Decision Tree-wk 10

Case Study: https://cdn-media.waldenu.edu/2dett4d/Walden/NURS/6630/DT/week_08/index.html

 

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

Introduction to the case (1 page)

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

Decision #1 (1 page)

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

Decision #2 (1 page)

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

Decision #3 (1 page)

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

Conclusion (1 page)

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

References to include:

 

  • Stahl, S. M. (2021). Stahl’s essential psychopharmacology: Neuroscientific basis and practical applications (5th Ed.) Cambridge University Press.
    • Chapter 13, “Impulsivity, Compulsivity, and Addiction” (pp. 538-578)

 

  • Salmon, J. M., & Forester, B. (2012). Substance abuse and co-occurring psychiatric disorders in older adults: A clinical case and review of the relevant literature. Journal of Dual DiagnosisLinks to an external site., 8(1), 74–84. https://doi.org/10.1080/15504263.2012.648439

Nursing

  

Hello, this work is on Advanced Pathophysiology, it must have a minimum of 300 words and a bibliographic reference. The bibliography used on the topic is McCance, K. L. & Huether, S. E. (2019). Pathophysiology: the biological basis of diseases in adults and children. But you can use another one in addition to this one.

What is a major function of the limbic system? Explain your answer.

a. Overall control of fluid balance

b. Required for logical thinking, reason, and decision-making.

c. Determines emotional responses.

d. Responsible for artistic and musical talents

Career Informative Speech — Geriatric Nursing

Please help me write this speech! I will add personal details to it later. Here is the relevant info, as well as the completed outline attached.

The purpose of the speech is to inform on a specific career related to the Academic Degree you are pursuing. The speech is not specifically about you.  Instead, it is about the career itself.

How To Get Started:

Imagine you are delivering a speech during Career Day at a school. Describe to your audience the nature of this profession such as specific daily job duties, working environment, educational requirements, job prospects, advancement prospects, salaries, etc.

Required Speech Details

  1. Educational and Training requirements
  2. Job prospects
  3. Type of physical location job occurs in such as office buildings, hospitals, outdoors, travel, etc.
  4. Type of social environment such as group settings, partners, solo work, etc.
  5. Day to day duties
  6. Salaries
  7. Continuing education and training required
  8. An interesting fact or anecdote about profession
  9. Formally cite three source citations in your speech. Sources can come from any verifiable publications: books, websites, journals, etc. Only one citation from each “type” of source is allowed. For example, one website, one magazine, one book, etc. 

Cardiovascular

Discuss what is happening on a cellular level with the disease process. Be careful to realize that patients have co-morbidities and you may need to discuss the other diseases impact on the pathophysiology and care of the patient.  Three (3) resources after 2008 are required along with APA format. 

A 70 year old black American female who has the following
preexisting conditions;

Hypertension (HTN): longterm

Heart failure (CHF) : 2 months

Coronary artery disease (CAD) : longterm

Myocardial infarction (MI) : five years ago

Ejection (EF) of 55% : 2 months ago

Socioeconomic data:

Widow, Lives alone, independent ADL’s, Nonsmoker, Nondrinker

Pharmacologic data:

Aspirin (acetylsalicylic acid, ASA)

Clopidogrel bisulfate (Plavix)

Lisinopril (Prinivil, Zestril)

Carvedilol (Coreg)

Furosemide (Lasix)

Potassium chloride (KCL)

Client Profile:

70 year old woman originally from Alabama. She lives alone and is able to manage herself independently. She is active in her community and church. Diagnosed with heart failure 2 months age and is followed up at home with a visiting nurse every other week for to assist is managing her heart failure symptoms. She is being referred to the nurse practitioner for follow up of changes in her symptoms.

Assessment:

At the office the following subjective and objective data was supplied:

“I noticed my legs were getting a bit bigger and they are achy, too.”

She has gained 10 pounds over the last 5 days.

She gets short of breath when ambulating from one room to the other (approximately 20 feet) and must sit down to catch her breath.

Her oxygen saturation is 95% on room air. Bibasilar crackles are heard when auscultating her lung sounds.

She denies any chest, arm, or jaw pain or nausea.

She denies any back pain, stomach pain, confusion, dizziness, or a feeling faint.

She admits only to feeling a little more tired than usual.

Eats Southern Cooking when at home.

Vital signs :

T= 97.6 F (36.4C), BP 140/70, P 93, R 22.

Labs ordered:

complete blood count (CBC), basic metabolic panel (BMP), brain natriuretic peptide (B-type natriuretic peptide assay or BNP), troponin, creatine kinase (CPK), creatine kinase-MB (CKMB), and albumin. The APN also prescribes oral (PO) Furosemide and arranges an outpatient electrocardiogram (ECG, EKG), chest X-ray, and echocardiogram.

Questions

1. Which assessment findings during this visit are consistent with heart failure?

2. Why did the APN ask about back pain, stomach pain, confusion, dizziness or a feeling that she might faint?

3. Explain what the following terms indicate and include the normal values: cardiac output, stroke volume, afterload, preload, ejection fraction and central venous pressure. Is an ejection fraction of 55% significant. Provide rationale.

5. Discuss the body’s compensatory mechanisms during hear failure. Include an explanation of the Frank-Starling law in your discussion.

6. Heart failure can be classified as left or right ventricular failure, systolic versus diastolic, according to the New York Heart Association (NYHA) and using the ACC/AHA (American Heart Association) guidelines. Explain these four classification systems and the signs and symptoms that characterize each. Which Classification fits this patient?

7. Provide a rationale for why each of the following medications have been prescribed: Aspirin, Clopidogrel bisulfate (Plavix), Lisinopril(Prinivil/Zestril) , and Carvedilol (Coreg).

8. What information will each of the following tests provide: CBC, BMP, BNP, Troponin, CPK, CKMB, and albumin, EKG, CXR, and Echocardiogram

NURSING

Introduction

Interprofessional collaboration is a critical aspect of a nurse’s work. Through interprofessional collaboration, practitioners and patients share information and consider each other’s perspectives to better understand and address the many factors that contribute to health and well-being (Sullivan et al., 2015). Essentially, by collaborating, health care practitioners and patients can have better health outcomes. Nurses, who are often at the frontlines of interacting with various groups and records, are full partners in this approach to health care.Reflection is a key part of building interprofessional competence, as it allows you to look critically at experiences and actions through specific lenses. From the standpoint of interprofessional collaboration, reflection can help you consider potential reasons for and causes of people’s actions and behaviors (Saunders et al., 2016). It also can provide opportunities to examine the roles team members adopted in a given situation as well as how the team could have worked more effectively.As you begin to prepare this assessment you are encouraged to complete the What is Reflective Practice? activity. The activity consists of five questions that will allow you the opportunity to practice self-reflection. The information gained from completing this formative will help with your success on the Collaboration and Leadership Reflection Video assessment. Completing formatives is also a way to demonstrate course engagement Note: The Example Kaltura Reflection demonstrates how to cite sources appropriately in an oral presentation/video. Your assessment will reflect on either a professional collaboration you experienced or a collaboration case study scenario that you imagine you experienced

References

Saunders, R., Singer, R., Dugmore, H., Seaman, K., & Lake, F. (2016). Nursing students’ reflections on an interprofessional placement in ambulatory care. Reflective Practice, 17(4), 393–402.Sullivan, M., Kiovsky, R., Mason, D., Hill, C., Duke, C. (2015). Interprofessional collaboration and education. American Journal of Nursing, 115(3), 47–54.

Demonstration of Proficiency

  • Competency 1: Explain strategies for managing human and financial resources to promote organizational health.
    • Identify how poor collaboration can result in inefficient management of human and financial resources supported by evidence from the literature.
  • Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
    • Reflect on an interdisciplinary collaboration experience noting ways in which it was successful and unsuccessful in achieving desired outcomes.
    • Identify best-practice interdisciplinary collaboration strategies to help a team to achieve its goals and work more effectively together.
  • Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
    • Identify best-practice leadership strategies from the literature, which would improve an interdisciplinary team’s ability to achieve its goals.
  • Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
    • Communicate via video with clear sound and light.
    • The full reference list is from relevant and evidence-based (published within 5 years) sources, exhibiting nearly flawless adherence to APA format.

Professional Context

This assessment will help you to become a reflective practitioner. By considering your own successes and shortcomings in interprofessional collaboration, you will increase awareness of your problem-solving abilities. You will create a Kaltura video of your reflections, including a discussion of best practices for interprofessional collaboration and leadership strategies, supported by references to the literature.You may choose to reflect on a collaborative interprofessional project you worked on in your current or former place of practice, or you may choose to imagine that you worked on the collaborative interprofessional scenario presented in the Assessment 01 Supplement: Collaboration and Leadership Reflection Video [PDF] resource.

Scenario

As part of an initiative to build effective collaboration at a site where you work as a nurse, you have been asked to:

  • Reflect on an interprofessional collaborative project.
  • Examine what happened during the collaboration.
  • Identify positive aspects and areas for improvement.
  • Research best practice for interprofessional collaboration.
  • Use lessons learned from your research and experience to create a video reflection (5-10 minutes) that share suggestions for improving interprofessional collaboration that can be shared with leadership and colleagues.

Instructions

Using Kaltura, record a video (5–10 minutes) where you reflect on an interprofessional collaboration experience, proposing recommendations for how to improve interprofessional collaboration that can be shared with leadership and colleagues. Support these recommendations with references to the literature.The interprofessional project that you reflect on may be one that you collaborated on at your current or former place of practice, or you may choose to imagine you collaborated on the interprofessional project presented in the Assessment 01 Supplement: Collaboration and Leadership Reflection Video [PDF] Download Assessment 01 Supplement: Collaboration and Leadership Reflection Video [PDF]resource and reflect on that.Be sure that your assessment addresses the following criteria. Please study the scoring guide carefully so you will know what is needed for a distinguished score:

  • Reflect on an interdisciplinary collaboration experience, noting ways in which it was successful and unsuccessful in achieving desired outcomes.
    • Explain aspects of the collaboration that helped the team make progress toward relevant goals or outcomes.
    • Explain aspects of the collaboration that could have been improved.
  • Identify how poor collaboration can result in inefficient management of human and financial resources, citing supporting evidence from the literature.
    • Discuss the ways in which the interdisciplinary team did not collaborate effectively.
    • Discuss the negative implications for the human and financial resources of the interdisciplinary team and the organization as a whole.
    • Cite the literature for support.
  • Identify best-practice leadership strategies from the literature that would improve an interdisciplinary team’s ability to achieve its goals, citing at least one author from the literature.
    • Identify at least one leadership best practice or strategy that you believe would improve the team’s ability to achieve their goals.
    • Identify the strategy and its source or author and provide a brief rationale for your choice of strategy.
    • Cite the literature for support.
  • Identify best-practice interdisciplinary collaboration strategies to help a team achieve its goals and work together, citing the work of at least one author.
    • Identify at least one best practice or strategy for interdisciplinary collaboration to help the team achieve its goals and work more effectively together.
    • Identify the strategy, its source, and reasons why you think it will be effective.
  • Communicate in a professional manner, is easily audible, and uses proper grammar. Format reference list in current APA style.
    • Submit an APA-formatted reference list for any sources that you cited specifically in your video or used to inform your presentation.
    • The Example Kaltura Reflection will show you how to cite scholarly sources in the context of an oral presentation.
  • Notes: 
  • Refer to the Campus tutorial Using Kaltura [PDF] as needed to record and upload your reflection.
  • If you require the use of assistive technology or alternative communication methods to participate in this activity, please contact [email protected] to request accommodations.
  • If, for some reason, you are unable to record a video, please contact your faculty member as soon as possible to explore options for completing the assessment.

Additional Requirements

  • References: Cite at least 3 professional or scholarly sources of evidence to support the assertions you make in your video. Include additional properly cited references as necessary to support your statements.
  • APA Reference Page: Submit a correctly formatted APA reference page that shows all the sources you used to create and deliver your video.
    • You may wish to refer to the Campus APA Module for more information on applying APA style.
  • Portfolio Prompt: Remember to save the final assessment to your ePortfolio so that you may refer to it as you complete the final Capstone course.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and scoring guide criteria:

  • Competency 1: Explain strategies for managing human and financial resources to promote organizational health.
    • Identify ways poor collaboration can result in inefficient management of human and financial resources, supported by evidence from the literature.
  • Competency 2: Explain how interdisciplinary collaboration can be used to achieve desired patient and systems outcomes.
    • Reflect on an interdisciplinary collaboration experience, noting ways in which it was successful and unsuccessful in achieving desired outcomes.
    • Identify best-practice interdisciplinary collaboration strategies to help a team to achieve its goals and work together more effectively.
  • Competency 4: Explain how change management theories and leadership strategies can enable interdisciplinary teams to achieve specific organizational goals.
    • Identify best-practice leadership strategies from the literature that would improve an interdisciplinary team’s ability to achieve its goals.
  • Competency 5: Apply professional, scholarly, evidence-based communication strategies to impact patient, interdisciplinary team, and systems outcomes.
    • Communicate via video with clear sound and light.
    • The full reference list is from relevant and evidence-based (published within 5 years) sources, exhibiting nearly flawless adherence to APA format.

week5 information system

Trends in Informatics

Discussion

Purpose

This week's graded discussion topic relates to the following Course Outcomes (COs).

Preparing the Discussion

· Discussions are designed to promote dialogue between faculty and students, and students and their peers. In discussions students:

· Demonstrate understanding of concepts for the week

· Integrate outside scholarly sources when required

· Engage in meaningful dialogue with classmates and/or instructor

· Express opinions clearly and logically, in a professional manner

· Use the rubric on this page as you compose your answers.

· Best Practices include:

· Participation early in the week is encouraged to stimulate meaningful discussion among classmates and instructor.

· Enter the discussion often during the week to read and learn from posts.

· Select different classmates for your reply each week.

Discussion Question

This is the week to really see where technology and healthcare are connecting. Select ONE of the following trends and discuss your understanding of this trend in healthcare and its potential impact on your practice as a nurse. What are the legal, privacy, and ethical considerations of this trend? (Everyone attempt to choose a different topic so that we will learn about the many advancements in technology).

· Nanotechnology

· Consumer health informatics (CHI)

· Social media healthcare applications

· Health-focused wearable technology

· eHealth

· Artificial Intelligence

· Simulation

· Computerized provider order entry (CPOE)

· Bar Code Medication Administration (BCMA)

· Creative measures in healthcare for use with 3D printers

· Smart Pumps

· Smart Rooms

· Robotics in healthcare

· Mobile technology in outpatient care

· Web-based tools and software technology

· Risk Management tools

· Chatbots or Bots in healthcare

· Telenursing

· Telemedicine

· Telepharmacy

· Telerehabilitation

· Teleconsultation

· Telehospice

· Technology advancement from your clinical practice

· Palm Vein Technology

· Microchip use in healthcare

· Optical head-mounted computer glasses (Google Glass)

· Smart hospital beds

· EBOOK to use for one citation:

· https://bookshelf.vitalsource.com/reader/books/9781323903148/epubcfi/6/492%5B%3Bvnd.vst.idref%3DP7001015544000000000000000002CB2%5D!/4/2%5BP7001015544000000000000000002CB2%5D/2/2%5BP7001015544000000000000000002CB3%5D/7:6%5B%20In%2Cter%5D

· email:
[email protected]

· Pwd: Leroyismyhero1#

·

let me know if you cannot have access to the ebook

·
Prof needs one citation from the ebook and one external citation

· At least 2 citations

PMHNP

Research the 3 highest priority Differential Diagnoses, the proposed interventions with rationale and respond to the case.  

Discussion

 1) Does a person in need of an organ transplant have a moral right to obtain that transplant, supposing the availability of the needed organ?

 2) How should we choose who gets a transplant, supposing that there are not enough organs for all who need them?

 3) Please cite the textbook and any other source used in APA format.

informatics

Read pages 460-461 of your textbook to learn more about the challenges of long-term care. Based on what you have learned so far (1) Why is important and challenging to offer insurance for long-term care? (2) What kind of solution you can think of to increase value and/or reduce costs in long-term care? (3) Are there any type of organizations (think ACOs, etc) be able to offer these services at a low cost that would allow insurers to participate in this market?

Discusssion

 Read

APRNs are primary care providers, pivotal in providing primary health care and preventive services in communities. Advanced practice nursing is defined by the Nurse Practice Act but governed by the Board of Nursing in different states or territories. Where the Nurse Practice Act falls short in interpretation, the Board of Registered Nursing guides the form of an opinion (American Nurses Association, n.d.). Advanced practice nurses should understand how these laws and regulations shape practice.

            I am from California, and I chose Iowa for comparison. In both states, APRN nursing regulations allow advanced practice nurses to function as primary care providers with permission to certify disability pursuant to the unemployment insurance code section2708 (California Legislative Information, n.d.). Similarly, in both states, APRNs also sign POLST forms.

            APRNs in California can prescribe controlled substances after fulfilling specific requirements, including six months of physician supervision, a pharmacology course, and another specific course about schedule II-controlled drugs. Iowa Board of Registered Nursing also allows nurse practitioners to prescribe Schedule II drugs after registering with the pharmaceutical board. Both states require the prescriber to be registered with the Drug Enforcement Agency.

           Advanced Registered Nurse Practitioners in Iowa have autonomy in practice; alternately, they can collaborate with a physician or surgeon, but this is not a requirement of the Iowa Board of Nursing. APRNs in Iowa practice autonomously. California has a standardized procedure arrangement for advanced practice nurses to diagnose, treat, and prescribe. APRNs in California have career-long supervision, delegation, or team management by a physician. Largely, California regulations allow advanced nurse practitioners to approve, sign, or modify treatment plans after consultation with a physician.

          California Board of Registered Nursing allows for using marijuana by nurses as long as it is not used within the workstation. The legislation makes it unlawful for an employer to eliminate hiring someone based on that person using Cannabis away from their workstation. The legislation further guides that a nurse who uses cannabis for medical purposes should also be exempted from this policy. On the contrary, recreational use of marijuana is illegal under Iowa law. A nurse may be affected even if the positive drug screen was done in another state that allows the use of marijuana. Potential employers usually forward positive marijuana screens where a nurse has a license.

           Advanced Practice Registered Nurses with full legal authority to practice at full scope will have issues practicing autonomously in California because of the restricted practice legislation. One of the objectives of the ANA is to fight barriers to nursing practice so that nurses practice to the full extent of their education and training despite being in different territories. All nurses are licensed by their state of practice or by a multistate license. The Nurse Licensure Compact provides APRNs with a multistate license that allows nurses to practice in the home state and other compact states (NCSBN. (n.d.). Not all states are compact states.

            Nurses adhere to the rules through continuous education to keep up with the latest practices and technology. Many approved colleges provide the necessary certification; some are state-specific, and others can be found online. Joining Professional organizations is also useful for sources of the latest information in the medical world.

explain how the regulatory environment and the regulations selected by your colleague differ from your state/region. Be specific and provide examples.