology Ques

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NURS 6630 Walden Psychopharmacological Approaches to Treat Psychopathology Ques

Description

Assignment 1: Short Answer Assessment

As a psychiatric nurse practitioner, you will likely encounter patients who suffer from various mental health disorders. Not surprisingly, ensuring that your patients have the appropriate psychopharmacologic treatments will be essential for their overall health and well-being. The psychopharmacologic treatments you might recommend for patients may have potential impacts on other mental health conditions and, therefore, require additional consideration for positive patient outcomes. For this Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.

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Photo Credit: Getty Images/Collection Mix: Sub

TO PREPARE

  • Review the Learning Resources for this week.
  • Reflect on the psychopharmacologic treatments that you have covered up to this point that may be available to treat patients with mental health disorders.
  • Consider the potential effects these psychopharmacologic treatments may have on co-existing mental health conditions and/or their potential effects on your patient’s overall health. NURS 6630 Walden Psychopharmacological Approaches to Treat Psychopathology Ques

TO COMPLETE:

Address the following Short Answer prompts for your Assignment. Be sure to include references to the Learning Resources for this week.

  1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse. Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
  2. List 4 predictors of late onset generalized anxiety disorder.
  3. List 4 potential neurobiology causes of psychotic major depression.
  4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
  5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.

Assignment 2: Assessing and Treating Patients With Sleep/Wake Disorders

Sleep disorders are conditions that result in changes in an individual’s pattern of sleep (Mayo Clinic, 2020). Not surprisingly, a sleep disorder can affect an individual’s overall health, safety, and quality of life. Psychiatric nurse practitioners can treat sleep disorders with psychopharmacologic treatments, however, many of these drugs can have negative effects on other aspects of a patient’s health and well-being. Additionally, while psychopharmacologic treatments may be able to address issues with sleep, they can also exert potential challenges with waking patterns. Thus, it is important for the psychiatric nurse practitioner to carefully evaluate the best psychopharmacologic treatments for patients that present with sleep/wake disorders.

Reference: Mayo Clinic. (2020). Sleep disorders. https://www.mayoclinic.org/diseases-conditions/sle…

TO PREPARE FOR THIS ASSIGNMENT:

  • Review this week’s Learning Resources, including the Medication Resources indicated for this week.
  • Reflect on the psychopharmacologic treatments you might recommend for the assessment and treatment of patients with sleep/wake disorders. NURS 6630 Walden Psychopharmacological Approaches to Treat Psychopathology Ques

THE ASSIGNMENT: 5 PAGES

Examine Case Study: Pharmacologic Approaches to the Treatment of Insomnia in a Younger Adult. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’s pharmacokinetic and pharmacodynamic processes.

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

Introduction to the case (1 page)

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

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Decision #1 (1 page)

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

Decision #2 (1 page)

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

Decision #3 (1 page)

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

Conclusion (1 page)

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

Note: Support your rationale with a minimum of five academic resources. While you may use the course text to support your rationale, it will not count toward the resource requirement. You should be utilizing the primary and secondary literature. NURS 6630 Walden Psychopharmacological Approaches to Treat Psychopathology Ques

NRS-440 – Examine Changes Introduced To Reform Or Restructure The U.S. Health Care Delivery System

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NRS-440 – Examine Changes Introduced To Reform Or Restructure The U.S. Health Care Delivery System

Holistic Care and Treatments Assignment

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Holistic Care and Treatments Assignment

The use of complementary and alternative therapies in the treatment of cancer patients, terminal patients, and many other types of patients is steadily increasing. The Resources also contain much information about the various alternative therapies currently being used. For this Discussion, you will consider alternative therapies and discuss the challenges associated with them.

 

To prepare for this Discussion:

 

  • Review the Resources pertaining to alternative therapies.
  • Select one of the following areas where alternative therapies are being used: Cancer treatment o Cancer symptom management o End-of-life care o Palliative care
  • Find at least one scholarly journal article discussing alternative therapies in your chosen subtopic. By Day 3 Respond to the following:
  • Identify at least one challenge associated with the nurse’s role in providing alternative therapies for patient care. Holistic Care and Treatments Assignment
  • Explain how the nurse might integrate the use of Complementary and Alternative Medicine (CAM) approaches in your chosen subtopic and discuss the ethical issues nurses may face.
  • What are the main elements you would include in a teaching plan for nurses on the use of CAM in your chosen subtopic?
  • What is the shared role of the nurse and patient in developing care plans?

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Support your response with references from the professional nursing literature. Note Initial Post: A 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations.

 

Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ? 5 years old). Holistic Care and Treatments Assignment

Week 2 Discussion Social Determinants Of Health Assignment

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Week 2 Discussion Social Determinants Of Health Assignment

Week 2 Discussion Social Determinants of Health

Social Determinants of Health The discussion assignment provides a forum for discussing relevant topics for this week on the basis of the course competencies covered. For this assignment, make sure you post your initial response to the Discussion Area by the due date assigned and complete your participation for this assignment by Day 7.

To support your work, use your course and text readings and also use resources from the South University Online Library. As in all assignments, cite your sources in your work and provide references for the citations in APA format. Support your work, using your course lectures and textbook readings. Helpful APA guides and resources are available in the South University Online Library.

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Below are guides that are located in the library and can be accessed and downloaded via the South University Online Citation Resources: APA Style page. The American Psychological Association website also provides detailed guidance on formatting, citations, and references at APA Style.

• APA Citation Helper
• APA Citations Quick Sheet
• APA-Style Formatting Guidelines for a Written Essay
• Basic Essay Template Begin reviewing and replying to peer postings/responses early in the week to enhance peer discussion. Week 2 Discussion Social Determinants Of Health Assignment

See the rubric for participation points. Participate in the discussion by asking a question, providing a statement of clarification, providing viewpoints with a rationale, challenging aspects of the discussion, or indicating relationships between two or more lines of reasoning in the discussion. Always use constructive language, even in criticism, to work toward the goal of positive progress. TASK Post your initial response to one of the two topics below. Social Determinants of Health Topic 1 Increasingly, health policymakers are becoming aware of the social determinants of health and the role they play in prevention disease and promoting health and wellness.

In the “Frameworks for Action in Policy and Politics” chapter, examine Box 1-1 (Political Aspects of the Social Determinants of Health) and Figure 1-6 (The Who, What, Where, When, and Why of Nursing’s Policy Influence). Compare these with the story about Lilian Wald’s work in New York City. Reflect on the “what” of Wald’s strategies. In your opinion, which did she use effectively? Looking further at the “what” in Figure 1-6, answer any one of the following questions:

Discuss at least three competencies/strategies that you have used effectively. Identify three competencies/strategies that you don’t currently use and discuss how you might incorporate them into your advocacy toolbox. Topic 2 Review the four recommendations in the IOM report The Future of Nursing: Leading Change, Advancing Health and find your state’s action coalition. Discuss your state’s action coalition’s work as it aligns with these four recommendations. Is each recommendation being addressed? Based on your analysis of the website, how would you describe your state’s progress toward meeting the IOM recommendations? Week 2 Discussion Social Determinants Of Health Assignment

Research Plan Preparation Worksheet Assignment

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Research Plan Preparation Worksheet Assignment

After selecting a historical topic to research further, the next step in the research process is to create a research plan that compiles primary and secondary sources. First, applying what you just learned about narrowing research questions, revise your research questions from your Topic Exploration Worksheet.

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Explain how you approached revising your research questions to assist your instructor in understanding your approach. This will help you draft an introduction to a hypothetical research paper with a strong thesis statement. Finally, applying what you have learned about comparing primary sources and analyzing secondary sources, do a deeper dive into the primary sources you listed in Part 3 of your Topic Exploration Worksheet to help you start your research plan.

 

Describe what these sources add to your understanding of your selected topic. The feedback you receive from this assignment should be implemented as you work towards your Research Plan and Introduction for Project 3.

NURS – 6051N Module 4: Technologies Supporting Applied Practice and Optimal Patient Outcomes

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NURS – 6051N Module 4: Technologies Supporting Applied Practice and Optimal Patient Outcomes

Discussion: Healthcare Information Technology Trends

 

Throughout history, technological advancements have appeared for one purpose before finding applications elsewhere that lead to spikes in its usage and development. The internet, for example, was originally developed to share research before becoming a staple of work and entertainment. But technology—new and repurposed—will undoubtedly continue to be a driver of healthcare information. Informaticists often stay tuned to trends to monitor what the next new technology will be or how the next new idea for applying existing technology can benefit outcomes. In this Discussion, you will reflect on your healthcare organization’s use of technology and offer a technology trend you observe in your environment. NURS – 6051N Module 4: Technologies Supporting Applied Practice and Optimal Patient Outcomes

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To Prepare:

  • Reflect on the Resources related to digital information tools and technologies.
  • Consider your healthcare organization’s use of healthcare technologies to manage and distribute information.
  • Reflect on current and potential future trends, such as use of social media and mobile applications/telehealth, Internet of Things (IoT)-enabled asset tracking, or expert systems/artificial intelligence, and how they may impact nursing practice and healthcare delivery.

 

By Day 3 of Week 6 Post a brief description of general healthcare technology trends, particularly related to data/information you have observed in use in your healthcare organization or nursing practice. Describe any potential challenges or risks that may be inherent in the technologies associated with these trends you described. Then, describe at least one potential benefit and one potential risk associated with data safety, legislation, and patient care for the technologies you described.

 

Next, explain which healthcare technology trends you believe are most promising for impacting healthcare technology in nursing practice and explain why. Describe whether this promise will contribute to improvements in patient care outcomes, efficiencies, or data management. Be specific and provide examples. NURS – 6051N Module 4: Technologies Supporting Applied Practice and Optimal Patient Outcomes

NRS-493 – New Practice Approaches Interprofessional Collaboration Health Care Delivery And Clinical Systems

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NRS-493 – New Practice Approaches Interprofessional Collaboration Health Care Delivery And Clinical Systems

Hematopoietic And Cardiovascular Assignment

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Hematopoietic And Cardiovascular Assignment

Hematopoietic: J.D. is a 37 years old white woman who presents to her gynecologist complaining of a 2-month history of intermenstrual bleeding, menorrhagia, increased urinary frequency, mild incontinence, extreme fatigue, and weakness. Her menstrual period occurs every 28 days and lately there have been 6 days of heavy flow and cramping. She denies abdominal distension, back-ache, and constipation. She has not had her usual energy levels since before her last pregnancy. Past Medical History (PMH): Upon reviewing her past medical history, the gynecologist notes that her patient is a G5P5with four pregnancies within four years, the last infant having been delivered vaginally four months ago. All five pregnancies were unremarkable and without delivery complications. All infants were born healthy. Patient history also reveals a 3-year history of osteoarthritis in the left knee, probably the result of sustaining significant trauma to her knee in an MVA when she was 9 years old. When asked what OTC medications she is currently taking for her pain and for how long she has been taking them, she reveals that she started taking ibuprofen, three tablets each day, about 2.5 years ago for her left knee. Hematopoietic And Cardiovascular Assignment

 

 

Due to a slowly progressive increase in pain and a loss of adequate relief with three tablets, she doubled the daily dose of ibuprofen. Upon the recommendation from her nurse practitioner and because long-term ibuprofen use can cause peptic ulcers, she began taking OTC omeprazole on a regular basis to prevent gastrointestinal bleeding. Patient history also reveals a 3-year history of HTN for which she is now being treated with a diuretic and a centrally acting antihypertensive drug. She has had no previous surgeries. Case Study Questions Name the contributing factors on J.D that might put her at risk to develop iron deficiency anemia. Within the case study, describe the reasons why J.D. might be presenting constipation and or dehydration.

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Why Vitamin B12 and folic acid are important on the erythropoiesis? What abnormalities their deficiency might cause on the red blood cells? The gynecologist is suspecting that J.D. might be experiencing iron deficiency anemia. In order to support the diagnosis, list and describe the clinical symptoms that J.D. might have positive for Iron deficiency anemia. If the patient is diagnosed with iron deficiency anemia, what do you expect to find as signs of this type of anemia? List and describe. Labs results came back for the patient. Hb 10.2 g/dL; Hct 30.8%; Ferritin 9 ng/dL; red blood cells are smaller and paler in color than normal. Research list and describe for appropriate recommendations and treatments for J.D.

 

Cardiovascular Mr. W.G. is a 53-year-old white man who began to experience chest discomfort while playing tennis with a friend. At first, he attributed his discomfort to the heat and having had a large breakfast. Gradually, however, discomfort intensified to a crushing sensation in the sternal area and the pain seemed to spread upward into his neck and lower jaw. The nature of the pain did not seem to change with deep breathing. When Mr. G. complained of feeling nauseated and began rubbing his chest, his tennis partner was concerned that his friend was having a heart attack and called 911 on his cell phone. The patient was transported to the ED of the nearest hospital and arrived within 30 minutes of the onset of chest pain. In route to the hospital, the patient was placed on nasal cannula and an IV D5W was started. Mr. G. received aspirin (325 mg po) and 2 mg/IV morphine. He is allergic to meperidine (rash). His pain has eased slightly in the last 15 minutes but is still significant; was 9/10 in severity; now7/10. In the ED, chest pain was not relieved by 3 SL NTG tablets.

 

He denies chills. Case Study Questions For patients at risk of developing coronary artery disease and patients diagnosed with acute myocardial infarct, describe the modifiable and non-modifiable risk factors. What would you expect to see on Mr. W.G. EKG and which findings described on the case are compatible with the acute coronary event? Having only the opportunity to choose one laboratory test to confirm the acute myocardial infarct, which would be the most specific laboratory test you would choose and why?

 

How do you explain that Mr. W.G temperature has increased after his Myocardial Infarct, when that can be observed and for how long? Base your answer on the pathophysiology of the event. Explain to Mr. W.G. why he was experiencing pain during his Myocardial Infarct. Elaborate and support your answer. Submission Instructions: Include both case studies in your post. Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources. Hematopoietic And Cardiovascular Assignment