Tag Archive for: nursing

psychopharmacologic treatments

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In 3–4 pages, write a treatment plan for a with schizophrenia spectrum and other psychotic disorder client in which you do the following:

  • Describe the HPI and clinical impression for the client.
  • Recommend psychopharmacologic treatments and describe specific and therapeutic endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical impression.)
  • Recommend psychotherapy choices (individual, family, and group) and specific therapeutic endpoints for your choices.
  • Identify medical management needs, including primary care needs, specific to this client.
  • Identify community support resources (housing, socioeconomic needs, etc.) and community agencies that are available to assist the client.
  • Recommend a plan for follow-up intensity and frequency and collaboration with other providers.

Developmental Red Flags

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Developmental Red Flags

 

Case Study 1:

 

A mother brings in her 16-month-old, Brittany, for treatment of an acute illness. During the history, the mother reports that her mother-in-law is concerned about the toddler’s development. Further questioning reveals the following:

 

•Brittany was a term infant born vaginally with no intrapartum complications. Birth weight was 8 pounds 1 ounce and current weight is 26 pounds 9 ounces.

 

•She was breastfed until 12 months of age and now drinks 24 ounces of whole milk and eats table foods daily.

 

•Physical milestones are as follows: Rolled front to back at 6 months, developed pincer grasp at 11 months, crawled at 8 months, and began cruising at 10 months. She does not walk independently.

 

•Social development includes mimicking adult behavior, four-word vocabulary (mama, dada, baba, and no), follows one-step commands, and quiets easily when comforted.

 

 

 

To prepare:

 

•Review this week’s media presentations, as well as “Developmental Management of Infants” and “Developmental Management of Toddlers and Preschoolers” in the Burns et al. text.

 

•Think about how physical, social, and cognitive development vary during infancy, toddlerhood, and the preschool years. Reflect on normal versus abnormal growth and development and consider the decision-making process of identifying and managing red flags of abnormal development.

 

•Select one of the three case studies provided. Reflect on the patient information included in the case study and consider any developmental red flags.

 

•Reflect on standardized screening tools, clinical guidelines, and management strategies that would be used to assess and manage the patient in your selected case study.

 

 

 

Post    2 discussion page paper on :An explanation of any developmental red flags that presented in the case study you selected based on the stages of normal physical, social, and cognitive development for infants, toddlers, and preschoolers. Explain how you differentiated between normal and abnormal growth and development for this patient and identify which standardized screening tools, clinical guidelines, and management strategies you might use to assess and manage this patient and why

 

REFERENCES

 

Readings

 

• Burns, C. E., Dunn, A. M., Brady, M. A., Starr, N. B., & Blosser, C. G. (2013). Pediatric primary care (5th ed.). Philadelphia, PA: Elsevier.

 

◦ Chapter 5, “Developmental Management of Infants” (pp. 59–75).

 

◦ Chapter 6, “Developmental Management of Toddlers and Preschoolers” (pp. 76–91

 

◦ Chapter 11, “Breastfeeding” (pp. 186-201)

 

Chapter 17, “Role Relationships” (pp. 334–344)

 

Hagan, J. F., Jr., Shaw, J. S., Duncan, P. M. (Eds.). (2008). Bright futures: Guidelines for health supervision of infants, children, and adolescents (3rd ed.). Elk Grove Village, IL: American Academy of Pediatrics

 

Infancy” (pp. 253–380)

 

◦“Early Childhood” (pp. 381–461)

 

 

 

Media

 

•Laureate Education (Producer). (2013c). Strategies for determining red flags. Retrieved from https://class.waldenu.edu

Gynecologic Health

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Gynecologic Health

 

 

 

Select a patient that you examined as a nurse practitioner student during the last three weeks of clinical on OB/GYN Issue. With this patient in mind, address the following in a SOAP Note 1 OR 2 PAGES :

 

Subjective: What details did the patient provide regarding her personal and medical history?

 

Objective: What observations did you make during the physical assessment?

 

Assessment: What were your differential diagnoses? Provide a minimum of three possible diagnoses. List them from highest priority to lowest priority. What was your primary diagnosis and why?

 

Plan: What was your plan for diagnostics and primary diagnosis? What was your plan for treatment and management, including alternative therapies? Include pharmacologic and nonpharmacologic treatments, alternative therapies, and follow-up parameters for this patient , as well as a rationale for this treatment and management plan.

 

Very Important:  Reflection notes: What would you do differently in a similar patient evaluation?

 

 

 

Reference

 

Gagan, M. J. (2009). The SOAP format enhances communication. Kai Tiaki Nursing New Zealand, 15(5), 15.

 

Tharpe, N. L., Farley, C., & Jordan, R. G. (2013). Clinical practice guidelines for midwifery & Women’s health (4th ed.). Burlington, MA: Jones & Bartlett Publishers.

 

 

 

Chapter 6, “Care of the Well Woman Across the Life Span” ,“Care of the Woman Interested in Barrier Methods of Birth Control” (pp. 275–278)

 

Chapter 7, “Care of the Woman with Reproductive Health Problems”

 

“Care of the Woman with Dysmenorrhea” (pp. 366–368)

 

“Care of the Woman with Premenstrual Symptoms, Syndrome (PMS), or Dysphoric Disorder (PMDD)” (pp. 414–418)

 

Having a bab

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Having a baby: Is it really all fun and games???

#baby crying

As the text states, having a newborn enter the household can be a trying time, to say the least! Here is an activity/discussion that will help you gain greater insight into both the pressures of the addition of a newborn, as well as effective techniques for dealing with this pressure. This week you will:

  1. Interview at least two parents (they could be your own) concerning the issues that they faced upon the birth of their child(ren). This interview should focus on both the problems encountered and effective solutions that the parents employed to deal with the problems.  Regardless of who you choose to interview, be sure to do each interview individually and privately. Some students do the interview through Facetime or Zoom.
  2. Find an interesting website that deals with a circumstance discussed in one of your interviews and provide the web address.
  3. Share results from these informal interviews by summarizing in the discussion board.
  4. Share the results from your research and tell us what you learned.  Be sure to include the websites you used.  Note:  To add a web page to a discussion thread type the title of the webpage, highlight and click on the paper clip above the text box, and copy the web address in the URL box and click insert link.
  5. Read your fellow students’ posts and respond to at least 2 students in the class in a meaningful way. For confidentially reasons please never discuss the actual name(s) of the people you interview.   I look forward to reading about your experience!

Euthanasia

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Assignment 6.1: Euthanasia

Step 1: Read about Death and Dying

The death often reflect about spiritual beliefs, the importance of spirituality, and how it influences their view of death.

Step 2: In a two page paper:

  • Define Euthanasia.
  • Discuss the two types of euthanasia.
  • Discuss whether or not you believe that euthanasia is acceptable in some situations
  • How do you feel about other forms of assisted suicide?
  • Support your opinions with 3-5 references.

Science and Ethical Issues

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  • Assignment:
  • What are some of the challenges facing major religious traditions in the modern world? As nurses, what are some of the particular issues that you might encounter with patients regarding the intersection of faith and healthcare (see the Science and Ethical Issues section of Chapter 12; you can address one or more of the issues noted in this section)? How might the material covered in this course affect the way in which you respond to these concerns?
  • Select one of the topics from Chapter 12 listed under Modern Influences on the Future of Religion and examine how modern religious traditions are dealing with these contemporary challenges. If you identify with a particular religious tradition, how has your religious tradition responded to the topic you have chosen? Make sure that you support your answer.
  • Example:

Dr. Rooney

There are many challenges facing the major religious traditions including: peer to peer networks, integration of religion and technological advancement (Bauwens, 2003). These challenges stem from the increasing interconnection of religions and cultures as well as the availability of information sharing. Nursing provides opportunity for unique encounters and challenges. The differences in culture and religion may intersect medical decisions on issues such as fertility, ethical termination of life at various stages, organ transplant, stem-cell research, and animal and environmental rights (Molloy, 2014). Working in the ICU, I often encounter challenges in both organ transplant (heart and lung) as well as futility of care and termination of adult life. People draw on their faith to help with decision making in these difficult circumstances. In these cases, it is important for the nurse to recognize and be respectful of potential religious differences. Learning of the different religions throughout this class will enable me to better understand and support decision making. The nurses’ role in facilitation of a healing environment and religious connection is integral, especially for the patient and family brought to the unfamiliar hospital environment. In my workplace we have various private quiet spaces, I direct people to these areas (if they prefer this space) for prayer and meditation as it is outside of the bustle of the ICU. In my 15 years of nursing experience I have found when people are able to connect with their faith, and feel supported by the multidisciplinary team, they are able to make more confident decisions about medical treatment. Though my personal beliefs and connection with God may be different than the people I encounter, this class has given me perspective. I will continue to be respectful of the space needed for prayer and meditation.

I identify as a Roman Catholic Christian. Working in a 32-bed cardiac surgery ICU at a large university hospital brings ethical challenges that may not be seen in other nursing specialties. Throughout my unit, I care for patients who have undergone high risk cardiovascular and thoracic surgeries, received Ventricular Assist Devices, heart and lung transplantation, or ECMO. Many of these patients have successful treatments, but the risks are high and occasionally I am faced with ethical challenges. With regards to advanced medical and surgical care, futile treatment and euthanasia, the Catholic Church has held a historically strong position. Euthanasia is against Catholic teaching, while “[it] is also permitted, with the patient’s consent, to interrupt these means, where the results fall short of expectations. But for such a decision to be made, account will have to be taken of the reasonable wishes of the patient and the patient’s family, as also of the advice of the doctors who are [especially] competent in the matter” (CAN, n.d., para. 8). Therefore, discontinuing treatment or withdrawing mechanical means of life support are not against the teachings of the Catholic Church.

Roman Catholics have strong associations with the sacraments and traditions. The sacrament “Anointing of the Sick” is occasionally brought to a patient for whom I am caring. There have been times when there is a plan to withdraw life support and this sacrament was offered. Families are invited to pray and offer support to the patient for peace and comfort at the time of suffering. This sacrament is not only for those who are actively dying but may also be done when a patient is diagnosed with a terminal illness. The anointing is believed to bring strength and peace to the person being anointed, and though God does not always heal the person physically this sacrament is strongly valued within the faith (Catholic Answers, 2013). A spiritual compass is provided to those who follow a religious path. It is important to be respectful of the differences and support each other in our journey through life.

Angie

References:

Bauwens, M. (2003). Three Challenges for Global Religion in the 21st Century. Religion and Globalization. Retrieved from: http://www.integralworld.net/bauwens.html (Links to an external site.)

Catholic Answers. (2013). Anointing of the Sick. Catholic Answers. Retrieved from: https://www.catholic.com/tract/anointing-of-the-sick (Links to an external site.)

CNA. (n.d.). Vatican Document on Euthanasia. Catholic News Agency. Retrieved from: https://www.catholicnewsagency.com/resources/life-and-family/euthanasia-and-assisted-suicide/vatican-document-on-euthanasia

Demonstration of Proficiency

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Create a 3-5-page submission in which you develop a PICO(T) question for a specific care issue and evaluate the evidence you locate, which could help to answer the question.

PICO(T) is an acronym that helps researchers and practitioners define aspects of a potential study or investigation.

It stands for:

  • P – Patient/population/problem.
  • I – Intervention.
  • C – Comparison (of potential interventions, typically).
  • O – Outcome(s).
  • T – Time frame (if time frame is relevant).

The end goal of applying PICO(T) is to develop a question that can help guide the search for evidence (Boswell & Cannon, 2015). From this perspective, a PICO(T) question can be a valuable starting point for nurses who are starting to apply an evidence-based model or EBPs. By taking the time to precisely define the areas in which the nurse will be looking for evidence, searches become more efficient and effective. Essentially, by precisely defining the types of evidence within specific areas, the nurse will be more likely to discover relevant and useful evidence during their search.

You are encouraged to complete the Vila Health PCI(T) Process activity before you develop the plan proposal. This activity offers an opportunity to practice working through creating a PICO(T) question within the context of an issue at a Vila Health facility. These skills will be necessary to complete Assessment 3 successfully. This is for your own practice and self-assessment and demonstrates your engagement in the course.

Demonstration of Proficiency

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

  • Competency 1: Interpret findings from scholarly quantitative, qualitative, and outcomes research articles and studies.
    • Explain the findings from articles or other sources of evidence.
  • Competency 2: Analyze the relevance and potential effectiveness of evidence when making a decision.
    • Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
    • Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
  • Competency 3: Apply an evidence-based practice model to address a practice issue.
    • Define a practice issue to be explored via a PICO(T) approach.
  • Competency 5: Apply professional, scholarly communication strategies to lead practice changes based on evidence.
    • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.
Reference

Boswell, C., & Cannon, S. (2015). Introduction to nursing research. Burlington, MA: Jones & Bartlett Learning.

Professional Context

As a baccalaureate-prepared nurse, you will be responsible for locating and identifying credible and scholarly resources to incorporate the best available evidence for the purposes of enhancing clinical reasoning and judgement skills. When reliable and relevant evidence-based findings are utilized, patients, health care systems, and nursing practice outcomes are positively impacted.

PICO(T) is a framework that can help you structure your definition of the issue, potential approach that you are going to use, and your predictions related the issue. Word choice is important in the PICO(T) process because different word choices for similar concepts will lead you toward different existing evidence and research studies that would help inform the development of your initial question.

Scenario

For this assessment, please use an issue of interest from your current or past nursing practice.

If you do not have an issue of interest from your personal nursing practice, then review the optional Case Studies presented in the resources and select one of those as the basis for your assessment.

Instructions

For this assessment, select an issue of interest an apply the PICO(T) process to define the question and research it.

Your initial goal is to define the population, intervention, comparison, and outcome. In some cases, a time frame is relevant and you should include that as well, when writing a question you can research related to your issue of interest. After you define your question, research it, and organize your initial findings, select the two sources of evidence that seem the most relevant to your question and analyze them in more depth. Specifically, interpret each source’s specific findings and best practices related to your issues, as well explain how the evidence would help you plan and make decisions related to your question.

If you need some structure to organize your initial thoughts and research, the PICOT Question and Research Template document (accessible from the “Create PICO(T) Questions” page in the Capella library’s Evidence Based Practice guide) might be helpful.

In your submission, make sure you address the following grading criteria:

  • Define a practice issue to be explored via a PICO(T) approach.
  • Identify sources of evidence that could be potentially effective in answering a PICO(T) question.
  • Explain the findings from articles or other sources of evidence.
  • Explain the relevance of the findings from chosen sources of evidence to making decision related to a PICO(T) question.
  • Communicate using writing that is clear, logical, and professional with correct grammar and spelling using current APA style.

Example Assessment: You may use the following to give you an idea of what a Proficient or higher rating on the scoring guide would look like:

Additional Requirements

Your assessment should meet the following requirements:

  • Length of submission: Create a 3–5-page submission focused on defining a research question and interpreting evidence relevant to answering it. A title page is not required but you must include a reference list.
  • Number of references: Cite a minimum of four sources of scholarly or professional evidence that support your findings and considerations. Resources should be no more than 5 years old.
  • APA formatting: Format references and citations according to current 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.

American Society of Nephrology

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Monica Bullock 4 posts Re: Topic 2 DQ 2 After learning about evidenced based practice in the work place and nursing practice I feel like my organization is making an effort to shift nursing practice. In dialysis a patient is complicated and they come in with many co morbities. On top of disease they come with many life issues such as no housing, minimal insurance, and a fixed income. In order for a dialysis patient to have a good patient outcome the staff must work as an interdisciplinary team to ensure success (Desai, 2008). Many practices in dialysis are based on evidenced based practice, for example fluid management and access care. I feel like my organization does a good job in educating staff about practices and changes in practice. Knowledge is list as one of the top reasons to effectively incorporate evidence into clinical practice (Garner, 2016). We have a lot of online training, but it would be helpful to have more continued education in person with our educators. I see the efforts of incorporating evidence based practice, but the struggle is the time to read and look over the information provided. On a typical day there is minimal down time making it difficult to do the online training and reading the information provided for the topic. On days off the information is not accessible, not saying that anyone would want to look at work related stuff on their days off. Allowing may be off the floor time to read and study the materials would be beneficial. Gardner, J. K., Kanaskie, M. L., Knehans, A. C., Salisbury, S., Doheny, K. K., & Schirm, V. (2016). Implementing and Sustaining Evidence Based Practice Through a Nursing Journal Club. Applied Nursing Research, 31, 139–145. https://doi-org.lopes.idm.oclc.org/10.1016/j.apnr.2016.02.001 Desai, A. A., Bolus, R., Nissenson, A., Bolus, S., Solomon, M. D., Khawar, O., … Spiegel, B. M. (2008). Identifying best practices in dialysis care: results of cognitive interviews and a national survey of dialysis providers. Clinical journal of the American Society of Nephrology : CJASN, 3(4), 1066–1076. doi:10.2215/CJN.04421007

health care organization

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Create an 8–10-slide mobilization plan PowerPoint presentation (with detailed speaker’s notes) for a mobilization plan by your health care organization to commit 20 nurses to participate in a 4-month-long multinational effort to treat patients exposed to a highly contagious virus in a hot zone in Africa.

Nursing leaders must incorporate approaches that are inclusive and respectful of all stakeholders in the health care workforce, patient population, and the larger community that is served by the organization. Communication among members of teams, between departments and service lines, within large networks, with strategic business partners, and with patients, families, or support persons requires awareness of various facets of effective communication and cultural competence. A mobilization plan for an international medical mission requires careful planning of organizational structure roles, power distribution, and team member empowerment.

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

Competency 1: Identify nursing leadership priorities, using a systems perspective.
Apply systems thinking to determine a) the impact of the mobilization effort on hospital staffing and b) the actions needed to assure safe, quality care for the mission patients and personnel.
Competency 2: Apply systems theory and systems thinking to facilitate health care delivery and patient outcomes.
Identify the major stakeholders within the health care system that would be affected by the mobilization plan.
Competency 3: Analyze the role of multiculturalism and diversity in organizational and systems structure and leadership.
Examine potential multicultural and diversity issues that mission personnel may encounter.
Competency 4: Evaluate how power relates to health care organizational structure, behavior, and leadership.
Describe the medical mission team’s organizational structure and assess how this structure empowers team members.
Competency 5: Communicate in a manner that is consistent with the expectations of a nursing professional.
Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.

Preparation
Use the Internet to help you complete this assessment.

This assessment is based upon the scenario below. The scenario is very limited in detail; where more detail is needed, incorporate any assumptions you make to flesh out the scenario. It is intended to assess your ability to communicate your approach to a challenge by evaluating issues of organization, leadership, safety, quality improvement, multiculturalism and diversity.

Your approach should be very conceptual and high-level.

Scenario
Your health care organization has recently committed 20 nurses to participate in a 4-month-long multinational effort to treat patients exposed to a highly contagious virus in a “hot zone” in Africa. The director of your organization has asked you, because of your previous medical mission experience, to outline nursing-related plans for preparing for the mobilization and present this information at an upcoming staff meeting.
Deliverable: Mobilization Plan PowerPoint Presentation
Create an 8–10-slide PowerPoint presentation (with detailed speaker’s notes) of your mobilization plan. It should be targeted toward members of the hospital’s administrative staff, nurses, and the physicians who will also participate in this medical mission.

Use bullet points and phrases on the slides.
The narrative, or explanation for each slide, should be in the speaker’s notes section.
The mobilization plan should address the following:

Identify the major stakeholders within the health care system that would be affected by the mobilization plan.
Analyze how the mobilization effort will impact staffing patterns and nursing care at the hospital.
Describe the medical mission team’s organizational structure of the mission team and how power is distributed.
Include one slide of an organizational diagram for the mission.
Describe the roles (in the speaker’s notes).
Assess how the organizational structure empowers team members.
Provide 1–2 examples of how team members will have power.
Identify key actions needed to assure quality of care and safety for mission patients and personnel.
Evaluate potential power issues that may arise when dealing with a multinational contingent.
(Be generic; that is, do not address individual nationalities, races, et cetera.)
Consider interactions with health care personnel from other countries.
Examine potential multicultural and diversity issues that mission personnel may encounter.
Consider that the indigenous population may be hostile to treatment.
Outline possible training requirements to improve cultural competencies of the personnel.
Additional Requirements
Written communication: Written communication should be free of errors that detract from the overall message.
APA formatting: Resources and in-text citations should be formatted according to current APA style and formatting.
Length: Presentation should be 8–10 slides. Include speaker’s notes on each content slide.
References: Include a minimum of three peer-reviewed resources on the final slide (in APA format).
General formatting: Choose an appropriate theme if using a template.
Assessment 4 Example

Introduction to Clinical Inquiry

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o Prepare:

  • Review the Resources and identify a clinical issue of interest that can form the basis of a clinical inquiry.
  • Based on the clinical issue of interest and using keywords related to the clinical issue of interest, search at least four different databases in the Walden Library to identify at least four relevant peer-reviewed articles related to your clinical issue of interest. You should not be using systematic reviews for this assignment, select original research articles.
  • Review the results of your peer-reviewed research and reflect on the process of using an unfiltered database to search for peer-reviewed research.
  • Reflect on the types of research methodologies contained in the four relevant peer-reviewed articles you selected.

Part 1: An Introduction to Clinical Inquiry

Create a 4- to 5-slide PowerPoint presentation in which you do the following:

  • Identify and briefly describe your chosen clinical issue of interest.
  • Describe how you used keywords to search on your chosen clinical issue of interest.
  • Identify the four research databases that you used to conduct your search for the peer-reviewed articles you selected.
  • Provide APA citations of the four peer-reviewed articles you selected.

Part 2: Identifying Research Methodologies

After reading each of the four peer-reviewed articles you selected, use the Matrix Worksheet template to analyze the methodologies applied in each of the four peer-reviewed articles. Your analysis should include the following:

  • The full citation of each peer-reviewed article in APA format.
  • A brief (1-paragraph) statement explaining why you chose this peer-reviewed article and/or how it relates to your clinical issue of interest, including a brief explanation of the ethics of research related to your clinical issue of interest.
  • A brief (1-2 paragraph) description of the aims of the research of each peer-reviewed article.
  • A brief (1-2 paragraph) description of the research methodology used. Be sure to identify if the methodology used was qualitative, quantitative, or a mixed-methods approach. Be specific.
  • A brief (1- to 2-paragraph) description of the strengths of each of the research methodologies used, including reliability and validity of how the methodology was applied in each of the peer-reviewed articles you selected.

By Day 7 of Week 3

Submit Part 1 and Part 2 of your Evidence-Based Project.

Note: Part 1 is a 4-5 slide PowerPoint and Part 2 is the Matrix. Be sure to attach both of your documents (Part 1 and Part 2) before you click Submit.