1. Describe your motivation for pursuing the family nurse practitioner role
When I think about my motivation for pursuing the family nurse practitioner; I can only think on my favorite nursing quote.“Your work is going to fill a large part of your life, and the only way to be truly satisfied is to do what you believe is great work. The only way to do great work is to love what you do” Steve JobsThis quote defines my career as a nurse, as a mother, as a friend and as a human being. Nursing for me is not only about optimization of health, prevention of illness and alleviation of suffering; it is more than this; it is a dynamic process that involves emotional connections, compassion, listening, touch, exploring, teaching, healing, empathy, respect, cultural competence, tolerance and acceptance. As a family nurse practitioner; I will have the opportunity to care for a variety of populations which includes different ethnicities, backgrounds, and ages. Further; I will have the honor to assist families in need by providing a high quality of health care, but most important an exceptional holistic care that includes structural and detail physical, psychological, sociocultural, spiritual, cognitive, functional, developmental, and economic assessments.
Family Nurse Practitioner degree would enable me to grow as a professional, to improve my nursing skills, to implement and utilize new knowledge, strategies, advance communication skills, and new clinical experiences that will allow me to improve healthcare outcomes. Furthermore; the NPR field has endless opportunities for all different areas of interest. For instance; one of my main professional goals is to specialize in the Pediatrics field. Particularly; I would love to work with children with cognitive and physical disabilities. During my pediatrics rotations in nursing school; I experienced the need and demand for nurses in this area. I feel like this sensible population has been forgotten. There is an urgent need to addresses their needs and access to resources, treatments, interventions, medications, and improvement of care for this community.
By being a family Nurse Practitioner, I will be able to advocate for this community through a holistic perspective and by applying the best available evidence and research data to diagnose disease, to implement plan of care, to treat illness, and to improve and ease my patient’s quality of life.
2. How your personal and professional experiences have prepared you for the family Nurse Practitioner Role.
MY clinical experience during nursing school, my experience working at 4 south Neurology unit and my experiences as a float nurse in the post-operative and orthopedics units have given me the insights, clinical experiences and knowledge to treat patients according to my scope and standards of practice. Most important, I have learned in many clinical scenarios to identify new onsets of symptoms, changes in Pt’s status, to intervene immediately to prevent any further deterioration in my Pt conditions, and to have a respectful and trustful relationship with doctors and internal staff such as charge nurses, colleagues, rapid response nurses, and nurse’s practitioners of the neurological team.
I know Nursing is a learning process. I am always learning something new at work, and I will never be able to know it all. However, I have the motivation and the enthusiasm to learn new concepts, new interventions, new skills, new knowledge; I am open to anything that can make me a better nurse; anything that can provide me the tools and resources to improve the outcomes of care. I am strongly believer that with care, determination, and compassion I can be able to accomplish everything I set my mind and my heart into it.
3. Why Nursing at USC is the best fit for you and how the program will help you to meet your career and educational goals.
Three of FNP curriculum that USC offers which help me to choose this University as the best fit for me were the following, First, online classes and virtual classes. Second, the opportunity to meet and to interact with a diverse population of students along the program, during the white coat ceremony, health assessments skills checks. Also important is being able to build relationships with my classmates nationwide. Equally important is the convenience to attend to clinicals in my own community.
I Choose USC because I believe this University’s NPR program integrate the science and art of nursing by basing their teaching not only on an analytical framework of critical thinking, nursing skills, knowledge, evidence-base and practice, but it also embraces the patient as a human person not as an illness by incorporating care in a holistic approach.

I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 100-120 WORDS
1) What health risks associated with obesity does Mr. C. have? Is bariatric surgery an appropriate intervention? Why or why not?
Health risks associated with obesity that Mr.C has are:
– Elevated fasting blood glucose at 146/mg/dL (Mr. C. possibly might have diabetes)
– Elevated 172/96 with RR at 26. Mr. C. has hypertension and his RR shows that his body has to work harder to breathe; sleep apnea is another health risk.
– elevated total cholesterol is 250mg/dL (desirable value is below 200mg/dl).
– HDL is 30 mg/dL, which is low. Optimal value that protects ones heart is above 60 mg/dL.
– Elevated triglycerides at 312mg/dl and the desirable value should be below 200 mg/dl (Cholesterolmenu, 2017).
“Consensus guidelines suggest that the surgical treatment of obesity should be reserved for patients with a body-mass index (BMI) >40 kg/m(2) or with BMI >35 kg/m(2) and 1 or more significant comorbid conditions, when less invasive methods of weight loss have failed and the patient is at high risk for obesity-associated morbidity and mortality “ (Pentin, Nashelsky, 2005). Mr. C.’s Height: 68 inches (170 cm); Weight 134.5 kg; BMI is 46.9 (BMI calculator, 2017). Mr. C. is considered obese and meets criteria for beriatric surgery with BMI of 46.9 and at least one comobordity that puts him at risk for heart disease and stroke.
2) Mr. C. has been diagnosed with peptic ulcer disease and the following medications have been ordered:
Magnesium hydroxide/aluminum hydroxide (Mylanta) 15 mL PO 1 hour before bedtime and 3 hours after mealtime and at bedtime.
Ranitidine (Zantac) 300 mg PO at bedtime.
Sucralfate/Carafate 1 g or 10ml suspension (500mg / 5mL) 1 hour before meals and at bedtime.
The patient reports eating meals at 7 a.m., noon, and 6 p.m., and a bedtime snack at 10 p.m. Plan an administration schedule that will be most therapeutic and acceptable to the patient.
06:00: Carafate
10:00 Mylanta
11:00: Carafate
15:00 Mylanta
17:00 Carafate
21:00 Mylanta
21:00 Carafate
22:00 Mylanta and Zantac
22:30 (after snack) Carafate
3) Assess each of Mr. C.’s functional health patterns using the information given (Hint: Functional health patterns include health-perception – health management, nutritional – metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception – self-concept, role-relationship, sexuality – reproductive, coping – stress tolerance).
What actual or potential problems can you identify? Describe at least five problems and provide the rationale for each.
Health perception – health management: Mr.C.is obese. He seeks information about bariatric surgery. He was always heavy but within last 2-3 years gained about 100lb. Potential problem within health perception and management for this individual is knowledge deficit. Mr. C.’s labs reveal high cholesterol, triglycerides. Mr C. knows he has high blood pressure but the only intervention is sodium restriction. Mr C. does not know how to manage his weight and needs to be aware about the risks he might be facing like heart disease, stroke. Even with surgery Mr C. still needs to know about what his daily nutrition should be.
nutritional – metabolic: Mr.C has imbalanced nutrition: more than body requirements. He consumes too much food and possibly not the healthy nutrients that his body needs (HDL is low). Sedentary lifestyle (working at a call center where he is sitting all day) is contributing to his obesity. Mr C. was diagnosed with peptic ulcer as well. According to a study by the National Institutes of Health [NIH], obesity can be a contributing factor to the development of gastric ulcers (2014).
Elimination: there is not enough data to examine this pattern.
activity-exercise: Mr.C’s job requires him to sit most of the day at the call center. Physical activity deficit is consequitive problem. Lack of exercise is contributing to Mr. C.’s obesity. Intervention with safe exercise plan is needed for Mr. C.
sleep-rest: Sleep pattern is disturbed due Mr. C.’s sleep apnea. This problem can cause him to be tired and weak during the day. Body that is depleted from oxygen can suffer other negative consequences such as heart problems.
self-perception – self-concept: Mr.C’s body image is disturbed due to his obesity. He knows that he is overweight and his self esteem is probably low. We can assume he is self aware and is looking for change since he is seeking information about surgery. He needs support, help and education
role-relationship: Mr. C. is single. Further assessment is needed for more information
References:
Cholesterolmenu. (2017). A comprehensive Guide on Ideal Cholesterol Levels. Retrieved from: http://www.cholesterolmenu.com/cholesterol-levels-chart/
National Institutes of Health [NIH]. (2014). Measures of adiposity are associated with increased risk of peptic ulcer. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/24681076
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Mucor belongs to the mold genus, together with yeasts and mushrooms. Mucor comprises of several species which have been identified across the globe. They are eukaryotic organisms living in soil, plants, rotting matter, digestive systems and are capable of causing fatal infections among patients whose immune systems are compromised. Infections from these forms of fungi result in what is commonly known as mucormycosis. Typically, mucormycosis attacks the lungs and sinuses, but may at times affect any part of the body in immunocompromised persons (Rajagopalan, Tachamo, Pathak & Hingorani, 2016). The symptoms of the illness manifest depending on the route of exposure.
Currently, research has identified cutaneous as well as pulmonary exposure (Spellberg & Ibrahim, 2010). Individuals who are at an increased risk of developing mucormycosis include all cases of immune suppression, including those with organ transplants. Patients with ketoacidosis also have a higher chance of developing the disease. Prompt management of the symptoms is essential, bearing in mind the rapidity upon which the infection spreads. The disease attacks the alveoli mucor, which is the first line of defense. A weak defense will allow spores to penetrate within the spaces in the alveoli, an occurrence that triggers a person’s body to trigger an immune reaction in response. A result will be an increase in the number of leucocytes in the alveoli. Similarly, the increase in reactions will cause excess fluid to leak from the blood vessels to the alveoli, causing pneumonia.
Nursing Interventions
Place the patient on oxygen if they are not receiving hyperbaric treatment. In the meantime, the nurse should monitor the patient’s vital signs and pain frequently. Pneumonia impairs the oxygen transport system; necessitating the need for initiating an incentive spirometer aimed at expelling excess fluids from the lungs (Spellberg, 2017).
Question 2
The abnormal laboratory values include a pH of 7.5, partial pressure of oxygen=59, bicarbonate level of 29, partial pressure of 25. All these values show that the patient’s body is compensated partially. The patient has lymphocytes level of 10%, indicating that their immune system is compromised. Similarly, the increased white blood cell count of 15,200/mm means that presence of infection cannot be ruled out in this particular patient.
Question 3
The most important aspect of this patient’s plan of care would be to address the underlying cause of their current state. Neutropenia should be managed by use of colony stimulating factors whereas insulin should be given to patients with diabetic ketoacidosis. Whichever the case, immunosuppressive drugs need to be avoided since they would only worsen the patient’s case. According to Spellberg & Ibrahim, (2010), the lipid formulations of Amphotericin B deoxycholate would safely be administered to patients with mucormycosis. Their significantly reduced nephrotoxicity nature allows practitioners to deliver high doses for long. The drug remains highly preferred since they are more affordable and result in fewer effects. Amphotericin B deoxycholate is administered in the same manner as the lipid formulations of Amphotericin B deoxycholate. The only difference is that the latter cannot be used patients with cardiac conditions (Spellberg, 2017).
Posaconazole and, or isavuconazole medications should be considered in cases where patients do not respond to Amphotericin B treatment. These drugs may be used conjunctively, or when an initial treatment of Amphotericin B has been done (Spellberg, 2017). Of the drugs discussed, Amphotericin B can only be administered intravenously, while the rest can be given by mouth or through the vein. Sometimes, a doctor may request for surgery to cut away the tissue, or tissues (Spellberg, 2017).

A poem by T.S. Eliot (1943) says, “We had the experience but missed the meaning.” As your experience in this course comes to a close, I don’t want you to miss the meaning of the materials you have read, papers you have written, and discussions we have had throughout the session. They are more than a series of assignments and grades – the end result should be an improvement in your higher-order thinking and your ability to make connections between thoughts and ideas.
You can achieve that through reflection, the art of taking charge of your own mind. Reflection is a mental process that challenges you to use critical thinking to examine the course information, analyze it carefully, make connections with previous knowledge and experience, and draw conclusions based on the resulting ideas.
A well cultivated critical thinker (Paul & Elder, 2008): raises vital questions and problems, formulating them clearly and precisely; gathers and assesses relevant information, using abstract ideas to interpret it effectively comes to well-reasoned conclusions and solutions, testing them against relevant criteria and standards; thinks open-mindedly within alternative systems of thought, recognizing and assessing, as need be, their assumptions, implications, and practical consequences; and communicates effectively with others in figuring out solutions to complex problems.
For this discussion, take some time to reflect upon 2 concepts that you learned in this course. What are the concepts? What insight or ideas did you gain from learningeach of these concepts? Were there aspects of the concepts that you would challenge? What is the importance of these concepts to public health? How will you use this new wisdom in your current or future career? In order to earn maximum credit, the comment should be more than your opinion, and more than a quick “off the top of your head” response. Be sure to support your statements, cite sources properly within the text of your comments, and list your reference(s). The response must be a minimum of 250 words.
Britton, B. & Serrat (2013). Reflective Practice. Retrieved from http://www.slideshare.net/Celcius233/reflective-practice-27714069
Eliot. T.S. (1944) Four Quartets, The Dry Salvages, pt.2. London. Paul, R. & Elder, L. (February, 2008). The Miniature Guide to Critical Thinking Concepts and Tools. Foundation for Critical Thinking Press