Tag Archive for: nursing

“General Appraisal Overview for All Studies,

MODULE 2

DQ 1

Review the “General Appraisal Overview for All Studies,” available in Appendix B in the textbook. You should save this tool and use it throughout the development of the PICOT question, problem description, and literature review.

Begin the development of your PICOT question, using the following resources:

1. “Appendix A: Template for Asking Clinical Questions,” available in the textbook appendix

2. Text readings

Formulate your PICOT question and post it to the main forum. Respond to at least four other statements, providing feedback. Review the statements to see if the clinical issue is clearly defined and that all aspects are identified. Also refer to the “PICOT: Components of an Answerable, Searchable Question” table, located in chapter 2 of the text. If one PICOT statement has at least three feedback posts, move to another statement.

You will be using the feedback to make revisions to your PICOT question before using it in your “Section B: Problem Description” assignment.

Here is something to think about.

· Population/ Patient Problem: Who is your patient? (Disease or Health status, age, race, sex)

· Intervention: What do you plan to do for the patient? (Specific tests, therapies, medications)

· Comparison: What is the alternative to your plan? (ie. No treatment, different type of treatment, etc.)

· Outcome: What outcome do you seek? (Less symptoms, no symptoms, full health, etc.)

· Time:  What is the time frame? (This element is not always included.)

Example: 

Prevention:

For________ (P) does the use of ______ (I) reduce the future risk of ________ (O) compared with _________ (C)?

In acute care cancer patients, does the use of scheduled pain medication regimes reduce the risk of uncontrolled pain compared with non-scheduled pain medication regimes.

DQ 2

What strategies will you use in your new practice as an advance practice nurse to review and critique literature pertinent to your practice?

As a Christian nurse will you focus on one particular genre of literature more than others. or will you be looking at specific topics related to your practice.

RESOURCES

1. Evidence-Based Practice Resources on the World Wide Web

Read “Evidence-Based Practice Resources on the World Wide Web,” by Stevens, from the Academic Center for Evidence Based Practice, located on the Wayback Machine archive website.

http://replay.waybackmachine.org/20080521225345/http://acestar.uthscsa.edu/Resources_www.htm

e-Library Resource

1. Evidence-Based Nursing

Access “Evidence-Based Nursing.” Use all issues of the journal to further explore your individual PICOT topic.

https://lopes.idm.oclc.org/login?url=http://gateway.ovid.com.lopes.idm.oclc.org/ovidweb.cgi?T=JS&NEWS=N&PAGE=toc&SEARCH=00124408-201007000-00000.kc&LINKTYPE=asBody&LINKPOS=1&D=ovft

2. Joanna Briggs Institute EBP Database

Use the Joanna Briggs Institute EBP Database to search for EBP resources related to your capstone project.

http://joannabriggs.org/jbi-approach.html#tabbed-nav=JBI-approach

Website

1. Centre for Evidence-Based Medicine

Explore the Centre for Evidence-Based Medicine (CEBM) website.

http://www.cebm.net/

2. Cochrane Database of Systematic Reviews

Access the full text of “Cochrane Database of Systematic Reviews,” located on The Cochrane Library website.

http://www.thecochranelibrary.com/view/0/index.html

3. Cochrane Library Database

Explore the Chochrane Library Database.

https://lopes.idm.oclc.org/login?url=http://www.cochranelibrary.com

4. Guide to Clinical Preventive Services

Explore the Agency for Healthcare Research and Quality website. Be sure to access the “Guide to Clinical Preventive Services,” located on the Agency for Healthcare Research and Quality website.

politics and medical science

When politics and medical science intersect, there can be much debate. Sometimes anecdotes or hearsay are misused as evidence to support a particular point. Despite these and other challenges, however, evidence-based approaches are increasingly used to inform health policy decision-making regarding causes of disease, intervention strategies, and issues impacting society. One example is the introduction of childhood vaccinations and the use of evidence-based arguments surrounding their safety.

In this Discussion, you will identify a recently proposed health policy and share your analysis of the evidence in support of this policy.

To Prepare:

  • Review the Congress website provided in the Resources and identify one recent (within the past 5 years) proposed health policy.
  • Review the health policy you identified and reflect on the background and development of this health policy.

By Day 3 of Week 7

Post a description of the health policy you selected and a brief background for the problem or issue being addressed. Explain whether you believe there is an evidence base to support the proposed policy and explain why. Be specific and provide examples.

health care organizations

  • One component for health care organizations when conducting a TOWS (threats-opportunities-weaknesses-strengths) matrix analysis is incorporating the facilities requirements from an emergency preparedness plan for the local community. Review the Riverbend City scenario and discuss the issues, using a TOWS matrix analysis, that the long-term care facility needs in its planning process to allow them to respond to the disaster and to safely evacuate their residents.
  • In your response, include a detailed discussion of the advantages a TOWS matrix offers strategic managers when addressing external opportunities and threats. You may wish to review Exhibit 7-1, “External/Internal Strategy Matrix,” in your text, Strategic Management of Health Care Organizations when drafting your response.

specialization and collaboration

Nature offers many examples of specialization and collaboration. Ant colonies and bee hives are but two examples of nature’s sophisticated organizations. Each thrives because their members specialize by tasks, divide labor, and collaborate to ensure food, safety, and general well-being of the colony or hive.

Of course, humans don’t fare too badly in this regard either. And healthcare is a great example. As specialists in the collection, access, and application of data, nurse informaticists collaborate with specialists on a regular basis to ensure that appropriate data is available to make decisions and take actions to ensure the general well-being of patients.

In this Discussion, you will reflect on your own observations of and/or experiences with informaticist collaboration. You will also propose strategies for how these collaborative experiences might be improved.

To Prepare:

  • Review the Resources and reflect on the evolution of nursing informatics from a science to a nursing specialty.
  • Consider your experiences with nurse Informaticists or technology specialists within your healthcare organization.

Post a description of experiences or observations about how nurse informaticists and/or data or technology specialists interact with other professionals within your healthcare organization. Suggest at least one strategy on how these interactions might be improved. Be specific and provide examples. Then, explain the impact you believe the continued evolution of nursing informatics as a specialty and/or the continued emergence of new technologies might have on professional interactions.

 

McGonigle, D., & Mastrian, K. G. (2017). Nursing informatics and the foundation of knowledge (4th ed.). Burlington, MA: Jones & Bartlett Learning.

  • Chapter 25, “The Art of Caring in Technology-Laden Environments” (pp. 525–535)
  • Chapter 26, “Nursing Informatics and the Foundation of Knowledge” (pp. 537–551)

 

In the Discussion for this module, you considered the interaction of nurse informaticists with other specialists to ensure successful care. How is that success determined?

Patient outcomes and the fulfillment of care goals is one of the major ways that healthcare success is measured. Measuring patient outcomes results in the generation of data that can be used to improve results. Nursing informatics can have a significant part in this process and can help to improve outcomes by improving processes, identifying at-risk patients, and enhancing efficiency.

To Prepare:

  • Review the concepts of technology application as presented in the Resources.
  • Reflect on how emerging technologies such as artificial intelligence may help fortify nursing informatics as a specialty by leading to increased impact on patient outcomes or patient care efficiencies.

The Assignment: (4-5 pages)

In a 4- to 5-page project proposal written to the leadership of your healthcare organization, propose a nursing informatics project for your organization that you advocate to improve patient outcomes or patient-care efficiency. Your project proposal should include the following:

  • Describe the project you propose.
  • Identify the stakeholders impacted by this project.
  • Explain the patient outcome(s) or patient-care efficiencies this project is aimed at improving and explain how this improvement would occur. Be specific and provide examples.
  • Identify the technologies required to implement this project and explain why.
  • Identify the project team (by roles) and explain how you would incorporate the nurse informaticist in the project team.

HIV/AIDS prevention and control

View the video or read the book, And, The Band Played On. Respond to the following essay questions.

 

1.  Based on what you observed in the film or read in the book; clearly articulate at least three of the sociopolitical factors that influenced public health policy development for HIV/AIDS prevention and control in the United States. Briefly discuss each of the three sociopolitical factors.

2.  How were early victims and contacts identified and located? How is this the same, or different in 2017?

3.  Select an epidemiological model. (Module 3). Apply the events in the video/book to components of the epidemiological model.

4. What was your overall reaction after viewing this film/book with respect to the impact on the health care system in the United States?

5. Compare the historical perspective of the emergence of HIV with the current HIV situation in the US.

No cover page needed; References Required.

nursing practice and health care.

The benchmark assesses the following competencies:

1.4 Participate in health care policy development to influence nursing practice and health care.

Research public health issues on the “Climate Change” or “Topics and Issues” pages of the American Public Health Association (APHA) website. Investigate a public health issue related to an environmental issue within the U.S. health care delivery system and examine its effect on a specific population.

Write a 750-1,000-word policy brief that summarizes the issue, explains the effect on the population, and proposes a solution to the issue.

Follow this outline when writing the policy brief:

1. Describe the policy health issue. Include the following information: (a) what population is affected, (b) at what level does it occur (local, state, or national), and (c) evidence about the issues supported by resources.

2. Create a problem statement.

3. Provide suggestions for addressing the health issue caused by the current policy. Describe what steps are required to initiate policy change. Include necessary stakeholders (government officials, administrator) and budget or funding considerations, if applicable.

4. Discuss the impact on the health care delivery system.

Include four peer-reviewed sources and two other sources to support the policy brief.

Prepare this assignment according to the guidelines found in the APA Style Guide,  An abstract/thesis is required.

drug distribution

Question

Week 1 Quiz

Question 1 A patient has a blood serum drug level of 50 units/mL. The drug’s half-life is 1 hour. If concentrations above 25 units/mL are toxic and no more of the drug is given, how long will it take for the blood level to reach the nontoxic range?

Question 2 During a clinic visit, a patient complains of having frequent muscle cramps in her legs. The nurse’s assessment reveals that the patient has been taking over-the-counter laxatives for the past 7 years. The nurse informed the patient that prolonged use of laxatives

Question 3 Which of the following affects drug distribution throughout the body?

Question 4 An unconscious patient has been brought to the hospital, and the physician has prescribed a life-saving drug to be administered parenterally. Which of the following methods would be the most appropriate for the nurse to use when administering the medication?

Question 5 An older adult patient with a history of Alzheimer’s disease and numerous chronic health problems has been prescribed several medications during his current admission to hospital and recent declines in the patient’s cognition have impaired his ability to swallow pills. Which of the following medications may the nurse crush before administering them to this patient?

Question 6 A nurse has been administering a drug to a patient intramuscularly (IM). The physician discontinued the IM dose and wrote an order for the drug to be given orally. The nurse notices that the oral dosage is considerably higher than the parenteral dose and understands that this due to

Question 7 A patient who has ongoing pain issues has been prescribed meperidine (Demerol) IM. How should the nurse best administer this medication?

Question 8 A 56-year-old female patient has been admitted to the hospital with chronic muscle spasms and has been prescribed a new medication to treat the spasms. She has a poorly documented allergy to eggs, synthetic clothes, and perfumes. What is the priority action of the nurse to ensure that prescribed medication does not experience an allergic reaction?

Question 9 The nurse is caring for a patient receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which of the following will alert the nurse that the patient may be experiencing nephrotoxicity?

Question 10 A nurse is caring for a patient who has recently moved from Vermont to south Florida. The patient has been on the same antihypertensive drug for 6 years and has had stable blood pressures and no adverse effects. Since her move, however, she reports “dizzy spells and weakness” and feels that the drug is no longer effective. The nurse suspects that the change in the effectiveness of the drug is related to

Question 11 A patient with a recent diagnosis of acute renal failure has a long-standing seizure disorder which has been successfully controlled for several years with antiseizure medications. The nurse should recognize that the patient’s compromised renal function will likely

Question 12 A nurse is caring for a patient who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the patient’s care, the nurse should consider a possible alteration in which of the following aspects of pharmacokinetics?

Question 13 A nurse who is responsible for administering medications should understand that the goals of the MedWatch program are to (Select all that apply.)

Question 14 The nurse’s assessment of a community-dwelling adult suggests that the client may have drug allergies that have not been previously documented. What statement by the client would confirm this?

Question 15 A patient with a variety of chronic health problems is being seen by her nurse practitioner, who is currently reviewing the patient’s medication regimen. Which of the patient’s medications should prompt the nurse to teach her to avoid drinking grapefruit juice?

Question 16 On the 1 a.m. rounds, the nurse finds a patient awake and frustrated that she cannot go to sleep. The nurse administers an ordered hypnotic to help the patient sleep. Two hours later, the nurse finds the patient out of bed, full of energy and cleaning her room. The nurse evaluates the patient’s response to the hypnotic as

Question 17 Which of the following statements best defines how a chemical becomes termed a drug?

Question 18 In light of her recent high blood pressure readings, a patient has been started on a thiazide diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most likely rationale for using two medications to address the patient’s hypertension?

Question 19 In which of the following patients would a nurse expect to experience alterations in drug metabolism?

Question 20 30 ml = _______________tbsp

Question 21 Tylenol 325 mg/tablet, patient needs 650 mg; how many tables should patient take?

Question 22 A patient who has been admitted to the hospital for a mastectomy has stated that she has experienced adverse drug effects at various times during her life. Which of the following strategies should the nurse prioritize in order to minimize the potential of adverse drug effects during the patient’s stay in the hospital?

Question 23 A patient has been prescribed several drugs and fluids to be given intravenously. Before the nurse starts the intravenous administration, a priority assessment of the patient will be to note the

Question 24 A nurse is discussing with a patient the efficacy of a drug that his physician has suggested, and he begin taking. Efficacy of a drug means which of the following?

Question 25 A patient has been prescribed 1 mg lorazepam (Ativan) sublingual prior to the scheduled insertion of a peripherally inserted central (PIC) line. How should the nurse direct the patient when administering this medication?

Question 26 A 79-year-old woman with a medical history that includes osteoporosis has recently moved to a long-term care facility. Medication reconciliation indicates that the woman has been taking calcitonin, salmon for several years. The nurse should recognize that the most likely route for the administration of this drug is

Question 27 Mrs. Houston is a 78-year-old woman who resides in an assisted living facility. Her doctor prescribed digoxin at her last visit to the clinic and she has approached the nurse who makes regular visits to the assisted-living facility about this new drug. What teaching point should the nurse emphasize to Mrs. Houston?

Question 28 A nurse is caring for an 81-year-old patient in a long-term care facility who takes nine different medications each day. The patient has a recent diagnosis of seizure disorder and has begun treatment with phenytoin (Dilantin), a highly protein-bound drug. After 1 month of Dilantin therapy, the patient is still extremely drowsy and sluggish. The nurse determines that the prolonged adverse effect is likely due to

Question 29 A 72-year-old man who is unable to sleep since admission into the hospital is given a hypnotic medication at 9 p.m. The nurse finds the patient drowsy and confused at 10 a.m. the next day. The nurse is aware that this behavior is most likely due to

Question 30 An 80-year-old man has been prescribed oxycodone for severe, noncancer, chronic pain. He tells the nurse that he has difficulty swallowing and asks if he can crush the tablet before swallowing. The nurse will advise the patient that

Question 31 A 72-year-old man with pain issues is being given a drug by the intramuscular route. His serum blood level concentrations have been erratic. The nurse suspects that this may be due to

Question 32 An older adult who lives in a long-term care facility has recently begun taking losartan (Cozaar) for the treatment of hypertension. The nurse who provides care for this resident should recognize  that this change in the resident’s medication regimen make create a risk for

Question 33 A 77-year-old man with a long history of absence seizures has been treated with ethosuximide for many years. The man is now in the process of moving to a long-term care facility and a nurse is creating a plan of care. The nurse understands the potential adverse effects of this drug and would consequently prioritize which of the following nursing diagnoses?

Question 34 A 70-year-old woman with a history of a trial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse’s admission assessment, the nurse realizes that the patient has been taking ginkgo biloba supplements in addition to her prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this patient’s care?

Question 35 A 67-year-old man is admitted to the hospital with pneumonia. He reports to the nurse that he has chronic arthritis and circulation problems. Further assessment by the nurse reveals that the patient has a history of mild hypertension. He explains that he owns a business and lives alone. The nurse determines that he is within the normal weight range for his height and age but has a fondness for spicy foods and sweets. Which of the mentioned patient variables will have the greatest impact on the effectiveness  of the patient’s drug therapy?

Question 36 Mr. Lacuna is an 83-year-old resident of a long-term care facility who has a diagnosis of moderate Alzheimer disease. Mr. Lacuna’s physician recently prescribed oral rivastigmine, but he was unable to tolerate the drug due to its gastrointestinal effects. As a result, he has been ordered the transdermal patch form of the medication. When administering this form of rivastigmine, the nurse should

Question 37 Frequent episodes of exercise-related chest pain have caused a 79-year-old woman to use her prescribed nitroglycerin spray several times in recent weeks. This patient’s age will have what effect on her use of nitroglycerin?

Question 38 A nurse notes new drug orders for a patient who is already getting several medications. Which of the following is the most important consideration when preparing to administer the new drugs?

Question 39 A 79-year-old woman who takes several medications for a variety of chronic health problems has been prescribed an oral ant platelet aggregator that is to be taken once daily. The nurse has encouraged the woman to take the pill at the same time of day that she takes some of her other medications. What is the most likely rationale for the nurse’s advice?

Question 40 A home health nurse is performing a home visit to an elderly client who has early-stage dementia. The nurse observes that some of the client’s pill bottles are empty, even though the client is not due for refills for 2 weeks. What nursing diagnosis should the nurse prioritize when planning this client’s care?

health care articles

Search the GCU Library and find two new health care articles that use quantitative research. Do not use articles from a previous assignment, or articles that appear in the Topic Materials or textbook.

Complete an article analysis for each using the “Article Analysis: Part 2” template.

Refer to the “Patient Preference and Satisfaction in Hospital-at-Home and Usual Hospital Care for COPD Exacerbations: Results of a Randomised Controlled Trial,” in conjunction with the “Article Analysis Example 2,” for an example of an article analysis.

While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance.

Career planning

 Details:
Rate yourself using the results from the “Nurse Manager Skills Inventory”:

http://www.aone.org/resources/nurse-manager-skills-inventory.pdf

Write a reflection of 750-1,000 words in which you identify your strengths and weaknesses related to the four content areas below:

  1. Personal and professional accountability
  2. Career planning
  3. Personal journey disciplines
  4. Reflective practice reference behaviors/tenets

Discuss how you will use your current leadership skill set to advocate for change in your workplace.

Identify one personal goal for your leadership growth and discuss your implementation plan to achieve that goal.

A minimum of Five scholarly references are required for this assignment. solid academic writing is expected, and in-text citations and references should be presented using APA documentation guidelines, an abstract is not required, CITE WEBSITE SOURCE

Manuscripts of the Early Middle Ages

Question 1: Manuscripts of the Early Middle Ages

Before the invention of the printing press, books were copied by hand one at a time by illuminators, and the vellum was often embellished with beautiful calligraphy and intricate patterns and designs.

Using your course textbook locate three examples of illuminated manuscripts from the early Middle Ages. Read about each one in your textbook, course lectures, and through reliable internet resources

First, completely identify each manuscript and/or manuscript page by title, date, and location where it was created.

In a minimum of 2 well-developed paragraphs address the following questions:

  1. Who commissioned the creation of the manuscript? Why?
  2. What was the purpose of the manuscript?
  3. How do the visual characteristics of each manuscript contribute to or enhance its message or meaning?
  4. How do the reasons these manuscripts were created compare with religious texts created today?

Be sure to explain your ideas clearly and support them by discussing specific details about each manuscript.

Question 2: Romanesque and Gothic Cathedrals

Both Romanesque and Gothic architecture displayed distinctive characteristics and features. For this assignment, select one example of Romanesque church architecture and one example of Gothic church architecture from your course textbook. Read about each one in your textbook, course lectures, and through reliable internet resources.

First, completely identify the two cathedrals you have selected by name, date, and location.

Then, in a minimum of 3 well-developed paragraphs, address the following questions:

  1. What architectural details are evident in each cathedral that make it representative of either the Romanesque or Gothic style?
  2. What sort of decoration (interior and exterior) was employed in each cathedral? What was the meaning of the sculptures, paintings, windows that adorned each cathedral?
  3. What was the visitor or viewer experience in each cathedral?

Respond to both questions as thoroughly as possible, making sure to use information from the readings and the lectures. All responses should be in complete sentence form, using proper spelling and grammar.