Module 05 Written Assignment – Reflection
What have you learned so far in this course that will help you conduct effective health assessments?
What skills do you have you gained?
Describe any areas that are still unclear and ways you will gain clarity.
Submit your completed assignment by following the directions linked below. Please check the Course Calendar for specific due dates.
please see the attached files for the detailed poster template required to be complete with answers based on your proposal you have done or a new one.
Respond at least 2 times each. The goal is for the discussion forum to function as robust clinical conferences on the patients.
CASE INTRODUCTION – Charlotte Greene, a registered nurse, is discharging a pediatric patient, Joey Slater, to home care under the supervision of his mother. The child returns to the hospital five weeks later with some concerning issues
Brief Summary of Case
SCENE 1: Joey Slater, an 8-year-old child who received blood transfusion for femur, is now ready for discharge. Stacey, a licensed practical nurse/licensed vocational nurse (LPN/LVN), offers to take care of discharge teaching about cast care, while Charlotte, an RN, calls home health care to arrange a home visit.
SCENE 2: Five weeks later, Joey is readmitted to the pediatric floor. On assessment by the RN, maggots were coming out of the cast, and perineal skin breakdown was noted. As Charlotte and the mother discuss the situation, it’s clear that there was a lack of education. The mother also states that home health nurses never contacted her. Later, Charlotte calls the agency and discovers that they tried repeatedly to contact the family without success.
SCENE 3: Charlotte tells Joey that the doctor says he can go home, but he seems worried and scared. Later, Charlotte calls social services to involve them in the patient’s care. Charlotte advocates for the patient by delaying his discharge and reporting subjective and objective findings to social services.
Instructions:
1. Read the case study above and then, answer the following questions for
Scene 1:
a. What primary violation of the Code of Ethics in Nursing did you witness in this scene?
b. What evidence do you see for proper delegation, if any, by the RN in the video case?
· What improper delegation took place?
· What would you as the nurse have delegated in this scene?
2. Now, answer the following questions for
Scene 2:
a. What evidence do we have of the potential for professional negligence and malpractice in the care delivery for this patient?
b. Which of the nine Code of Ethics for Nursing provisions were upheld by the registered nurse in this scene?
3. Your paper should be:
. One (1) page
. Typed according to
APA Writing StyleLinks to an external site.
for margins, formatting and spacing standards.
Week 4 ion channel —2 Peer Response 800w. due9-26-23
Instructions:
Please read and respond to the two peers' initial postings for week 2 below. Consider the following questions in your responses.
Compare and contrast your initial posting with those of your peers.
1. How are they similar or how are they different?
2. What information can you add that would help support the responses of your peers?
3. Ask your peers a question for clarification about their post.
4. What most interests you about their responses?
5. Summaries at least 1 evidence based article that supports there point.
Please be sure to validate your opinions and ideas with citations and references in APA format.
·
Response 1 400 words mam
·
·
Differentiate between the opening of a ligand-gated ion channel and a voltage-sensitive ion channel.
· In the nervous system, there are two important types of ion channels: voltage-gated ion channels and ligand-gated ion channels. Both of these ion channels play crucial roles in transmitting electrical signals, often referred to as messages, throughout the nervous system. Each type of channel has its own specific mechanism for opening and closing. These ion channel proteins are influenced by various stimuli or external factors, which can trigger their activation or deactivation within the cell's plasma membrane (Xiao-Yu, 2023).
· Ligand-gated ion channels, as their name suggests, require a ligand to open. Ligands are chemical messengers that can bind to protein receptors on the channel. In simpler terms, when a specific chemical, such as a neurotransmitter, binds to the channel's receptor, it triggers a conformational change in the protein channel. As a result, the channel gains the ability to open, allowing ions (usually Na+, K+, or Cl-) to flow through the channel pore (Stahl, 2021). Ligands can include neurotransmitters, hormones, medications, and other molecules. Each ligand-gated ion channel has a specific binding site for its particular ligand. Most ligand-gated ion channels are located at synapses. When neurotransmitters are released into the synaptic cleft, they can bind to their specific binding sites on ligand-gated ion channels found in the post-synaptic cell membrane. This binding facilitates the transfer of signals. Ligand-gated channels are known for their rapid response and are well-suited for fast synaptic transmissions (Stahl, 2021).
· Voltage-gated ion channels are distinct from ligand-gated channels in that they respond to changes in electrical charge, specifically the membrane potential, rather than chemical ligands. These ion channels are regulated by alterations in the voltage across the cell membrane. The distribution of positive and negative ions on either side of the cell membrane varies. Typically, during the resting state, the inside of the cell membrane carries a more negative charge compared to the outside. When a signal is potent enough to elevate the positive voltage within the cell membrane, reaching a critical threshold, the voltage-gated channels open (depolarization). During the depolarization period, voltage-gated ion channels allow the transfer of ions, which initiates an action potential. Various stimuli or external factors have the capability to trigger the activation or deactivation of voltage-gated channel proteins present within the cell's plasma membrane. Voltage-sensitive channels are distributed along the axons and dendrites of neurons throughout the nervous system. Additionally, they can be found in other excitable cell types, including muscle and cardiac cells (Stahl, 2021).
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References
· Stahl, S. M. (2021).
Stahl’s essential psychopharmacology: Neuroscientific basis and practical application (5th ed.).
· Xiao-Yu, D. (2023). Calcium ion channels in Saccharomyces cerevisiae.
Journal of Fungi, 9(5), 524. https://doi.org/10.3390/jof9050524
Response 2. 400 words mc
Compare and contrast the two different major classes of ion channels.
The two major classes of ion channels according to Stahl (2021), are
ligand-gated ion channels, ionotropic receptors and ion-channel-linked receptors and
voltage-sensitive or voltage-gated ion channels. Ligand-gated ion channels are ion channels that are closed and opened by actions of neurotransmitter ligands at receptors acting as gatekeepers. The neurotransmitter binds to the gatekeeper receptor, which in turn causes a conformational change in the receptor, opening the ion channel. The receptors regulate the opening and closing of the ion channels and are therefore ligand-gated ion channels. On the other hand, the opening and closing of voltage-sensitive or voltage-gated ion channels is regulated by voltage potential or ionic charge across the membrane in which they reside (Stahl, 2021).
Explain the difference between full agonists, partial agonists, antagonists, inverse agonists.
The action of full agonists is to change the conformation of the receptor to open the ion channel the maximum amount and frequency allowed by the binding site (Stahl, 2021). Consequently, the maximum amount of downside signal transduction is triggered and medicated by the binding site. In contrast, partial agonists change the receptor conformation to open the ion channel to a greater extent and more frequently than its resting state (Stahl, 2021). As a result, the downstream signal transduction and ion flow produced in the absence of an agonist is greater than the resting state but less than that of full agonists.
Antagonists, on the other hand, stabilize the receptor in the resting state, which is similar to the state of the receptor in the absence of agonist (Stahl, 2021). Antagonists are said to be silent or neutral because the resting state is the same in the absence or presence of an antagonist. The resting state of an antagonist is not a fully closed ion channel and as a result, some degree of ion flow through the channel even in the absence of an agonist and in the presence of antagonist. Inverse agonists are neither neutral nor silent like the antagonists. They produce a conformational change in the receptors at ligand-gated ion channels causing the channel to close first, then stabilizing it in an inactive form. As a result of inactive conformation action of inverse agonists, ion flow and signal transduction are functionally reduced compared to the resting state. The action of inverse agonists is reversed by antagonists (Stahl, 2021).
References
Stahl, S. M. (2021).
Stahl's essential psychopharmacology: Neuroscientific basis and practical applications (5th ed.). Cambridge University Press.
1.
Two new associate-degree graduates were hired for the pediatric unit. Both worked three 12-hour shifts a week; Jan worked the day-to-evening shift and Rosemary worked the night shift. Whenever their shifts connected, they would compare notes on their experience. Jan felt she was learning rapidly, gaining clinical skills and beginning to feel at ease with her colleagues.
Rosemary, however, still felt unsure of herself and often isolated. There have been times that she was the only registered nurse on the unit all night. The aides and LPNs were very experienced, but Rosemary feels she is not ready for that kind of responsibility. Rosemary knows she must speak to the nurse manager about this, but she’s called several times, and she’s never available. The shift assignments are left in the staff lounge by an assistant.
Your discussion post should answer the following questions in a well-constructed commentary. Use references, in APA format, where appropriate.
Read the following case study an answer the reflective questions. Please provide evidence based practice rationals for your answers with scholarly references no older than 5 years APA 7th ed needs to be followed.
CASE STUDY: Albert
Albert Mitchell is a 36-year-old man who will be traveling to Dubai to give a business presentation in 3 months. Although he has traveled widely in the United States as a consultant, this is his first trip to the Middle East.
He requests information regarding immunizations needed before his trip. Albert states that as he will be in Dubai for only a few days, he is unlikely to contract a disease in such a short time and therefore believes that it is illogical to obtain immunizations.
Albert states that he has heard that the side effects of the immunizations might be worse than the diseases they prevent. He is also concerned about leaving his wife at home alone because she is 6 months pregnant.
Reflective Questions
How would you address Albert’s beliefs?
What learning would be needed in each domain?
What learning theories would you consider?
How might his family concerns be addressed?
A burn injury can severely affect a patient’s physical and emotional well-being. As a nurse you may be in charge of taking care of a patient during any of the three phases of burns. Please complete the Phases of Burn Injury table to better understand the needs of a burn patient and ways to meet those needs.
Assignment, you will review and apply your understanding of psychopharmacologic treatments for patients with multiple mental health disorders.
1. In 3 or 4 sentences, explain the appropriate drug therapy for a patient who presents with MDD and a history of alcohol abuse ( use an SSRI Sertraline and an alcohol cessation medication naltrexone). Which drugs are contraindicated, if any, and why? Be specific. What is the timeframe that the patient should see resolution of symptoms?
2. List 4 predictors of late onset generalized anxiety disorder.
3. List 4 potential neurobiology causes of psychotic major depression.
4. An episode of major depression is defined as a period of time lasting at least 2 weeks. List at least 5 symptoms required for the episode to occur. Be specific.
5. List 3 classes of drugs, with a corresponding example for each class, that precipitate insomnia. Be specific.
References x 3 to include:
Morgenthaler, T. I., Kapur, V. K., Brown, T. M., Swick, T. J., Alessi, C., Aurora, R. N., Boehlecke, B., Chesson, A. L., Friedman, L., Maganti, R., Owens, J., Pancer, J., & Zak, R. (2007). Practice parameters for the treatment of narcolepsy and other hypersomnias of central origin.
SLEEPLinks to an external site.
, 30(12), 1705–1711. https://j2vjt3dnbra3ps7ll1clb4q2-wpengine.netdna-ssl.com/wp-content/uploads/2017/07/PP_Narcolepsy.pdf
Sateia, M. J., Buysse, D. J., Krystal, A. D., Neubauer, D. N., & Heald, J. L. (2017). Clinical practice guideline for the pharmacologic treatment of chronic insomnia in adults: An American Academy of Sleep Medicine clinical practice guideline.
Journal of Clinical Sleep MedicineLinks to an external site.
, 13(2), 307–349. https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6470
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