Harold, a 61-year-old male smoker, suffers from chronic bronchitis, which was diagnosed two years ago.   At that time, he was treated with antibiotics, told to stop smoking and given a prescription for albuterol.  He attempted to give up smoking, but he says that, although he has cut back, he still smokes about half a pack a day.  He has been faithful about seeing his doctor for follow-up visits every six months and has occasionally required antibiotic therapy when his bronchitis flairs up. On his most recent visit he reports that his dyspnea is getting worse, and he experiences wheezing whenever he does anything strenuous.  His doctor notes a slight bluish tint to his lips and mucous membranes, as well as peripheral edema and some enlargement of the liver. He informs Harold that his chronic bronchitis is getting worse and he is beginning to experience symptoms of cor pulmonale.

Harold, a 61-year-old male smoker, suffers from chronic bronchitis, which was diagnosed two years ago.   At that time, he was treated with antibiotics, told to stop smoking and given a prescription for albuterol.  He attempted to give up smoking, but he says that, although he has cut back, he still smokes about half a pack a day.  He has been faithful about seeing his doctor for follow-up visits every six months and has occasionally required antibiotic therapy when his bronchitis flairs up. On his most recent visit he reports that his dyspnea is getting worse, and he experiences wheezing whenever he does anything strenuous.  His doctor notes a slight bluish tint to his lips and mucous membranes, as well as peripheral edema and some enlargement of the liver. He informs Harold that his chronic bronchitis is getting worse and he is beginning to experience symptoms of cor pulmonale.

Each student will be assigned two of the case studies below. Your post should be approximately 250 words in length and contain substantive information that contributes to an understanding of the disorder under discussion. You may post graphics from online sources, but please do NOT simply cut and paste entire entries from the internet. You are expected to provide references for all the information cited.

Discussion Questions

1. Relate history to the diagnosis. What risk factors are present, and how does each predispose to disease?

2. Explain the cause of the disease in this patient.

3. How could this disease have been prevented in this patient?

4. Discuss the complications that might develop in this patient.

5. Discuss the treatments available to the patient.

6. What is the probable prognosis for this patient?

Case Study# 1: A 27-year-old male who works on a construction site visits his family physician three days after suffering a puncture wound from a nail gun in his foot.  The site of the injury is painful, red, warm and swollen with evidence of pus. There are reddish streaks extending up his ankle and lower leg. His temperature is 101 °F.

Case Study# 2:  Harold, a 61-year-old male smoker, suffers from chronic bronchitis, which was diagnosed two years ago.   At that time, he was treated with antibiotics, told to stop smoking and given a prescription for albuterol.  He attempted to give up smoking, but he says that, although he has cut back, he still smokes about half a pack a day.  He has been faithful about seeing his doctor for follow-up visits every six months and has occasionally required antibiotic therapy when his bronchitis flairs up. On his most recent visit he reports that his dyspnea is getting worse, and he experiences wheezing whenever he does anything strenuous.  His doctor notes a slight bluish tint to his lips and mucous membranes, as well as peripheral edema and some enlargement of the liver. He informs Harold that his chronic bronchitis is getting worse and he is beginning to experience symptoms of cor pulmonale.

The post Harold, a 61-year-old male smoker, suffers from chronic bronchitis, which was diagnosed two years ago.   At that time, he was treated with antibiotics, told to stop smoking and given a prescription for albuterol.  He attempted to give up smoking, but he says that, although he has cut back, he still smokes about half a pack a day.  He has been faithful about seeing his doctor for follow-up visits every six months and has occasionally required antibiotic therapy when his bronchitis flairs up. On his most recent visit he reports that his dyspnea is getting worse, and he experiences wheezing whenever he does anything strenuous.  His doctor notes a slight bluish tint to his lips and mucous membranes, as well as peripheral edema and some enlargement of the liver. He informs Harold that his chronic bronchitis is getting worse and he is beginning to experience symptoms of cor pulmonale. appeared first on Shine Essay.

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

  • Decision #1 
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. 
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2 
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. 
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3 
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources. 
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

reflect on the decisions that you made and share ethical considerations that relate to the case. I would like to see your reasoning for selecting one medication over the other options.

The post Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes. appeared first on Shine Essay.

 A research critique demonstrates your ability to critically evaluate an investigative study. For this assignment, choose an original or primary research study related to nursing or medicine. The purpose of this assignment is to review a research study in-depth and to decide whether or not it is a valid research study that can be used in practice. It is your written evaluation of the study, not just a summary of the study.

 A research critique demonstrates your ability to critically evaluate an investigative study. For this assignment, choose an original or primary research study related to nursing or medicine. The purpose of this assignment is to review a research study in-depth and to decide whether or not it is a valid research study that can be used in practice. It is your written evaluation of the study, not just a summary of the study.

The body of your paper should follow APA Style guidelines, and it should 4–6 pages double-spaced plus a cover page and reference list. The full article must be attached to the critique for credit.

Note: Because submission of the article is part of the assignment requirements and is necessary for grading, any assignment submitted without the accompanying article will be considered incomplete. An incomplete assignment will be initially assigned a zero. The student has the opportunity to submit the article to complete the assignment. However, if it is submitted after the due date and time, the late penalty will apply. After five days, submissions will not be accepted, as per University policy, and the grade will remain a zero.

  • Articles used for one assignment cannot be used for the other assignments. (Students should find new research articles for each assignment.)
  • The selected articles should be original research studies. Review articles, concept analysis, meta-analysis, meta-synthesis, integrative review, and systemic review should not be used.
  • Mixed-methods studies should not be used.

Your critique should include the following:

Research Problem/Purpose

  • Describe the problem as it is presented in the study.
  • State the purpose of the research.
  • Have the investigators placed the study problem within the context of existing nursing or healthcare knowledge?
  • Will the study solve a problem relevant to nursing?

Review of the Literature (may be part of the author’s introduction or conclusion)

  • Identify the concepts explored in the literature review.
  • Are the references current in relation to the publication date of the study? If not, what are the possible reasons for using older sources?

Theoretical Framework

  • Do the authors identify their overall assumptions or a theoretical framework for the study? Are these assumptions appropriate for the study?
  • Does the research draw only on nursing theory, or does it draw on theory from other disciplines?
  • If a formal theory is not identified, suggest one (preferably a nursing theory) that might be suitable for the study. Various nursing theories can be found at http://www.nursing-theory.org/theories-and-models/

Variables/Hypotheses/Questions/Assumptions

  • What is the research question or the hypothesis? Is it clearly stated or implied?
  • What are the independent and dependent variables in the hypothesis or research question?
  • Are the variables clearly defined so that the reader understands the researchers’ interpretation of the variables?
  • Is the dependent variable concrete and measurable?

Methodology

  • What type of design (quantitative, qualitative) was used in this study?
  • Was inductive or deductive reasoning used in this study?
  • State the sample size and study population, sampling method, and study setting.
  • Did the investigator choose a probability or non-probability sample?
  • Describe how the independent variable was tested or surveyed in the study.
  • Describe how the dependent variable was measured.
  • Discuss the reliability and the validity (quantitative) or the credibility (qualitative) of the measurement tools.
  • How were ethical considerations addressed? What ethical considerations were necessary for this type of study?

Data Analysis

  • What data analysis method was used?
  • How were the results in the study presented to the reader?
  • Discuss at least one (1) finding from the authors’ results and relate it to the dependent variable of the study.

Summary/Conclusions, Implications, and Recommendations

  • What are strengths and limitations of the study other than those stated by the authors?
  • Can the researcher generalize the findings to other populations? Explain.
  • What is the significance of the findings and conclusions for you in your personal nursing practice? For nursing as a profession?

The body of your paper should be 4–6 pages double-spaced plus a cover page and a reference page. The critique must be attached to the article and follow APA Style guidelines.

The post  A research critique demonstrates your ability to critically evaluate an investigative study. For this assignment, choose an original or primary research study related to nursing or medicine. The purpose of this assignment is to review a research study in-depth and to decide whether or not it is a valid research study that can be used in practice. It is your written evaluation of the study, not just a summary of the study. appeared first on Shine Essay.

  Psychological disorders, such as  bipolar disorder can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders. 

  Psychological disorders, such as  bipolar disorder can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders. 

For this Discussion, you will select an interactive media piece to practice decision making when treating patients with psychological disorders. You will recommend the most effective pharmacotherapeutic to treat the psychological disorder presented and examine potential impacts of pharmacotherapeutics on a patient’s pathophysiology. 

The post   Psychological disorders, such as  bipolar disorder can present several complications for patients of all ages. These disorders affect patients physically and emotionally, potentially impacting judgment, school and/or job performance, and relationships with family and friends. Since these disorders have many drastic effects on patients’ lives, it is important for advanced practice nurses to effectively manage patient care. With patient factors and medical history in mind, it is the advanced practice nurse’s responsibility to ensure the safe and effective diagnosis, treatment, and education of patients with psychological disorders.  appeared first on Shine Essay.

In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days?

In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days?

Week 2: The Clinical Issue and Research Questions Developed Using PICOT

PICOT is an acronym used to help develop clinical research questions and guide you in your search for evidence:

P = Patient population

I = Intervention or issue of interest

C = Comparison of interventions or comparison of interests

O = Outcome

T = Time frame

For example, you may wish to research the effects of interrupted sleep on cognition of ICU patients 65 or older.

Using this PICOT model,

In _________(P), how does __________ (I) compared to _________ (C) influence _________ (O) over ________ (T)?

In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days?

Assignment Directions

Begin by selecting a topic in nursing or medicine that is of interest to you. Next, use PICOT to format possible research questions about that topic. Provide 3 possible PICOT research questions.

Include the following:

  • Title page
  • Provide a brief description of the topic and background information.
  • Explain the significance of the topic to nursing practice.
  • Provide 3 clearly stated PICOT questions.

Your paper should: 

  • Be 2–3 pages (not including the title page and reference page)
  • Use current APA format to style your paper and to cite your sources. 

Review the rubric for further information on how your assignment will be graded.

The post In ICU patients who are 65 or older, how does interrupted sleep (awakened one time or more in four hours) as compared to uninterrupted sleep influence the patient’s cognitive ability over 5 days? appeared first on Shine Essay.

The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

Examine Case Study: A Puerto Rican Woman With Comorbid Addiction. You will be asked to make three decisions concerning the medication to prescribe to this client. Be sure to consider factors that might impact the client’s pharmacokinetic and pharmacodynamic processes.

At each decision point stop to complete the following:

  • Decision #1
    • Which decision did you select?
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #1 and the results of the decision. Why were they different?
  • Decision #2
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #2 and the results of the decision. Why were they different?
  • Decision #3
    • Why did you select this decision? Support your response with evidence and references to the Learning Resources.
    • What were you hoping to achieve by making this decision? Support your response with evidence and references to the Learning Resources.
    • Explain any difference between what you expected to achieve with Decision #3 and the results of the decision. Why were they different?

case Study and the decisions

BACKGROUND

Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.”

SUBJECTIVE

Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health.

She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.

Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money.

MENTAL STATUS EXAM

The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

Decision Point One

Select what the PMHNP should do:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.png

Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.png

Antabuse (Disulfiram) 250 mg orally daily

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.png

Campral (Acamprosate) 666 mg orally three times/day

Decision Point Two

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.png

Add on Valium (diazepam) 5 mg orally TID/PRN/anxiety

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.png

Refer to a counselor to address gambling issues

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.png

Add on Chantix (varenicline) 1 mg orally BID

Decision Point Three

Select what the PMHNP should do next:

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-red.png

Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-blue.png

Encourage Mrs. Perez to continue seeing her current counselor as well as continuing with the Gamblers Anonymous group

https://mym.cdn.laureate-media.com/2dett4d/Walden/NURS/6630/08/mm/co-morbid_addiction_etoh_and_gambling/img/pill-yellow.png

Discontinue Vivitrol. Encourage Mrs. Perez to continue seeing her counselor and to continue participating in the Gamblers Anonymous groupBACKGROUND

Mrs. Maria Perez is a 53 year old Puerto Rican female who presents to your office today due to a rather “embarrassing problem.”

SUBJECTIVE

Mrs. Perez admits that she has had “problems” with alcohol since her father died in her late teens. She reports that she has struggled with alcohol since her 20’s and has been involved with Alcoholics Anonymous “on and off” for the past 25 years. She states that for the past two years, she has been having more and more difficulty maintaining her sobriety since they opened the new “Rising Sun” casino near her home. Mrs. Perez states that she and a friend went to visit the new casino during their grand opening at which point she was “hooked.” She states that she gets “such a high” when she is gambling. While gambling, she “enjoys a drink or two” to help calm her during high-stakes games. She states that this often gives way to more drinking and more reckless gambling. She also reports that her cigarette smoking has increased over the past two years and she is concerned about the negative effects of the cigarette smoking on her health.

She states that she attempts to abstain from drinking but that she gets such a “high” from the act of gambling that she needs a few drinks to “even out.” She also notices that when she drinks, she doesn’t smoke “as much” but enjoys smoking when she is playing at the slot machines. She also reports that she has gained weight from drinking so much- she currently weights 122 lbs., which represents a 7 lb. weight gain from her usual 115 lb. weight.

Mrs. Perez is quite concerned today because she has borrowed over $50,000 from her retirement account to pay off her gambling debts. She is very concerned because her husband does not know that she has spent this much money.

MENTAL STATUS EXAM

The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation.

Decision Point One

Select what the PMHNP should do:

 Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks

 Antabuse (Disulfiram) 250 mg orally daily

 Campral (Acamprosate) 666 mg orally three times/day

Decision Point Two

Select what the PMHNP should do next:

 Add on Valium (diazepam) 5 mg orally TID/PRN/anxiety

 Refer to a counselor to address gambling issues

 Add on Chantix (varenicline) 1 mg orally BID

Decision Point Three

Select what the PMHNP should do next:

 Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings

 Encourage Mrs. Perez to continue seeing her current counselor as well as continuing with the Gamblers Anonymous group

 Discontinue Vivitrol. Encourage Mrs. Perez to continue seeing her counselor and to continue participating in the Gamblers Anonymous group

My decisions

DECISION POINT ONE

Ø Naltrexone (Vivitrol) injection, 380 mg intramuscularly in the gluteal region every 4 weeks

RESULTS OF DECISION POINT ONE

Client returns to clinic in four weeks

Mrs. Perez said that she felt “wonderful” as she has not “touched a drop” to drink since receiving the injection

Client reports that she has not been going to the casino, as frequently, but when she does go she “drops a bundle” (meaning, spends a lot of money gambling)

Client She is also still smoking, which has her concerned. She is also reporting some problems with anxiety, which also have her concerned

DECISION POINT TWO

Ø Refer to a counselor to address gambling issues

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Client reports that the anxiety that she had been experiencing is gone

Client reports that she has met with the counselor, but did not really like her. She did start going to a local meeting gamblers anonymous. She stated that last week, for the first time, she spoke during the meeting. She reports feeling supported in this group

DECISION POINT THREE

Ø Explore the issue that Mrs. Perez is having with her counselor, and encourage her to continue attending the Gamblers Anonymous meetings

Guidance to Student

Although controversy exists in the literature regarding how long to maintain a client on Vivitrol, four weeks is probably too soon to consider discontinuation. The psychiatric mental health nurse practitioner should explore the issues that Mrs. Perez is having with her counselor. As you will learn in future courses, ruptures and the therapeutic alliance can result in clients stopping therapy. Clearly, if the client does not continue with therapy, the likelihood of the gambling problem spontaneously remitting is lower (than had the client continued to receive therapy). Recall that there are no FDA approved treatments for gambling addiction, and the mainstay of treatment for this disorder is counseling. Since Mrs. Perez reports good perceived support from the gamblers anonymous meetings, she should be encouraged to continue her participation with this group.

The PMHNP needs to discuss smoking cessation options with Mrs. Perez in order to address the totality of addictions, and to enhance her overall health.

The post The client is a 53 year old Puerto Rican female who is alert, oriented to person, place, time, and event. She is dressed appropriately for the weather and time of year. Her speech is clear, coherent, and goal directed. Her eye contact is somewhat avoidant during the clinical interview. As you make eye contact with her, she looks away or looks down. She demonstrates no noteworthy mannerisms, gestures, or tics. Her self-reported mood is “sad.” Affect is appropriate to content of conversation & self-reported mood. She visual or auditory hallucinations, no delusional or paranoid thought processes are readily appreciated. Insight and judgment are grossly intact, however, impulse control is impaired. She is currently denying suicidal or homicidal ideation. appeared first on Shine Essay.

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem.

The PICOT question will provide a framework for your capstone project change proposal.

In a paper of 500-750 words, clearly identify the clinical problem and how it can result in a positive patient outcome.

Describe the problem in the PICOT question as it relates to the following:

  1. Evidence-based solution
  2. Nursing intervention
  3. Patient care
  4. Health care agency
  5. Nursing practice

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

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

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. 

The post Review your problem or issue and the study materials to formulate a PICOT question for your capstone project change proposal. A PICOT question starts with a designated patient population in a particular clinical area and identifies clinical problems or issues that arise from clinical care. The intervention used to address the problem must be a nursing practice intervention. Include a comparison of the nursing intervention to a patient population not currently receiving the nursing intervention, and specify the timeframe needed to implement the change process.  Formulate a PICOT question using the PICOT format (provided in the assigned readings) that addresses the clinical nursing problem. appeared first on Shine Essay.

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

The purpose of this assignment is to create an educational risk management presentation.

Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.

Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide.  However, you may include supplementary images, graphs, and data where relevant.

To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:

  1. Introduction
  2. Rationale
  3. Support
  4. Implementation
  5. Challenges
  6. Evaluation
  7. Opportunities

You are required to support your statements with a minimum of six citations from appropriate credible sources.

Refer to the resource, “Creating Effective PowerPoint Presentations,” located in the Student Success Center, for additional guidance on completing this assignment in the appropriate style. 

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

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

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Demonstrate critical thinking and documentation skills in order to perform his/her nursing duties with appropriate judgment.

Demonstrate critical thinking and documentation skills in order to perform his/her nursing duties with appropriate judgment.

Purpose

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the NUR3065C course.  

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

  • Apply the assessment component of the nursing process
  • Demonstrate critical thinking and documentation skills in order to perform his/her nursing duties with appropriate judgment.

Points

This assignment is worth a total of 100 points (10%).

Due Date

Submit your completed assignment under the Assignment tab by Sunday 11:59 p.m. EST of Week 15 as directed.

Requirements

  1. The Course Reflection is worth 100 points (10%) and will be graded on quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
  2. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab.
  3. The length of the reflection is to be within three to six pages excluding title page and reference pages.
  4. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):

Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).

  1. Course Reflection
  2. Conclusion

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Little or very general self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Little or no reflection on pertinent BSN sub-competencies (AACN, 2008) or reflection not supported with examples.

Little or very general self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Little or no reflection on pertinent BSN sub-competencies (AACN, 2008) or reflection not supported with examples.

Course Reflection Guidelines

Purpose

The purpose of this assignment is to provide the student an opportunity to reflect on selected RN-BSN competencies acquired through the NUR3805 course.  

Course Outcomes

This assignment provides documentation of student ability to meet the following course outcomes:

  • The students will be able to identify the evolution and history of the nursing profession (ACCN Essential I, II, V, VII; QSEN: safety, evidence-based practice, teamwork and collaboration, and patient centered care).
  • The student will identify the scope of the nursing practice (ACCN Essential I, II, V, VII; QSEN: safety, evidence-based practice, teamwork and collaboration, and patient centered care).
  • The student will identify the importance of the evidence-based practice in the nursing profession and its impact on the healthcare guidelines (ACCN Essential I, II, V, VII; QSEN: safety, evidence-based practice, teamwork and collaboration, and patient centered care).
  • The student will be able to identify the different roles in the nursing profession (ACCN Essential I, II, V, VII; QSEN: safety, evidence-based practice, teamwork and collaboration, and patient centered care).

Points

This assignment is worth a total of 100 points (10%).

Due Date

Submit your completed assignment under the Assignment tab by Sunday 11:59 p.m. EST of Week 15 as directed.

Requirements

  1. The Course Reflection is worth 100 points (10%) and will be graded on quality of self-assessment, use of citations, use of Standard English grammar, sentence structure, and overall organization based on the required components as summarized in the directions and grading criteria/rubric.
  2. Follow the directions and grading criteria closely. Any questions about your essay may be posted under the Q & A forum under the Discussions tab.
  3. The length of the reflection is to be within three to six pages excluding title page and reference pages.
  4. APA format is required with both a title page and reference page. Use the required components of the review as Level 1 headers (upper and lower case, centered):

Note: Introduction – Write an introduction but do not use “Introduction” as a heading in accordance with the rules put forth in the Publication manual of the American Psychological Association (2010, p. 63).

  1. Course Reflection
  2. Conclusion

Preparing Your Reflection

-The BSN Essentials (AACN, 2008) outline a number of healthcare policy and advocacy competencies for the BSN-prepared nurse.

– Reflect on the NUR3805 course readings, discussion threads, and applications you have completed across this course and write a reflective essay regarding the extent to which you feel you are now prepared to:

  1. “Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice.
  2. Use telecommunication technologies to assist in effective communication in a variety of healthcare settings.
  3. Apply safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers.
  4. Understand the use of CIS systems to document interventions related to achieving nurse sensitive outcomes.
  5. Use standardized terminology in a care environment that reflects nursing’s unique contribution to patient outcomes.
  6. Evaluate data from all relevant sources, including technology, to inform the delivery of care.
  7. Recognize the role of information technology in improving patient care outcomes and creating a safe care environment.
  8. Uphold ethical standards related to data security, regulatory requirements, confidentiality, and clients’ right to privacy.
  9. Apply patient­care technologies as appropriate to address the needs of a diverse patient population.
  10. Advocate for the use of new patient care technologies for safe, quality care.
  11. Recognize that redesign of workflow and care processes should precede implementation of care technology to facilitate nursing practice.
  12. Participate in evaluation of information systems in practice settings through policy and procedure development.
  13. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.
  14. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology.
  15. Implement holistic, patient­ centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health­ illness continuum, across the lifespan, and in all healthcare settings.
  16. Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network.
  17. Deliver compassionate, patient­ centered, evidence-based care that respects patient and family preferences.
  18. Implement patient and family care around resolution of end ­of ­life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences.
  19. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care.
  20. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.
  21. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.
  22. Facilitate patient­ centered transitions of care, including discharge planning and ensuring the caregiver’s knowledge of care requirements to promote safe care.
  23. Provide nursing care based on evidence that contributes to safe and high-quality patient outcomes within healthcare microsystems.
  24. Create a safe care environment that results in high quality patient outcomes.
  25. Revise the plan of care based on an ongoing evaluation of patient outcomes.
  26. Demonstrate clinical judgment and accountability for patient outcomes when delegating to and supervising other members of the healthcare team.
  27. Manage care to maximize health, independence, and quality of life for a group of individuals that approximates a beginning practitioner’s workload 
  28. Demonstrate the application of psychomotor skills for the efficient, safe, and compassionate delivery of patient care.
  29. Develop a beginning understanding of complementary and alternative modalities and their role in health care. 
  30. Develop an awareness of patients as well as healthcare professionals’ spiritual beliefs and values and how those beliefs and values impact health care.
  31. Manage the interaction of multiple functional problems affecting patients across the lifespan, including common geriatric syndromes.
  32. Understand one’s role and participation in emergency preparedness and disaster response with an awareness of environmental factors and the risks they pose to self and patients
  33. Engage in caring and healing techniques that promote a therapeutic nurse patient relationship.
  34. Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system as related to nursing practice.” (pp. 18-19, 31-32).

Reference:

American Association of Colleges of Nursing [AACN]. (2008). The essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.

Directions and Grading Criteria

Category Points % Description

(Introduction – see note under requirement #4 above)

8

8

Introduces the purpose of the reflection and addresses BSN Essentials (AACN, 2008) pertinent to healthcare policy and advocacy.

You Decide Reflection

80

80

Include a self-assessment regarding learning that you believe represents your skills, knowledge, and integrative abilities to meet the pertinent BSN Essential and sub-competencies (AACN, 2008) as a result of active learning throughout this course. Be sure to use examples from selected readings, threaded discussions, and/or applications to support your assertions to address each of the following sub-competencies:

  1. “Demonstrate skills in using patient care technologies, information systems, and communication devices that support safe nursing practice.
  2. Use telecommunication technologies to assist in effective communication in a variety of healthcare settings.
  3. Apply safeguards and decision-making support tools embedded in patient care technologies and information systems to support a safe practice environment for both patients and healthcare workers.
  4. Understand the use of CIS systems to document interventions related to achieving nurse sensitive outcomes.
  5. Use standardized terminology in a care environment that reflects nursing’s unique contribution to patient outcomes.
  6. Evaluate data from all relevant sources, including technology, to inform the delivery of care.
  7. Recognize the role of information technology in improving patient care outcomes and creating a safe care environment.
  8. Uphold ethical standards related to data security, regulatory requirements, confidentiality, and clients’ right to privacy.
  9. Apply patient­care technologies as appropriate to address the needs of a diverse patient population.
  10. Advocate for the use of new patient care technologies for safe, quality care.
  11. Recognize that redesign of workflow and care processes should precede implementation of care technology to facilitate nursing practice.
  12. Participate in evaluation of information systems in practice settings through policy and procedure development.
  13. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches.
  14. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology.
  15. Implement holistic, patient­ centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health­ illness continuum, across the lifespan, and in all healthcare settings.
  16. Communicate effectively with all members of the healthcare team, including the patient and the patient’s support network.
  17. Deliver compassionate, patient­ centered, evidence-based care that respects patient and family preferences.
  18. Implement patient and family care around resolution of end ­of ­life and palliative care issues, such as symptom management, support of rituals, and respect for patient and family preferences.
  19. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care.
  20. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan.
  21. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions.
  22. Facilitate patient­ centered transitions of care, including discharge planning and ensuring the caregiver’s knowledge of care requirements to promote safe care.
  23. Provide nursing care based on evidence that contributes to safe and high-quality patient outcomes within healthcare microsystems.
  24. Create a safe care environment that results in high quality patient outcomes.
  25. Revise the plan of care based on an ongoing evaluation of patient outcomes.
  26. Demonstrate clinical judgment and accountability for patient outcomes when delegating to and supervising other members of the healthcare team.
  27. Develop a beginning understanding of complementary and alternative modalities and their role in health care. 
  28. Develop an awareness of patients as well as healthcare professionals’ spiritual beliefs and values and how those beliefs and values impact health care.
  29. Manage the interaction of multiple functional problems affecting patients across the lifespan, including common geriatric syndromes.
  30. Understand one’s role and participation in emergency preparedness and disaster response with an awareness of environmental factors and the risks they pose to self and patients
  31. Engage in caring and healing techniques that promote a therapeutic nurse patient relationship.
  32. Demonstrate tolerance for the ambiguity and unpredictability of the world and its effect on the healthcare system as related to nursing practice.” (pp. 18-19, 31-32).

Conclusion

4

4

An effective conclusion identifies the main ideas and major conclusions from the body of your essay. Minor details are left out. Summarize the benefits of the pertinent BSN Essential and sub-competencies (AACN, 2008) pertaining to scholarship for evidence-based practice.

Clarity of writing

6

6

Use of standard English grammar and sentence structure. No spelling errors or typographical errors. Organized around the required components using appropriate headers. Writing should demonstrate original thought without an over-reliance on the works of others.

APA format

2

2

All information taken from another source, even if summarized, must be appropriately cited in the manuscript and listed in the references using APA (6th ed.) format:

  1. Document setup
  2. Title and reference pages
  3. Citations in the text and references.

Total:

100

100

A quality essay will meet or exceed all of the above requirements.

Grading Rubric

Assignment Criteria

Meets Criteria

Partially Meets Criteria

Does Not Meet Criteria

(Introduction – see note under requirement #4 above)

(8 pts)

Short introduction of selected BSN sub-competencies (AACN, 2008) pertinent to scholarship for evidence-based practice. Rationale is well presented, and purpose fully developed.

7 – 8 points

Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.

5 – 6 points

Little or very general introduction of selected BSN sub-competencies (AACN, 2008). Little to no original explanation; inappropriate emphasis on an area.

0 – 4 points

You Decide Reflection

(80 pts)

Excellent self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Reflection on pertinent BSN sub-competencies (AACN, 2008) supported with examples.

70 – 80 points

Basic self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Reflection on pertinent BSN sub-competencies (AACN, 2008) not supported with examples.

59 – 69 points

Little or very general self-assessment of skills, knowledge, and integrative abilities pertinent to healthcare policy and advocacy. Little or no reflection on pertinent BSN sub-competencies (AACN, 2008) or reflection not supported with examples.

0 – 58 points

Conclusion

(4 pts)

Excellent understanding of pertinent BSN sub- competencies (AACN, 2008). Conclusions are well evidenced and fully developed.

3 – 4 points

Basic understanding and/or limited use of original explanation and/or inappropriate emphasis on an area.

2 points

Little understanding of pertinent BSN sub-competencies (AACN, 2008). Little to no original explanation; inappropriate emphasis on an area.

0 – 1 point

Clarity of writing

(6 pts)

Excellent use of standard English showing original thought with minimal reliance on the works of others. No spelling or grammar errors. Well organized with proper flow of meaning.

5 – 6 points

Some evidence of own expression and competent use of language. No more than three spelling or grammar errors. Well organized thoughts and concepts.

3 – 4 points

Language needs development or there is an over-reliance on the works of others. Four or more spelling and/or grammar errors. Poorly organized thoughts and concepts.

0 – 2 points

APA format

(2 pts)

APA format correct with no more than 1-2 minor errors.

2 points

3-5 errors in APA format and/or 1-2 citations are missing.

1 point

APA formatting contains multiple errors and/or several citations are missing.

0 points

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