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pediatric patients

In clinical settings, pediatric patients often present with hematologic and metabolic disorders such as anemia and diabetes. Many of these disorders are manageable with drug therapy and lifestyle changes, but they can pose serious complications for patients if left untreated. In your role as the advanced practice nurse, you must identify patients at risk of hematologic and metabolic disorders and provide the appropriate education for them and their families. Consider potential treatment, management, and education strategies for the patients in the following case studies.

Case Study 1

You see a 1-week-old Asian infant for a weight check. The infant is back to his birth weight and is breastfeeding for 10 minutes every 2 hours with one 3-hour stretch a day. He is alert, has bowel movements with each feeding, and wets 8–10 diapers a day. His blood type is A+ and his mother’s blood type is A+. Coombs’ testing at birth was negative. You note slight scleral and skin jaundice.

Case Study 2

Jimmy is a 3-year-old “picky” eater according to his mother. He refuses to eat anything but waffles for breakfast and macaroni and cheese or chicken nuggets for lunch and dinner. He will eat apples and bananas but refuses all vegetables except corn. After a normal physical examination, you obtained blood testing that revealed the hemoglobin is 11.4 mg/dl and his hematocrit is 30% (both obtained by venipuncture). The CBC revealed microcytic hypochromic RBCs.

Case Study 3

Melissa is a 13-year-old who presents to your office for a well-child check. Physical examination reveals a thin child who is short of stature. Breast Tanner stage is II and pubic hair development is Tanner I. Neurologic, skin, heart, lung, abdominal, and HEENT examinations are normal.

To prepare:

  • Review “Endocrine and Metabolic Disorders” and “Hematologic Disorders” in the Burns et al. text.
  • Review and select one of the three provided case studies. Analyze the patient information.
  • Consider a differential diagnosis for the patient in the case study you selected. Think about the most likely diagnosis for the patient.
  • Think about a treatment and management plan for the patient. Be sure to consider appropriate dosages for any recommended pharmacologic and/or non-pharmacologic treatments.
  • Consider strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

By Day 3

Post an explanation of the differential diagnosis for the patient in the case study you selected. Explain which is the most likely diagnosis for the patient and why. Include an explanation of unique characteristics of the disorder you identified as the primary diagnosis. Then, explain a treatment and management plan for the patient, including appropriate dosages for any recommended treatments. Finally, explain strategies for educating patients and families on the treatment and management of the hematologic or metabolic disorder.

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career/employment

Identify an older adult age 65 +, use a 1st and last initial. Execute a therapeutic assessment interview with them for at least two interview sessions assessing their self-identified:

·  Demographics, life time education and career/employment

·  Two most significant (positive) times in their lives

·  What past hardship or loss has the client successfully negotiated in the past?

·  Two personal strengths

·  Engage them in identifying what is healthy versus non-healthy coping skills

·  Inquire of 2 healthy coping skills they have used in the past and/or now

·  Three (3) pieces of advice they would give to their younger self if they could?

·  Support the client in taking the Geriatric Depression Scale.pdf

·  Support the client in taking the Fulmer SPICES Assessment.pdf

·  Perform a Mini Mental State Exam.pdf and Patient_Stress_Questionnaire.pdf (attach here)

·  Perform a Hall, Hall, and Chapman Article.pdf

·  Report the findings from the Geriatric Depression Scale, Fulmer Spices, Patient stress questionnaire and the mini mental status exam

·  Discuss your older adult’s level of ego integrity vs. despair as described by psychoanalyst Erik Erikson. If you had to rate them on a scale of 1-10, with 1 representing a full state of despair and 10 representing full ego integrity, what rating would you give your older adult?

·  Describe at least two nursing diagnoses for this client.

·  Create a plan of care for the client to include at least three nursing goals with two nursing interventions each.

The assignment should be written in an APA-formatted essay. The essay should be at least 1500 words in length and include at least two scholarly sources other than provided materials.

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s patient safety and quality outcomes

Create a one-page patient education tool that explains usage of a medication and factors that can affect outcomes. Then, write 2–3 pages in which you explain how the tool promotes patient safety and quality outcomes, and adheres to the principles and practices of cultural competence.

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

  • Competency 1: Apply practice guidelines and standards of evidence-based practice related to pharmacology for safe and effective nursing practice.
    • Explain the appropriate use of a medication.
    • Explain how a patient education tool promotes patient safety related to pharmacology.
  • Competency 2: Explain the relationship between quality patient outcomes, patient safety, and the appropriate use of pharmacology and psychopharmacology.
    • Identify specific factors that may affect the efficacy of a medication.
    • Describe possible chemical reactions, side effects, or other negative reactions a patient may experience from a medication.
    • Explain correct handling, storage, and disposal of a medication.
  • Competency 3: Apply the principles and practices of cultural competence with regard to pharmacological interventions.
    • Explain how a patient education tool adheres to the principles and practices of cultural competence.
  • Competency 4: Communicate in a manner that is scholarly, professional, and consistent with the expectations of a nursing professional.
    • Write content clearly and logically with correct use of grammar, punctuation, and mechanics.
    • Correctly format paper, citations, and references using current APA style.

context:

Do any of these sound familiar?

  • “I felt better right away, so I did not think I had to take the rest of the medicine.”
  • “Every time I took it, I threw up, so I just did not take it anymore.”
  • “I lost my health insurance a couple of months ago and cannot afford my medication all the time. I take it when I can afford to buy it. This is better than nothing, right?”

In addition to administering medications, nurses are assigned the responsibility of educating patients about the proper use of the medications that have been prescribed for them. Not an easy task! With all the demands on a nurse’s time, it is easy to fall into the habit of reciting instructions without taking the time to make sure those instructions have been understood. When considering patient education, you have to understand the differences between drug reactions, interactions, allergies, and individual variations in drug responses.

In order to promote better patient safety and quality outcomes, the instruction that nurses provide must be patient-centered and clearly understood. Proper education helps patients learn about their medications, how to take them correctly, avoid potentially harmful errors or drug interactions, and have the desired quality outcome.

Medication errors can occur at any point in the drug administration process. As the last person who touches a medication before the patient actually takes it, it is vital that nurses are familiar with the process of administration and be able to evaluate any discrepancies.

 

Imagine your supervisor has asked you to develop a patient education tool for new medication starts in your current area of practice. This tool needs to provide important information to the patient, yet be concise enough to require no more than one page.

Preparation

Review the suggested list of possible topics in Part 1 of the Requirements and then search the Capella library and the Internet for supporting resources. You will need to provide support for the information you choose to include in the patient education tool.

Requirements

Complete both Part 1 and Part 2 of this assessment. You may submit both parts in one document or submit them as separate documents. Be sure you complete both parts!

Submit a total of 4–5 pages. Write no more than one page for Part 1. Write 2–3 pages, plus a separate reference page, for Part 2.

Part 1: Patient Education Tool

Complete the following:

  1. Choose one of the following topics as the basis for your patient education tool:
    • Antibiotics (Amoxil/Amoxicillin) for pediatric ear infections.
    • Statin therapy (Zocor/Simvastatin) for a newly diagnosed patient with hypercholesterolemia.
    • Antihypertensive (ACE inhibitors/Lisinopril/Zestril) for a patient who was discovered to have hypertension at a health screening at work.
    • Drugs for treating gastric acidity (Proton pump inhibitors/antacids/H2 blockers) for a patient complaining of chronic indigestion and heartburn.
    • Ear drops or eye drops (or both) for an elderly patient.
    • Any newly released medication for a patient in your area of practice. This might be a new drug for diabetes, hypertension, or arthritis or a new antibiotic.
  2. Include the following in your patient education tool:
    • Explain appropriate use of the medication.
    • Identify specific factors (age, access, culture, and so on) that may affect the efficacy of the medication.
    • Describe possible chemical interactions, side effects, or other negative reactions patients need to be aware of.
    • Explain correct handling, storage, and disposal of the medication.
    • Include any other information you feel would be beneficial and promote patient safety and quality outcomes.

You may format Part 1, the patient education tool, any way you wish, but be sure it is logical and understandable by the typical patient who would use it. Feel free to include pictures or diagrams to reinforce the information.

Part 2: Evidence-Based Practice

Provide evidence for the information you included in the patient education tool:

  • Explain how the information in the patient education tool promotes patient safety and quality outcomes.
  • Explain how the patient education tool adheres to the principles and practices of cultural competence. In other words, is the tool appropriate for all cultures, genders, ages, et cetera; or could it be easily adapted for specific needs?

Format Part 2 according to APA guidelines. This is not a document you would provide to a patient but, for this assessment, it will provide faculty with the academic and professional principles necessary to evaluate your work.

Additional Requirements

  • At least 2 current scholarly or professional resources.
  • For Part 2 only:
    • Use Times New Roman font, 12 point, double-spaced font.

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A SOAP note

In this course project assignment, you are presented with clinical notes for two different patients. These progress notes have been recorded as SOAP notes. A SOAP note is a common method of documenting a patient’s visit with a healthcare provider. These notes are saved in a patient’s medical record and will be used for treatment, billing, and other activities to monitor the patient’s health over time.

SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. Each of these components is used to record a vital part of the patient’s visit.

  • Subjective: Includes the patient’s complaints and states the patient’s symptoms in his or her own words
  • Objective: Includes information that the provider can measure, such as vital signs, weight, or findings from a physical exam
  • Assessment: Includes a differential diagnosis or summary of signs and symptoms
  • Plan: Includes treatments performed, follow-up appointment information, referrals, or other orders

You will be exploring the medical terminology used in these SOAP notes and will be asked to interpret the meanings of various words and abbreviations.

To complete this assignment, do the following:

  1. Download the clinical notes for the two patients:

    Kay Salisbury Clinical Notes  (I have attached it below)
    Virginia Thompson Clinical Notes (I have attached it below)

  2. Download, complete, and submit the document below. This document contains questions you will answer regarding the clinical notes for each patient.

    Module 02 Course Project Assignment Template (I have attached it below)

PLEASE USE A BLANK WORD DOCUMENT TO ANSWER THE QUESTIONS ON THE COURSE PROJECT QUESTIONS DOCUMENT

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comprehensive speaker’s notes

Develop a 10-15-slide presentation with comprehensive speaker’s notes that covers all of the major areas of your evidence-based practice proposal.

You will need to post a rough draft of your evidence-based practice presentation to the Main Forum in Topic 8 DQ 1 for peer feedback.

While APA style is not required for the body of this assignment, solid academic writing is expected, and in-text citations and references compiled from the final project should be presented using APA documentation 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.

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Leadership Strategy

Discussion: Leadership Strategy

As a nurse, you serve an important role in identifying strategies to effectively manage health care resources and in leading health care quality improvement. You must be able to decide what leadership style or strategy to apply in a given situation to achieve an effective resolution of the issue. Read the following two scenarios and select one to focus on in this Discussion. Consider the leadership style or strategy that might be most effective in the scenario you selected.

Scenario 1

You work in a for-profit nursing home, with about 100 beds, on a 20-bed unit that is largely patients with Alzheimer’s disease. Your patient mix is predominantly Medicare and Medicaid patients. Your nursing home is part of a larger system that includes a major medical center, as well as VNA, outpatient dialysis, and a fully integrated network. Your nurse manager is getting feedback from the hospital that your nursing home is sending too many patients to the ED who really don’t need to go. How would you go about figuring out what could be done at the nursing home to prevent avoidable ED visits?

By Day 3

Select one of the scenarios, and post the following:

Describe the most appropriate leadership style and/or strategy to apply in the scenario you chose in order to implement the recommendations successfully. Justify your selection.

Support your response with references from the professional nursing literature. Your posts need to be written at the capstone level (see checklist)

Notes Initial Post: This should be a 3-paragraph (at least 350 words) response. Be sure to use evidence from the readings and include in-text citations. Utilize essay-level writing practice and skills, including the use of transitional material and organizational frames. Avoid quotes; paraphrase to incorporate evidence into your own writing. A reference list is required. Use the most current evidence (usually ≤ 5 years old). (Refer to AWE Checklist, Capstone)

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breast cancer

Assignment (4 pages, not including title and reference pages):

75-year-old non-English speaking female recently diagnosed with breast cancer

Adult Health Case:
Include the following:

· An explanation of the health issues and risks that are relevant to the person you were assigned.

· Describe additional information you would need in order to further assess his or her weight-related health.

· Identify and describe any risks and consider what further information you would need to gain a full understanding of the adult’s health. Think about how you could gather this information in a sensitive fashion.

· Taking into account the parents’ and caregivers’ potential sensitivities, list at least three specific questions you would ask about the child to gather more information.

· Provide at least two strategies you could employ to encourage the parents or caregivers to be proactive about their adults’s health and weight.

· Based on the risks you identified, consider what further information you would need to gain a full understanding of the patient’s health. Think about how you could gather this information in a sensitive fashion.

· Consider how you could encourage the patient or caregivers to be proactive toward the patient’s health.

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Evidence-Based Practice

Approx 150-180 words APA format with references and in-text citations response to the discussion below. 

The term “Evidence-Based Practice” (EBP) was fairly new when I was entering nursing school in 1999.
Although it made sense that nursing practice was based on academic research and findings, many nurses have passed down traditions simply based on the notion that “it has always been done this way”. I can remember this new term, and the exciting thought that nursing would be more valued and respected with a greater emphasis on practice based in facts and best outcomes. I became an RN in 2004, and I have worked in the psychiatric field for the majority of my career. The American Psychiatric Nurses Association (APNA) was my chosen healthcare organization website. This can be found at https://www.apna.org/i4a/pages/index.cfm?pageid=1 . Although I was already somewhat familiar with what the website had to offer, I gained a greater understanding and admiration for this site as I dug a little deeper.

The Institute of Medicine’s Roundtable on Evidence-Based Medicine put an emphasis on three major areas: a learning healthcare system, generating evidence to support effective healthcare strategies, and improving public awareness regarding the importance of EBP in healthcare (Melnyk, & Fineout-Overholt, 2018). The APNA website contributes to the IOM’s goal of improving public awareness related to EBP. This is evident in the numerous resources on the website from academic journals, continuing education (conferences and CEU’S), standards of practice updates, and also the ability to find information about academic programs and scholarships. The Journal of the American Psychiatric Nursing Association is a peer-reviewed journal which publishes original research, practice-focused articles, editorials, and interviews. One tab entitled “Reports & Surveys” shares the latest national reports and surveys covering topics related to the future of nursing and nurses’ health.

Although the website is not entirely based in EBP (some tabs are related to the organization and membership) it is clear that its goal is to promote the understanding of psychiatric nursing through the recent solid research. One item available for free via ebook to members (and for sale to non-members) is “Psychiatric-Mental Health Nursing: Scope and Standards of Practice”. This spells out important aspects of psychiatric-mental health nursing- the who, what, when, where, and how of practice- at various levels and in multiple settings. The latest edition was published with the input and expertise of psychiatric nurses from the APNA and the International Society of Psychiatric-Mental Health Nurses (ISPN). Goals established prior to the easy access of the internet are able to be met not only through scholarly articles, but with new styles of sharing information and with a culture of networking to filter out the most relevant, and timely information.

Crabtree, E., Brennan, E., Davis, A., & Coyle, A. (2016). Improving patient care through nursing engagement in evidence-based practice. Worldviews on Evidence-Based Nursing, 13(2), 172–175. doi:10.1111/wvn.12126

https://www.apna.org/i4a/pages/index.cfm?pageid=1

Laureate Education (Producer). (2018). Introduction to Evidence-Based Practice and Research [Video file]. Baltimore, MD: Author.

Melnyk, B. M., & Fineout-Overholt, E. (2018). Evidence-based practice in nursing & healthcare: A guide to best practice (4th ed.). Philadelphia, PA: Wolters Kluwer.

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Social media

Social media plays a significant role in the lives of nurses in both their professional and personal lives. Additionally, social media is now considered a mainstream part of the process for recruiting and hiring candidates. Inappropriate or unethical conduct on social media can create legal problems for nurses as well as the field of nursing.

Login to all social media sites in which you engage. Review your profile, pictures and posts. Based on the professional standards of nursing, identify items that would be considered unprofessional and potentially detrimental to your career and that negatively impact the reputation of the nursing field.

In 500-750 words, summarize the findings of your review. Include the following:

  1. Describe the posts or conversations in which you have engaged that might be considered inappropriate based on the professional standards of nursing.
  2. Discuss why nurses have a responsibility to uphold a standard of conduct consistent with the standards governing the profession of nursing at work and in their personal lives. Include discussion of how personal conduct can violate HIPAA or be considered unethical or unprofessional. Provide an example of each to support your answer.
  3. Based on the analysis of your social media, discuss what areas of your social media activity reflect Christian values as they relate to respecting human value and dignity for all individuals. Describe areas of your social media activity that could be improved.

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

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rofessional Development

Week 5 | Part 5: Professional Development

I have developed a curriculum vitae to capture my academic and professional accomplishments to date. I have also developed a statement identifying one or more professional development goals, and a statement proposing how I might align one or more of these professional development goals with the University’s emphasis on social change.

The results of my efforts are below.

Directions: Complete Step 1 by developing (or copying and pasting) a curriculum vitae (CV) in the space provided. Complete Step 2 by completing a statement identifying your professional development goals space identified. Complete Step 3 by writing a statement proposing how you might align one or more of your professional development goals with the University’s emphasis on social change.

Step 1: Curriculum Vitae (CV)

Use the space below to write your CV based on your current education and professional background. Alternatively, you may write this in a separate document and copy/paste the results below. 

NOTE: If needed there are a variety of online resources available with tips and samples of graduate nurse CVs. 

Step 2: Professional Development Goals

Use the space below to write a statement identifying your professional development goals.

Step 3: Alignment with Social Change

Use the space below to write a statement proposing how you might align one or more of your professional development goals with the University’s emphasis on social change.

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