Discussion: The Systems Development Life Cycle and the Nurse Informaticist

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Discussion: The Systems Development Life Cycle and the Nurse Informaticist

The systems development life cycle (SDLC) is a model for planning and implementing change within an organization. It is important for many individuals to be represented in the process, especially the end users of the system or the employees who must live with the change. As informatics become more and more widespread throughout the health care field, collaboration between information technology (IT) professionals and health care practitioners is becoming increasingly important. The nurse informaticist is able to combine the perspective of the information technology side with the clinical nursing perspective. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

While the titles and specific responsibilities of nurse informaticists vary across organizations and practice settings, the fundamental purpose of the role remains the same. Nurse informaticists synthesize their knowledge of how technology can improve health care with an understanding of clinical practice and workflow. This is why nurse informaticists can be instrumental in facilitating the SDLC for informatics in health care. For this Discussion, you examine the relationship between the nurse informaticist and the use of the SDLC. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

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To prepare:

  • Review the information in this week’s Learning Resources on the SDLC and the role of the nurse informaticist. Reflect on Chapter 1 of the Dennis, Wixom, and Roth course text and consider how the information about the systems analyst role translates into nursing and health care.
  • Consider a recent change in your organization related to the implementation of a new technology or system. How was this change handled? What was the general SDLC process? Who was involved, and what were the outcomes?
  • Identify whether your organization (or one with which you are familiar) has a formal title or position for the nurse informaticist. This position may be called by a different name, such as nurse informatics specialist or informatics analyst, so be sure to review the position description.
  • If your organization has a position for the nurse informaticist, what are the responsibilities of that position? If your organization does not have such a position, conduct research in the Walden Library and at credible online sources on the role of the nurse informaticist.
  • Reflect on the role of the nurse informaticist in the overall health care field. How is this position connected to the SDLC? Assess the benefits of having this specialized position within health care organizations and involving the nurse informaticist in the SDLC. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

    Post by tomorrow 8/30/16 550 words in APA format with a minimum of 3 references from the list provided under Required Readings. Apply the level 1 headings as numbered below:

    1) A description of how the systems development life cycle is utilized in your organization (Hospital), or in one with which you are familiar, and assess its effectiveness.

    2)  Assess the role of the nurse informaticist in your organization. If the nurse informaticist is not a current position within your organization, provide a description of the generally accepted role of the nurse informaticist based on this week’s Learning Resources and your own research.

    3)  Explain why it is important for the nurse informaticist to be involved in the SDLC process and the overall organizational benefits of having such involvement. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

     Required Readings

     Dennis, A., Wixom, B. H., & Roth, R. M. (2015). Systems analysis and design (6th ed.). Hoboken, NJ: Wiley.

Chapter 1, “The Systems Analyst and Information Systems Development” (pp. 1–34)

In this chapter, the authors clarify the relationship between systems analysts and information systems development. The chapter also covers the basic business applications of information systems.

McGonigle, D., & Mastrian, K. G. (2015). Nursing informatics and the foundation of knowledge (3rd ed.). Burlington, MA: Jones and Bartlett Learning.

Chapter 10, “Systems Development Life Cycle: Nursing Informatics and Organizational Decision Making” Discussion: The Systems Development Life Cycle and the Nurse Informaticist

Chapter 11, “Administrative Information Systems”

Quality, organizational decision making is a requisite to successful advancements in technology. This chapter explores how workplaces respond to the necessity for improved information systems.

Anderson, C., & Sensmeier, J. (2011). Nursing informatics scope of practice expands, salaries increase. Computers, Informatics, Nursing, 29(5), 319–320. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

 

Retrieved from the Walden Library databases.

 

This article assesses the growing need for informaticists in the health care industry. The combination of clinical and information technology experience that informaticists possess makes them invaluable in assisting in the health care industry’s transition into a heavier use of information systems.

Houston, S. M. (2012). Nursing’s role in IT projects. Nursing Management, 43(1), 18–19.

Retrieved from the Walden Library databases.

The societal advancements of information technology (IT) are major factors in the governance of health care organizations. This article gives an overview of how nurse informaticists blend their clinical know-how with IT to improve workflow and patient care  Discussion: The Systems Development Life Cycle and the Nurse Informaticist

 

 McLane, S., & Turley, J. P. (2011). Informaticians: How they may benefit your healthcare organization. The Journal of Nursing Administration, 41(1), 29–35.

Retrieved from the Walden Library databases.

Nursing informaticists help guide the implementation of information systems into health care organizations. The authors of this article evaluate how informaticists effect change in management and improve meaningful use in nursing practice.

Prestigiacomo, J. (2012). The rise of the senior nurse informaticist. Healthcare Informatics, 29(2), 38–43. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

 

Retrieved from the Walden Library databases.

 

The author of this article highlights the conditions of the health care industry and its growing reliance on data-driven decision making. Nurse informaticists are important in this transition, playing a major role in the development and utilization of electronic health records (EHRs).

Warm, D., & Thomas, B. (2011). A review of the effectiveness of the clinical informaticist role. Nursing Standard, 25(44), 35–38.

Retrieved from the Walden Library databases.

Health care organizations rely heavily on information management and technology for organizational maintenance and patient care. This article examines the clinical informaticist’s role in facilitating the implementation of health information technology and spearheading clinical risk management. Discussion: The Systems Development Life Cycle and the Nurse Informaticist

NURS-6501 week 1 discussion – sore throat essay

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NURS-6501 week 1 discussion – sore throat essay

NURS-6501 Module 1, week1 discussion. Topic: Discussion: Alterations in Cellular Processes

Alterations of cellular responses are caused by multiple changes occurring within the cell in response to the environmental stressors. When signals sent by the signaling molecules are received by the target cell, the normal cellular response is the end of the line. However, diseases cause alterations of cellular responses resulting in abnormal changes in the normal response processes and is often caused by…

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A 16-year-old boy comes to clinic with chief complaint of sore throat for 3 days. Denies fever or chills. PMH negative for recurrent colds, influenza, ear infections or pneumonias. NKDA or food allergies. Physical exam reveals temp of 99.6 F, pulse 78 and regular with respirations of 18. HEENT normal with exception of reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+. Positive anterior and posterior cervical adenopathy. Rapid strep test performed in office was positive. His HCP wrote a prescription for amoxicillin 500 mg po q 12 hours x 10 days disp #20. He took the first capsule when he got home and immediately complained of swelling of his tongue and lips, difficulty breathing with audible wheezing. 911 was called and he was taken to the hospital, where he received emergency treatment for his allergic reaction. NURS-6501 week 1 discussion – sore throat essay.
By Day 3 of Week 1

Post an explanation of the disease highlighted in the scenario you were provided. Include the following in your explanation:
•The role genetics plays in the disease.
•Why the patient is presenting with the specific symptoms described.
•The physiologic response to the stimulus presented in the scenario and why you think this response occurred.
•The cells that are involved in this process.
•How another characteristic (e.g., gender, genetics) would change your response.
Use three scholarly peer review article not later than FIVE YEARS eg 2015 to 2020 in writing this NURS-6501 week 1 discussion – sore throat essay paper.

 

Resources

https://www.youtube.com/watch?v=FXSuEIMrPQk

https://www.youtube.com/watch?v=Jz0wx1-jTds

McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.

file:///C:/Users/obyok/AppData/Local/Packages/Microsoft.MicrosoftEdge_8wekyb3d8bbwe/TempState/Downloads/Pathophysiology-%20The%20Biologic%20Basis%20for%20Disease%20in%20Adults%20and%20Children%20%20(1).pdf

Use this textbook and the YouTube videos and three scholarly peer reviewed articles related to cell and immunity and disease to write this 2 page discussion. The articles must be from 2015 to 2020. Cite in APA format. The link following the textbook is the E version of the textbook. NURS-6501 week 1 discussion – sore throat essay.

 

Rubric Detail

 

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

Name: NURS_6501_Discussion_Rubric

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

Answers all parts of the Discussion question(s) with reflective critical analysis and synthesis of knowledge gained from the course readings for the module and current credible sources. NURS-6501 week 1 discussion – sore throat essay

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.

 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.

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.

 35 (35%) – 39 (39%)

Responds to some of the Discussion question(s).

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.

 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.

Does not adhere to current APA manual writing rules and style.
Main Post: Timeliness 10 (10%) – 10 (10%)

Posts main post by Day 3.

 0 (0%) – 0 (0%)

N/A

 0 (0%) – 0 (0%)

N/A

NURS-6501 week 1 discussion – sore throat essay

 0 (0%) – 0 (0%)

Does not post main post by Day 3.
First Response 17 (17%) – 18 (18%)

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

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.

 15 (15%) – 16 (16%)

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.

 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.

NURS-6501 week 1 discussion – sore throat essay

 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.
Second Response 16 (16%) – 17 (17%)

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

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.

 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.

 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.

 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.
Participation 5 (5%) – 5 (5%)

Meets requirements for participation by posting on 3 different days.

 0 (0%) – 0 (0%)

N/A

 0 (0%) – 0 (0%)

N/A

 0 (0%) – 0 (0%)

Does not meet requirements for participation by posting on 3 different days.
Total Points: 100
NURS-6501 week 1 discussion – sore throat essay

Name: NURS_6501_Discussion_Rubric

 

 

NURS-6501 Module 1, week1 discussion. Topic: Discussion: Alterations in Cellular Processes

Alterations of cellular responses are caused by multiple changes occurring within the cell in response to the environmental stressors. When signals sent by the signaling molecules are received by the target cell, the normal cellular response is the end of the line. However, diseases cause alterations of cellular responses resulting in abnormal changes in the normal response processes and is often caused by diseases and are demonstrated as signs and symptoms. This paper examines a case study of a 16-year-old boy who visits the clinic with a chief complaint of sore throat for 3 days presenting in multiple symptoms. However, he experiences a severe allergic reaction after the administration of amoxicillin 500 mg. therefore, the role of genetics, presentation of specific symptoms and the impact of age factor are explored in this assignment.

Role of genetics

Recurrent sore throat is common particularly in children. It is caused by a Streptococcus group A bacteria and is often linked to genetics. Genetic variations taking place at the HLA region are linked to the recurrent nature of sore throat (Chauhan et al., 2016). In essence, these specific variations of the gene are evident during genetic testing and are associated with the immune systems interaction with pathogens. As such, the patient becomes more susceptible to sore throat following the genetic changes causing variations. Notably, insufficient responses of the antibody responses against SpeA bacteria are connected to immunologic and genetic factors (Chauhan et al., 2016). This challenges the recognition of the Streptococcus group A bacteria factor. NURS-6501 week 1 discussion – sore throat essay

Why the patient presents with the specific symptoms

The alteration of normal responses within the cells of the body results in the development of signs and symptoms of diseases. For instance, the invasion of Streptococcus group A bacteria in the body causes the secretion of pus and reddening as well as the inflammation of the throat. Clinical manifestations are thus associated with the pharynx colonialization by the fibronectin-binding proteins of Streptococcus pyogenes (Soderholm, Barnett, Sweet & Walker, 2018). On the other hand, the symptoms occurring on the patient after the administration of the first capsule of amoxicillin 500 mg are as a result of allergic reactions to antibiotics. Severe nausea and vomiting, dizziness, swelling of lips and face, fast heart rates, shortness of breath, wheezing and shock are common allergic responses to antibiotics.

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Physiologic response and cells involved in the process

The physiologic responses evident in this patient include reddened posterior pharynx with white exudate on tonsils that are enlarged to 3+. Positive anterior and posterior cervical adenopathy is also observed. On carrying out the rapid strep test, the patient turned out positive of Streptococcus group A bacteria. The adaptive and innate responses are responsible for the physiologic responses as they create a defense mechanism to fight the infection. Cellular mediators produce PGE2 and leukotriene B4 (LTB4 ), chemokines, antimicrobial peptides (AMPs), eicosanoids and proinflammatory cytokines among other substances which induce and maintain host responses. These cells include epithelial cells, macrophages, neutrophils and dendritic cells. NURS-6501 week 1 discussion – sore throat essay

How age factor would change the response

Age influences the risks of contracting diseases. This is to mean that some illnesses are more common in the young persons while others are common among the elderly. The increased prevalence of sore throat is recorded in children of between 5 to 15 years. According to Campbell et al. (2018), a 5 to 10% risk of sore throat infection exists among the adults regardless of the already established strong immune system. Safe pharmacologic treatment of sore throat patients should thus be guided by the age of the patient to prevent adverse reactions and allergies.

 

 

References

Campbell, P. T., Frost, H., Smeesters, P. R., Kado, J., Good, M. F., Batzloff, M., … & Steer, A. (2018). Investigation of group A Streptococcus immune responses in an endemic setting, with a particular focus on J8. Vaccine, 36(50), 7618-7624.

Chauhan, S., Kashyap, N., Kanga, A., Thakur, K., Sood, A., & Chandel, L. (2016). Genetic diversity among group A streptococcus isolated from throats of healthy and symptomatic children. Journal of tropical pediatrics, 62(2), 152-157.

Soderholm, A. T., Barnett, T. C., Sweet, M. J., & Walker, M. J. (2018). Group A streptococcal pharyngitis: Immune responses involved in bacterial clearance and GAS‐associated immunopathologies. Journal of leukocyte biology, 103(2), 193-213. NURS-6501 week 1 discussion – sore throat essay

 

Case Study On Death And Dying

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Case Study On Death And Dying

The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.

Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic study materials you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview. Case Study On Death And Dying

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Provide a 1,500-2,000-word ethical analysis while answering the following questions:

  1. How would George interpret his suffering in light of the Christian narrative, with an emphasis on the fallenness of the world?
  2. How would  George interpret his suffering in light of the Christian narrative, with an emphasis on the hope of resurrection?
  3. As George contemplates life with amyotrophic lateral sclerosis (ALS), how would the Christian worldview inform his view about the value of his life as a person?
  4. What sorts of values and considerations would the Christian worldview focus on in deliberating about whether or not George should opt for euthanasia?
  5. Given the above, what options would be morally justified in the Christian worldview for George and why?
  6. Based on your worldview, what decision would you make if you were in George’s situation? Case Study On Death And Dying

Remember to support your responses with the topic study materials.

Prepare this assignment according to the guidelines found in the APA Style Guide. An abstract is required.

This assignment uses a rubric.You are required to submit this assignment to LopesWrite.

1. Bioethics: A Primer for Christians

Read Chapters 6 and 12 in Bioethics: A Primer for Christians.

http://gcumedia.com/digital-resources/wm-b-eerdmans-publishing-co/2013/bioethics_a-primer-for-christians_ebook_3e.php
2. Called to Care: A Christian Worldview for Nursing

Read Chapters 10-12 in Called to Care: A Christian Worldview for Nursing.

http://gcumedia.com/digital-resources/intervarsity-press/2006/called-to-care_a-christian-worldview-for-nursing_ebook_2e.php Case Study On Death And Dying

3. Defining Death: Medical, Legal and Ethical Issues in the Determination of Death

Read the Introduction and Chapters 1-3 of “Defining Death: Medical, Legal and Ethical Issues in the Determination of Death” by the President’s Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research (1984).

https://repository.library.georgetown.edu/bitstream/handle/10822/559345/defining_death.pdf?sequence=1

Rubric

  1. Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  2. Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  3. Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.12%
  4. Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12% Case Study On Death And Dying
  5. Evaluation of which options would be justified in the Christian worldview for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials. 12%
  6. Reflection hypothesis of which personal choices would be make if faced with ALS based on personal worldview is clear, relevant, and insightful. 10%
  7. Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear. 7%
  8. Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative. 8%
  9. Writer is clearly in command of standard, written, academic English. 5%
  10. All format elements are correct.5%
  11. Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error. 5% Case Study On Death And Dying

6501 Week 3 discussion : Pathophysiology of Pain

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6501 Week 3 discussion : Pathophysiology of Pain

Pathophysiology of Pain

             Pain is described by Huether and McCance (2017) as a complex experience, one that includes physical, cognitive, spiritual, emotional, and environmental factors, which may be a signal of tissue damage, lasting from seconds to as long as three months, or chronic lasting greater than three to six months and have no purpose (p.340-341). Pain is an unpleasant sensation that can only be described by the person who feels it. The sensation of pain is transmitted by the central nervous system, which processes potentially harmful stimuli by way of nociceptors, which are pain receptors. (Huether & McCance, 2017) 6501 Week 3 discussion : Pathophysiology of Pain. Nociceptors are distributed throughout the body, which transmits the sensation of pain, and responds to the stimuli in different ways (Huether & McCance, 2017). Different types of stimuli cause different types of pain sensations, such as mechanical, thermal and chemical. Some chemical receptors that are associated with the sensation of pain include bradykinin, histamine, leukotrienes and prostaglandins. (Huether & McCance, 2017).  Pain has been recognized in the past as the fifth vital sign, making it an important part of the assessment process. Pain can be characterized in many different ways, such as acute, chronic, or referred, which are dependent on the different criteria that identify each.

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  Acute Pain

Acute pain is a sensation that last only seconds to day, but may be present for up to three months. Acute pain is a mechanism of the body that warns of immediate danger that can cause harm, which causes the person to immediately respond to remove the cause of the pain. Acute pain is normally self-limiting, resolving within days or weeks, but may continue longer as healing occurs (Anwar, 2016).  Acute pain results in autonomic nervous stimulation, which results in increase in heart rate, hypertension, diaphoresis and dilated pupils (Huether & McCance, 2017, p. 340). Acute pain is further divided into classifications, which include somatic, visceral or referred, which help to diagnose and treat the pain more effectively (Huether & McCance, 2017). Somatic pain is pain that is felt as sharp and well localized, or dull, aching, throbbing, which can be poorly localized (Huether & McCance, 2017). Acute pain is commonly the type of pain that patients experience after surgery, traumatic injuries, tissue damage and the inflammatory process (Anwar, 2016).

 

Chronic Pain

 

Chronic pain is pain that has been present for longer than three to six months and beyond the natural healing time (Huether & McCance, 2017).  Although it may accompany any type of injury, chronic pain serves no purpose and causes suffering of the individual (Huether & McCance, 2017). Chronic pain often leads to negative impact on quality of life, well-being and a person’s long term ability of function (Anwar, 2016). Huether and McCance (2017) explain that with chronic pain, there have been actual changes to the peripheral and central nervous systems that cause a dysregulation of nociception and the pain modulation process (p. 340). Over time, people who suffer with chronic pain have adaptations that lead to normalization of heart rate and blood pressure, which can lead to the misconception that these patients are not actually in pain. Chronic pain that is not controlled leads to problems such as depression, poor eating and sleeping habits, preoccupation with pain and avoidance of any stimuli that causes the pain (Huether & McCance, 2017). Patients who experience chronic pain also are commonly faced with the fact that their pain may never be completely resolved, which is normally achieved with acute pain.

 

Referred Pain

 

Referred pain is pain that is felt in a different area that where the pain originates from. An example is symptoms of MI, such as pain in the jaw or shoulder. Referred pain can be from an acute problem or it can be chronic, such as pain felt from sciatic with a chronic back injury. Huether and McCance (2017) explain that the reason behind pain being referred to other areas in the body is because the brain cannot distinguish the origin due to the many impulses that are being received from cutaneous and visceral neurons that converge at the same ascending neurons.

 

Gender and Age

 

Shea and McDonald (2010) explain that women and their descriptions of pain had been shown to be dependent on social interactions, and that women who suffered chronic pain seemed to have difficulty with self-esteem, and dignity as patients. Age has an impact on the way pain may be reported, or even assessed due to cognitive function. As a hospice nurse, I have learned that the elderly, cognitively impaired patients often act out when in pain, similar to young children, which leads to undertreatment of pain. I have worked with physicians in the past who did not believe in treating pain with infants, for instance, when circumcising newborns, he refused to order any type of topical pain control. As a nurse, I have worked on both ends of the spectrum, and I have seen pain that was poorly controlled at both ends. I had also done research to support my teaching of patients and families about pain control and the safety of morphine use at the end of life, which has led me many times to learn that patients with dementia are very undertreated for pain, partly because they can’t verbalize, and partly because physicians and nurses are afraid of overdosing them, which leads to poorly controlled pain. Shea and McDonald (2010) explained that it is imperative that healthcare providers have a keen awareness of hour to accurately assess for pain in patients of all ages, so that it can be treated effectively.

 

 

Anwar, K. (2016). Pathophysiology of pain. Disease-a-Month, 62(9), 324-329. Retrieved

 

From https://doi.org/10.1016/j.disamonth.2016.05.015.

 

Huether, S.E. & McCance, K.L. (2017) Understanding pathophysiology (6th ed.). St. Louis,

 

MO: Mosby.

 

Shea, M., & McDonald, D. (2010). Factors associated with increased pain communication by

 

Older adults. Western Journal of Nursing Research, 33(2), 169-206. Retrieved from

 

http://journals.sagepub.com.ezp.waldenlibrary.org/doi/abs/10.1177/0193945910372775

 

 

Week 3

Pain

The neurological system affects all parts and functions of the body through nerve stimulation. Nerves also control the sensation and perception of pain. While pain can be described in a variety of ways, it is essentially labeled according to its duration and source. As an advanced practice nurse evaluating a patient, you need to consider the following questions: Does the pain quickly come and go, or is it persistent and ongoing? Does the pain arise at the source of injury or in another location? In this Discussion, you compare three common types of pain—acute, chronic, and referred.

To prepare:

·        Review this week’s media presentation on the neurological system, as well as Chapter 13 in the Huether and McCance text.

·        Identify the pathophysiology of acute, chronic, and referred pain. Consider the similarities and differences between these three types of pain.

·        Select two of the following patient factors: genetics, gender, ethnicity, age, or behavior. Reflect on how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain.

Post A 1 page paper APA format

1 a description of the pathophysiology of acute, chronic, and referred pain, including similarities and differences between them.

2 Then, explain how the factors you selected might impact the pathophysiology, diagnosis, and prescription of treatment for acute, chronic, and referred pain. 6501 Week 3 discussion : Pathophysiology of Pain.

 

Course resources

·        Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

o   Chapter 12, “Structure and Function of the Neurologic System”

This chapter begins with an overview of the structure and function of the nervous system. It also explains the importance of the central, peripheral, and autonomic nervous systems.

o   Chapter 13, “Pain, Temperature, Sleep, and Sensory Function”

This chapter covers the role of pain, sleep, stress, and the senses on body functions. It also explores alterations involving pain, sleep, stress, and the senses.

o   Chapter 14, “Alterations in Cognitive Systems, Cerebral Hemodynamics, and Motor Function”

This chapter explores disorders of cognitive systems, neuromotor function, tone, movement, and motor performance. It also examines factors that impact these disorders as well as clinical manifestations.

o   Chapter 15, “Disorders of the Central and Peripheral Nervous Systems and Neuromuscular Junction”

This chapter examines the pathophysiology, clinical manifestations, and evaluation and treatment of central and peripheral nervous system disorders. Tumors of the central nervous system are also covered. 6501 Week 3 discussion : Pathophysiology of Pain.

o   Chapter 16, “Alterations of Neurologic Function in Children”

This chapter focuses on the pathophysiology, clinical manifestations, evaluation, and treatment of neurologic disorders and brain tumors in children. Normal growth and development is also examined.

·        McPhee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introduction to clinical medicine (Laureate Education, Inc., custom ed.). New York, NY: McGraw-Hill Medical.

o   Chapter 7, “Nervous System Disorders”

This chapter begins with an overview of the structure and function of the nervous system to lay a foundation for exploring nervous system disorders. It then examines several nervous system disorders such as Parkinson’s disease, epilepsy, dementia, Alzheimer’s disease, and stroke. 6501 Week 3 discussion: Pathophysiology of Pain.

Chapter 12, “Disorders of the Adrenal Medulla”

This chapter examines disorders relating to alterations of the adrenal medulla. It classifies disorders by the organ or tissue that is most impacted by the disorder. The pathophysiology, clinical manifestations, symptoms, and signs of the disorders are also covered.

Chapter 19, “Disorders of the Hypothalamus & Pituitary Gland”

This chapter covers the structure and function of the hypothalamus and pituitary glands. It also explores disorders of the hypothalamus and pituitary glands.

Chapter 21, “Disorders of the Adrenal Cortex”

This chapter begins by exploring the structure and function of the adrenal cortex. It then explores disorders relating to alterations of the adrenal cortex.

Media

·        Laureate Education, Inc. (Executive Producer). (2012f). The neurological system. Baltimore, MD: Author.

This media presentation outlines the pathophysiology of the neurological system and associated alterations.

Optional Resources

·        Alzheimer’s Association. (2012). Retrieved from http://www.alz.org/

·        National Multiple Sclerosis Society. (2012). Retrieved fromhttp://www.nationalmssociety.org/index.aspx

·        National Parkinson Foundation. (2012). Retrieved from http://www.parkinson.org/

 

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NURS 6501N-6 Advanced Pathophysiology

Pain

Pain is defined as “an unpleasant sensory and emotional experience associated with actual or potential tissue damage”, per the American Pain Society (Huether & McCance, 2012, p.324). Pain descriptions are subjective to the person experiencing it and at times can be very hard to control once started. This week’s discussion will consider types of pain, including acute, chronic and referred pain and their similarities and differences. Also, other factors that affect pain will be discussed and their effects on pathophysiology, diagnosis and treatment. 6501 Week 3 discussion : Pathophysiology of Pain.

Acute Pain

Acute pain begins when the body is attempting to warn of a potentially harmful experience, to relieve it (Huether & McCance, 2012, p.327). It is usually sudden or unexpected, and may linger for minutes to days, depending on location and severity. Acute pain can be further divided into somatic, visceral, or referred. Somatic pain comes from the skin, while visceral pain is pain from internal organs (p.327). Referred pain, however, refers to the air where the pain is felt (p.328) “The polymodal peripheral receptors initiate unpleasant sensations that can be modulated in the dorsal horn and the anterior columns of the spinal cord before reaching the cerebral cortex” (Fink, 2005, p. 277). Although neurological pathways of the body allow for sensation of pain, skin and visceral sensations are different.

Chronic Pain

Chronic pain is constant pain lasting a minimum of 3 months (Huether & McCance, 2012). Chronic pain can be sub grouped into neuropathic pain, which results from a neurological lesion dysfunction, or peripheral neuropathic pain, that results from trauma or disease of a peripheral nerve. There is also central neuropathic pain that develops from dysfunction in the brain or spinal cord (p.328). The process of nociception drives chronic pain. When nociceptors are stimulated, an action potential is started along the nerve that it is attached to 6501 Week 3 discussion : Pathophysiology of Pain. The nerves, composed of axons are classified per the nerve innervated. Some axons are myelinated, which help to protect the myelin and produce a faster pain transmission signal. Nerve endings that respond to sensory processes such as heat, cold and touch have different myelination properties and neurotransmitters that they respond to (Rashiq et al., 2008).

Referred Pain

Pain felt in the area other than the point of origin is defined as referred pain (Huether& McCance, 2012). Research has shown that the mechanism of convergence is the explanation for referral pain. When primary afferent fibers from different sites converge on the same second-order neuron in the brainstem nucleus (Hashemipour & Borna, 2014). In a case study on orofacial pain, referred pain was of greatest concern when the pathology became progressive in conditions such as “infections, vascular disorders, and neoplastic disease. Well-known sources of pain referred to the jaws include the pain of ischemic cardiac disease, esophageal pathology, and central lesions that cause increased intracranial pressure or produce compression of one or more of the cranial nerves” (p. 152).

Pain Comparison

Onset between the specific types of pain differ. Acute pain is sudden, whereas, chronic and referred pain occur due to some other etiology. Description of pain also differs. In acute pain, the exact area and reason for the pain is easily identified, whereas, chronic and referred pain usually occur because of some other problem, and may be harder to diagnose. Signs and symptoms of acute pain are usually immediately felt and observed, while chronic and referred pain may show symptoms slowly over time (Huether & McCance, 2012) 6501 Week 3 discussion : Pathophysiology of Pain.

Age and Genetic Factors on Pain

            At any age, pain effects the body differently. As an infant and child, the pain threshold, or the lowest toleration of pain is very low due painful experiences (Huether & McCance, 2012). Physiological changes in heartrate and breathing often show signs of pain or discomfort. 6501 Week 3 discussion : Pathophysiology of Pain Behavioral changes in facial muscles, crying, and restlessness, also show an observable change that could be a response to pain. In adults, the pain threshold is subjective and can change within moments. Physiological changes in behavior are like infants and children, but adults can be more specific about what they are feeling (p.330).

Genetic research has shown that a rare disease called congenital insensitivity to pain with anhidrosis (lack of sweating), also known as hereditary sensory and autonomic neuropathy type 4.  It is characterized by profound insensitivity to noxious stimuli and absence of sweating, as well as secondary complications such as repeated injuries, self-mutilation, and recurrent febrile episodes. Delayed developmental milestones, hyperactivity, emotional lability, and intellectual disabilities are also observed to varying degrees. Morphologic studies revealed that insensitivity to pain and anhidrosis result from the absence of sensory and sympathetic postganglionic neurons (Wang et al., 2016).

Conclusion

Structures and functions of the neurological system are very complex, yet it continues to regulate the body with little help from us. Pain is regulated by this system, and helps to warn the body of potentially dangerous experiences. Pain treatments vary individually, and can take time to diagnose and maintain. Pain will always be an issue that the human body faces daily. With continued research, the pathophysiology may be better understood and possibly better treatments invented. 6501 Week 3 discussion : Pathophysiology of Pain.

References

Fink, W. A. (2005). The pathophysiology of acute pain. Emergency Medicine Clinics of North America, 23(2), 277-284. doi:10.1016/j.emc.2004.12.001

Hashemipour, M. A., & Borna, R. (2014). Incidence and characteristics of acute referred orofacial pain caused by a posterior single tooth pulpitis in an Iranian population. Pain Practice, 14(2), 151-157. doi:10.1111/papr.12034

Huether, S. E., & McCance, K. L. (2012). Understanding pathophysiology (Laureate custom ed.). St. Louis, MO: Mosby.

Rashiq, S., Schlopflocher, D., Taenzer, P., & Jonsson, E. (2008). Chronic pain: A health policy perspective. Weinheim, Germany: Wiley-Blackwell/Wiley-VCH.

Wang, Q., Guo, S., Duan, G., Ying, Y., Huang, P., Liu, J. Y., & Zhang, X. (2016). Phenotypes and genotypes in five children with congenital insensitivity to pain with anhidrosis. Pediatric Neurology, 61, 63-69. doi:10.1016/j.pediatrneurol.2016.04.006 6501 Week 3 discussion : Pathophysiology of Pain

Gastroesophageal Reflux Disease

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Gastroesophageal Reflux Disease

Soap note about chronic  Disease in these case I selected: Gastroesophageal Reflux Disease.

I attach an example to make more easy your work. Please put 2 references between 2015 to 2019.

EXAMPLE: Gastroesophageal Reflux Disease

 

PATIENT INFORMATION

Name: Mr. W.S.

Age: 65-year-old

Sex: Male

Source: Patient

Allergies: None

Current Medications: Atorvastatin tab 20 mg, 1-tab PO at bedtime

PMH: Hypercholesterolemia

Immunizations: Influenza last 2018-year, tetanus, and hepatitis A and B 4 years ago.

Surgical History: Appendectomy 47 years ago.

Family History: Father- died 81 does not report information

Mother-alive, 88 years old, Diabetes Mellitus, HTN

Daughter-alive, 34 years old, healthy

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Social Hx: No smoking history or illicit drug use, occasional alcoholic beverage consumption on social celebrations. Retired, widow, he lives alone. Gastroesophageal Reflux Disease

SUBJECTIVE:

Chief complain: “headaches” that started two weeks ago

Symptom analysis/HPI:

The patient is 65 years old male who complaining of episodes of headaches and on 3 different occasions blood pressure was measured, which was high (159/100, 158/98 and 160/100 respectively). Patient noticed the problem started two weeks ago and sometimes it is accompanied by dizziness. He states that he has been under stress in his workplace for the last month.

Patient denies chest pain, palpitation, shortness of breath, nausea or vomiting.

ROS:

CONSTITUTIONAL: Denies fever or chills. Denies weakness or weight loss. NEUROLOGIC: Headache and dizzeness as describe above. Denies changes in LOC. Denies history of tremors or seizures.

HEENT: HEAD: Denies any head injury, or change in LOC. Eyes: Denies any changes in vision, diplopia or blurred vision. Ear: Denies pain in the ears. Denies loss of hearing or drainage. Nose: Denies nasal drainage, congestion. THROAT: Denies throat or neck pain, hoarseness, difficulty swallowing. Gastroesophageal Reflux Disease

Respiratory: Patient denies shortness of breath, cough or hemoptysis.

Cardiovascular: No chest pain, tachycardia. No orthopnea or paroxysmal nocturnal

dyspnea.

Gastrointestinal: Denies abdominal pain or discomfort. Denies flatulence, nausea, vomiting or

diarrhea.

Genitourinary: Denies hematuria, dysuria or change in urinary frequency. Denies difficulty starting/stopping stream of urine or incontinence.

MUSCULOSKELETAL: Denies falls or pain. Denies hearing a clicking or snapping sound.

Skin: No change of coloration such as cyanosis or jaundice, no rashes or pruritus.

Objective Data

CONSTITUTIONAL: Vital signs: Temperature: 98.5 °F, Pulse: 87, BP: 159/92 mmhg, RR 20, PO2-98% on room air, Ht- 6’4”, Wt 200 lb, BMI 25. Report pain 0/10.

General appearance: The patient is alert and oriented x 3. No acute distress noted. NEUROLOGIC: Alert, CNII-XII grossly intact, oriented to person, place, and time. Sensation intact to bilateral upper and lower extremities. Bilateral UE/LE strength 5/5.

HEENT: Head: Normocephalic, atraumatic, symmetric, non-tender. Maxillary sinuses no tenderness. Eyes: No conjunctival injection, no icterus, visual acuity and extraocular eye movements intact. No nystagmus noted. Ears: Bilateral canals patent without erythema, edema, or exudate. Bilateral tympanic membranes intact, pearly gray with sharp cone of light. Maxillary sinuses no tenderness. Nasal mucosa moist without bleeding. Oral mucosa moist without lesions,.Lids non-remarkable and appropriate for race. Gastroesophageal Reflux Disease

Neck: supple without cervical lymphadenopathy, no jugular vein distention, no thyroid swelling or masses.

Cardiovascular: S1S2, regular rate and rhythm, no murmur or gallop noted. Capillary refill < 2 sec.

Respiratory: No dyspnea or use of accessory muscles observed. No egophony, whispered pectoriloquy or tactile fremitus on palpation. Breath sounds presents and clear bilaterally on auscultation.

Gastrointestinal: No mass or hernia observed. Upon auscultation, bowel sounds present in all four quadrants, no bruits over renal and aorta arteries. Abdomen soft non-tender, no guarding, no rebound no distention or organomegaly noted on palpation

Musculoskeletal: No pain to palpation. Active and passive ROM within normal limits, no stiffness.

Integumentary: intact, no lesions or rashes, no cyanosis or jaundice.

Assessment

Essential (Primary) Hypertension (ICD10 I10): Given the symptoms and high blood pressure (156/92 mmhg), classified as stage 2. Once the organic cause of hypertension has been ruled out, such as renal, adrenal or thyroid, this diagnosis is confirmed.

Differential diagnosis: Gastroesophageal Reflux Disease

Ø Renal artery stenosis (ICD10 I70.1)

Ø Chronic kidney disease (ICD10 I12.9)

Ø Hyperthyroidism (ICD10 E05.90)

Plan

Diagnosis is based on the clinical evaluation through history, physical examination, and routine laboratory tests to assess risk factors, reveal identifiable causes and detect target-organ damage, including evidence of cardiovascular disease.

These basic laboratory tests are:

· CMP

· Complete blood count

· Lipid profile

· Thyroid-stimulating hormone

· Urinalysis

· Electrocardiogram

Ø Pharmacological treatment: 

The treatment of choice in this case would be:

Thiazide-like diuretic and/or a CCB

· Hydrochlorothiazide tab 25 mg, Initial dose: 25 mg orally once daily.

Ø Non-Pharmacologic treatment:

· Weight loss

· Healthy diet (DASH dietary pattern): Diet rich in fruits, vegetables, whole grains, and low-fat dairy products with reduced content of saturated and trans l fat

· Reduced intake of dietary sodium: <1,500 mg/d is optimal goal but at least 1,000 mg/d reduction in most adults

· Enhanced intake of dietary potassium

· Regular physical activity (Aerobic): 90–150 min/wk

· Tobacco cessation

· Measures to release stress and effective coping mechanisms. Gastroesophageal Reflux Disease

Education

· Provide with nutrition/dietary information.

· Daily blood pressure monitoring at home twice a day for 7 days, keep a record, bring the record on the next visit with her PCP

· Instruction about medication intake compliance.

· Education of possible complications such as stroke, heart attack, and other problems.

· Patient was educated on course of hypertension, as well as warning signs and symptoms, which could indicate the need to attend the E.R/U.C. Answered all pt. questions/concerns. Pt verbalizes understanding to all Gastroesophageal Reflux Disease

Follow-ups/Referrals

· Evaluation with PCP in 1 weeks for managing blood pressure and to evaluate current hypotensive therapy. Urgent Care visit prn.

· No referrals needed at this time.

References

Domino, F., Baldor, R., Golding, J., Stephens, M. (2017). The 5-Minute Clinical Consult 2017 (25th ed.). Print (The 5-Minute Consult Series).

Codina Leik, M. T. (2014). Family Nurse Practitioner Certification Intensive Review (2nd ed.). ISBN 978-0-8261-3424-0 Gastroesophageal Reflux Disease

Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays

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Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays

Systemic Lupus Erythematosus & Psoriasis

This week’s discussion will deal with the pathophysisology of Systemic Lupus Erythmatosus (SLE) and Psoriasis. The discussion will entail the compensatory mechanisms, maladaptive and physiological responses of the two disorders.  The age inference with regards to the pathophysiology of both SLE and Psoriasis will be reviewed.

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Pathophysiology of Systemic Lupus Erythematosus

Systemic Lupus Erythmatosus originates from autoimmune system and is a multisystem inflammatory disease. During the disease state, there is production of huge varieties of auto antibodies against nucleic acids (single and double stranded DNA), erythrocytes, coagulation proteins, lymphocytes, platelets, and many other self- proteins which causes inflammation, pain, and damage in various parts of the body(Lupus Foundation of America, 2012). These autoimmune reactions are directed against constituents of the cell nucleus that is antinuclear antibodies, particularly DNA, and as a result, the circulating immune complexes containing antibody against DNA are deposited in the basement membranes of capillaries in the kidneys, heart, skin, brain, and joints. Once the complement is activated, inflammation occurs. Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays It is imperative for advanced practice nurses to know that the specific manifestations of SLE depends on type of cell or organs that is involved (Lewis, Heitkemper, Dirksen, Bucher, & Camera, 2011)

Pathophysiology of Psoriasis

Psoriasis is a chronic dermatitis and relapsing inflammatory disease involving excessively rapid turnover of epidermal cells.  During the inflammatory cascade of this disorder, there is secretion of multiple inflammatory mediators( interferon, tumor necrosis factor- alpha), and cytokines (interleukin-12, 13, 17) due to complex interactions between macrophages, fibroblasts, dendritic cells, natural killer cells, T helper cells, and regulatory T cells (Huether  &McCance, 2017) Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays.

Variation in Physiological Responses

SLE is extremely variable in its severity, ranging from a relatively mild disorder to a rapidly progressive one affecting multiple body system due to accumulation of circulating immune complexes (Lupus Foundation of America, 2012), whereas psoriasis can be mild, moderate, or severe, depending on the size, distribution, and inflammation of the lesions implicating mostly the dermis and epidermis due to cellular hyper-proliferation, altered keratinocyte differentiation, and expanded dermal vasculature (Huether & McCance, 2017). The most commonly affected tissues by the SLE are the skin and muscle, the lining of the lungs, heart, nervous tissue, and the kidneys whereas psoriasis mostly affects the skin, scalp, and the nails.  Generalized complaints like fever, weight loss, arthralgia, and excessive fatigue may precede an exacerbation of SLE activity, whereas a well-demarcated, thick, silvery, scaly erythematous plaque surrounded by normal skin is the most common clinical manifestation of psoriasis (Lewis et al., 2011). It is very crucial that advanced practice nurses should familiarize themselves with this variation for proper diagnosis and treatment. Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays.

Patient Factor: Age

According to Huether and McCance (2017), psoriasis can occur at any age, but the onset is generally established by forty years of age. Any onset of psoriasis at later stage in life is less familial and much secondary to co-morbidities, like obesity, smoking, high blood pressure, and diabetes. With SLE, symptoms and diagnosis occur most often when women are in their childbearing years, between the ages of 15 and 44. Symptoms of lupus will occur before age 18 in 15 percent of the people who are later diagnosed with the disease (Lupus Foundation of America, 2012) Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays.

Conclusion

Both SLE and psoriasis are both inflammatory disorders, but psoriasis mostly affect the skin while SLE is multiple system based. Both disorders involve complex interactions to precipitate a pathological responses of the disease state. Age is cited in different research findings as one of the factors that implicate the pathophysiology of both SLE and psoriasis.

 

References

Huether, S. E., & McCance, K. L. (2017). Understanding pathophysiology (6th ed.). St. Louis,

MO: Mosby.

Lewis, S. L., Heitkemper, M.M., Dirksen, S. R., & Bucher, L., & Camera, I. (2011). Medical-

surgical nursing: Assessment and management of clinical problems (7th ed.). St. Louis,

Missouri: Mosby. Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays

Lupus Foundation of America. (2012).What are the risk factors for developing lupus? Retrieved

from http://www.lupus.org/answers/entry/risks-for-developing-lupus

Lupus Foundation of America. (2012).What happens in autoimmune diseases like lupus?

Retrieved from http://www.lupus.org/answers/entry/what-happens-in-autoimmune-diseases-like-lupus

 

 

NURS 6501

Week 2, Discussion 2, Initial Post

Osteoarthritis

Osteoarthritis (OA) is joint inflammation related to the destruction of cartilage. There can be genetic factors involved in OA, but the primary mechanism of damage in this condition is an excess of wear (Huether & McCance, 2012). The cartilage that lines the joints is worn away, and the bones begin to rub against one another with joint movement causing friction and bone breakdown, which in turn prompts bone growth in the form of osteophytes or bone spurs. There are also some proteolytic actors in play that aid in the degeneration of the cartilage (Vincent, Conrad, Fregly, & Vincent, 2012). Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays.

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Primary treatment of OA is pain control and lifestyle modifications including resting inflamed joints, weight loss if indicated, and range of motion exercises to promote joint capsule health. Treatment for severe cases of OA include surgical procedures to address bone spurs, manage/correct joint deformities, and to replace entire joints when necessary.

Rheumatoid Arthritis

Rheumatoid arthritis (RA), while causing similar joint damage to that of OA, is an autoimmune disorder rather than an age-related disorder (Mcphee & Hammer, 2010). Pannus, or granulation tissue forms in response to inflammation of the synovium. Ankylosing, or fixation of the joint in an abnormal position occurs due to destruction of the articular cartilage and subchondral bone. Rheumatoid factor, IgM antibody and neutrophils are the primary autoimmune culprits responsible for the destruction of tissue in RA (Choy, 2012). Treatment consists of control and reduction of  inflammation. Disease modifying anti-rheumatic drugs help decrease joint damage. Anti-inflammatory meds and steroids can help with the pain and inflammation. Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays.

Patient Factors

Genetics plays a role in both OA and RA. Continued research is necessary to increase understanding of the genetics impact of both OA (Vincent, Conrad, Fregly, & Vincent, 2012) and RA (Choy, 2012). Advancement of genetic research related to OA and RA could lead to new treatments and even the potential of preventative therapies/treatments.

References

Choy, E. (2012). Understanding the dynamics: Pathways involved in the pathogenesis of rheumatoid arthritis. Rheumatology, 51, v3-v11. doi:10.1093/rheumatology/kes113

Huether, S., & McCance, K. (2012). Understanding Pathophysiology (5th ed.). St. Louis, Missouri: Elsevier.

Mcphee, S. J., & Hammer, G. D. (2010). Pathophysiology of disease: An introducion to clinical medicine (6th ed.). Boston: McGraw-Hill.

Vincent, K. R., Conrad, B. P., Fregly, B. J., & Vincent, H. K. (2012). The pathophysiology of osteoarthritis: A mechanical perspective on the knee joint. Physical Medicine and Rehabilitation, 4(5 0), S3-S9. doi:10.1016/j.pmrj.2012.01.020 Nurs 6501 week 2 discussion – Erythematosus & Psoriasis Essays

 

NR 509 Week 4 Shadow Health Chest Pain Physical Assessment Assignment

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Pre Brief
This assignment provides the opportunity to conduct a focused exam on a patient presenting with recent episodes of chest pain in a non-emergency setting  NR 509 Week 4 Shadow Health Chest Pain Physical Assessment Assignment Interview Mr. Foster and be sure to thoroughly assess the cardiovascular system as well as related body systems in order to compile a list of differential diagnoses. This case study offers you the opportunity to evaluate Mr. Foster’s personal and family history with heart disease and identify lifestyle risk factors. During the physical examination, thoroughly examine the cardiovascular system and carefully evaluate and document the patient’s heart sounds. Reason for visit: Patient presents complaining recurrent chest pain.
  • Chest Pain Results: Overview
  • Chest Pain Results: Transcript
  • Chest Pain Results: Subjective Data Collection
  • Chest Pain Results: Objective Data Collection
  • Chest Pain Results: Education & Empathy
  • Chest Pain Results: Documentation
  • Chest Pain Results: Self-Reflection

Direct Practice Improvement Project

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Direct Practice Improvement Project

Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project

Week Two Assignment Instructions DNP 820

Please read the instructions thoroughly there are strict requirements

I need at least 10 different articles/literature reviews added to the ones in the 815 attachment. I have also included the chart to be filled out All within 5 years and pertinent to the subject. Direct Practice Improvement Project

Tutor MUST have a good command of the English language

The Rubric must be followed, and all the requirements met

This is a thorough professor, and she has strict requirements

I have attached the PICOT and the first 10 points (DNP 815) assignment. This is a continuation of that assignment. Please read the attachments

The following needs to be addressed:

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Please note the followings: The introduction and the literature review are complete and thorough. The problem statement is written clearly PICOT is clear and very good Sample:  Direct Practice Improvement Project

· How will you determine the sample size? 

· What are the inclusion/exclusion criteria of the subjects? Methodology: Why is the selected methodology is appropriate? Please justify! 

· Data collection approach needs to be clear. How will you collect your data? What is needed here is to describe the process of collecting data form signing the informed consent until completing the measuring.

· Data analysis-What test will you use to answer your research question? 

Clinical/PICOT Questions:  

“In adult patients with CVC at a Clear Lake Regional Medical Center, does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to standard care over a one-month period?” Direct Practice Improvement Project

P: Patients with Central Venous Catheters

I: Staff re-education related to Hygiene of the hub

C: Other hospitals

O: Reduce probability of CLABSIs

T: Two months

“In Patients > 65 years of age with central line catheters at a Clear Lake Regional Medical Center, how does staff training of key personnel and reinforcement of central line catheter hub hygiene after its insertion, along with the apt cleansing of the insertion site, before every approach compared with other area hospitals, reduce the incidence of CLABSIs (Central Line Associated Blood-stream Infections) over a one-month period?”

P: Patients > 65 years of age with a Central line

I: Staff training and reinforcement of Central Catheter, Hub Hygiene 

C: Other area hospitals 

O: Reduce probability of CLABSIs

“In adult patients, with define CVC (CVC), does interventional staff education about hub hygiene provided to RN’s who access the CVC impact CLABSI rates compared to pre and post-intervention assessments 

1. I used central Missouri as an example, replace with a description of your site. 

2. While you might be interested in CLASBI rates as a primary variable, there are other patient outcomes that would also be important to consider

3. Ensure you can find validity and reliability measures on CLASBI rates if you cannot, we need to determine another question to help

4. How are your two comparison groups different, as they are currently stated the groups seem very much the same, could you state, standard care instead of pre and post intervention assessments? 

5. One month is the longest time you can use for a prospective project

Please note the following regarding the instructors grading Direct Practice Improvement Project

IMPORTANT INFORMATION ABOUT MY GRADING STYLE

As you prepare for written papers and manuscripts I’d like to give you some details about my grading style. I provide significant feedback on your papers, this is because I believe you should be working towards improving your writing so that at the end of this program you are able to successfully write your DPI project. In order to write well, you need feedback and you need to review that feedback and make progress on the next written work. To that end I always grade accordingly. This means that if I provide feedback one an item (for example APA format of your reference page) I expect that this will be improved on the next written submission. Otherwise I will deduct additional points. In addition, some other criteria to get down pat now. References should always

1. Be current, no older than 5 years that means 5 years from your proposed graduation date (2014-2019). Otherwise you will have to redo everything in DNP 955.

2. Be primary sources. You can no longer cite Young declared literary war in 1956 (as cited by Brown 2006). You must cite Young 1956. That means go find that paper and read it and make sure that you agree with what Brown said. What if you don’t agree due to some very valid points? Then the literary war is not what occurred, but instead you have concerns regarding point ____, ____, and ____.

3. You may no longer cite textbooks, they are 1) secondary sources and 2) not current enough, and please use peer reviewed manuscripts.

One more item that is not a reference. You may not use direct quotes any longer. There is no need. This may be difficult at first, but you are moving towards a different type of writing. This is manuscript writing (scientific writing). Scientific writing is terse, clear, and concise. No frilly words. In order to avoid the use of direct quotes you will synthesize the literature. There is a great resource for synthesizing the literature under Resources – Add-ons. These are also some other great writing resources there.

Details: Direct Practice Improvement Project

In the prospectus, proposal, and scholarly project there are 10 strategic points that need to be clear, simple, correct, and aligned to ensure the research is doable, valuable, and credible. The 10 strategic points emerge from researching literature on a topic that is based on or aligned with the learner’s personal passion, future career purpose, and degree area. These 10 points provide a guiding vision for DPI Project. In this assignment, you will continue the work begun in DNP-815, working on your draft of a document addressing the 10 key strategic points that define your intended research focus and approach.

General Requirements:

Use the following information to ensure successful completion of the assignment:

  • Locate      the “The 10 Strategic Points for the      Prospectus, Proposal, and Direct Practice Improvement Project” that      you completed in DNP-815.
  • Doctoral      learners are required to use APA style for their writing assignments. The      APA Style Guide is located in the      Student Success Center. An abstract is not required.
  • This      assignment uses a rubric. Please Review the rubric prior to the beginning to become familiar with the      expectations for successful completion.
  • You      are required to submit this assignment to Turnitin. Please refer to the      directions in the Student Success Center. Direct Practice Improvement Project

Directions:

Use the “The 10 Strategic Points for the Prospectus, Proposal, and Direct Practice Improvement Project” resource to draft statements for each of the 10 points for your intended research study.

You worked on this last in DNP 815. Pick up from where you left off (if you transferred in and did not complete this, you will have to begin fresh). Please include a copy of your last instructor feedback when you submit this assignment. You can either copy and paste the instructor feedback into your current paper (as an appendix and clearly marked); or upload two separate papers. I expect significant improvement from your last submission.

Please review the 10 Strategic Points document for additional instructions and an example. Add references to this document, I suggest 5-10 at this point. You need to realize that your literature review chapter will need at least 50+ articles by the time you get to DNP 955, so work on expanding your literature search each week, to include more and more to this paper as you move through each course. If you cannot locate 50+ articles you can ask your faculty for assistance or chose a different topic.

For the methodology and design sections. Methodology should cover the broad methods you plan to use (qualitative, quantitative, or mixed methods). The design portion will then go into more detail and discuss the design (i.e. correlational, cross-sectional, pre/posttest, etc.). Describe each and explain why your chosen methodology and design are appropriate to your topic and project questions. You may NOT use qualitative, GCU leadership does not support a qualitative methodology. Direct Practice Improvement Project

Intervention. You must have an intervention that you implement. Since you cannot evaluate a project that has already been implemented, please write up a description of your intervention and what your role will be in implementing this intervention. This is not a section listed on your 10 Strategic Points document as of yet, so add it after the methodology and design sections. Describe step by step what the intervention consists of, how it is evidence based, how you will implement, and your role in implementation.

Data collection should go step by step (extremely over-detailed) on how you will collect the data. Tell me about all instruments, surveys, and/or questions you will ask of participants. One MUST be a valid and reliable tool.

Data Analysis. Tell me the specific statistics you will use. Start with descriptive statistics, which ones will you use, why (cite current primary sources). Then tell me how you will compare your data (which statistic), what your p value will be before you start your data collection. Direct Practice Improvement Project

Community Health Field Experience

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Community Health Field Experience

Task 1: Social Media Campaign

Introduction:

Part of cultural competency is advocating for sensitive patient populations with regard to health issues or needed improvements in the community. A big part of advocacy is uncovering effective stories discovered in your community assessment. Equally important is understanding how to broadcast your discoveries to the larger community. In our society today, social media is a powerful leveraging tool to get a story out, build support, and demonstrate advocacy. Community Health Field Experience

Requirements:

Your submission must be your original work. No more than a combined total of 30% of the submission and no more than a 10% match to any one individual source can be directly quoted or closely paraphrased from sources, even if cited correctly. Use the Turnitin Originality Report available in Taskstream as a guide for this measure of originality.

You must use the rubric to direct the creation of your submission because it provides detailed criteria that will be used to evaluate your work. Each requirement below may be evaluated by more than one rubric aspect. The rubric aspect titles may contain hyperlinks to relevant portions of the course. Community Health Field Experience

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Part 1: Field Experience Project Submission
Note: Your timelog must be submitted with your assessment. If both are not submitted at the same time, your task may be returned to you without evaluation.
A.  Submit a completed “Community Health Field Experience Timelog” by doing the following:

1.  Include the date of each activity.

2.  Include a brief description of each activity.

3.  Include the name of the contact person, a working phone number, and a full physical address.
Note: If an email address is available for the contact person, you may choose to include it.
4.  Include the number of hours spent on each activity (not including preparation time).

5.  Describe how each activity relates to your selected Field Experience topic.

6.  Record a total of 90 hours that meet each of the following requirements:

●  65 student planned activity hours based on the attached “Field Experience Activities List”

●  a maximum of five individual interview hours (i.e., no more than five interviews, no more than one hour per interview) Community Health Field Experience

●  no prep time hours (i.e., prep time is not to be included in reported hours)

Note: If your timelog is returned from evaluation, you are required to do an addendum.  Please use the link below to access the DocuSign addendum document.  Both the original timelog and the addendum timelog must be submitted with the task.

Note: Random audits and verification of time log activities do occur. Violation of the WGU Code of Student Conduct or the Academic Authenticity Policy could result in disciplinary action.  Community Health Field Experience
Part 2: Social Media Campaign

Note: The “CDCynergy” web link provided in the web links section below may be useful in completing your social media campaign. The use of this web link is optional, i.e., not required.
B.  Write your community health nursing diagnosis statement.

1.  Explain how the health concern from your community health nursing diagnostic statement is linked to a health inequity or health disparity within the target population.

a.  Discuss the primary community resources and primary prevention resources currently in place to address the health concern.

b.  Discuss the underlying causes of the health concern. Community Health Field Experience
2.  Discuss the evidence-based practice associated with the Field Experience topic.

a.  Identify data about the selected Field Experience topic from the local (e.g., county), state- Florida, and/or national level.
C.  Develop a community health nursing social media campaign strategy that will convey your health message and address the Field Experience topic by doing the following: Community Health Field Experience

1.  Describe your social media campaign objective.

2.  Recommend two population-focused social marketing interventions and justify how each would improve the health message related to your selected Field Experience topic.

3.  Describe a social media platform you would use that is appropriate for communicating with the target population-Adults

a.  Discuss the benefits of the selected social media platform in supporting preventative healthcare.
4.  Discuss how the target population will benefit from your health message.
D.  Describe best practices for implementing social media tools for health marketing.
E.  Create a social media campaign implementation plan by doing the following:

1.  Describe stakeholder roles and responsibilities in implementing the plan.

2.  Discuss potential public and private partnerships that could be formed to aid in the implementation of your campaign.

3.  Create a specific timeline for implementing your campaign.

4.  Explain how you will evaluate the effectiveness of the campaign.

5.  Discuss the costs of implementing your campaign. Community Health Field Experience
F.  Reflect on how social media marketing supports the community health nurse’s efforts to promote healthier populations.

1.  Reflect on how your social media campaign could apply to your future nursing practice.
G.  Acknowledge sources, using in-text citations and references, for content that is quoted, paraphrased, or summarized.
H.  Demonstrate professional communication in the content and presentation of your submission. Community Health Field Experience

Philosophy Of Nursing Paper

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Philosophy Of Nursing Paper

Use the questions in the table in chapter 3 on page 101 of your textbook as a guide as you write your personal philosophy of nursing. The paper should be three typewritten double spaced pages following APA style guidelines. The paper should address the following: Philosophy Of Nursing Paper

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  1. Introduction that includes who you are and where you practice nursing
  2. Definition of Nursing
  3. Assumptions or underlying beliefs
  4. Definitions and examples of  the major domains (person, health, and environment) of nursing
  5.  Summary that includes:
    1. How are the domains connected?
    2. What is your vision of nursing for the future?
    3. What are the challenges that you will face as a nurse?
    4. What are your goals for professional development? Philosophy Of Nursing Paper

Grading criteria for the Personal Philosophy of Nursing Paper:

Introduction                                                                            10%

Definition of Nursing                                                                20%

Assumptions and beliefs                                                         20%

Definitions and examples of domains of nursing                        30%

Summary                                                                               20%

Total              100%

Your paper must be written in APA style Philosophy Of Nursing Paper