In your opinion, what is the potential or realized impact of this legislation on the community?

Visit the website of a legislative body that has the ability to create rules, codes, or ordinances that impact the environment. Examples of these types of agencies include: Green Dallas, Fort Worth Environmental Management Department, Texas House of Representatives Committee on Environmental Regulation, U.S. House of Representatives Committee on Natural Resources, U.S. Senate Committee on Environment and Public Works and U.S. Environmental Protection Agency (EPA). Select one piece of legislation (or rule, or ordinance), either proposed or actual, and summarize it for the class. Ideally, you should select legislation that will directly impact your community.

  • Review the discussion board prior to selecting a proposal or prior to posting your message to the discussion board in order to avoid duplicating resources.
  • List the title of the legislative bill, rule, or ordinance. Include the title of the legislative body that drafted, proposed, or authorized the legislation.
  • Summarize the environmental legislation in one or two paragraphs. Identify key concepts included in the legislation.
  • In your opinion, what is the potential or realized impact of this legislation on the community?
  • Do you agree or disagree with the legislation? Support your answer.
  • Your original post should consist of complete sentences and should be at least two complete paragraphs but no more than three paragraphs.

What medication do you think is likely to be prescribed for this client and why? 

Medications Used to Treat Mental Illness

You are a nurse at an outpatient clinic and are presented with a 68-year-old female client.  She is experiencing the following symptoms: decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem. The doctor diagnoses the client with major depressive disorder.  Answer the following questions:

  • What medication do you think is likely to be prescribed for this client and why?
  • What are some important teachings you would give this client when administering the first dose?
  • When following up with the client 2 months later.  What are some changes you may expect to see with the client? If the client is not displaying the expected outcomes, what are some possible alternatives for the client

In diabetic patients above 65 years of age, how does nutrition compared to no nutrition influence the health of the patient over one week?

Topic: Effect of Nutrition of Diabetic Patient.

PICOT Questions

  1. 1. In diabetic patients above 65 years of age, how does nutrition compared to no nutrition influence the health of the patient over one week?

2. In diabetic patients below the age of 65 years, how does nutrition compared to

physical exercise influence the health of the patient over one week?

3. In a diabetic patient of any age, how does nutrition compared to other treatments

influence the health of the patient over one week?

Week 4: Quantitative and Qualitative Summary (Abstract)

This week, you will submit summaries of quantitative and qualitative studies. The purpose of this assignment is to become familiar with published research, research designs, and methodologies. For the assignment, you will select one quantitative research study and one qualitative study related to the field of nursing and write a summary of each study. Each summary must be accurate, succinct, and clear. These articles should be somewhat related to your PICOT questions.

Ensure the following questions are addressed in each summary:

1. What type of research is it (quantitative, qualitative, and design)?
2. What was the research question(s) or hypothesis?
3. What is the sample, the sample size, and sample attributes?
4. What was the setting of the study?
5. What were the researcher’s findings? (Identify one.)

 You must submit the research study articles along with your summaries.

  • Each summary should be between 150–250 words. 
  • 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.

Due Sunday, 11:59 p.m. (Pacific time)

Points  150

Impact of Medication Administration Errors on 3-4-Year-old Leukemia Patient

This week’s post will focus on Chapter Three. Please address the areas below in your discussion post this week. Please write at least five concise statement discussing the content in this area. Spelling and grammar will be reviewed and graded. Note: When you write the chapters, adhere to the Proposal Paper requirements.

TOPIC: Impact of Medication Administration Errors on 3-4-Year-old Leukemia Patients

Population and Sample Selection: This section discusses the setting, total population, project population, and project sample. The discussion of the sample includes the project terminology specific to the type of sampling for the project.

Instrumentation or Sources of Data: This section describes, in detail, all data collection instruments and sources (tests, questionnaires, interviews, databases, media, etc.); the specific instrument or source to collect data for each variable or group (quantitative project).

Validity and Reliability: This section provides specific validity statistics for quantitative instruments, identifying how they were developed, and explains how validity will be addressed during data collection approaches. This section provides specific reliability statistics for quantitative instruments, identifying how the statistics were developed, and explains how reliability will be addressed during data collection approaches.

Data Collection Procedures: Describe the step-by-step procedures used to carry out all the major steps for data collection for the project in a way that would allow another investigator to replicate the project. Can say Step 1, Step 2, Step 3…

Data Analysis Procedures: This section provides a description of how the data will be collected and organized for each variable or group; a description of the type of data to be analyzed, identifying the descriptive, inferential, or nonstatistical analyses; a description of how the raw data will be organized and prepared for analysis; and a step-by-step description of the procedures used to conduct the data analysis.

Ethical Considerations: This section discusses the potential ethical issues surrounding the DPI project, as well as how human subjects and data will be protected. It identifies how any potential ethical issues will be addressed.

Limitations: This section discusses, in detail, the limitations related to the project approach and methodology and the potential impacts on the results.

Post the following statement to this topic’s discussion forum after your references:

“I am attending class, I am engaged in the writing of my DPI Project, and I am communicating regularly with my DPI Project Chairperson/Committee.”

Resources

Read:

Sole, M. L., Talbert, S., Bennett, M., Middleton, A., Deaton, L., & Penoyer, D. (2018). Collecting Nursing Research Data 24 Hours a Day: Challenges, Lessons, and Recommendations. American Journal of Critical Care27(4), 305–311.

URL:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=130296171&site=ehost-live&scope=site

Read:

Hammer, M. J. (2017). Research Ethics in Big Data. Oncology Nursing Forum44(3), 293–295.

URL:https://lopes.idm.oclc.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=122723364&site=ehost-live&scope=site

Read:

Corwin, E., Jones, D., & Dunlop, A. (2019). Symptom science research in the era of big data: Leveraging interdisciplinary resources and partners to make it happen. Journal of Nursing Scholarship, 51(1), 4-8.

URL:https://lopes.idm.oclc.org/login?url=https://search-proquest-com.lopes.idm.oclc.org/docview/2169563196?accountid=7374

Do these students have integrity?

Two nursing students cheated on several assignments.  Although the evidence is irrefutable, both students deny cheating.  Discuss these students in terms of virtue ethics.

  1. Do these students have integrity?
  2. Do these students have the character to become good nurses?
  3. Should the instructor allow them another chance?

What is self-awareness

A.  What You Should Know

Define:

Deontology:___________________________________________________________________, Kantianism_____________________________________________________________________, virtue ethics____________________________________________________________________, compassion____________________________________________________________________, discernment____________________________________________________________________, trustworthiness_________________________________________________________________, integrity_______________________________________________________________________, and particularism________________________________________________________________.

1. What are focal virtues?___________________________________________________________

2. What are values?________________________________________________________________ How are they acquired and clarified?________________________________________________

3. Why is self-awareness important in professional nursing?________________________________

4. What is the difference between overt and covert values?_______________________________

5. Define these terms as they relate to nursing: autonomy_________________________________, informed consent_______________________________________________________________, paternalism_____________________________________________________________________ beneficence____________________________________________________________________ prevent harm___________________________________________________________________, remove evil or harm_____________________________________________________________, Nonmaleficence_________________________________________________________________, veracity, _______________________________________________________________________

confidentiality,_________________________________________________________________

justice_________________________________________________________________________

distributive justice_______________________________________________________________,

use of material rules_____________________________________________________________,

fidelity________________________________________________________________________.

6. How can moral distress impact nursing practice?_______________________________________

___________________________________________________

B. What You Should Know

*Instructions: Complete this document either in Word or manually (and scanned) and place in the appropriate drop-box before the start of class (ex. If your class begins at 12:00 pm, submit no later than 11:59). This must be completed in its entirety to receive the allotted participation points. All of this information is found in the Power Point presentations and assigned readings. You must be prepared to discuss this information during the synchronous class session. Format your submission: LastnameFirstinitial_Class2_WYSK.doc or .pdf

Week 1, Class 2: What you should know…

1. Where are values learned__________________________________________________?

2. How many levels are in Kohlberg’s Theory of Moral Development?________. Name and define them______________________________________________________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

3. How many stages are in the theory?_______ What are they called? _________________

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

4. What is an androgenic study? What is the significance of this topic to us?____________

________________________________________________________________________

5. What is the underlying premise for Gilligan’s study of the Psychological Development of Women?________________________________________________________________

6. How many phases are in Gilligan’s theory? _____What are they called?______________

________________________________________________________________________

7. What is Fowler’s definition of faith? __________________________________________

________________________________________________________________________

8. What are the stages of Fowler’s Theory of Faith Development?_____________________

________________________________________________________________________

9. Why should nurses be spiritually & culturally sensitive in their practice?______________

________________________________________________________________________

10. Define wholistic health care_________________________________________________

11. Define spiritual care_______________________________________________________

12. Define American individualism_______________________________________________

13. How can a nurse’s faith & spiritual health impact their practice?____________________

________________________________________________________________________

14. What is complementary medicine?___________________________________________

15. Name some cultural healthcare treatments____________________________________

_________________________________________

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template

The Assignment (Evidence-Based Project)

Part 4A: Critical Appraisal of Research

Conduct a critical appraisal of the four peer-reviewed articles you selected by completing the Evaluation Table within the Critical Appraisal Tool Worksheet Template. Choose a total of four peer- reviewed articles that you selected related to your clinical topic of interest in Module 2 and Module 3.

Note: You can choose any combination of articles from Modules 2 and 3 for your Critical Appraisal. For example, you may choose two unfiltered research articles from Module 2 and two filtered research articles (systematic reviews) from Module 3 or one article from Module 2 and three articles from Module 3. You can choose any combination of articles from the prior Module Assignments as long as both modules and types of studies are represented.

Part 4B: Critical Appraisal of Research

Based on your appraisal, in a 1-2-page critical appraisal, suggest a best practice that emerges from the research you reviewed. Briefly explain the best practice, justifying your proposal with APA citations of the research

Medication Used To Treat Mental Illness

You are a nurse at an outpatient clinic and are presented with a 68-year-old female client.  She is experiencing the following symptoms: decreased appetite, disturbed sleep pattern, fatigue, difficulty concentrating, disordered thought process, anhedonia, guilt, and low self-esteem. The doctor diagnoses the client with major depressive disorder.  Answer the following questions:

  • What medication do you think is likely to be prescribed for this client and why?
  • What are some important teachings you would give this client when administering the first dose?
  • When following up with the client 2 months later.  What are some changes you may expect to see with the client? If the client is not displaying the expected outcomes, what are some possible alternatives for the client

Assessing And Treating Clients With Psychosis And Schizophrenia

Examine Case Study: Pakistani Woman with Delusional Thought Processes.  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?

Also include how ethical considerations might impact your treatment plan and communication with clients.

BACKGROUND

The client is a 34-year-old Pakistani female who moved to the United  States in her late teens/early 20s. She is currently in an “arranged”  marriage (her husband was selected for her since she was 9 years old).  She presents to your office today following a 21 day hospitalization for  what was diagnosed as “brief psychotic disorder.” She was given this  diagnosis as her symptoms have persisted for less than 1 month.

Prior to admission, she was reporting visions of Allah, and over the  course of a week, she believed that she was the prophet Mohammad. She  believed that she would deliver the world from sin. Her husband became  concerned about her behavior to the point that he was afraid of leaving  their 4 children with her. One evening, she was “out of control” which  resulted in his calling the police and her subsequent admission to an  inpatient psych unit.

During today’s assessment, she appears quite calm, and insists that  the entire incident was “blown out of proportion.” She denies that she  believed herself to be the prophet Mohammad and states that her husband  was just out to get her because he never loved her and wanted an  “American wife” instead of her. She tells you that she knows this  because the television is telling her so.

She currently weighs 140 lbs, and is 5’ 5”

SUBJECTIVE

Client reports that her mood is “good.” She denies auditory/visual  hallucinations, but believes that the television does talk to her. She  believes that Allah sends her messages through the TV.  At times  throughout the clinical interview, she becomes hostile towards the  PMHNP, but then calms down.

You reviewed her hospital records and find that she has been  medically worked up by a physician who reported her to be in overall  good health. Lab studies were all within normal limits.

Client admits that she stopped taking her Risperdal about a week  after she got out of the hospital because she thinks her husband is  going to poison her so that he can marry an American woman.

MENTAL STATUS EXAM

The client is alert, oriented to person, place, time, and event. She  is dressed appropriately for the weather and time of year. She  demonstrates no noteworthy mannerisms, gestures, or tics. Her speech is  slow and at times, interrupted by periods of silence. Self-reported mood  is euthymic. Affect constricted. Although the client denies visual or  auditory hallucinations, she appears to be “listening” to something.  Delusional and paranoid thought processes as described, above. Insight  and judgment are impaired. She is currently denying suicidal or  homicidal ideation.

The PMHNP administers the PANSS which reveals the following scores:

-40 for the positive symptoms scale

-20 for the negative symptom scale

-60 for general psychopathology scale

Diagnosis: Schizophrenia, paranoid type

Decision Point One

Start Invega Sustenna 234 mg intramuscular X1 followed by 156 mg intramuscular on day 4 and monthly thereafter

RESULTS OF DECISION POINT ONE

  • Client returns to clinic in four weeks
  • A decrease in PANSS score of 25% is noted at this visit
  • Client seems to be tolerating medication
  • Client’s husband has made sure she makes her appointments for injections (one thus far)
  • Client has noted a 2 pound weight gain but it does not seem to be an important point for her
  • Client complains of injection site pain telling the PMHNP that she  has trouble siting for a few hours after the injections and doesn’t like  having to walk around for such a long period of time

Decision Point Two

 Continue  same decision made but instruct administering nurse to begin injections  into the deltoid at this visit and moving forward

RESULTS OF DECISION POINT TWO

  • Client returns to clinic in four weeks
  • Client’s PANNS has reduced by a total of 50% from the initiation of Invega sustenna
  • When questioned about injection site pain, client states it is much better in the arm
  • Client’s weight has increased by an  additional 2.5 pounds (total of 4.5 pounds in a 2 month period). She is  somewhat bothered by the weight gain and is afraid that her husband does  not like it. He is not present at this visit as she brought herself
  • Client likes how she feels on the  Invega Sustenna but is wondering if there is another drug like it that  would not cause the weight gain

Decision Point Three

 Continue  with the Invega Sustenna. Counsel client on the fact that weight gain  from Invega Sustenna is not as much as what other drugs with similar  efficacy can cause. Make appointment with a dietician and an exercise  physiologist. Follow up in one month

Guidance to Student
Weight gain can occur with Invega  Sustenna. It is modest in nature and can be controlled with proper  nutrition and exercise. It is always a good idea to try and control a  client’s weight through consultation with a dietician and exercise  physiologist (life coach) before switching to another agent when a  product is showing efficacy for at least 6 months.
Abilify Maintena is a good option for someone who has good  response to abilify oral. Remember that Abilify does not bind to the D2  receptor for a great period of time (such as Invega) and can be less  affective in certain individuals. Also, remember that akathisia  can be a  possible side effect. Once an IM long acting medication is given, the  effects of the drug (both efficacious and untoward effects) can be  maintained for a long duration (up to a month or longer). Tolerability  and efficacy should be established with oral medication first before  administering the first injection. Also a disadvantage to Abilify  Maintena is a 2-week overlap of oral therapy is required due to  effective blood levels lagging behind the induction dose.
Qsymia is a weight loss medication that is a combination of  Phenteramine and Topiramate. It is only indicated to treat obesity. This  client’s BMI (28.9 kg/M2) does not fit the definition of obesity (BMI  >30 Kg/M2- Following from CDC website: Class 1: BMI of 30 to < 35,  Class 2: BMI of 35 to < 40, Class 3: BMI of 40 or higher. Class 3  obesity is sometimes categorized as “extreme” or “severe” obesity).   There are two things wrong with this therapy option. First, there are  only a few occasions where add-on therapy to treat a side effect is  acceptable and weight gain is not one of those scenarios. Secondly,  Phenteramine has a lot of cardiovascular toxicities (such as elevated  BP, HR, increased workload on the heart).

Discuss the cognitive, emotional, and physical (fine and gross) development that occurs in infancy

Step 1: Review Chapter 3 on Infancy and reflect on the following scenario:

Educational DVD’s and toys have become popular amongst today’s society with the assumption that they raise intelligence in babies.

Step 2: In a two page paper:

  • Discuss the cognitive, emotional, and physical (fine and gross) development that occurs in infancy.
  • Using the developmental concepts you discussed in infancy, apply the data to refute or support the claims of a book or educational program’s promise to help parents increase their babies’ intelligence.
  • Based on valid research, what suggestions would you give to a patient’s parent to increase the intellectual development of infants?
  • Discuss how your knowledge of development within infancy can be applied in your Obstetrics and Pediatrics clinical rotation.

Provide 3-5 references for your submission.