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Choose one of the following to respond to in Week 1 Discussion Board;

·
Chapter 1, Exercise 1.5 or

·
Chapter 2, Exercise 2.1 or

·
Chapter 2, Exercise 2.4

Respond with a minimum of two (2) paragraphs of 4-5 sentences each.

1.
You should address each bullet point in the exercise you select.

2.
Your work should have in-text citations integrating at a minimum one scholarly article from this week's readings and course textbook.

3.
APA format should be utilized to include a reference list.

4.
Correct grammar, spelling, and APA should be adhered to when writing, work should be scholarly without personalization or first person use.

Discussion 7

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Although nurses take active leadership roles in hospitals throughout the U.S., they are underrepresented on hospital boards. Since a 2011 survey found that only 6%Links to an external site. of board members in 1000 hospitals were nurses (meanwhile 20% were physicians) there has been a push toward including nurses in the boardroom. As part of this push, a national coalition of organizations, including the American Nurses Association (ANA), the American Academy of Nursing (AAN), and the American Nurses Foundation (ANF) among 18 other nationally-recognized organizations, has been formed to create the Nurses on Boards CoalitionLinks to an external site., which seeks to implement a comprehensive strategy that will “bring nurses’ valuable perspective to governing boards, as well as state-level and national commissions.” With big players like AARP and the Robert Wood Johnson Foundation backing this initiative, it is likely their recommendation that nurses play bigger roles in “improving the health of all Americans” will see mores nurses becoming movers and shakers not only in their field but also in hospitals as a whole.

After completing the required readings identified above, please respond to the following prompt:

Choose one of the ten barriers identified in Addressing Barriers in Leadership for Nurses and search the library databases for at least one quality/scholarly article that pertains to the barrier and discuss/share the findings in the article.  Does the article support or refute the concept of the barrier?  What questions are left unanswered in the article?

Nursing homework help

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A 60-year-old male patient is admitted with chest pain to the telemetry unit where you work. While having a bowel movement on the bedside commode, the patient becomes short of breath and diaphoretic. The ECG waveform shows bradycardia.

What other assessment findings should you anticipate?

Why does this patient probably have bradycardia?

Does this dysrhythmia need treatment?

Why or why not?

What intervention would you implement first?

What is the drug treatment and dosage of choice for symptomatic bradycardia?

How does this drug increase heart rate?

This assignment is to be completed using APA format. Please use complete sentences to answer the questions. Ensure that you are using correct grammar. In additions, support your answers by using your textbooks, scholarly journals, and credible Internet sources. All citations must be in APA format. The body of your submission must be at least 350 words.

Nursing module 3 assignment

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please follow all directions 

Nursing Nursing Assignment 6-B

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After studying Module 2: Lecture Materials & Resources, submit the following:

  • Starting with the precursor substance tyrosine or tryptophan, draw three diagrams showing how the various enzymes convert this substance to serotonin, dopamine and norepinephrine.

Submission Instructions:

Response

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PLEASE RESPOND IN 50 WORDS OR MORE TO THE FOLLOWING:

1. What staffing model is implemented at the facility where you work?  What would you recommend for modifying the staffing model where you work, what is you recommendation based on and how would you implement the change?  (Support your thoughts/ideas with academic literature OR required readings) 

The staffing model the facility where I work is a nursing home. We use a census as our staffing model. On my floor there is a total of 23 rooms and 2 clients per room. Most of the time we are short staffed, and as a result there are only 2 nurses and we each have 23 patients sometimes less if patients get discharged. Per facility each nurse is suppose to have 9 patients. When dividing patients among nurses I think it is important to take into account patient acuity, some patients require more intense care than others. Meaning if the patients are equally divided the workload may not be. I believe that it is important to talk to your coworkers about this concern to prevent placing patients at risk and create a positive environment where the workload is shared. A lot of times coworkers are not willing to change assignments and that is where I think the unit manager should step in. To fix this problem more staff should be hired to keep the 9:1 ratio and the unit nurse should review assignments, before they are given. Most nurses experience substantial fatigue, with high acuity patients having an overall greater impact. We recommend that NPAs shall contain fewer high acuity patients than lower acuity patients. Additionally, The OFER acute fatigue scale (OPER-AF) suggests that assignments should contain no more than five patients to mitigate fatigue (Mollica and Schwerha, 2021).

Reference

Mollica, & Schwerha, D. (2021). Exploring the Relationship between Patient Acuity, Patient Assignments and Fatigue among Nurses. Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 65(1), 1200–1204. https://doi.org/10.1177/1071181321651016

Nursing help with homework

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help

Case study respiratory

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see attached

case study week 9

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Examine 
Case Study: A Young Caucasian Girl with ADHD. You will be asked to make three decisions concerning the medication to prescribe to this patient. Be sure to consider factors that might impact the patient’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.

Case

BACKGROUND

Katie is an 8 year old Caucasian female who is brought to your office today by her mother & father. They report that they were referred to you by their primary care provider after seeking her advice because Katie’s teacher suggested that she may have ADHD. Katie’s parents reported that their PCP felt that she should be evaluated by psychiatry to determine whether or not she has this condition.

The parents give the PMHNP a copy of a form titled 
“Conner’s Teacher Rating Scale-Revised”. This scale was filled out by Katie’s teacher and sent home to the parents so that they could share it with their family primary care provider. According to the scoring provided by her teacher, Katie is inattentive, easily distracted, forgets things she already learned, is poor in spelling, reading, and arithmetic. Her attention span is short, and she is noted to only pay attention to things she is interested in. The teacher opined that she lacks interest in school work and is easily distracted. Katie is also noted to start things but never finish them, and seldom follows through on instructions and fails to finish her school work.

Katie’s parents actively deny that Katie has ADHD. “She would be running around like a wild person if she had ADHD” reports her mother. “She is never defiant or has temper outburst” adds her father.

SUBJECTIVE

Katie reports that she doesn’t know what the “big deal” is. She states that school is “OK”- her favorite subjects are “art” and “recess.” She states that she finds her other subjects boring, and sometimes hard because she feels “lost”. She admits that her mind does wander during class to things that she thinks of as more fun. “Sometimes” Katie reports “I will just be thinking about nothing and the teacher will call my name and I don’t know what they were talking about.”

Katie reports that her home life is just fine. She reports that she loves her parents and that they are very good and kind to her. Denies any abuse, denies bullying at school. Offers no other concerns at this time.

MENTAL STATUS EXAM

The client is an 8 year old Caucasian female who appears appropriately developed for her age. Her speech is clear, coherent, and logical. She is appropriately 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. Self-reported mood is euthymic. Affect is bright. Katie denies visual or auditory hallucinations, no delusional or paranoid thought processes readily appreciated. Attention and concentration are grossly intact based on Katie’s attending to the clinical interview and her ability to count backwards from 100 by serial 2’s and 5’s. Insight and judgment appear age appropriate. Katie denies any suicidal or homicidal ideation.

Diagnosis: Attention deficit hyperactivity disorder, predominantly inattentive presentation

RESOURCES

§ Conners, C. K., Sitarenios, G., Parker, J. D. A., & Epstein, J. N. (1998). Revision and restandardization of the Conners' Teacher Rating Scale (CTRS-R): Factors, structure, reliability, and criterion validity. Journal of Abnormal Child Psychology, 26, 279-291.

Decision Point One

Begin Wellbutrin (bupropion) XL 150 mg orally daily

RESULTS OF DECISION POINT ONE

·  Client returns to clinic in four weeks

·  Katie’s parents inform you that they stopped giving Katie the medication because about 2 weeks into the prescription, Katie told her parents that she was thinking about hurting herself. This scared the parents, but they didn’t want to “bother you” by calling the office, so they felt that it would be best to just stop the medication as they would be seeing you in two weeks

Decision Point Two

Educate the parents that Bupropion sometimes causes suicidal ideation in children and that this is normal, and re-start the drug at the previous dose

RESULTS OF DECISION POINT TWO

Client returns to clinic in four weeks

Katie's parents again report that after about a week of treatment with the Bupropion, Katie began telling her parents that she wanted to hurt herself and began having dreams about being dead. This scared her parents, and they stopped giving her the medication At this point, they are quite upset with the results of their daughter’s treatment and are convinced that medication is not the answer

Decision Point Three

Refer the parents to a pediatric psychologist who can use behavioral therapy to treat Katie’s ADHD.

Guidance to Student

Bupropion is used off-label for ADHD and is used more commonly in adults. It’s mechanism of action results in increasing the neurotransmitters norepinephrine/noradrenaline and dopamine. Since dopamine is inactivated by norepinephrine reuptake in frontal cortex, (which largely lacks dopamine transporters) bupropion can increase dopamine neurotransmission in this part of the brain, which may explain its effectiveness in ADHD. However, Bupropion as well as other antidepressants have been linked to suicidal ideation in children and adolescents- despite the fact that it was being used initially to treat ADHD, it is still an antidepressant.

At this point, the parents are probably quite frustrated as no parent wants to hear their child talking about hurting themselves or having dreams about being dead. If the parents are adamant about no more medications, referral to a pediatric psychologist or similar therapist skilled in the use of behavioral therapies to treat ADHD in children. However, it should be noted that behavioral therapies work best when combined with medication, however, if the parents are insistent, then behavioral therapy may be the only alternative left in the treatment of Katie.

In terms of the pathophysiology of ADHD, whereas it may be true that increasing age may demonstrate some improvement in symptoms (some people will actually experience complete resolution of symptoms by adulthood), it is not helping Katie in the here and now. Katie still needs help with her symptoms which are causing academic issues.

The PMHNP should attempt to repair the rupture in the therapeutic alliance (the parents now believe that medications are not the answer) by explaining rationale for the use of Bupropion (many people like to start with Bupropion because it has a low-risk for addiction). The family should be encouraged to allow the PMHNP to initiate Adderall as it has a very good track record in terms of its efficacy in treating ADHD.

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ASSESSMENT-1-4060

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Assessment 1

Health Promotion Plan

INSTRUCTIONS- Develop a hypothetical health promotion plan, 3-4 pages in length, addressing a specific health concern for an individual or a group living in the community that you identified from the topic list provided.

· Bullying.

· Teen Pregnancy.

· LGBTQIA + Health.

· Sudden Infant Death (SID).

· Immunization.

· Tobacco use (include all: vaping, e-cigarettes, hookah, chewing tobacco, and smoking) cessation.

INTRODUCTION- The first step in any effective project or clinical patient encounter is planning. This assessment provides an opportunity for you to plan a hypothetical clinical learning experience focused on health promotion associated with a specific community health concern or health need. Such a plan defines the critical elements of who, what, when, where, and why that establish the foundation for an effective clinical learning experience for the participants. Completing this assessment will strengthen your understanding of how to plan and negotiate individual or group participation. This assessment is the foundation for the implementation of your health promotion educational plan (Assessment 4).

Note: Assessment 1 must be completed first before you are able to submit Assessment 4. Complete the assessments in this course in the order in which they are presented.

Preparation- You will need to satisfactorily pass Assessment 1 (Health Promotion Plan) before working on your last assessment (Assessment 4).

To prepare for the assessment, consider a various health concern or health need that you would like to be the focus of your plan from the topic list provided, the populations potentially affected by that concern or health need, and hypothetical individuals or groups living in the community. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.

As you begin to prepare this assessment, you are encouraged to complete the Vila Health: Effective Interpersonal Communications activity. The information gained from completing this activity will help you succeed with the assessment. Completing activities is also a way to demonstrate engagement.

For this assessment, you will propose a hypothetical health promotion plan addressing a particular health concern or health need affecting a fictitious individual or group living in the community. The hypothetical individual or group of your choice must be living in the community; not in a hospital, assistant living, nursing home, or other facility. You may choose any health issues or need from the list provided in the instructions.

In the Assessment 4, you will simulate a face-to-face presentation of this plan to the individual or group that you have identified.

Please choose one of the topics below:

· Bullying.

· Teen Pregnancy.

· LGBTQIA + Health.

· Sudden Infant Death (SID).

· Immunizations.

· Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (
MUST address all tobacco products).

In addition, you are encouraged to:

· Complete the 

Vila Health: Effective Interpersonal Communications
 simulation.

· Review the health promotion plan assessment and scoring guide to ensure that you understand the work you will be asked to complete.

· Review the MacLeod article, ”

Making SMART Goals Smarter
.”

Note: As you revise your writing, check out the resources listed on the Writing Center's 

Writing Support
 page.

INSTRUCTIONS- Note: Assessment 1 must be completed first before you are able to submit Assessment 4.

Health Promotion Plan

· Choose a specific health concern or health need as the focus of your hypothetical health promotion plan. Then, investigate your chosen concern or need and best practices for health improvement, based on supporting evidence.

· Bullying.

· Teen Pregnancy.

· LGBTQIA + Health.

· Sudden Infant Death (SID).

· Immunizations.

· Tobacco use (include all: vaping e-cigarettes, hookah, chewing tobacco, and smoking) cessation. (
MUST address all tobacco products).

· Create a scenario as if this project was being completed face-to-face.

· Identify the chosen population and include demographic data (location, lifestyle, age, race, ethnicity, gender, marital status, income, education, employment).

· Describe in detail the characteristics of your chosen hypothetical individual or group for this activity and how they are relevant to this targeted population.

· Discuss why your chosen population is predisposed to this health concern or health need and why they can benefit from a health promotion educational plan.

· Based on the health concern for your hypothetical individual or group, discuss what you would include in the development of a sociogram. Take into consideration possible social, economic, cultural, genetic, and/or lifestyle behaviors that may have an impact on health as you develop your educational plan in your first assessment. You will take this information into consideration when you develop your educational plan in your fourth assessment.

· Identify their potential learning needs. Collaborate with the individual or group on SMART goals that will be used to evaluate the educational session (Assessment 4).

· Identify the individual or group's current behaviors and outline clear expectations for this educational session and offer suggestions for how the individual or group needs can be met.

· Health promotion goals need to be clear, measurable, and appropriate for this activity. Consider goals that will foster behavior changes and lead to the desired outcomes.

Document Format and Length

Your health promotion plan should be 3-4 pages in length.

Supporting Evidence

Support your health promotion plan with peer-reviewed articles, course study resources, and Healthy People 2030 resources. Cite at least three credible sources published within the past five years, using APA format.

Graded Requirements

The requirements outlined below correspond to the grading criteria in the scoring guide, so be sure to address each point. Read the performance-level descriptions for each criterion to see how your work will be assessed.

· Analyze the health concern that is the focus of your health promotion plan.

· Consider underlying assumptions and points of uncertainty in your analysis.

· Explain why a health concern is important for health promotion within a specific population.

· Examine current population health data.

· Consider the factors that contribute to health, health disparities, and access to services.

· Explain the importance of establishing agreed-upon health goals in collaboration with hypothetical participants.

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

· Write with a specific purpose and audience in mind.

· Adhere to scholarly and disciplinary writing standards and APA formatting requirements.

Before submitting your assessment for grading, proofread it to minimize errors that could distract readers and make it difficult for them to focus on the substance of your plan.

CONTEXT- Historically, nurses have made significant contributions to community and public health with regard to health promotion, disease prevention, and environmental and public safety. They have also been instrumental in shaping public health policy. Today, community and public health nurses have a key role in identifying and developing plans of care to address local, national, and international health issues. The goal of community and public health nursing is to optimize the health of individuals and families, taking into consideration cultural, racial, ethnic groups, communities, and populations. Caring for a population involves identifying the factors that place the population's health at risk and developing specific interventions to address those factors. The community/public health nurse uses epidemiology as a tool to customize disease prevention and health promotion strategies disseminated to a specific population. Epidemiology is the branch of medicine that investigates causes of various diseases in a specific population (CDC, 2012; Healthy People 2030, n.d.).

As an advocate and educator, the community/public health nurse is instrumental in providing individuals, groups, and aggregates with the tools that are essential for health promotion and disease prevention. There is a connection between one's quality of life and their health literacy. Health literacy is related to the knowledge, comprehension, and understanding of one's condition along with the ability to find resources that will treat, prevent, maintain, or cure their condition. Health literacy is impacted by the individual's learning style, reading level, and the ability understand and retain the information being provided. The individual's technology aptitude and proficiency in navigating available resources is an essential component to making informed decisions and to the teaching learning process (CDC, 2012; Healthy People 2030, n.d.).

It is essential to develop trust and rapport with community members to accurately identify health needs and help them adopt health promotion, health maintenance, and disease prevention strategies. Cultural, socio-economical, and educational biases need to be taken into consideration when communicating and developing an individualized treatment and educational plan. Social, economic, cultural, and lifestyle behaviors can have an impact on an individual's health and the health of a community. These behaviors may pose health risks, which may be mitigated through lifestyle/behaviorally-based education. The environment, housing conditions, employment factors, diet, cultural beliefs, and family/support system structure play a role in a person's levels of risk and resulting health. Assessment, evaluation, and inclusion of these factors provide a basis for the development of an individualized plan. The health professional may use a genogram or sociogram in this process.

What is a genogram? A genogram, similar to a family tree, is used to gather detailed information about the quality of relationships and interactions between family members over generations as opposed to lineage. Gender, family relationships, emotional relationships, lifespan, and genetic predisposition to certain health conditions are components of a genogram. A genogram, for instance, may identify a pattern of martial issues perhaps rooted in anger or explain why a person has green eyes.

What is a sociogram? A sociogram helps the health professional to develop a greater understanding of these factors by seeing inter-relationships, social links between people or other entities, as well as patterns to identify vulnerable populations and the flow of information within the community.

References

Centers for Disease Control and Prevention. (2012). Lesson 1: Introduction to epidemiology. In 
Principles of Epidemiology in Public Health Practice (3rd ed.). https://www.cdc.gov/csels/dsepd/ss1978/lesson1/section1.html

U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (n.d.). 
Healthy People 2030. https://health.gov/healthypeople

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

Competency 1: Analyze health risks and health care needs among distinct populations.

·

·

· Analyze a community health concern or need that is the focus of a health promotion plan.

Competency 2: Propose health promotion strategies to improve the health of populations.

· Explain why a health concern or need is important for health promotion within a specific population.

· Establish agreed-upon health goals in collaboration with hypothetical participants.

Competency 5: Apply professional, scholarly communication strategies to lead health promotion and improve population health

· Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

· Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.

Scoring Guide

Use the scoring guide to understand how your assessment will be evaluated.

Health Promotion Plan Scoring Guide

CRITERIA

NON-PERFORMANCE

BASIC

PROFICIENT

DISTINGUISHED

Analyze a community health concern or need that is the focus of a health promotion plan.

Explain why a health concern or need is important for health promotion within a specific population.

Establish agreed-upon health goals in collaboration with hypothetical participants.

Organize content so ideas flow logically with smooth transitions; contains few errors in grammar/punctuation, word choice, and spelling.

Apply APA formatting to in-text citations and references exhibiting nearly flawless adherence to APA format.