Tag Archive for: nursing

ADHD

/0 Comments/in /by

Case 2: Volume 1, Case #14: The scatter-brained mother whose daughter has ADHD, like mother, like daughter

· Review the patient intake documentation, psychiatric history, patient file, medication history, etc. As you progress through each section, formulate a list of questions that you might ask the patient if he or she were in your office.

· Based on the patient’s case history, consider other people in his or her life that you would need to speak to or get feedback from (i.e., family members, teachers, nursing home aides, etc.).

· Consider whether any additional physical exams or diagnostic testing may be necessary for the patient.

· Develop a differential diagnoses for the patient. Refer to the DSM-5 in this week’s Learning Resources for guidance.

· Review the patient’s past and current medications. Refer to Stahl’s Prescriber’s Guide and consider medications you might select for this patient.

Post a response to the following:

· List three questions you might ask the patient if he or she were in your office. Provide a rationale for why you might ask these questions.

· Identify people in the patient’s life you would need to speak to or get feedback from to further assess the patient’s situation. Include specific questions you might ask these people and why.

· Explain what physical exams and diagnostic tests would be appropriate for the patient and how the results would be used.

· List three differential diagnoses for the patient. Identify the one that you think is most likely and explain why.

· List two pharmacologic agents and their dosing that would be appropriate for the patient’s ADHD therapy based on pharmacokinetics and pharmacodynamics. From a mechanism of action perspective, provide a rationale for why you might choose one agent over the other.

· If your assigned case includes “check points” (i.e., follow-up data at week 4, 8, 12, etc.), indicate any therapeutic changes that you might make based on the data provided.

· Explain “lessons learned” from this case study, including how you might apply this case to your own practice when providing care to patients with similar clinical presentations.

Case study 

/0 Comments/in /by

Please create a Power Point to answer the following:

Case study 

Ann, a community nurse, made an afternoon home visit with Susan and her father. After the death of her mother, Susan had growing concerns about her father living alone. “I worry about my father all the time. He is becoming more forgetful and he has trouble seeing. Mom used to take care of him. I am not sleeping and I am irritable around him. Yesterday I shouted at him because he wouldn’t let me help him with his laundry. I felt terrible! I am at my wits’ end! My brothers and sisters do not want to put dad in a nursing home but they are not willing to help out. As usual, they have left me with all the responsibility. I work part time and have two small children to care for.” Susan’s father, Sam, sat quietly with tears filling his eyes. He was well nourished and well-groomed but would not make eye contact. Nurse Ann noticed that the house was clean and orderly. A tray in front of the TV had the remains of a ham sandwich and glass of ice tea. Mail was piled up, unopened on a small table near the front door. There was only one car in the driveway and the yard was in need of attention.

1.  What questions does Orlando’s theory guide the nurse to consider in caring for Susan and Sam?

2.  Develop a family plan of care from the perspective of Orlando.

Explore the 1950 and 60’s in the United States:

1.  Explore was happening in the United States during this time (culture, social, economics, struggles)

2.  What did nursing look like during this time (what were their jobs like, responsibilities, dress, autonomy, respect)

3.  What is the most influential accomplishment in nursing theory from the 1950’s and 1960’s?

Power Point should include at least 4 outside references and the textbook. It should include title and reference slides and be 14-20 slides.

·  Smith, M. C., &  Parker, M. E. (2015). Nursing Theories and Nursing Practice (4th ed.).  Philadelphia, PA: F.A. Davis. ISBN  978-0-8036-3312-4

Using the Practicum Experience for Professional Growth

/0 Comments/in /by

Using the Practicum Experience for Professional Growth

Your practicum experiences in NURS 8410, NURS 8400, and NURS 8500 have provided opportunities to gain knowledge, perspective, and skills that bolster your specialty area practice. They have laid a foundation for reflecting on your own strengths and challenges as a scholar-practitioner and a nurse leader in a dynamic workplace. Indeed, significant self-analysis is a core aspect of this course, and you will be asked to integrate this type of reflection into your work on several assignments in the upcoming weeks.

This Discussion serves as a springboard for the Practicum assignment you are to develop this week. As you plan your practicum experience for this course, consider how you can effectively communicate with key stakeholders in your practicum setting regarding the implementation, evaluation, and dissemination of an evidence-based project.

To prepare:

  • View      and consider the “To prepare” section of the Week 1 Assignment area.
  • Reflect      on your practicum experiences in NURS 8410, NURS 8400, and NURS 8500.
  • Assess      the professional growth (including development of leadership and      communication skills) you have achieved through previous practicum      experiences in the DNP program. Also, think about the topics presented in      courses you completed earlier in the program. Are there content areas or      skills that you would like to—or may need to—address to facilitate your continued      development as a scholar-practitioner and a nurse leader?
  • Think      about competencies that support the successful implementation, evaluation,      and dissemination of an evidence-based project, and assess your strengths      and areas for growth with regard to these competencies.
  • Begin      to develop your plan for the practicum, including two or three learning      objectives.

By tomorrow Tuesday May 28, 2019 write a minimum of 550 words essay in APA format with at least three scholarly references. Include the level one header as numbered below:

Post a cohesive response that addresses the following:

1) Describe how you intend to use your practicum experience to further your goals for successful evidence-based project implementation, evaluation, and dissemination and for your development as a scholar-practitioner and a nurse leader.

Required Readings

Oermann, M. H., & Hays, J. C. (2016). Writing for publication in nursing (3rd ed.). New York, NY: Springer Publishing Company.

· Chapter 1, “Getting Started”

This chapter introduces the steps an author can follow in planning, writing, and publishing manuscripts in nursing. The chapter predominantly focuses on early writing decisions.

· Chapter 2, “Selecting a Journal”

Chapter 2 focuses on how to evaluate and select journals. The chapter also provides guidelines for writing a query letter to gauge the interest of journal editors.

· Chapter 4, “Reviewing the Literature”

In this chapter, the authors make suggestions for conducting and writing a literature review for a manuscript.

Keep in mind that, as noted in Chapter 4, the Literature Review section of an article for publication must be tailored for that format; it is not the same as for an academic paper.

Required Media

Laureate Education, Inc. (Executive Producer). (2012b). The DNP Project. Baltimore, MD: Author.

Note: The approximate length of this media piece is 6 minutes.

Dr. Kristen Mauk shares her experiences and insights on developing and completing her DNP Project.

Project Plan

/0 Comments/in /by

Assignment 1:

Practicum Project Plan

 

As a foundation for engaging in scholarly writing, the nurse leader-manager or nurse informaticist must be able to engage in critical thinking and anticipate the needs, questions, and concerns of the intended audience. A scholarly writer must be able to craft a paper that demonstrates clarity, specificity, fairness, relevance, and consistency (Dexter, 2000).

As you reflect on the development of your Practicum Project Plan, take some time to consider how you will communicate your proposal objectively yet persuasively.

To prepare:
  • Review the information in the Practicum Project Plan (PPP) Overview document introduced in Week 3. The overview describes the components that must be included in your plan.
  • Reflect on the development of your Practicum Project Plan thus far. Address any questions you have and/or identify areas in need of further consideration or improvement.
  • Develop any outstanding components of your Practicum Project Plan. For instance, you may need to continue your review of literature that justifies your project and create your project timeline.
  • Review the information on scholarly writing in this week’s Learning Resources; be sure to integrate these principles as you develop your Practicum Project Plan.
  • If you posted a draft of Practicum Project Plan in this week’s optional Discussion, incorporate, as appropriate, feedback you received from your colleagues.

To complete the Practicum Project Plan:

Write a 4- to 6-page scholarly paper that includes the following:

  • Title
  • Introduction
  • Goal statement
  • Project objectives
  • Evidence-based review of the literature for project justification
  • Methodology
  • Resources
  • Formative evaluation
  • Summative evaluation
  • Timeline
  • References

Required Readings

Reminder: Review resources from previous courses as necessary.

Walden University, Online Writing Center. (2013). Literature reviews. Retrieved from http://writingcenter.waldenu.edu/50.htm

 

View the information in this resource provided by the Walden University Online Writing Center. It provides information on conducting a literature review.

Walden University, Online Writing Center. (2013). Synthesis. Retrieved from http://writingcenter.waldenu.edu/synthesis.htm

 

View the information in this resource provided by the Walden University Online Writing Center. It defines synthesis, a core aspect of scholarly writing.

Walden University, Online Writing Center. (2013). What is scholarly writing? Retrieved from http://writingcenter.waldenu.edu/312.htm

 

View the information in this resource provided by the Walden University Online Writing Center. It defines and conveys characteristics of scholarly writing.

Optional Resources

The following resources provide guidance and suggestions for conducting a literature review:

Napa Valley College. (2011). Conducting a literature review. Retrieved from http://www.napavalley.edu/Library/Pages/ConductingaLiteratureReview.aspx

Taylor, D. (n.d.). The literature review: A few tips on conducting it. Retrieved May 20, 2013, from http://www.writing.utoronto.ca/advice/specific-types-of-writing/literature-review

health care quality model

/0 Comments/in /by

To write your reflection paper; find an article on one of the health care quality model that we have discussed in class (see the power point. week 4)

1. Identify the main theme.

2. Summarize your understanding of the article

3. In your own ideas or experience, how the model affects health care practice?

primary care nurse practitioner 

/0 Comments/in /by

The work for this paper entails interviewing  TWO different categories of advanced practice nurses (APNs). One APN has to be a primary care nurse practitioner (e.g., family NP, adult NP, pediatric NP); that is, the NP cannot be one who is an acute care NP. Furthermore, the NP must work in a primary care setting such as a “doctor’s office” or community health center—that is, in a setting the buzz-word for which is now medical home. An NP who works in a retail clinic or free-standing urgent care center would also be acceptable (but NOT an emergency department). Yes, there are many APNs who are prepared as FNPs or adult NPs who take jobs in non-primary care settings (e.g., as hospitalists and as providers in nursing homes). But a common premise with health care reform and the Affordable Care Act is that there already is and will be a huge need for primary care providers, thus paving the way for even greater opportunities for NPs in this area. It is important that you get a firm grasp of how NPs are prepared for primary care, and thus why NP organizations assert an important solution to the primary care provider shortage is educating more NPs which is why every state should allow full independent practice authority for APNs, especially NPs.

The other APN may be your choice of one of the following: a certified nurse midwife (CNM) or a certified nurse anesthetist (CRNA) or a clinical nurse specialist (CNS). There is no limitation regarding the types of settings these APNs might work. Be sure to indicate the state(s) where the APNs practice.

Although the information gathered from these APNs will be acquired via an interview, the paper should be written in summary format (i.e., it should not look like a dialogue between you and the APN). Information on both interviews should be in a single document. It is not necessary to provide the APNs’ full names. Most elements of APA format should be used, including a title page and abstract. Most students’ papers that address all of these questions for both APN are about five double-spaced pages, without counting the title page or abstract (be sure to read your APA manual regarding what an abstract should look like!). An exception to the APA format requirement is that a reference list is not required, since all of the information will be derived from two sources (the APNs whom you interviewed). Although you have free range to discuss other topics about advanced practice nursing, you must address the following issues with each APN (please follow the order of list below):

1. Reason for their choosing their specific APN specialty.

2. Descriptions of: (a) the type of setting where they work (e.g., community hospital, major medical center, private primary care practice, clinic for the underserved, etc.), and (b) a “typical” day as they render care.

3. Level of satisfaction with their role in general, and specifically within the system where they are currently employed.

4. The type of APN certification that they hold, including identifying the accurate name of the certifying body with which they are certified (Note: Review your textbooks for the correct names of these certifying bodies. Also note there are several different certifying bodies for NPs).

5. Whether they have prescriptive authority and whether they prescribe controlled substances. If they do prescribe controlled substances, you must indicate from which schedules of controlled substances they are allowed prescribe.

6. Whether they must practice according to an agreement with a physician. If so, is the relationship supervisory or collaborative?

7. Are they credentialed and privileged by a hospital or health system?  If the answer is “yes,” ask them to explain what the credentialing and privileging process entails at their organization (e.g., are the documents reviewed by only the human resources department, the nursing department, or the medical staff office, a combination of all three, etc.).

8. Whether they belong to a professional organization(s) that specifically addresses APN issues. If so, which one (s)? If not, why not?

9. Their understanding about the DNP degree (i.e., have them actually explain what they know about the degree) and whether they have this degree already or intend to pursue it. Be sure to probe to see if they have positive or negative feelings about the DNP—and why.

10. Final grading criterion: Paper’s adherence to APA format (with the exception that references are not required for this particular paper), including grammar, spelling, punctuation, sentence structure, etc.

Total points for this assignment is 100; each question above is worth 10 points. 

: Overview of Grand Nursing Theories

/0 Comments/in /by

Topic: Overview of Grand Nursing Theories

Applying Theory to a Practice Problem: Part 1: Introduction and Problem of Practice 

PURPOSE:

It is important to understand how research can help you in your everyday environment as a nurse. In this assignment, you will identify a practical problem that emerges from the evidence in the extant literature or professional practice.

DIRECTIONS:

Chose a problem that you are encountering in your practice or about which you have read in the current literature.

Write a paper (250 to 500 words) that describes a practical problem that emerges from the evidence in the extant literature or professional practice. The paper should do the following:

1. Clearly describe the problem.

2. Provide a rationale for the significance of this problem. The rationale must be supported by the current or seminal literature.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

Communicate therapeutically with patients.

/0 Comments/in /by

The benchmark assesses the following competency:

4.2 Communicate therapeutically with patients.

The RN to BSN program at Grand Canyon University meets the requirements for clinical competencies as defined by the Commission on Collegiate Nursing Education (CCNE) and the American Association of Colleges of Nursing (AACN), using nontraditional experiences for practicing nurses. These experiences come in the form of direct and indirect care experiences in which licensed nursing students engage in learning within the context of their hospital organization, specific care discipline, and local communities.

Note:  The teaching plan proposal developed in this assignment will be used to develop your Community Teaching Plan: Community Presentation due in Topic 5. You are strongly encouraged to begin working on your presentation once you have received and submitted this proposal.

Select one of the following as the focus for the teaching plan:

  1. Primary Prevention/Health Promotion
  2. Secondary Prevention/Screenings for a Vulnerable Population
  3. Bioterrorism/Disaster
  4. Environmental Issues

Use the “Community Teaching Work Plan Proposal” resource to complete this assignment. This will help you organize your plan and create an outline for the written assignment.

  1. After completing the teaching proposal, review the teaching plan proposal with a community health and public health provider in your local community.
  2. Request feedback (strengths and opportunities for improvement) from the provider.
  3. Complete the “Community Teaching Experience” form with the provider. You will submit this form in Topic 5.

Prepare this assignment according to the guidelines found in the APA Style

Elevator Consult

/0 Comments/in /by

No Plegarism please, assignment will be checked with Turnitin. 

Will need minimum of 1 to 1 and 1/2 full content pages, plus title, and reference page APA Style, double spaced, times new romans, font 12, and and 3 references with intext citations. References within 3 years (2016-2018). 

 

Location: XYZ Family Practice

You are an NP student in this practice. Your next patient is the following:

“I had to come in today because I have been coughing for a long time”

Amanda Smith (69 year old, black female) is a retired postal worker. During the visit, she is coughing continually. She states the cough started 5 days ago intermittently but 2 days ago it became constant. Her chart indicates that she has been a patient of the practice for 5 years, gets care regularly and her HTN has been controlled for 4 years.

Social History

Married – 2 adult children A & W

Non-Smoker now. Smoke 1 pack a day for 15 years. Quit x5 years ago

No alcohol or drug use

Baptist, attends church regularly and is a member of the choir

Family History

Mother – Deceased at age 27 from traumatic accident

Father – Deceased age 78 related to renal failure secondary to diabetes type II

Siblings – one brother age 61 A & W

Medical/Surgical/Health Maintenance Hx

Measles, mumps and chicken pox as a child.

Tetanus/Diptheria/Pertussis – Last dose 2 years ago

Influenza – Last dose 9 months ago

Pneumococcal vaccine at age 65

Zostivax at age 60

Chronic diagnoses – HTN x 5 years

Takes HCTZ 25 mg daily

ROS

General

Usual weight has been maintained

Fever for 5 days up to 101

Skin

Dry skin, uses emollient frequently

HEENT

Wears reading glasses

Dentition fair. Partial upper denture

Neck

No swelling or stiffness

Chest

Substernal pain on cough

Respiratory

Began coughing 4 days ago. Started mild, intermittent and non-productive. Two days ago became constant and productive of frothy sputum. Keeps her awake at night. No relief with OTC cough syrup. She states she is short of breath today.

CV

No CP at rest or when not coughing

PV

Some swelling of feet and ankles at end of day, relieved by elevating feet

GI

Decreased appetite for one week

No change in bowel habits

GU

No frequency, hesitancy, nocturia or change in bladder habits

Genitalia

No changes

MS
Stiffness in hands and legs on awakening. Relieved with activity

Psych

No depression, anxiety, or memory change

Neurologic

No numbness, weakness, headache, change in mentation, or paralysis

Hematologic

No past anemia

Endocrine

No change in weight, thirst, heat/cold intolerance.

Your physical exam reveals:

Temp 101.4, Resp 30 labored, no retractions, BP 135/92, HR 110, Pulse Ox 90 Wt 130 lbs

General appearance – Alert in all spheres, in mild respiratory distress, able to answer questions with short sentences, tripod breathing

HEENT –

Eyes ,ear, nose, head wnl

Mouth -mucosa dry

Pharynx – tonsils present not enlarged, normal pink color

Lymph – no enlargement

Skin – Dry and scaly legs and arms. Tenting of skin noted

Heart- regular rhythm at 110 bpm, no murmurs or extra sounds

Lungs – normal breath sound without crackles, bronchophony or egophony

Abdomen – no mass, tenderness, rigidity

Extremities – Hands – no swelling, Feet/legs – +1 edema feet to ankle level

Pedal pulses – wnl

Differential diagnoses:

  • CAP
  • Acute bronchitis
  • Congestive heart failure
  • Influenza

Plan – transfer to acute care setting for further work-up

Assignment Details:

The “Elevator Consult”

In this activity, you will practice giving a synopsis of your patient to your preceptor. In practice, you may often give this type of report if you are sending a patient for a consultation and your phone the specialist to discuss the patient. This report should be concise and clear. The receiver should, within one minute (slightly less for simple cases, slightly more for complex cases) have a picture of the patient in his/her head. You will report on ONLY items pertaining to the acute problem in this case. Do not include extraneous material or material not directly impacting the decision-making regarding this problem. Remember, this is a FOCUSED visit and assessment to evaluate a focused concern. The history and physical exam applies techniques relevant to the specific complaint for the patient at that visit. Your report should be similarly focused, providing only information that relates specifically to the presenting problem.

Please review the grading rubric under Course Resources in the Grading Rubric section.

ethical principles of autonomy,

/0 Comments/in /by

The Tuskegee Syphilis Study is one of the most important landmark cases related to ethics in medical research. It offers chilling insight into why ethics is so critically important to the advancement of medical research and practice.

To prepare for this Application, review this week’s Learning Resources, paying close attention to those related to the four ethical principles and the Tuskegee Syphilis Study. Consider how the four ethical principles of autonomy, beneficence,non-maleficense, and justice can be applied to this historic case.

To complete this Application, write a 1- to 2-page paper that addresses the following:

  • Summarize the Tuskegee Syphilis Study.
  • Identify how each of the four ethical principles can be applied to the case.
  • What are some of the legal and ethical lessons that can be learned from the Syphilis Tuskegee Study?

Your written assignments must follow APA guidelines. Be sure to support your work with specific citations

Resources:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1733786/pdf/v029p00275.pdf

https://www.cdc.gov/tuskegee/timeline.htm

References to the added files below:

Gillon, R. (1994). Medical ethics: Four principles plus attention to scope. British Medical Journal, 309(6948), 184.

Gamble, V. (1997). Under the shadow of Tuskegee: African Americans and health care. American Journal of Public Health, 87(11), 1773-1778.

Walker, C. (2009). Lest we forget: The Tuskegee experiment. Journal of Theory Construction & Testing, 13(1), 5-6